RURAL HAITIANS ARE VANGUARD IN AIDS BATTLE
By Celia W. Dugger

November 30, 2003 – (NYT) In the cool mist of daybreak, hundreds of villagers fanned out across the forsaken reaches of this nation's remote interior, fording rivers swollen by torrential rains, slogging through muddy cornfields and clambering up slippery mountainsides to reach people sickened by AIDS.

At each home, they handed out the little white pills that have brought their neighbors, wasted by the disease, back to robust life.

"If the medicines weren't here, I'd be dead," said Manesse Gracia, 39, a mother of six who was plump in a workday dress the color of orange sherbet. "My children would live in destitution. My husband is a farmer, but the earth gives back nothing."

Mrs. Gracia is part of a pioneering program run here by a Boston-based nonprofit group, Partners in Health, that has become an influential model in the frenetic global race to expand drug treatment in dozens of poor countries.

More than two decades into the pandemic, 22 million people have died of AIDS, and 40 million people are infected with H.I.V., the virus that causes AIDS. Millions will perish next year unless they get the medicines.

"Bringing antiretroviral therapy to all who need it is the most medically challenging task that the world has ever taken on," said Dr. Richard Feachem, executive director of the Geneva-based Global Fund to Fight AIDS, Tuberculosis and Malaria.

The fund has approved $800 million for AIDS treatment, but that is only enough to supply antiretroviral drugs to just 700,000 people in five years.
The World Bank is increasing support, and the United States Congress is close to appropriating about $2 billion, more than half of it for treatment.
No program to treat people in the poorest countries has more intrigued experts than the one started in Haiti by Partners in Health — which has succeeded by enlisting help from hundreds among Haiti's vast pool of unemployed and underemployed workers.

It is the rainy season now. So each morning and evening, 700 villagers strike out across dirt roads turned into a morass of mud and dung to deliver medicines to people with AIDS and tuberculosis. They tramp through muck and wade through streams on foot; a lucky few sit atop mules or donkeys.

Margareth Guerrier, wearing a jaunty, broad-brimmed hat, set out on a recent morning from her small concrete house, threading her way past squatters' shacks up a steep, treacherously slick mountain.

At the top, she stopped at a small house and took the AIDS medicines from a black case slung over her shoulder. A 9-year-old girl named Fanise, ready for school in a navy dress, swallowed her pills dutifully as her grandmother looked on.

Then Mrs. Guerrier walked on to deliver pills to another grandmother, two mothers and a father. "There were some among them who seemed more dead than alive," she said. "When they start taking their medicines, they get better."

The AIDS treatment program here, one of the first of its kind in the world, was started by Dr. Paul Farmer, an American, and the group he founded, Partners in Health. It began giving antiretroviral drugs to patients here in 1999, when such efforts were virtually unknown.

"We didn't do it to be a model program," said Dr. Farmer, 44, a Harvard medical professor and anthropologist, who is also the subject of a recent book, "Mountains Beyond Mountains," by Tracy Kidder. "We did it because people were croaking."

Adeline Merçon, who tested positive for H.I.V. in 1991, took a terrible turn for the worse in 1999. When Dr. Farmer hiked through jagged hills to her home, he found her bedridden and withered to about half her usual weight. Her father drew him outside to the rickety stoop and showed him the planks he had gathered to build her coffin.

Dr. Farmer promised to return with medicines to save her. Back in Boston, he scavenged drugs from AIDS patients, doctors and clinics. Partners in Health bought more with money donated by Thomas J. White, a retired Boston businessman, and raised yet more cash by selling its headquarters in Cambridge.

From: http://www.nytimes.com/2003/11/30/international/americas/30HAIT.html