* Partners in Health to start vaccinating in January
* Move follows months of debate over vaccine option
* Haiti's cholera epidemic is worst in world, expert says
By Pascal Fletcher
MIAMI, Oct 19 A U.S. NGO plans to start a
ground-breaking cholera vaccination campaign in Haiti in
January, it said on Wednesday, as experts warned that efforts
to combat the year-old deadly epidemic were faltering badly.
Paul Farmer, co-founder of Boston-based Partners in Health
(PIH), told a conference call that Haiti's cholera epidemic was
now the most serious in the world proportionate to the size of
the poor earthquake-ravaged Caribbean nation.
One year after the cholera outbreak began, close to half a
million Haitians out of a population of more than 9.5 million
have been sickened by the disease and more than 6,500 have
died. The cholera started nine months after a 2010 earthquake
wrecked the capital Port-au-Prince, killing tens of thousands
and leaving many more homeless.
Farmer acknowledged that the cholera epidemic began and
expanded even as one of the largest international humanitarian
operations in the world was underway in Haiti to deal with the
aftermath of the catastrophic Jan. 12 2010 quake.
"It's possible because of a list of flaws in the way that
the humanitarian machine works ... It's possible to have right
under the noses of a very vast operation a neglected problem
that then explodes into a large one," he said.
For months after the epidemic began, Haiti's health
authorities and the World Health Organization/Pan American
Health Organization argued that logistical challenges and fears
of social unrest made a nationwide cholera vaccination program
impractical and unwise. There were also doubts about the
effectiveness and availability of cholera vaccines.
But Farmer said with medical NGOs increasingly withdrawing
from the cholera treatment fight in Haiti, partially because of
lack of funding, it was essential to add a serious vaccination
program to other important anti-cholera measures such as
establishing clean water and sanitation facilities.
"We're not trying to win an argument ... we're trying to
get this epidemic slowed," said Farmer, who is also chair of
the Department of Global Health and Social Medicine at Harvard
He noted that the WHO/PAHO had since swung behind the idea
of a cholera vaccination program in Haiti.
AID "ATTENTION DEFICIT"
Working with a Haitian medical NGO, PIH planned to start
administering an oral vaccine in January, aiming to treat
100,000 people in two areas -- one an urban zone of the capital
Port-au-Prince and the other a rural community in the central
Artibonite region that was the epicenter of the epidemic.
The vaccine used would be Shanchol, which is produced by
Sanofi Aventis' India-based division Shantha.
Currently some 200,000 doses of this vaccine were available to
be purchased, PIH officials said.
"If we can get started and show it's feasible, we will be
able to gain more leverage ... already there's momentum around
this, it will help others to get on board," PIH's Senior Health
and Policy Advisor Louise Ivers told the conference call.
Farmer said he and Ivers were campaigning to raise the
funds needed to support the limited vaccination program.
PIH announced the vaccination initiative as a chorus of
health charities, including Doctors Without Borders and
International Medical Corps, warned that anti-cholera efforts
in Haiti were running out of financial support and momentum.
"Even though the international community has pledged huge
sums of money to assist Haiti, thousands of Haitians are still
getting sick from cholera every week and some are still dying,"
MSF Haiti mission chief Romain Gitenet said in a statement.
PIH's Director of Policy and Advocacy Donna Barry said that
out of $4.6 billion committed by international donors to
Haiti's post-quake recovery for 2010-2011, excluding debt
relief, only 43 percent had been actually disbursed.
U.N. agencies were also reporting that, due to a
withdrawal of aid partners, levels of access to clean water and
sanitation in camps housing 600,000 homeless quake survivors
had declined significantly compared to earlier this year.
Farmer attributed this to what he called the "ADD"
(Attention Deficit Disorder) of international humanitarian
operations, in which the funding and work of aid groups in a
particular country dropped off after initial intense activity.
Cholera is a water-borne disease transmitted when
bacteria-contaminated human fecal matter gets into water, food
or onto someone's hands. It can cause severe diarrhea and
vomiting and kill in hours by dehydrating victims.