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The Challenge

On October 21, 2010, in the aftermath of the devastating January 2010 earthquake, the Haitian Ministry of Health and Population confirmed cases of cholera for the first time in at least a century. The U.S. Government was already on the ground, helping Haiti to build sustainable health systems to detect and combat the spread of communicable diseases, and therefore was in a position to respond quickly. At the request of the Government of Haiti, the U.S. Government immediately began working with the MSPP, the National Directorate for Potable Water and Sanitation (DINEPA), and the Pan American Health Organization (PAHO) to lessen the severity of the outbreak.

Since the beginning of the cholera outbreak, and as of December 8, 2014, Haiti has reported 724,430 cumulative cases and 8,807 deaths. Based on information received from the MSPP Cholera Management Unit, from January 1 to November 30, 2014, 170 deaths have been registered at the facility level and 74 at the community level, for a total of 244 deaths. There was a 69 percent decrease in the number of deaths from 2011 to 2012, and a 34 percent decrease from 2012 to 2013. There has also been a 60 percent decrease in cases seen between January and November 2014, compared to the same period in 2013.


The U.S. Government, through the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Agency for International Development (USAID), provided expertise and more than $95 million during the emergency phase of the cholera response by:

  • Supporting cholera prevention and treatment efforts through social marketing and distribution of drinking water purification products, oral rehydration salts (which prevent dehydration in patients with acute, watery diarrhea), and soap for washing hands and household items.
  • Working side-by-side with the Ministry of Health and other partners to establish a national system for tracking cases of cholera, respond to cholera outbreaks, and routinely test suspected cases of cholera at the National Public Health Laboratory.
  • Supporting treatment for cholera and other diarrheal diseases at public and non-governmental organization health facilities nationwide at the height of the epidemic.
  • Providing technical assistance and support to DINEPA to improve its capacity to provide clean water, sanitation, and improved hygiene (WASH).
  • Providing training for 264 Communal Potable Water Technicians (TEPACs) who are deployed to all 133 rural communes outside of Port-au-Prince, where they promote community water system operations and disinfection.
  • Training more than 6,000 community health workers to conduct outreach activities on cholera prevention and treatment throughout Haiti.
  • Improving access to clean water in communities by providing support to drill new wells, repair others, and promote safe household water practices.
  • Working with the Ministry of Health to evaluate various aspects of the recent oral cholera vaccine campaign.

Challenges Ahead

Access to clean water and availability of sanitation systems are limited in Haiti, and cholera is likely to persist until access to adequate water and sanitation improves. The U.S. Government is committed to strengthening the Haitian healthcare system to prevent and contain future outbreaks and treat those who become ill.

In line with the Ministry of Health’s desire to integrate cholera prevention and treatment into overall health programming, the U.S. Government is working more broadly on the prevention and treatment of all causes of diarrheal diseases. To reduce vulnerability to cholera and other diarrheal diseases, the U.S. Government is providing the Government of Haiti and other partners with support to improve access to treated drinking water at the community and household levels in urban and rural communities. In addition, the U.S. Government, in collaboration with PAHO, UNICEF, and the Governments of Haiti and the Dominican Republic, helped launch the Coalition for the Elimination of Cholera on the island of Hispaniola, which aims to coordinate and leverage WASH efforts that contribute to the elimination of cholera on the island.

USAID is currently conducting an assessment to evaluate the state of the WASH sector, examine factors related to the sustainability of WASH programs, and determine where potential future USAID programming can have the greatest impact.

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Last updated: February 01, 2016

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