The more pressing need was to combat a mortality rate that went as high as 5 percent. Dehydrated Haitians were dropping dead in the streets and hills as health workers scrambled to hydrate survivors in makeshift treatment centers.
At the time, there was only one vaccine available - Dukoral, which is manufactured by the Dutch biopharmaceutical company Crucell N.V. The global supply was limited to about 250,000 doses.
The vaccine, sold at $6 a dose, is used mostly by affluent travelers rather than people in cholera-infected countries.
In recent months, the vaccine option has grown more viable for several reasons. For one, the World Health Organization in September approved the use of a second vaccine, Shanchol, which is made by Shanta Biotechnics Ltd., an Indian subsidiary of Sanofi SA. The approval was needed so U.N. agencies such as UNICEF could procure the vaccine.
Plus, Haiti’s new leaders, President Michel Martelly and his prime minister, Dr. Garry Conille, support the campaign.
In January, health workers will fan out in the Central Plateau and the capital, urging people to seek vaccinations and then documenting those who do. They aim to reach 80 percent of their targeted population living in those areas.
The project includes 200,000 doses of the vaccine currently available, its delivery to Haiti, health workers’ salaries, and construction of a refrigerated facility to store Shanchol, according to Partners in Health. Each dose costs less than Dukoral, at $1.85, and altogether the cost will run about $870,000.
Peter J. Graaff, the Haiti representative of the World Health Organization, acknowledged complications associated with the program.
“Cholera vaccination is not the easiest form of vaccination,” Mr. Graaff said in his Port-au-Prince office, pointing out the need for a second dose and refrigeration for the vaccine and the limited vaccine supply worldwide. “It’s obviously one of a number of preventative measures.”
Jon Weigel, a researcher for Dr. Farmer, counters the concerns about a follow-up dose by pointing to a successful vaccination program Partners in Health launched just before the January 2010 earthquake. Health workers sought to inoculate 3,000 girls with the Gardasil vaccine for human papillomavirus, the main cause of cervical cancer.
The distribution was relatively more complicated. It required three doses over a period of six months. Plus, chaos from the earthquake threatened to disrupt delivery of the final dose. The completion rate: 75 percent.
Coming up with the money shouldn’t be an issue. Partners in Health is negotiating with donors, though it would not identify them.
The health care nonprofit is among the top recipients of aid in Haiti, and last year it brought in $151 million for its work in 12 countries, according to tax returns filed with the U.S. Internal Revenue Service.
Mr. Weigel stressed that efforts to develop Haiti’s water and sewer systems or to promote good hygiene won’t be ignored.
“We’re not doing this at the exclusion of water and sanitation,” he said. “We really think that it’s faulty logic to think that it’s one or the other.”