CDC in Haiti

HIV is a leading cause of death and a health threat to millions worldwide. As a key implementer of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), CDC works with Haiti’s Ministry of Public Health and Population (MSPP) to build a sustainable, high-impact national HIV response program with the goal to achieve epidemic control of HIV. CDC supports national efforts to prevent the transmission of HIV; increase the accessibility and quality of HIV clinical services and treatment; increase patient adherence and retention in treatment; strengthen surveillance, epidemiology, laboratory, and health information management systems; and expand the overall availability of tuberculosis (TB) treatment screening and treatment.

In today’s globally connected world, disease threats can spread faster and more unpredictably than ever before. CDC’s global health security efforts in Haiti help improve the country’s ability to prevent, detect, and respond to infectious disease outbreaks before they become global epidemics. These efforts are helping Haiti reach the targets outlined in the Global Health Security Agenda, a global partnership launched in 2014 to help make the world safer and more secure from infectious disease threats.

CDC is supporting the government of Haiti to minimize disease threats by bolstering laboratory and disease surveillance capacity, improving emergency preparedness and response, facilitating immunization efforts, and addressing antimicrobial resistance. CDC supported the establishment of a laboratory-enhanced surveillance system and Haiti’s National Epidemiological Surveillance Network, which monitors disease trends and detects potential outbreaks in real time, permitting timely case investigations. Additionally, CDC increased laboratory testing capacity in Haiti by supporting the establishment of a National Specimen Referral Network for the efficient transport of specimens to the National Public Health Laboratory.

CDC supports Haiti in strengthening the capacity of its workforce to investigate and respond to disease outbreaks through the establishment of a Field Epidemiology Training Program (FETP).  FETPs train a workforce of field epidemiologists — or disease detectives — ­to identify and contain outbreaks before they become epidemics. Participants focus on “learning by doing” to develop the skills for gathering critical data and turning it into evidence-based action. FETP residents and graduates are a vital component of Haiti’s health workforce and promote health security throughout all levels of Haiti’s public health system. Graduates serve in leadership roles as departmental health directors, work in the field collecting and analyzing surveillance data, and provide crucial epidemiological expertise during emergencies. Over 350  fellows have graduated from the program since it was established in 2011.

The Haitian government confirmed an outbreak of cholera in October 2010. As of 2018, nearly 820,000 suspected cases and more than 9,000 deaths have been reported. CDC is a major partner in Haiti’s Long-term Cholera Elimination Plan and is supporting efforts to eliminate cholera transmission by improving diarrheal disease surveillance, enhancing laboratories capacity to culture specimens, training rural potable water and sanitation technicians, expanding water, sanitation, and hygiene (WASH) capacity, and supporting oral cholera vaccine campaigns. Although cholera remains a persistent public health threat, cases are down 99% from the peak of the epidemic in 2011.

Haiti has the highest incidence of TB in the Western Hemisphere. To increase TB case detection, CDC has worked closely with the MSPP to build TB-related laboratory and clinical capacity at high-volume sites throughout Haiti. Laboratory diagnostic capacity for TB has expanded considerably, contributing to an overall increase in TB case finding since 2010. CDC is also supporting the MSPP to improve multi-drug resistant TB (MDR-TB) case detection and treatment through the establishment of a national biosafety level 3 (BSL-3) laboratory. Approximately 2.3% of all new TB cases and 13% of previously treated cases in Haiti test positive for MDR-TB. The national BSL-3 laboratory will greatly augment Haiti’s capacity to detect and treat MDR-TB and support critical research into the evolution of TB drug resistance in Haiti.

Malaria is a leading cause of death and disease in many developing countries. Malaria Zero was established to eliminate malaria from Hispaniola — the island that includes Haiti and the Dominican Republic — creating a malaria-free zone across the Caribbean. CDC’s Malaria Zero team, working in partnership with the National Malaria Control Program of Haiti, Pan American Health Organization, CDC Foundation, and other academic and non-governmental partners, is implementing an evidence-based strategy to accelerate malaria elimination in Haiti. Interventions include strengthening vector control, disease surveillance, case management, and community engagement to ensure that every case of malaria is tested, treated, and tracked within the national surveillance system.

Neglected tropical diseases are a group of diseases that persist in largely low-income and tropical settings. CDC works with Haiti to eliminate lymphatic filariasis (LF), a parasitic disease spread by mosquitoes that can cause permanent disability. Through Haiti’s National Program to Eliminate LF, CDC supports the MSPP to stop the spread of LF among at-risk populations through mass drug administration. CDC also supports efforts to eliminate rabies. In 2013, CDC began working with the Haitian government to initiate the Haiti Animal Rabies Surveillance Program — a cost effective intervention to reduce human rabies deaths using a multidisciplinary strategy. To date, the program has vaccinated more than 1.2 million dogs and reached more than 350,000 health professionals and community members with rabies education.