On the Road to Recovery

Posted: August 17, 2011 by Nick Malouin in Uncategorized

For the past eight weeks I have been working in Haiti with the Clinton Health Access Initiative, a subsidiary of the Clinton Foundation that focuses on improving access to health services by encouraging better supply chain management, procurement and cooperation among stakeholders. A major issue in Haiti is the vast network of funders, NGOs, clinics and suppliers all working in the same area.  Despite sharing a common mission, there is a lack of communication among NGO activities, leading to duplication of efforts and major inefficiencies in the health system. That’s one of the reasons why the Clinton Foundation started working in Haiti, and since the earthquake in January, 2010 the influx of NGOs and outside funding has made this even more important.

My specific project this summer was working with HIV clinics in Haiti that have had issues providing a continuous supply of antiretroviral (ARV) drugs to patients. One of the main concerns of ARV therapy is patients halting treatment, which can lead to drug resistance and more expensive treatment in the future. By keeping patients on therapy and ensuring that clinics properly manage their supply chain, more patients can be enrolled at lower costs.  I have been spending a week at each clinic, working with doctors, pharmacists, and hospital administrators in order to understand the treatment process and where the problems may lie. While each clinic has a unique set of issues, a common challenge is patient forecasting.  As prices decrease and patients are scaled up, each clinic must model patient demand in order to better predict the correct amount of supplies needed. Building tools to help clinics forecast drug supply and demand has been one of my priorities.

On a national level, what I have seen during my time in Haiti is encouraging, but immense challenges remain. Besides the usual difficulties facing a developing country, Haiti has a unique set of challenges. Eighteen months after the earthquake Haiti is still recovering and despite progress with debris removal, housing and basic sanitation, most experts believe reconstruction is barely half way to pre-earthquake levels. In addition, a national government has yet to form since election results were finalized in March.  It is difficult to negotiate funding with the Minister of Health when they have yet to be nominated. Still, there is a sense of optimism that things are getting better. The new President, Michel Martelly has indicated a desire to be more transparent and accountable to Haitians. He is encouraging foreign investment and emphasizing Haiti’s comparative advantages, including agriculture and tourism. The greatest challenge, however, may be managing expectations. With 3,000 NGOs operating in Haiti and billions of dollars spent, donors, the international community and Haitians are expecting results immediately. Developing the poorest country in the western hemisphere and building infrastructure essentially from scratch will probably take decades, requiring patience from everyone.

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