1 December 2016: The UN is combating communicable diseases through education, toilets, vaccines and and victim assistance, and has apologized to the people of Haiti for the inadequacy of UN response so far on its cholera outbreak. UN Secretary-General Ban Ki-moon said the UN “simply did not do enough,” and launched a proposed response package including US$400 million in aid.

Haiti’s cholera outbreak began in 2010 as the country struggled to recover from the aftermath of a major earthquake. The impacts worsened after Hurricane Matthew struck the country in October 2016. To date, more than 9,000 Haitians have died from cholera in the outbreak, and around 788,000 people have been affected. A vaccination campaign, supported by the World Health Organization (WHO) and the Pan American Health Organiation (PAHO), is underway in affected areas, where water and sanitation systems have been damaged.

Ban acknowledged that donors may be experiencing aid fatigue, but said limited sums are required to eliminate cholera in Haiti.

Ban addressed the people of Haiti during a UN General Assembly meeting to launch his report, titled ‘A New Approach to Cholera in Haiti,’ on 1 December. Saying “we are profoundly sorry for our role,” Ban noted that Haiti’s cholera tragedy also has damaged the UN’s reputation and global mission, and the UN must “do what is right for those affected.” The report proposes a two-track approach consisting of: improvements to water, sanitation and health systems, including the establishment of rapid response teams along with better communication and geographical targeting; and material assistance and support to Haitians who have been directly affected by cholera. Noting that funding for this aid package is not yet assured, Ban acknowledged that donors may be experiencing aid fatigue, but said limited sums are required to eliminate cholera in Haiti.

Meanwhile, UN agencies have stressed the importance of sanitation facilities and girls’ education in combating a range of diseases. Young women are at high risk of HIV infection, and prevention is key to breaking the cycle of new infections, according to a UN report. The Joint UN Programme on HIV/AIDS (UNAIDS) launched the report, “Get on the Fast-Track: the life-cycle approach to HIV” (A/71/620*) in Windhoek, Namibia, on 21 November, ahead of World AIDS Day.

Michel Sidibé, UNAIDS Executive Director pointed to the “triple threat” faced by young women aged 15-24 years, who are at high risk of HIV infection, have low rates of HIV testing, and adhere poorly to treatment. While men tend to be exposed to HIV at an older age, women are infected much earlier and continued the cycle of infection even though treatment rates have greatly increased among HIV-positive clients. The report shows that more than 18 million people were on antiretroviral treatment for HIV/AIDS by June 2016, well on the way to the UN target of having 30 million people on treatment by the year 2020.

Sidibé warned that, while progress on HIV/AIDS treatment has been remarkable, it is also fragile. The report calls for increasing synergy of approaches to HIV/AIDS and other communicable diseases, including tuberculosis (TB), human papillomavirus (HPV) and cervical cancer, and hepatitis C, all of which can cause deaths among HIV-infected populations.

On World Toilet Day on 18 November, the UN highlighted the role of sanitation access in promoting a strong economy based on good public health, estimating that lack of sanitation creates a 5% loss in GDP. In his message for the Day, Ban cited statistics that every US$1 invested in water and sanitation brings a return of US$4, and noted the need for women and girls to have private, clean, and safe sanitation facilities in order to manage menstruation and pregnancy-related conditions.

The World Health Organization (WHO) announced on 17 November that it has secured US$15 million to support the piloting of the world’s first malaria vaccine. The vaccine, known as ‘RTS,S,’ was developed through a partnership between the pharmaceutical company GlaxoSmithKline and the global non-profit organization PATH, with funds from the Bill & Melinda Gates Foundation. The UN anticipates a further US$37 million from partners to be contributed to cover the first four years of the vaccine’s use in sub-Saharan Africa, beginning in 2018. [UN Press Release on Haiti] [UN Press Release on Haiti Vaccination Campaign] [Report by the Secretary-General: A new approach to cholera in Haiti (A/71/620*)] [Get on the Fast-Track: the life-cycle approach to HIV] [UN Press Release on HIV/AIDS] [UN Press Release on World Toilet Day] [UN Secretary-General’s Message on World Toilet Day] [UN Press Release on Malaria Vaccine]