New Haiti cholera campaign faces tough questions

Associated Press

Haiti’s two most prominent health care organizations are preparing a new assault on the country’s deadly cholera epidemic: the dispatch of hundreds of workers to remote villages and gritty alleys in the capital to administer a vaccine against the raging disease.

But the pilot project, which has not yet secured the $870,000 it is estimated to cost, has set off a debate among some public health experts who question the wisdom of a program that will inoculate only 1 percent of the population and could deplete the world’s stock of available cholera vaccine, potentially putting people at risk in other vulnerable places.

Experts also wonder whether it will even be possible to successfully administer a vaccine that must be given in two dosages two weeks apart. They contend the money is best spent cleaning up the waterways that have allowed cholera to flourish in Haiti.

“Everybody thinks it’s going to do some good,” said Richard Garfield, a professor of public health and nursing at Columbia University. “But it’s hard to specify how much good and benefit will come out of that … There are bigger-bang-for-the-buck activities out there.”

“We’re not doing this at the exclusion of water and sanitation,” said Weigel. “We really think that it’s faulty logic to think that it’s one or the other.”

Farmer acknowledges the global shortage but believes the epidemic will spur pharmaceutical companies to increase supply.

“This is an oral vaccine that was designed to be used in poor countries,” Farmer said. “This is the lowest-hanging fruit.”

Still, Garfield and others say that the project poses some tough ethical dilemmas.

“It’s not clear who gets in the life boat and who doesn’t,” he said.
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