Back in January 2010, Haiti was struck by a devastating earthquake, causing buildings to crumble in just minutes and resulting in thousands of deaths.

However, the ripple effects of this natural disaster are still being felt today — especially in regards to the cholera outbreak that began shortly after in October 2010 and is still ongoing.

The length of the outbreak and the lack of a unified global response more than seven years later highlight the dramatic gaps in global public health prevention and preparedness initiatives that still exist today

According to the World Health Organization, cholera is a diarrheal disease, spread through bacteria-contaminated food or water. While cholera is easily treatable, its spread is exacerbated by poor sanitation conditions and natural disasters.

In December 2016, after months of speculation and calls for an investigation, the United Nations, under then-Secretary General Ban Ki Moon, released an apology for not doing enough to curb the initial outbreak. This apology came after a report traced the source of the outbreak to UN Peacekeepers from Nepal who arrived in Haiti to provide relief after the devastating earthquake.

At the height of the epidemic, which is the worst outbreak in recent history, there were 4,500 new new cases reported per day. According to Human Rights Watch, “Haiti’s cholera epidemic has claimed more than 9,300 lives and infected more than 780,000 people in five years”, while other estimates place the death toll north of 10,000.

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In addition to accepting responsibility, the UN, initially under Ban and now under Secretary General Antonio Guterres, announced a $400 million aid trust fund. This fund features both short-term objectives like preventing the transmission of the disease and improving treatment, and long-term goals including addressing water and sanitation infrastructure needs.

These goals, however, have yet to be actualized. To date, seven countries — South Korea, France, the United Kingdom, Chile, India, Liechtenstein and Sri Lanka — have contributed a total of $2.67 million, leaving a massive funding gap and no way forward.

While the initial outbreak occurred in 2010, natural disasters such as Hurricane Matthew in 2016 and seasonal flooding have exacerbated the effects of the cholera and reignited the disease nearly every year since.

This ongoing cholera epidemic highlights the two global health issues that need to be addressed. The first is the lack of infrastructure in place to respond to disease outbreaks as they occur. However, initiatives such as the Coalition for Epidemic Preparedness Innovations (CEPI), are stepping up to fill this gap in public health by preparing vaccines and responses for epidemics before an outbreak occurs.

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The cholera vaccine, which was released in a large scale campaign following Hurricane Matthew in 2016, has the power to prevent the disease from becoming widespread again. This vaccine has about a 65% rate of effectiveness after two doses, which can make a huge difference in avoiding an outbreak.

The second global health issue is the role of foreign aid and assistance in addressing these outbreaks. One of the biggest obstacles in overcoming the cholera epidemic in Haiti is the lack of effective, sanitary infrastructure such as toilets and clean drinking water. By investing in these vital systems ahead of time through foreign assistance, outbreaks will be easier to thwart before they spread. 

Both these long term and short term global health issues must be addressed in order to finally end the cholera epidemic in Haiti, and create an effective global response to avert future outbreaks.