9816: Haiti: Inter-American Development Bank Continues to Block (fwd)

[Bob Corbett <corbetre@webster.edu>]

From: MKarshan@aol.com

   Haiti: Inter-American Development Bank Continues to Block Health Loans - Approves Grant to NGO for HIV/AIDS

    WASHINGTON, Nov. 30 /PRNewswire/ -- Yesterday the Inter-American Development Bank approved a $1 million grant to the Pan American Health Organization (PAHO) for technical assistance to Haiti in the area of
HIV/AIDS.On its face this grant would seem like the proper response to a growing and dramatic health crisis, but as the current embargo on all loans and grants for Haiti remains enforced, this grant represents either a program that falls far short of the mark or a cynical gesture to mollify the Bank's critics who state that the embargo is inflicting needless damage on Haiti's socio-economic sectors.  In fact, several bank officials have quietly confirmed that this
grant is a move by its leadership to ensure simply that there will not be a ZERO recorded on its ledgers for the hemisphere's poorest country for financial year 2001.

    Meanwhile, Haiti's deteriorating economic conditions have impacted its health care infrastructure hardest.  Haiti's HIV/AIDS population has recently
surpassed 4% of its population or more than 300,000 persons.  This high infection rate equates to 163,000 orphans and 30,000 new adult cases per year.The physician-patient ratio is now only 1.2 doctors for every 10,000 Haitians. And potable water, a necessary ingredient in the health regime for infected
persons, is available to only 40% of Haitians.

    In September, Dr. George Alleyne, the Director of 
the Pan American Health Organization (PAHO) warned of Haiti's impending health crisis when he returned from travel there earlier this year.  Speaking at an Organization of American States meeting, Dr. Alleyne said that "I have just returned from (Haiti) and
am convinced that we have a collective responsibility to assist in improving the health situation there ... I am not insensitive to the political problems,but at the same time I am haunted by the fact that for every 1000
babies born, five mothers die. That is about 100 times worse than the situation in the best of our countries.  I have decided that we must make a special effort in
this area, and have the hope or dream that collective concern for health may form a platform for understanding among those who now manifest differences."

    The $1 million grant is intended to support PAHO's consultations with Haitian authorities and international practitioners about its growing crisis.
Ironically, the IDB embargo of loans and grants is blocking approximately $76 million in health related loans, many of which would support the Government's
national priorities to fight Haiti's exponential AIDS pandemic.

    The Ministry of Health is responsible for the management and distribution of services to millions of Haiti's poor.  Yet this grant is designed to work
with health officials at PAHO instead of through Haiti's government.  In fact,the project document states that "the Government is encouraged to
continue to facilitate coordinated efforts to address the AIDS issue and leave the delivery of HIV/AIDS care services to the private and/or NGO sectors to the
maximum extent possible."  In other words, the IDB is asking Haiti to omit its largest provider of services simply to justify its embargo.

    Nevertheless, the Government of Haiti has moved forward on a National Strategic Plan to combat this devastating scourge using all assets available,
including the state health infrastructure.  One of the main components is to set up 10 testing/counseling sites at state hospitals, where potentially
infected persons can be tested, receive counseling, nutritional support and direct treatment.  Pregnant women receive priority status.  At present, one
site is operational but it needs testing equipment and medication to treat infected pregnant women.   This program is a national priority and yet no funds from this grant are directed to support its aims.

    To illustrate the dynamics of this grant to PAHO further, the following is a summary of $1 million approved by the Board of Executive Directors
yesterday.  A review of the grant's budget reveals that in fact $467,550 will be used for PAHO staff related expenses and does not provide for any delivery
of health care services to persons with HIV/AIDS.

    * Total honoraria            $117,000
    * Travel and per diem        $ 83,350
    * Project Coordination Unit  $172,200
    * Administrative costs       $ 50,000
    * Project monitoring         $ 45,000

                        TOTAL:   $467,550

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