The problem of ending Haiti’s cholera epidemic does not stem from an absence of planning. There is a 10-year plan to eradicate cholera from Hispaniola, the island Haiti shares with the Dominican Republic, by 2022. Within the 10-year plan is a two-year plan to get the 10-year plan up and running. The United Nations has its own two-year plan to support that two-year plan. To tackle the crisis immediately, with treatment, vaccinations and other prevention efforts, there was a one-year plan for last year, and a new one for 2014.
In Port-au-Prince on Tuesday, Haitian government officials and international health agencies met to examine the progress of the cholera response. As they surely realized, the difficulty is never a lack of plans, but a lack of money. Last year’s plan called for spending $38 million, but raised only $10 million. The 2014 plan is for about $40 million. It has raised about $6 million. The government says it needs $448 million to carry out its two-year plan; it has raised less than half that.
The 10-year plan, an ambitious campaign to supply vaccinations and treatment and to build the clean water, sewage and health systems Haiti has never had, is expected to cost $2.2 billion. Needless to say, it is off to a bad start. And not surprisingly, other trends are moving in the wrong direction, as The Times reported last week.
The number of cholera treatment centers has plummeted, from 120 to barely 40, as aid organizations leave Haiti. The percentage of cholera patients who die in treatment centers is rising. The rainy season, which began this month, is expected to increase the caseload by tens of thousands as flooding spreads the disease in contaminated rivers and streams used for drinking and bathing.
More than 700,000 Haitians have been sickened since the outbreak began in 2010. More than 8,500 have died.
No one should get cholera, and no one who gets it should die. The cure is astoundingly simple: clean water and rehydrating salts, given intravenously if necessary, can swiftly bring a person back from the edge of death. The long-term solution, clean water and sewage systems, is straightforward. But the outpouring of good will and pledges of aid after the 2010 earthquake have dissipated, leaving little in the way of permanent improvements. Promises made are not the same as money delivered.
The United Nations is in an awkward spot in this crisis. It has been blamed for bringing cholera to Haiti in the first place, through its negligent soldiers who contaminated a river with their sewage. Because it has steadfastly refused to accept responsibility, it is a tarnished advocate, begging donors to send money that they have gotten tired of giving. But even if the conscience of the world no longer shocked by Haitian sickness and deaths, the Haitian people still need the world’s help. At current rates, officials expect 45,000 people to contract cholera this year. In what other country would such a vast and preventable tragedy be tolerated, with little more than wrung hands, empty promises and underfinanced plans?
A version of this editorial appears in print on April 24, 2014, on page A30 of the New York edition with the headline: Haiti in the Shadow of Cholera.