16336: (Hermantin)Miami Herald-Young AIDS victims in Haiti need a new plan (fwd)

[Bob Corbett <corbetre@webster.edu>]

From: leonie hermantin <lhermantin@hotmail.com>

Posted on Sun, Aug. 10, 2003

Young AIDS victims in Haiti need a new plan
By ANTHONY LAKE

Some good news for the people of Haiti, who receive so little: The U.S.
government has announced a multimillion dollar program to fight HIV/AIDS
there, focused on preventing the transmission of the disease from mothers to
children. The announcement should be applauded. But another step should be
taken, as well -- to achieve its greatest impact, the program should include
direct funding for the Haitian Ministry of Health. Our current policy toward
Haiti would preclude that.

Why change this policy? Let me begin with a scene vivid in my memory. It was
a moment in which I learned that my heart could both be lifted and broken at
the same time.

A group of us from the U.S. Fund for UNICEF were visiting HIV/AIDS projects
in Haiti. At every stop, we were strangely exhilarated by the courage,
competence and high morale of all the workers we met -- doctors,
technicians, counselors and others who were fighting to preserve life in the
midst of constant death.

We spent a few hours at the Arc en Ciel orphanage, where some 40 kids
receive wonderful care. Taking our hands, they showed us their rooms. The
echoing sound of their laughter was wonderful. As they put on an ebullient
dance performance, I was particularly drawn to one little girl, smaller than
the others. Her occasional frown of concentration as she tried but often
failed to stay in step reminded me of my own struggles to keep up when I was
her age. Her smiles were thus all the more engaging. The spirits of the
children were inspiring.

The heartbreak was this: Almost all the children at Arc en Ciel are not only
orphans. They themselves are infected by the HIV virus. According to the
blood tests done shortly before our visit, the little girl I was watching
should already have died. She may have died by now. And worse: Only a tiny
fraction of the tens of thousands of AIDS orphans in Haiti can get such
care. And each year, some 5,000 Haitian babies are born infected, joining an
estimated 300,000 other Haitians who live with the virus -- and will
probably die from it.

Yet, surprisingly, given the dismal social, economic and political situation
in Haiti, experts are looking at its HIV/AIDS programs as a source of some
hope in the global fight against this scourge. Overall infection rates in
Haiti are actually in decline. And our UNICEF group saw two programs, in
particular, that help explain why.

The GHESKIO Centers, under Dr. William Pape, are jointly supported by the
Ministry of Health, Cornell University and local sponsors. They treat tens
of thousands of patients a year and offer free testing. The prospect of
treatment helps persuade pregnant women to get tested -- and then, if the
tests are positive, to take the drugs that can prevent transmission of the
disease to their unborn babies.

In the central plateau, the celebrated Dr. Paul Farmer is proving that
first-rate medical care is possible even in the poorest circumstances.
Supported by his home university, Harvard, and foreign donors, his Partners
in Health project is saving thousands of lives while training and employing
local personnel.

Combining drug therapies and an effective outreach program, it is a model of
what could be done in poor regions throughout the world. But only if such
programs can be replicated in Haiti and beyond. Not an easy challenge. Pape
and Farmer cannot be cloned. Their programs rely heavily on donated
resources, especially medicines. And support from Cornell and Harvard, as
well other donors, cannot easily be duplicated.

This brings us to the central issue: U.S. and international policies toward
Haiti. For the best way to expand the success of these programs is through a
public/private partnership. This can best be achieved if the Ministry of
Health, one of the more-effective Haitian ministries, is fully involved. Yet
(with some rare exceptions) it is subject to the U.S. prohibition against
our aid going directly to the Haitian government.

To put pressure on the government for the political gridlock in Haiti,
American aid (which recently is actually increasing) flows through
nongovernmental organizations. The health ministry, thus, is supported
indirectly. (It should be noted that our ambassador there, Dean Curran, has
also taken a strong personal interest in HIV/AIDS programs, including some
effective fund-raising for the Arc en Ciel orphanage.) But the near total
ban on direct aid to the Ministry of Health cannot be justified in either
practical or moral terms.

In a practical sense, the Ministry of Health is the only institution with
reach to replicate local successes throughout Haiti. We need to build its
capacity to do so. And in any case, the ministry is not as sensitive
politically, as, say, those dealing with police matters or public works.

So how can we justify undercutting our initiative on HIV/AIDS by continuing
this ban on direct aid to such a crucial institution? Let the aid flow
there, requiring full transparency so that we may know it is not misused.
Not only for the sake of efficiency in how our dollars are spent, but for
the sake of all the Haitian babies who will otherwise come into the world
with three strikes against them. For the sake of some future child who could
have hope, unlike the little girl I met at Arc en Ciel.

Anthony Lake was national security advisor to President Clinton (1993-1997)
and special envoy to Haiti (1997-2000).

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