Successes and challenges of HIV treatment programs in Haiti: aftermath of the earthquake

This paper reports on the successes and challenges facing Partners In Health and the Haitian Study Group on Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), two non governmental organisations that work together with the Ministry of Health to provide and/or supervise treatment for nearly three-quarters of patients on HIV treatment in the country of Haiti.

The article posits that Haiti's HIV/AIDS programme has been highly successful, with a declining HIV prevalence, and long-term treatment outcomes that are similar to those of industrialised nations. The authors argue that Haiti is now on the way to providing universal treatment for HIV/AIDS nationwide.

This success is tied to:

• a strong foundation for HIV care in Haiti, which includes national guidelines issued by the Ministry of Health, political commitment at the highest levels of government, and non governmental organisations providing high quality care for decades.
  
• the assistance of the Global Fund to Fight AIDS, TB and Malaria, the US President's Emergency Plan for AIDS Relief (PEPFAR) and other private donors.

Challenges include:

• two different procurement systems, with different formulations of medications and different laboratory systems and the lack of a single monitoring and evaluation plan for HIV care.
  
• the earthquake in Haiti has killed over 150,000 people, injured and displaced hundreds of thousands more, and destroyed the infrastructure in Port-au-Prince, which was the power grid of the entire nation.

In conclusion, the authors argue that in spite of the overwhelming difficulties that Haiti now faces, the majority of HIV-infected patients continue to receive their antiretroviral therapy, and the Haitian government and a network of organisations are working together to treat the immediate needs of the survivors and to rebuild the healthcare system.