Haiti – FY 2010 Approved Funding by Program Area, Agency and Funding Source*
*Only appropriations from the GHCS (State) fund account are notified by the Global AIDS Coordinator.
With a clear vision and with Government of Haiti (GOH) objectives delineated in strategic plans, PEPFAR has worked together with the MOH and the Global Fund to implement a comprehensive and integrated HIV/AIDS prevention, care and treatment program in Haiti. This has been accomplished despite considerable setbacks, including an unstable social, economic, and political environment. In 2008, Haiti experienced many new challenges: food insecurity riots in April and a string of hurricanes which severely impacted programs and the fragile infrastructure system. On January 12, 2010, Haiti was struck by a magnitude 7.0 earthquake that damaged most of the infrastructure in the West and the Southeast departments, killed almost 300,000 people, and resulted in the mass migration of approximately 600,000 people. PEPFAR resources and partners were prominent in the immediate response to the earthquake and PEPFAR programs are positioned to provide an important platform contributing to the USG efforts to “build back better” in support of Haiti’s continued reconstruction efforts. Reinforcing and supporting the leadership role of the MOH is central to PEFPAR’s approach and will be critical moving forward.
Prevention activities in Haiti include PMTCT, abstinence and faithfulness programs, and other behavioral prevention interventions, including those that focus on high-risk populations and blood and injection safety programs. Prevention activities will also address new vulnerabilities resulting after the earthquake, including societal disruption, behavioral changes, gender-based violence, and a breakdown in public health care services. Stigma reduction will be addressed through information, education, and communication materials and other efforts targeting health care providers, caregivers, and communities surrounding HIV/AIDS care and treatment sites. Biomedical prevention efforts will include reconstruction of the blood donor services destroyed by the earthquake. Additionally, the HCT strategy for FY 2010 will include training and refresher courses for counselors, with an emphasis on specialized counseling for pregnant women and high-risk populations.
Care activities in Haiti include basic care and support, support to integrate TB and HIV programs, and support to OVCs. An emphasis is being placed on providing high-quality clinical care for HIV/AIDS patients, specifically the management of OIs, nutritional assessment, and counseling and support for both adult and pediatric patients. At the community level, PEPFAR will link care and support activities to HIV/AIDS prevention, care, and treatment centers by strengthening community-based organizations (CBOs) and faith-based organizations (FBOs). Cross-border collaboration also will take place between hospitals and CBOs that provide home and community-based palliative care and support. The strategy for TB/HIV integration includes PITC for all persons with TB as part of standard TB care. In FY 2010, the USG will support FBOs and NGOs in working with OVC throughout the country to provide a basic package of care and support. The package will include potable water, immunizations, access to health care and psychosocial support, provision of school fees and supplies, dietary assessment and nutritional support, HIV prevention and life skill programs, and assistance with income-generating activities for foster families and care-givers. In the immediate post-earthquake period, PEPFAR resources were mobilized to assess capacity at residential care centers, identify and register separated and unaccompanied children in six internally-displaced persons (IDP) camps, refer unaccompanied children to interim care centers, and provide emergency assistance to children in IDP camps.
HIV treatment activities in Haiti include the provision of ARV drugs and services, as well as laboratory support. PEPFAR partners involved in treatment were first-responders to immediately address urgent needs in the aftermath of the earthquake, including use as sites for emergency field hospitals, supplying emergency commodities and medical personnel. PEPFAR will contribute to re-establishing HIV treatment capacity and assuring that access continues for existing patients in the phase of displacement and re-location. USG will work to improve treatment for children and adults, working with local and international TA partners. FY 2010 funding will reinforce the adult treatment sites as well as those providing pediatric diagnostic and treatment services with emphasis on rebuilding those damaged by the earthquake and tracking of displaced PLWHAs on treatment. PEPFAR will build upon the disease surveillance activities initiated to monitor outbreaks in the post-earthquake response and continue to strengthen and rebuild the national laboratory infrastructure in FY 2010.
In SI, PEPFAR will continue to monitor and evaluate the progress of Haiti's national response to HIV/AIDS and PEPFAR and Global Fund achievements. These efforts will be directed at developing and implementing routine information management systems for reporting on both programs and patients at the facility and non-facility level, as well as ensuring the continuation of HIV/AIDS surveillance (biological and behavioral) via population-based surveys. Additionally, PEPFAR will collaborate with the MOH, Pan American Health Organization (PAHO), and other donors to develop a national human capacity assessment focused on HIV/AIDS health care providers.
Additionally, concerted efforts in health systems strengthening will focus on supporting the MOH to develop its capacity to lead, manage and evaluate a comprehensive response to the HIV epidemic.
PEPFAR meets regularly with the principal recipient of the Global Fund in order to carry out joint planning and review of implementing partners/sub-recipients’ activities, to preclude any duplication of funding and/or reporting of results. The MOH has identified as one of his priorities the revitalization of this national coordinating body, and PEPFAR will support this effort.
Haiti has gaps in health infrastructure at the primary, secondary and tertiary level. Facilities in Port-Au-Prince sustained damage in the January 2010 earthquake, including the University Hospital (HUEH) complex, other hospitals, Ministry buildings and training facilities. A post-disaster needs assessment estimated one billion dollars in health infrastructure needs throughout the country. While there have been significant donor commitments for infrastructure, they are insufficient to meet full infrastructure requirements, so prioritization of needs will be important.
The Ministry of Health (MoH) has identified HUEH reconstruction (as the center of a national health sciences campus) as its top priority, recognizing a longer term need to build tertiary capacity, along with other primary and secondary facilities. As the top-level referral facility in the system including primary and secondary-levels, HUEH will be reconstructed to include a range of sub-specialty care as well as infectious diseases (HIV, TB, cholera, etc.). The HUEH national health science campus will include a reconstructed Public Faculty of Medicine, the Faculty of Pharmacy, the Midwifery School and one other allied health professions, e.g. the Laboratory Technician Training School that was part of the Public Faculty of Medicine.
Funding will contribute to this infrastructure investment, which is contingent on a set of key conditions including reform of management and governance and sustainable business plan with increasing responsibility by the Government of Haiti. This project is to be co-funded with the Government of France.
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