Since the early 1980s, when the first patients were stricken by the strange and terrifying disease that still had no name, experts thought it could wipe out a third of the Haiti’s population; instead, as Jonathan Katz (Associated Press) reports, Haiti’s HIV infection rate stayed in the single digits, then plummeted. The Associated Press found that Haiti’s success in the face of chronic political and social turmoil came because organizations cooperated and tailored programs to the country’s specific challenges. As Katz indicates, much of the credit went to two pioneering nonprofit groups, Boston-based Partners in Health and Port-au-Prince’s GHESKIO, widely considered to be the world’s oldest AIDS clinic.

Partners in Health was founded in 1983, by two Haitians and two U.S. citizens, including Dr. Paul Farmer [also see Paul Farmer Replicates Haiti Project in Rwanda], as a small clinic treating infected people in the desperately poor hillside community of Cange. GHESKIO co-founder Dr. Jean W. Pape was awarded the French Legion of Honor for his work, and PIH’s Dr. Paul Farmer was recently named chairman of Harvard Medical School’s global health department. In May, Haiti was honored as the host of the opening ceremony of the 2009 International AIDS Candlelight Memorial.

By the mid-1980s alarming reports regarding the pandemic in Haiti damaged the country’s dignity and tourism, then its second-largest industry, which collapsed and never recovered. Yet the stigma may be what motivated Haiti to fight the disease harder, says Pape, the Haitian-born, Cornell-educated physician who helped found GHESKIO in May 1982. [GHESKIO was founded two months before the disease even had a name, hence its unwieldy French acronym for “Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections.”]  Pape explains that efforts to close unregulated blood banks, to treat the sick, and reducing mother-to-child transmissions helped curb the epidemic. Well-coordinated use of AIDS drugs, education campaigns, and behavioral changes, such as increased use of condoms have kept the disease from surging back.

Thanks in large part to UNAIDS, which awarded Haiti its first grant in 2002, and $420 million from the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR, an estimated 18,000 people are on AIDS drugs, most of them administered free through GHESKIO and PIH. Although statistics vary widely according to geographic areas, age groups, and many other factors, the official rate for men and women aged 15 to 49 is 2.2 percent, according to UNAIDS. That’s still far higher than in the developed world, but it’s lower than the Bahamas, Guyana and Suriname, and much lower than sub-Saharan Africa, where the rate averages about 5 percent but spikes to 24 percent in Botswana and 33 percent in Swaziland. Pape envisions a Haiti where the prevalence rate will dip below 1 percent.

Post based on excerpts from Jonathan Katz’s Associated Press article http://www.latimes.com/news/nationworld/wire/sns-ap-cb-haiti-aids-success,1,560398.story. The article gives a face to HIV/AIDS in Haiti by citing the example of Michelline Léon (shown in photo), whose parents prepared to buy her a coffin when she was diagnosed HIV-positive, but who is healthy after 15 years and whose 4 children, born after she was diagnosed, do not have the virus.