A Glimpse of the Needs of People Living with HIV in Haiti
As a physician and a native of Trinidad and Tobago, the health needs of people living in the Caribbean are never far from my mind. As medical director of Janssen’s Global Access & Partnership’s Program, I work each day to ensure that people living with HIV in some of the world’s poorest countries have access to the medicines they need to stay healthy. World AIDS Day provides an opportunity to reflect on the progress that’s been made in combatting HIV/AIDS worldwide. However, a recent trip to Haiti was a clear reminder that the task is far from over.
Haiti is a country in constant recovery. It’s been devastated by hurricanes and natural disasters, including the 2010 earthquake, which killed approximately 200,000 people and left 1.5 million Haitians homeless. Despite billions of dollars in international aid to help Haiti rebuild, there are still 350,000 people living in camps amidst severe sanitation problems and a lack of access to clean water today. Additionally, the worst cholera epidemic in recent history began in Haiti in October 2010: more than 8,300 people have died and almost 650,000 cases have been recorded.
In parallel, Haiti is experiencing the worst HIV/AIDS epidemic outside of sub-Saharan Africa. Current HIV infection rates are about 2.1% in the country with some pockets of prevalence as high as 8% in certain areas. Other infectious diseases pose even more serious health risks, including tuberculosis (TB) and multi-drug resistant TB (MDR-TB). Compounding these problems are high levels of malnutrition and a high rate of infant mortality. Often, those most affected are the most vulnerable – women and children.
In November, I joined a cross-functional delegation from Janssen and Johnson & Johnson to learn about the country’s health system needs and to look for opportunities for our Company to contribute to enhance the health and well-being of people in Haiti. The experience has been imprinted in my mind in vivid detail. As my colleagues and I toured healthcare facilities, I was struck by the resilience of the doctors and nurses working in healthcare centers overwhelmed with patients, understaffed with trained health care professionals and undersupplied with necessary medicines. I witnessed too many examples of babies suffering from malnutrition and illness, parents struggling to find money to pay for life-saving basic medicines, and people sleeping outside of clinics in the hope of being able to meet with a doctor or nurse in the morning.
But we also saw progress. Despite their serious difficulties, the people of Haiti are resilient and small gains are being made every day. Collaborations between International and local organizations – such as the Global Fund to fight AIDS, Tuberculosis and Malaria, the President’s Emergency Plan for AIDS Relief, Partners in Health, and the Catholic Medical Mission Board – have improved access to HIV medication significantly in the last decade. A major bright spot of this trip was visiting the St. Marc Clinic, which now follows 1,900 HIV patients – 1,400 of whom are on antiretroviral therapy (ARVs).
However, there is still a significant need for new HIV medicines for adults – and children – whose initial regimens are no longer working. Many physicians in Haiti also lack the appropriate tools, such as viral load and resistance testing, to ensure that those people who do have access to HIV care and treatment can stay healthy and avoid HIV treatment failure in the long-term.
So what can Janssen and Johnson & Johnson do? As a start, we’ve committed to return to Haiti for an in-depth fact finding mission, meeting with stakeholder organizations to learn more about what we can offer and how we can partner to address unmet health needs. As a developer of innovative medicines for people who have experienced HIV treatment failures, it’s also our responsibility to continue to ensure that our HIV medicines can be made available sustainably. We’re also looking into the possibilities of drug donation, at very early stages, for children in need of our HIV medicines. While providing medical goods is essential, it is also critical to instill capacity and knowledge to create lasting health system change. So we are exploring possibilities for facilitating medical education and training for physicians and nurses across the country on both pediatric and adult HIV treatment management. We know that our contributions may only be a small part of the solution, but we refuse to be a bigger part of the problem by doing nothing. I am proud to be part of an organization so committed to bringing about positive change for Haiti’s people and fighting the HIV epidemic.
Perry Mohammed is Medical Director of the Janssen Global Access and Partnerships Program. He is responsible for improving sustainable access to Janssen’s HIV medications in the developing world. This includes the development of partnerships with non-profit, government and non-government organizations. Working as a junior doctor in Trinidad and Tobago, his passion for working in the area of HIV budded after treating patients for opportunistic infections and providing palliative care to those who had no access to HIV medicines