Combating HIV/AIDs, Malaria and Other Diseases, Research Paper Example

Millennium Development Goal Six pertains to combatting HIV/AIDS, malaria and other diseases. This goal, while relevant in developed countries, aims at putting more effort into addressing the needs of the poorest countries. The world’s poorest countries are the countries most affected by infectious diseases. The targets created by the UN in an effort to have a base to compare results to were to “have halted by 2015 and begun to reverse the spread of HIV/AIDS,” to “achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it,” and to “have halted by 2015 and begun to reverse the incidence of malaria and other major diseases.”  The first two targets stated above relate to treating HIV/AIDS, while the third mainly focuses on other diseases like malaria and other major diseases, more recognized as diseases of the poor (United Nations).

In Haiti, there has been a huge success on the part of HIV/AIDS programs aiming to achieve the targets under this goal. However, the targets set by the UN have not been met at all by 2015. Challenges still remain at the basic levels that hinder the efforts of programs to achieving such goals any time soon. In regards to malaria and other diseases, the target is far from being achieved and has actually worsened since the MDGs were set. The achievements and challenges of meeting these goals are discussed further.

The HIV/AIDS program in Haiti has been recognized as the “most successful in the world.” Articles about HIV/AIDS programs demonstrate that Haiti’s success is tied to its strong historical foundations set long before external funding started coming into the country and the MDGs were set. Before external funding started coming in there were guidelines to eradicating disease by the Ministry of Health, a network of non-governmental organizations providing assistance with such issues, and strong political commitment from the state. For example, the NGO, Partners in Health (PIH) opened an “ambulatory clinic in the squatter settlement of Cange, Haiti’s Central Plateau” (Successes and Challenges) in 1985 and provided essential health services to refugees in the area. This area lacked electricity to even potable water. It was for development projects like PIH that clean water systems were placed in this community as well as schools and other things that created a foundation for other upcoming programs to succeed in certain areas of Haiti.

Partners in Health was essential to many of Haiti’s reported successes with HIV/AIDS because it also was among the first to provide counseling and HIV testing for patients in 1986. The services were free but problems came about when the resources of these clinics had no treatment available, especially affordable treatment. However, community health workers provided support by providing proper follow up care and even free medications. Zidovudine, a drug that could prevent mother-to child HIV transmission was offered to all pregnant women. Then, in 1996 while mortality was increasing because of a high use of ART, or antiretroviral therapy in the developed nations, there was no such resistance in Haiti because they did not have ART. ART was thought to be too complicated for resource poor areas, but PIH found funding to provide ART for almost all patients they received and were successful with great outcomes for many patients. The PIH model has made Haiti’s HIV/AIDS programs key for providing ART in “resource-poor settings” (Successes and Challenges).

In addition to PIH, another NGO, GHESKIO, has treated slum dwellers in Port-Au-Prince. Here, is one of the most populated and poorest slums. GHESKIO is deemed a “’Public Utility’” according to the “Haitian government” (Successes and Challenges). GHESKIO has been able to provide services for STI, TB, and other infectious diseases diagnosed patients that aid the HIV/AIDS programs’ efforts. This NGO has helped with the efforts of increased knowledge of safe sexual practices, STI treatment, and the use of condoms successes reported in the MDG 2013 report. Because STI’s proved to have an effect of the proportions of people getting diagnosed with HIV, multiple NGOs, like GHESKIO, and the government have developed a plan for prevention of STI’s in Haiti as well as treatment.

For mothers who are pregnant in Haiti, GHESKIO, the Ministry of Health, PIH and other network organizations have created guidelines for the prevention of mother to child transmission of HIV/AIDS. In 2003, the suggested drug was changed from Zidovudine to a triple drug ART. Programs for the prevention of mother to child transmission (PMTCT) in Haiti then provided treatment of infections already acquired and family planning knowledge and essentials needed for mothers during pregnancy. Prenatal testing for the virus has also doubled due to PMTCT programs. All of this has led to a “lower rate of vertical transmission of the virus” (Successes and Challenges). Furthermore, those infants that are infected through mother to child transmission are treated with triple drug ART as of 2003 after meeting “clinical and laboratory criteria”(Successes and Challenges).

While there have been successes in achieving target two of “providing access to treatment for HIV/AIDS for all who need it,” challenges exist that will be discusses further, but one major challenge that still exists from the challenges of HIV/AIDS is tuberculosis. Tuberculosis (TB) affects hundreds of people in Haiti. Because of HIV/AIDS, Haiti has “one of the highest rates of TB in the hemisphere” (Successes and Challenges). Many patients are found to be dually infected by HIV and TB. Multi-drug resistant TB (MDR-TB) has shown to be prevalent through studies conducted by GHESKIO in Haiti as well. It was reported, “10 of 49 patients had MDR-TB”(Successes and Challenges). In order to combat these challenges, the Green Light Committee of the World Health Organizations has made 90% of medications available without charge to the poorest countries, including Haiti. Haiti has also increased “coverage of DOTS anti-tuberculosis treatment from 55% to 80% between 2006 and 2009” (MDG Report 2013). Treating all residents of Haiti with TB medications remains a challenge, leaving Haiti as one of the countries with the highest TB prevalence.

Low cost effective medications and treatment for HIV/AIDS and TB patients remained a challenge for the different organizations’ efforts because of their financial limitations. Then in 2002, Haiti applied to the Global Fund for assistance with the Haiti HIV/AIDS and TB programs. Haiti received the support from the Global Fund and was also granted $320 million US dollars in 2003 from the U.S. Presidents Emergency Plan for AIDS Relief (PEPFAR). All the financial assistance given to Haiti made treatment and ART feasible for people throughout the country, helped with infrastructural projects, and other services. PEPFAR also made it possible for Haiti to partner with private partners and institutions to expand the research and “groundwork already established” (Successes and Challenges).

Overall, after PIH and GHESKIO received external funding after the years 2002 and 2003, more antiretroviral therapy and HIV/AIDS services have been provided. After 2008, it was reported “131 voluntary counseling and testing centers” (Successes) existed in Haiti. Haiti has not target 1 by halting the spread of HIV/AIDS completely and reversing the spread. Knowledge about HIV/AIDS treatment and prevention has increased in certain groups, like women and decreased in others, like the male group. Forty-six percent of women understand how HIV can be transmitted to their babies through breast-feeding. However, there are challenges of reaching 40% of women with knowledge about PMTCT and HIV counseling and services. In addition, there are challenges in giving everyone with HIV/AIDS antiretroviral therapy. According to the MDG 2013 Haiti report, adults and children receiving ART increased from 49% to 67.7%, but did not reach the original goal of treating 100% of the population by 2010. There are factors unaddressed that keep Haiti from reaching targets one and two of MDG Goal Six. HIV/AIDS is still prevalent in Haiti although it has decreased and remained stable at 2.2%, according to the MDG 2013 Haiti Report (MDG Report 2013: Haiti, a new look).

Target three aims to halt the spread of infectious diseases like malaria by 2015 and reverse it. Unfortunately, malaria rates are not as good as HIV/AIDS rates. Much data does not exist on malaria and other diseases, possibly due to the lack of attention from funders, NGOs and the government as well as underreporting of cases. Moreover, resources are lacked when regarding surveillance and trained staff. The data that exists on the World Bank reveals that the number of children receiving antimalarial drugs under 5 has decreased to 2.5%; half of what is was in 2006. According to the MDG 2013 report, antimalarial drug is not being taken and precautions like mosquito nets are only being used by 23% of children under age five. The MDG Report on Haiti also says malaria continues to affect every one in twenty people in Haiti. Journals on Malaria demonstrate that resistance of anti-malarial drugs exists, possibly worsening the epidemic. Data says that, “80% of Haitians are living in areas where malaria is endemic” (Malaria).

Chloroquine (CQ) is an antimalarial drug that has been used for over 67 years in Haiti. It remains a part of the treatment policy for malaria in the country and is heavily relied upon because of the affordability of the treatment and overall perceived efficacy (Malaria). CQ therapy was the primary treatment used in combination with pyrimethamine (P). A resistance to pyrimethamine was grown by the parasite. CQ has presented no real resistance and remains as the official treatment in Haiti.

Millennium Development Goal Six to combat HIV/AIDS, malaria and other diseases was not met by 2015. Target two has had success but will be long before it can be reached. While target two is reported to be successful, the other two make it obvious resources are not being spread evenly among the preventative and educational health programs in Haiti. In addition, many of the population are receiving the benefits but others in the outskirts have no access and remain as unreported cases. This skews data and leave people who do not seek treatment uncounted. Better education of all diseases faltered and is one of the most efficacious ways these goals could have been reached better, especially with all the external financial assistance. If NGOs could focus on other diseases and provide more education for a wider audience, progress could occur.