Speech Delivered by the First Lady of the Republic of Haiti,
the Honorable Mildred Trouillot-Aristide

Delivered at the ceremony launching the Interim Plan on HIV/AIDS

Jacmel, Haiti, October 4, 2001

Honorable Minister,
Honorable Members of Parliament,
Mayor of Jacmel,
Representatives of the Government,
Ambassadors,
Representatives of National and International Organizations,
Health Professionals,
Dear Citizens of Jacmel:

Last June 25, on the occasion of the extraordinary session of the United Nations on HIV/AIDS, Mr. Kofi Annan, the General Secretary of that organization, said that the world response to the AIDS epidemic did not meet the challenge. That the efforts already being deployed were not sufficient to fight AIDS.

Here in Haiti we knew this. To help increase our ability to fight AIDS the elaboration of a global plan was necessary. For that the Health Minister accelerated the process of elaboration of the Strategic Plan for 2002-2006 officially launched last May 7th by President Jean-Bertrand Aristide, which represents an important step within the context of this fight that concerns all of us. Diverse multi-sector consultations have been held in view of finalizing the Strategic Plan.

Today the Interim Plan that the Ministry is presenting responds to a timely need to increase and immediately reinforce the actions against AIDS. This is an operational plan that must bridge the gap with the strategic plan for 2002-2006. This inevitably implies an articulation and continuity between the interim and strategic plans.

I know that this document was created with the participation of national and international agencies that are working to meet the AIDS challenge and better respond to all those who are affected and those at risk of contracting AIDS. We welcome this cooperation with fraternity and a spirit of solidarity.

As you already know, I am neither a doctor nor a specialist in AIDS. I am a lawyer by profession. So I will let the Minister and the other technical experts explain in detail and in depth the Interim Plan.

But I would like to emphasize two points in the plan. First the multi-sector aspect in the fight against AIDS. Global statistics clearly show the correlation between AIDS and poverty: 90% of the people living with the disease live in developing countries where the healthcare infrastructures are poor, access to potable water difficult and the rate of literacy and education are low. In countries where if you are a woman you have a greater chance of suffering from discrimination. We know well, that fighting AIDS is more than a medical war, it is also a war against social injustice; it is a war against poverty.

But what are we doing concretely to advance this social justice in the context of the fight against AIDS in Haiti?

Last weekend we visited the department of Artibonite, the largest of our nine departments. There 1,091,374 inhabitants live on 4,983 square kilometers. Artibonite is often called the bread basket because it is the greatest producer of food for Haiti. The President chose this place to commemorate the 10th anniversary of the bloody coup d’etat of September 30, 1991; an event which, with the forced migration of approximately 300,000 people and the introduction of rape as a new instrument in the political repression, surely increased the number of persons and children exposed to HIV. The fight against AIDS from now on must be one of the responses to the injustices suffered by these victims.

A broader vision of the challenges posed by AIDS will lead us further in the fight. It will lead us to the necessity to better organize or re-organize the national healthcare system. To this end, the government last May finalized a loan of 22.5 million dollars with the Inter-American Development Bank to reinforce the healthcare structures in four departments, with the possibility to train health workers and purchase basic medicines, etc.

Unfortunately, instead of taking one step forward toward social justice with such an initiative, the freezing of these funds are limiting our efforts aimed at improving the health conditions of the population. We sincerely believe that this is unjust.

Back to the Artibonite. In the commune of Grand Saline, it is not a health center that the population is missing. It exists. But what is missing is an access road to get there. So even when there are healthcare services, without a road sick people cannot get the health care that they need. Infrastructure, like social justice, is an integral part of a healthcare program prepared to face this plague that AIDS represents.

Now moving from road systems to other systems apparently independent from health, it is the same thing. The agricultural system for example: approximately 60% of the employed population works in agriculture and contributes to supplying food to the country. But many people don’t have access to irrigation, fertilizers or even land. The result is a drop in the production of food and an increase in prices – with the disastrous consequences on nutrition and consequently on the population’s health. And it is not only in Haiti. Nearly one-third of the children under age 5 throughout the world suffer from malnutrition.

While the government has the obligation to take care of all our citizens who have AIDS, the strategy elaborated in consultation with different partners to combat AIDS must go beyond the medical field. Satisfying the fundamental needs of the people – nourishment, potable water, education – are important points of this strategy. Our laws, our educational system, our campaign for literacy, are tools which are essential to this struggle.

In all actions undertaken by the government, the participation of the people is the key element to achieving success.

The same is true for AIDS. The second point I want to underscore within the context of the Interim Plan is the participation of the population in the fight against AIDS. At the heart of the Interim Plan, are plans to develop in all of the state operated healthcare facilities voluntary testing and counseling centers to reinforce the capacity of the population to fully participate in the fight against AIDS. How?

First, by making information about AIDS available to the population. Second, by giving people the opportunity to be tested to find out if they are infected or not and how to protect themselves and others. Women in particular will be encouraged to make informed and rational decisions on matters of family planning. Infected persons will be cared for, with priority given to pregnant women, they will receive necessary social services, medications and nutritional support. Because throughout the world and not only in Haiti, people living with HIV/AIDS are the most determined and the most passionate advocates in this war, and in this war we need all our citizens.

Here, at St. Michel Hospital in Jacmel, the state is making a great effort in this regard by officially announcing the opening of the first voluntary testing and counseling center inside a state facility. I encourage the Minister and all of you to continue the implementation of the nine other departmental sites as quickly as possible.

Starting with the city of Jacmel, I believe that the government chose to pursue the vision of decentralization that is at the heart of its published program Investing in People. Emphasizing the reinforcement of public institutions, the state is fulfilling its obligation to provide healthcare for all Haitians, as mandated by Article 19 of the Constitution. That is the real work of a democratic and responsible government.

Last August, I took part in a conference on health and human rights at Partners in Health, a medical project in the Central Plateau. Among the diverse interventions and debates by patients, one said to us, “We hear much about the negotiations which are strangling the country. But for us, the real negotiations that should be held are those which will lower the cost of medicine, increase the number of Haitian doctors and nurses, and increase the number of hospitals in the country.”

I propose that we begin these negotiations within the context of the fight against AIDS. It is up to each actor to clearly identify her role in this context and assume their responsibilities, and together we will be able to stop this plague.

Thank you.