Six years ago, as the country attempted to rebuild following a massive earthquake, cholera began spreading in Haiti. And it didn’t stop.
Adults and children – many of whom contracted cholera by drinking untreated water from familiar rivers and streams – lay listless in hospitals packed to capacity with emergency cases. The death toll mounted. The months passed. The cases continued. Stories of pregnant women and tough little girls and boys struggling to survive became the norm and were well recorded by partners on the ground, who were bearing witness to what is now considered the worst cholera outbreak in recent history.
Today, as heartbreaking reports on the death toll from hurricane Matthew appear, we’re already hearing warnings about the potentially devastating aftermath: flooding and another surge in cholera cases, possibly reaching levels not seen since the earthquake.
However, though six years have passed – with countless lessons learned and apologies granted – we stand on the precipice of repeating the same mistake when it comes to cholera: delayed use of the cholera vaccine, a lesser known tool to fight the disease.
During the first outbreak in 2010, debates on whether to deplete very limited vaccine supplies – and hesitation and confusion among those not affected by cholera – prevented timely use. That meant the difference between life and death for too many families.
Cholera can be swift and severe, capable of killing within hours. Since the 2010 outbreak, nearly 800,000 Haitians have been infected and 9,000 have died.
We know that increasing access to clean water and sanitation is critical in preventing the spread of the disease – but, particularly when you are facing the aftermath of a natural disaster, vaccines have an essential role to play.
And the sooner the better.
A few years ago, a global vaccine stockpile was established to help countries experiencing outbreaks, or at high risk of cholera, easily access vaccines. This stockpile includes two World Health Organisation-approved oral cholera vaccines, which are inexpensive, easy to deliver and effective for a minimum of five years. These vaccines have been used successfully in multiple countries.
The UN – which recently acknowledged its role in bringing cholera to Haiti – is working on a cholera response plan in conjunction with the country’s Ministry of Health to be presented publically. But if we don’t want to repeat past mistakes, we need to jump-start our cholera response today.
Within two days the use of the stockpile could be approved and by next week the vaccine shipped to Haiti – if we act fast the vaccine could be used in Haiti’s hurricane-affected cholera hotspots in time to help prevent needless illness and death.
We have an effective tool, and it is the responsibility of the global health community to do everything in our power to get cholera vaccines to Haiti immediately, so that no more families are affected by this unforgiving disease.
We need to do more than plan given this current natural disaster. We must act urgently so that we do not fail Haiti again.
• Dr Anita Zaidi is the director of the enteric and diarrhoeal diseases programme at the Bill & Melinda Gates Foundation. Helen Matzger is a senior programme officer on the vaccine delivery team at the foundation, supporting the EDD portfolio on rotavirus and cholera vaccines
