Senator Patrick Leahy (D-Vt.), who chairs the Senate Appropriations Committee’s Subcommittee on the State, Foreign Operations, and Related Programs, “on Friday urged President Barack Obama’s administration to suspend direct aid to Haiti’s government and visas for its top officials until it ensures a fair and democratic outcome to disputed national elections,” Reuters reports.

“Leahy made the call as international pressure mounted on outgoing Haitian President Rene Preval’s government and Haitian electoral authorities to review the contested results of November 28 elections that have triggered violent protests across the poor Caribbean country,” the news service writes.

“As if Haiti did not have enough problems, now, once again, those in power there are trying to subvert the will of the people,” Leahy said in a statement. “The United States must come down squarely in support of the Haitian people’s right to choose their leaders freely and fairly,” he said, adding that Haiti needs “a legitimate government respected by the Haitian people and recognized by the international community.” A suspension of direct aid and visas for top officials and their families would communicate that message, according to the Senator (Delva/Gaestel, 12/10).

Health Experts Call For More Vaccines, Antibiotics To Address Cholera In Haiti

On Friday in a Lancet Comment, health experts called for more vaccines and antibiotics to be used to control the cholera epidemic in Haiti, Reuters reports.

“Their recommendation … adds to a growing chorus of voices speaking in support of a vaccination program. Health authorities, including the Pan American Health Organization, had argued against vaccination, saying it would be too difficult and expensive. But Paul Farmer of Harvard Medical School and colleagues … said current strategies are not working,” the news service reports (Fox, 12/10).

In the piece, Farmer and colleagues list five recommendations. “First, we must identify and treat all those with symptomatic cholera. This effort requires both the capacity to identify and refer those with symptoms, and the existence of centres equipped and trained to treat them,” they write. “Second, a concerted effort should be made to make oral cholera vaccines available in Haiti and elsewhere. This would require a global stockpile of cholera vaccine. … Third, prevention in this context means doing everything we can to remedy Haiti’s water insecurity and improve sanitation. … Fourth, all vertical health projects, whether focused on AIDS, cholera, nutrition, women’s health, or any other endeavour, must be dedicated at least in part to strengthening Haiti’s health system. … Fifth, cholera demands not simply a harmonisation of global health policy, but also raising the bar on our goals. 10 years ago, we argued that AIDS treatment with antiretroviral therapy was possible even in rural Haiti, and pressed for adequate funding of integrated prevention and care programmes,” the authors write (Ivers et al., 12/10).

“Rehydration alone without any antibiotics, in our view, is not a good idea, even for moderate cases of cholera,” Farmer said at a news briefing, according to Reuters. “Sometimes we are seeing them really late, when they are very ill and being carried in. Treatment needs to be much more aggressive,” he added (12/10).

Dan Epstein, a spokesperson for PAHO, cautioned, “Cholera vaccine is not going to be the magic bullet for stopping the cholera outbreak at this stage,” CNN’s blog “The Chart” reports. “For vaccination to work, he says, one has to take two oral doses one to two weeks apart and one isn’t fully protected until about a week after getting the second vaccine dose. However, Epstein and Farmer both say vaccines are part of the equation to slow the progression of the epidemic,” the news service writes (Falco, 12/10).

“There are only two brands of cholera vaccine in the world: Dukoral, made in Sweden, which is WHO-approved and costs $40 per dose, and Shanchol, introduced last year by India’s Shantha Biotechnics at $6 a dose,” the New York Times reports. Though Shanchol has not been approved by the WHO, “it was created at the International Vaccine Institute in Seoul, South Korea, under a grant from the Bill & Melinda Gates Foundation and designed to meet WHO standards,” the newspaper writes. The article notes the WHO’s “shifting” position on the use of a cholera vaccine in Haiti in light of new information about the availability of vaccines.

Now that PAHO is aware there might be one million to two million additional cholera vaccine doses, Jon Andrus, PAHO’s deputy director, said, “We recognize that it’s time to rethink our position.” Andrus added, “We don’t want to miss an opportunity.” PAHO “will hold a meeting of experts in Washington next Friday to consider whether to buy those doses and move them to Haiti,” according to the New York Times (McNeil, 12/10).

AP Examines U.S. Contracts To Rebuild Haiti

“Out of every $100 of U.S. contracts now paid out to rebuild Haiti, Haitian firms have successfully won $1.60, the Associated Press has found in a review of contracts since the earthquake on Jan. 12. And the largest initial U.S. contractors hired fewer Haitians than planned,” according to a story by the news service.

“Of the 1,583 U.S. contracts given so far in Haiti totaling $267 million, only 20 – worth $4.3 million – are going to Haitian-owned companies. And an audit this fall by USAID’s Inspector General [IG] found that more than 70 percent of the funds given to the two largest U.S. contractors for a cash for work project in Haiti was spent on equipment and materials. As a result, just 8,000 Haitians a day were being hired by June, instead of the planned 25,000 a day, according to the IG,” the AP reports (Mendoza, 12/12).