a450: Despite foreign aid impasse, Haiti battles AIDS (fwd)

[Bob Corbett <corbetre@webster.edu>]

From: Greg Chamberlain <GregChamberlain@compuserve.com>

     By Michael Deibert

     PORT-AU-PRINCE, Jan 22 (Reuters) - Surrounded by posters of smiling
couples holding packets of condoms, students, educators and officials
gathered at a health clinic recently for some honest talk on AIDS, a key
step in the fight against the public health scourge of this impoverished
Caribbean nation.
     Haiti's government has pressed ahead with attempts to halt the spread
of a disease that stigmatized Haitians in the 1980s despite an ongoing
political crisis that has strangled the flow of foreign aid destined for
the front lines of the AIDS war.
     Amid raucous cheers and speeches at the clinic in Petionville, a
suburb of Port-au-Prince, a young man barely out of his teens told the
assembled crowd: "This may be difficult for some of us to talk about. We
may be embarrassed, we may want to laugh. But we need to talk about it."
     Brightly painted banners bearing public health slogans, posters
promoting condoms, frank public discourse and a growing number of clinics
are all part of President Jean-Bertrand Aristide's ambitious battle plan
against AIDS, one of a series of social reforms proposed by Haiti's first
freely elected leader in his second term in office.
     The task facing this nation of 8 million people is enormous.
     About 30,000 new cases of AIDS were diagnosed in Haiti last year. And
though the spread of the disease has stabilized somewhat in recent years,
about 4.5 percent of the population -- some 360,000 people -- is infected,
the highest rate in the region, according to the Ministry of Health.
     "We have a detailed plan for fighting AIDS from 2002 through 2006,"
said Public Health Minister Henri Claude Voltaire. "It's a plan that was
created by experts, not government ministers, although they are certainly
involved."
     Currently there are clinics for HIV and AIDS testing and treatment in
the capital of each of Haiti's nine departments and two in the national
capital, Port-au-Prince. The government plan calls for increasing the
number of clinics.
     But the plan is being stymied by a political quagmire stemming from
disputed parliamentary elections in May 2000 that led to the suspension of
some $500 million in foreign aid.
     A coalition of opposition political parties, supported by
international donors, contend that elections officials improperly
calculated winning vote percentages for a number of candidates from the
ruling Lavalas Family party, giving them outright victories in seats that
should have gone to runoff elections.
     Talks are under way to rerun some of the elections but the aid package
has become a political football between Aristide and his opponents, with
Haitians trapped on the sidelines.
     "One of the loans that's being held up right now by the IDB
(Inter-American Development Bank) is a $22-million loan to reinforce the
national health care system," first lady Mildred Aristide said at a youth
group meeting at which students staged skits and songs about the prevention
and effects of AIDS/HIV.
     "We need the loans so we can have clinics throughout the country to
provide free testing and assistance to people in their own communities, so
they don't have to travel all the way to the capital to get testing or to
get treatment," she said.
     The IDB gave Haiti a $1 million grant, a small portion of the $22
million needed to fight AIDS, Voltaire said.
     "This money to combat AIDS is still dependent on the rerunning of the
May 2000 elections, as if AIDS were a political issue," Voltaire said.
"Well, it's not, and that's not logical. There's no justification, no
effective reason whatsoever why they haven't freed up this money."
     The United States, despite dispensing over $4 million to
nongovernmental organizations working in the country, said recently that it
was not inclined to release the aid.
     "The government of Haiti has not made sufficient progress in
implementing President Aristide's commitment to resolve flawed elections
... strengthen democracy, address security and migration issues and improve
respect for human rights," the State Department said.
     The poorest country in the Americas with average per capita income of
about $400 a year and nearly two-thirds of its people malnourished, Haiti
suffered the stigma of AIDS in the 1980s when health officials in the
developed world named Haitians a high-risk group for the sexually
transmitted disease then believed to be a virtual death sentence.
     The Ministry of Health estimates HIV infection rates in Haiti are
highest in the poor, rural Northwest and Northeast departments, with 13.9
percent and 6.25 percent of the population infected, respectively.
     This is substantially higher than the national average of 4.5 percent
and the government said it is acutely aware of the need for community-based
health programs.
     "In the hospitals in the capitals of each department, we are
installing centers where women who enter who are pregnant are tested
automatically," Voltaire said.
     "Ideally, we would want to give the women who test positive the
necessary drugs and treatment ... but all we have now is the ability to run
the tests."
     One bright light in Haiti's fight against AIDS is a state-of-the-art
hospital in Cange, a small town in the rural Central Plateau district.
     Part of an initiative that includes a tuberculosis facility, a women's
center and a clean-water program, the hospital launched Haiti's first
community-based HIV program in 1999, enrolling over 50 patients with
advanced AIDS into a regime of therapy and support services.
     "In my view, people who argue that the Aristide government is anything
less than committed have little historical memory for the past two
decades," said Paul Farmer, a Harvard-educated physician affiliated with
the American-based Partners in Health program, who helps maintain the
hospital.
     Farmer said Aristide's is the only Haitian government that has worked
HIV into its platforms and public speeches and has provided assistance for
training, serologic kits and medications for AIDS patients.
     "The Haitian government is completely broke and still does these
things," he said.
     With a trace of anger, Farmer said that at one point, the foreign
donors had pulled together a $175-million aid package for HIV programs in
the Caribbean -- none of it destined for Haiti, the country with the
region's worst HIV burden.
     "If the architects (of the suspension of aid) are trying to strangle
Haiti, they're doing a pretty good job," Farmer said. "And they're sure
making our work difficult."