New Haiti cholera campaign faces tough questions

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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 Graaff, the Haiti representative of the World Health Organization, acknowledged complications associated with the program.

“Cholera vaccination is not the easiest form of vaccination,” 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 Farmer, counters the concerns of 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 brought in $151 million for its work in 12 countries, according to tax returns filed with the U.S. Internal Revenue Service.

Weigel stressed 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,” said Weigel. “We really think that it’s faulty logic to think that it’s one or the other.”

Farmer acknowledges the global shortage but believes the epidemic will spur pharmaceutical companies to increase supply.

“This is an oral vaccine that was designed to be used in poor countries,” Farmer said. “This is the lowest-hanging fruit.”

Still, Garfield and others say that the project poses some tough ethical dilemmas.

“It’s not clear who gets in the life boat and who doesn’t,” he said.

Copyright 2014 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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