SIDALE: “AIDS Go Away” Program Makes A Difference

In January 2003, Pres. Bush proposed the establishment of the President’s Emergency Plan for AIDS Relief, or PEPFAR, in his second State of the Union address. With strong bipartisan support on Capitol Hill, Congress acted swiftly on the proposal and Pres. Bush signed PEPFAR into law May 27, 2003. Under PEPFAR, Congress authorized the appropriation of $15 billion over five years to fight the HIV/AIDS pandemic. The law required the bulk of this funding to be spent in 15 resource-limited countries experiencing especially high HIV/AIDS rates. With one of the highest HIV/AIDS prevalence rates in the world, it surprised no one that Haiti was designated one of the 15 focus countries for PEPFAR (approximately 2 percent of Haiti’s population is living with HIV/AIDS). In 2008, Congress reauthorized PEPFAR for another five years and increased funding to $48 billion. PEPFAR is up for reauthorization again this year.

Thus far, PEPFAR has provided nearly $775 million in funding to fight HIV/AIDS in Haiti. In 2004, Hôpital Sacré Coeur began to receive PEPFAR funding through the AIDSRelief Consortium, a faith-based HIV/AID program led by Catholic Relief Services (CRS) under a grant from the U.S. Department of Health and Human Services (HHS). The AIDSRelief Consortium operated in six African countries and Haiti.

In 2013, the AIDSRelief Consortium ended and the project in Haiti was transitioned from CRS to the Catholic Medical Mission Board (CMMB) under a $35 million, five year, HHS funded program called SIDALE.

The HSC Clinical lab provides HIV/AIDS testing and monitoring services.

In Creole, SIDALE means “AIDS Go Away.” CMMB operates SIDALE through six faith-based hospitals to care for 10,000 Haitians living with HIV/AIDS as well as to test and counsel thousands more who are at risk of infection.

The following hospitals make-up the SIDALE program:
• Hôpital Sacré Coeur (Milot)
• Hôpital St. Boniface (Fond des Blancs)
• Hôpital Alma Mater (Gros Morne)
• Hôpital St. Jean (Limbe)
• Clinic Bethel (Fond-des-Negres)
• Hôpital Esperance (Pilate)

Under the direction and guidance of CMMB, SIDALE funds the full-range of antiretroviral services for people living with HIV/AIDS, including the cost of medication as well hospital personnel and related expenses. SIDALE also funds testing and counseling services.

SIDALE has given Hôpital Sacré Coeur the resources to provide meaningful care to people living with HIV/AIDS in the Milot region and make real strides in controlling the spread of the disease.

Community education remains a key component of HIV/AIDS prevention.

In 2012, there were in excess of 12,000 visits to Hôpital Sacré Coeur’s Antiretroviral Clinic and more than 8,100 people received HIV testing and counseling services (either at the hospital in Milot or one of Hôpital Sacré Coeur’s community clinics), 2,300 of whom were pregnant women.

Along with providing high-quality care to people living with HIV/AIDS and reducing the prevalence of the disease, SIDALE’s other important objective is to strengthen Haiti’s healthcare system by making strategic investments in proficiency training, laboratory infrastructure, electronic medical records and other essential hospital systems.

The clinical laboratory at Hôpital Sacré Coeur has been a major recipient of support from SIDALE.

In addition to providing equipment and reagents, CMMB has made training of laboratory staff a priority for SIDALE. Subject Matter Experts and technicians from the University of Maryland’s Institute of Human Virology, a SIDALE partner, are a regular presence in the Hôpital Sacré Coeur laboratory where they conduct trainings and work with their Haitian counterparts to implement best practices.

Information technology systems, including electronic medical records, are a focus area for CMMB and SIDALE. Hôpital Sacré Coeur is receiving technical support, software and equipment through SIDALE to improve recordkeeping at the hospital. SIDALE’s IT partner has begun work at Hôpital Sacré Coeur to install and operationalize a reliable and user-friendly IT system to manage all records for HIV/AIDS patients. Once implemented for SIDALE, this system can be expanded to other services within the hospital.

Photo Courtesy Jeff Rhode/Holy Name Medical CenterCMMB has also invested SIDALE resources to make much needed improvements to Hôpital Sacré Coeur’s physical plant.

In September, work will begin on Hôpital Sacré Coeur’s new outpatient clinic. This facility will cost roughly $400,000 and will replace several temporary structures, including tents, to consolidate the hospital’s entire clinic place in one state-of-the-art structure. CMMB has committed to contribute more than $70,000 from SIDALE funds to this project.

CMMB has also committed $35,000 of SIDALE funds to acquire a medical waste incinerator for the hospital. At present, all hospital waste is burned in an open pit located across the street from the hospital building in the general services compound. This has long been a concern for hospital staff and the CMMB/SIDALE investment will improve sanitation and air quality at Hôpital Sacré Coeur.

By any reasonable measure, PEPFAR has been an historic success. Indeed, the program achieved a breathtaking milestone this year. Today, more than 1 million HIV-free babies have been born to mothers with the virus thanks to interventions organized and funded
by PEPFAR worldwide. PEPFAR is up for reauthorization this year and, unfortunately, the future for programs like SIDALE is somewhat uncertain.

The HHS PEPFAR participating agencies, including the Centers for Disease Control and Prevention and the Health Resources and Services Administration, are all seeing major budget reductions that may very well impact SIDALE. Only time will tell whether SIDALE and Hôpital Sacré Coeur’s HIV/AIDS program will continue to be funded by PEPFAR. But regardless of funding, the dire need for programs offering HIV/AIDS care and treatment at Hôpital Sacré Coeur will remain a sad fact for many years to come.