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After shock, recovery efforts meet AIDS threat

Text by Joseph BAMAT

Latest update : 2010-02-05

As international relief reaches a growing number of Haitians, the UN says the country’s AIDS response network is also recovering, but warns that thousands of displaced people, especially mothers and children, face a heightened HIV threat.

Haiti’s vital HIV/AIDS support and prevention networks are slowly resuming their work, the United Nations’ programme for HIV/AIDS (UNAIDS) has told As the recovery phase in the earthquake-stricken country continues, AIDS response organisations are regrouping staff and locating patients who had been receiving antiretroviral treatment (ART). But UNAIDS warns that Haitians, especially the thousands of displaced people, face an exacerbated HIV threat that could undermine all future reconstruction.

“We have 120,000 people living with HIV in Haiti; more than half of them are women. Neglecting HIV will compromise the social development of Haiti,” says Ernesto Guerrero, UNAIDS country coordinator for Haiti. Guerrero’s team knows of destruction and reconstruction first-hand. They were forced out of their office in Port-au-Prince when the quake struck and raised tents as makeshift offices to resume their mission in the decimated country.

Haiti is the country with the worst AIDS epidemic in the Caribbean. It is home to half of all people living with HIV in the region and has a prevalence rate that doubles that of it’s neighbour the Dominican Republic. The UN estimates that about 16 percent of HIV-positive Haitians were taking antiretroviral drugs before the quake, and that 57 percent of all those infected were living in the affected areas.

The ART centres that UNAIDS supports have suffered considerable damage, including the destruction of buildings and equipment, as well as human losses. Staff reported the destruction of medical supplies and lack of formula milk, which is used to prevent transmission from HIV-positive mothers to their children through breast milk.

In the immediate aftermath, centres that withstood the quake were transformed into emergency surgery blocks and dispensaries. But in the recovery phase most of these clinics have returned to their intended work. GHESKIO, Haiti’s oldest ART centre has accounted for 80 percent of their usual patients and says it has enough antiretrovirals to cover the immediate need.

Fears of HIV drug resistance

At a time when international experts assert that Haiti’s reconstruction will not start from zero, but from less than, Guerrero stresses that, contrary to first impressions, AIDS patients should be a priority in the recovery efforts. “It was difficult to make emergency responders understand the risk at first,” confesses Guerrero.

UNAIDS is anxious about the tens of thousands of displaced Haitians, especially mothers and their children, who it says now face a heightened HIV threat. The government and relief agencies have already launched mass vaccinations as reports of measles and tetanus sprung up at the improvised tent cities.

While unsanitary conditions and scarcity of food presents a mortal danger to HIV-positive people, the radical disruption of normal life can also lead to new infections. HIV-positive mothers risk infecting their children by changing established nursing habits, and displaced mothers and children are often the victims of sexual violence.

Moreover, a failure to combat the epidemic in the aftermath of the quake could produce an explosion of HIV drug resistance. “An interruption in the administration of drugs, even temporarily, or change to an improper protocol can lead to a person developing strains of HIV resistant to drugs,” explains Guerrero. “Also these new strains can be transmitted to other people, whether they are living with HIV or not.”

With an estimated 20 percent of patients not having returned to ART centres, UNAIDS and local organisations’ action will prove decisive in shaping the future of Haiti.

“There is good reason to make great efforts to find them and ensure they continue their treatment,” Guerrero insists.

Date created : 2010-02-05