This month’s main topic is the response to the cholera outbreak in Haiti. The Highlights provides first an overview of the health situation, then of WHO’s response and finally of the Cholera Inter-Sector Response Strategy.
The end of October saw the emergence of cholera in Haiti. Over the next month, the disease spread and it now threatens the lives of Haitians all across the country. Every crisis has challenges which affect the ability to provide for the needs of the people affected. In the case of Haiti, the combined effects of the damage caused by the January earthquake and the recent hurricane season affected the response to these disasters and to the cholera outbreak.
Even before the earthquake, health services in Haiti were weak. Badly damaged or destroyed infrastructures left little access to clean water, sanitation, health care and other basic services. Thirty of the 49 hospitals and clinics serving the areas worst-affected by the earthquake still need to be rebuilt. Functioning health facilities were overwhelmed with routine needs before the first cholera cases were confirmed.
Haitians are especially vulnerable to cholera. Haiti has not had cholera for at least a generation, so there is no immunity among the population, nor any awareness that this is a disease which can kill within hours if left untreated but, if treated 80% of cases can recover. Effective control measures rely on prevention and preparedness. Response includes access to safe water, sanitation and treatment.
The structural problems with water, sanitation and health infrastructure make the response to the cholera outbreak particularly challenging. The response capacity needs to be expanded to rural areas outside of Port-au-Prince.
So far more than 80 000 cases have been reported and an as many as 400 000 new cases could occur in the next 12 months. There is an urgent need to scale up operations for health care, water and sanitation, nutrition, and camp coordination and management. An inter-sectoral response plan has been developed to address this extraordinary situation with more than a standard response.
An Cholera Inter-Sector Response Strategy was launched in Geneva on 16 November requesting close to US$ 164 million, of which US$ 42.5 are for the health sector. So far the appeal remains insufficiently funded to support an adequate response. As of 29 November, only 16% of the funds needed by the health sector had been received. Brazil, Canada, Finland and the USA have already donated funds to support WHO’s activities and Italy, Andorra and Spain have made pledges.
The Highlights also features the polio outbreak in the Republic of the Congo, the Health Sector and WHO’s needs in the CAP 2011, the refined Business Model for WHO’s work in emergencies, the Global Forum on Migration and Development held recently in Puerto Vallarta, Mexico, and interagency issues.