On May 31 the World Bank, PAHO and UNICEF announced $28.1 million in new funding for cholera elimination efforts in Haiti. The new funding was announced following a meeting in Washington, D.C. of the Regional Coalition to Eliminate Cholera Transmission in Hispaniola. In February 2013, a $2.2 billion, 10-year cholera elimination plan was announced by the Government of Haiti, with the support of the coalition. The plan calls for $443.7 million over the first two years. Thus far, however, there have been few details of how the plan will be funded and coordinated. In announcing the new funding, PAHO noted that UNICEF would “take lead responsibility for the operation of a national trust fund to channel resources to cholera elimination.” While the terms of reference for the national fund are still being worked out, those familiar with the discussions told HRRW that it would be run by a steering committee led by the ministries of health of Haiti and the Dominican Republic. In contrast with previous aid and reconstruction funds that have largely bypassed the Haitian government and Haitian institutions, the new fund would have the ability to directly fund the work of the Haitian government as well as international NGOs. “Donors are looking for improved international cooperation with Haiti and this is a model they’re looking for,” said Kate Dickson, Senior Policy Advisor at PAHO. Dickson added, “it is a model that allows the respective governments, Haiti and the Dominican Republic, to actually take the lead, accompanied by a coalition at the international level.” This would represent a significant change from previous efforts, such as the Haiti Reconstruction Fund, which was only able to disburse funds to the U.N., World Bank and Inter-American Development Bank. It also may reflect the influence of Paul Farmer, named the U.N. Secretary General’s Special Envoy on Community Based Medicine and Lessons from Haiti. Under his previous role as Deputy U.N. Special Envoy, Farmer argued that “the way aid is channeled matters a great deal, and determines its impact on the lives of the Haitian people.”During the meeting between coalition partners and donor groups in late May, Farmer directly addressed this, in an appeal to donors: By December 2012, only 10% of the total $6.4 billion dollars invested in Haiti had gone through national systems. We have learned and relearned this lesson in Haiti: unless efforts are made to increase the amount of such resources to and through public institutions, the process of building them is slowed or thwarted. When we say “through”, we mean of course, that there can be local private entities, from contractors to NGOs, that wish to be part of rebuilding… Again, we are here not only to fund the national actions plans, but to do so in a way that strengthens ownership and local capacity, while accompanying local authorities and providers. This requires, as the Americans say, “boots on the ground” – not those of soldiers but of community health workers. Nevertheless, some traditional donors, reluctant to give up operational control of their aid funds may instead opt to work outside of the national fund. This is already evident. In December, when the U.N. Secretary General announced an initiative to support the cholera elimination plan, he stated that there had already been $238.5 million committed. However, with the recent funding commitments of $28.1 million announced last week, PAHO noted that it “brings the total funds committed to support the national plans to $209.4 million, less than half the amount needed over just the next two years.”
On May 31 the World Bank, PAHO and UNICEF announced $28.1 million in new funding for cholera elimination efforts in Haiti. The new funding was announced following a meeting in Washington, D.C. of the Regional Coalition to Eliminate Cholera Transmission in Hispaniola. In February 2013, a $2.2 billion, 10-year cholera elimination plan was announced by the Government of Haiti, with the support of the coalition. The plan calls for $443.7 million over the first two years. Thus far, however, there have been few details of how the plan will be funded and coordinated. In announcing the new funding, PAHO noted that UNICEF would “take lead responsibility for the operation of a national trust fund to channel resources to cholera elimination.” While the terms of reference for the national fund are still being worked out, those familiar with the discussions told HRRW that it would be run by a steering committee led by the ministries of health of Haiti and the Dominican Republic. In contrast with previous aid and reconstruction funds that have largely bypassed the Haitian government and Haitian institutions, the new fund would have the ability to directly fund the work of the Haitian government as well as international NGOs. “Donors are looking for improved international cooperation with Haiti and this is a model they’re looking for,” said Kate Dickson, Senior Policy Advisor at PAHO. Dickson added, “it is a model that allows the respective governments, Haiti and the Dominican Republic, to actually take the lead, accompanied by a coalition at the international level.” This would represent a significant change from previous efforts, such as the Haiti Reconstruction Fund, which was only able to disburse funds to the U.N., World Bank and Inter-American Development Bank. It also may reflect the influence of Paul Farmer, named the U.N. Secretary General’s Special Envoy on Community Based Medicine and Lessons from Haiti. Under his previous role as Deputy U.N. Special Envoy, Farmer argued that “the way aid is channeled matters a great deal, and determines its impact on the lives of the Haitian people.”During the meeting between coalition partners and donor groups in late May, Farmer directly addressed this, in an appeal to donors: By December 2012, only 10% of the total $6.4 billion dollars invested in Haiti had gone through national systems. We have learned and relearned this lesson in Haiti: unless efforts are made to increase the amount of such resources to and through public institutions, the process of building them is slowed or thwarted. When we say “through”, we mean of course, that there can be local private entities, from contractors to NGOs, that wish to be part of rebuilding… Again, we are here not only to fund the national actions plans, but to do so in a way that strengthens ownership and local capacity, while accompanying local authorities and providers. This requires, as the Americans say, “boots on the ground” – not those of soldiers but of community health workers. Nevertheless, some traditional donors, reluctant to give up operational control of their aid funds may instead opt to work outside of the national fund. This is already evident. In December, when the U.N. Secretary General announced an initiative to support the cholera elimination plan, he stated that there had already been $238.5 million committed. However, with the recent funding commitments of $28.1 million announced last week, PAHO noted that it “brings the total funds committed to support the national plans to $209.4 million, less than half the amount needed over just the next two years.”
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