Bi-national TB Initiative: A Bridge to Collaboration on Hispaniola

Tuberculosis is one of the leading public health problems facing both Haiti and the Dominican Republic today. Tuberculosis, or TB, is a bacterial disease which is spread through the air when a person infected with active TB coughs or sneezes. The tuberculosis bacteria most commonly attacks the lungs, but can also affect many other parts of the body. If left untreated, tuberculosis is often fatal.

Once a leading cause of death in North America, with the help of antibiotics, TB has become relatively rare in developed countries. Unfortunately, tuberculosis is still common in many developing countries. Even with advances in modern medical science, TB causes more deaths worldwide – approximately 2 million per year according to the World Health Organization – than any other infectious disease. Poverty-stricken people suffering from malnutrition and poor general health are more susceptible to tuberculosis. This is especially true for people living with HIV/AIDS, who are less able to fight off the disease because of their weakened immune systems. Overcrowded living conditions also contribute to the spread of TB. Haiti has the highest incidence of tuberculosis in the western hemisphere and the Dominican Republic is not far behind.

Established national tuberculosis programs already exist in both Haiti and the Dominican Republic and are demonstrating positive results in the war against TB. Since the mid 1970s, International Child Care has had a leading role in the prevention and cure of tuberculosis in Haiti. ICC supports a national network of clinics and tuberculosis control efforts throughout five of the ten geographic departments of the country. Through partnerships with organizations including the Haitian Ministry of Health, World Health Organization, U.S. Agency for International Development and Canadian International Development Agency, International Child Care supports TB services for over 5,000,000 people. ICC distributes drugs, monitors cure rates, provides training and technical assistance and facilitates program planning and coordination to a network of 149 rural and urban clinics throughout Haiti. In the Dominican Republic, another non-governmental organization, Family Health International, currently serves as lead contractor in TB health work for USAID.

Despite the gains being made in both Haiti and the Dominican Republic through national TB programs, public health leaders in both countries recognize that the prevention and cure of tuberculosis can only occur if they commit to an island-wide initiative. The significant flow of people in both directions across the Haiti – Dominican Republic border each year makes partnership imperative. Although there is little historical precedent for effective cross-border collaboration between the two countries, key international health agencies are working together to develop a plan for joint tuberculosis control activities. International Child Care has already been identified as the lead agency responsible for cross-border collaboration in Haiti. In the Dominican Republic, Family Health International has been appointed this task.

The strategic importance of this bi-national initiative for both Haiti and the Dominican Republic is considerable. This plan will not only contribute to improving TB control island-wide, but it could also serve as a bridge for future health initiatives that are of mutual concern to both Haiti and the Dominican Republic, particularly HIV/AIDS. Project leaders are hopeful that the bi-national TB initiative will be the beginning of a renewed spirit of cooperation across the island of Hispaniola.

To learn more about how ICC helps combat TB and other diseases on the island of Hispaniola, please visit the Health in Haiti page.