ÉTUDE DE BASE : Pont aérien humanitaire pour Haïti

BASELINE STUDY: Haiti Humanitarian Air Bridge February 6, 2023 Program Overview In October 2022, the ongoing humanitarian situation in Haiti worsened dramatically with the addition of the first cholera outbreak in the country in nearly three years. As a result of this emergency, healthcare systems have become overwhelmed with increasing numbers of cholera patients. Aid agencies have struggled to get humanitarian aid to the island owing to transport costs and escalating gang violence. The usual sea-focused supply chains for medicines and medical supplies have become severely constrained due to the main seaport’s closure and ongoing gang violence that has made transit between the ports and their program areas difficult; many containers with needed programmatic supplies have been stuck at the seaport for months due to the blockades. At the same time, air charter prices have increased 160 percent in the last six years (with the offloading cost alone increasing by 600% to more than $30,000 USD) and airfreight rates are at an all-time high ($3.50/kg from the US and $5.90/kg from the EU). Many NGOs have been left without viable, affordable options to send the large amounts of supplies necessary to sustain the emergency response as well as their ongoing programs. In view of the emergency in Haiti, as a result of the aforementioned challenges, Airlink and the United States Agency for International Development Bureau for Humanitarian Assistance (USAID/BHA) stood up the Haiti humanitarian air bridge (Haiti HAB) to provide cargo flights from the US and Europe to Port-au-Prince, Haiti. The goal of the program was to address the significant logistics challenges related to delivering health and water, sanitation, and hygiene (WASH) supplies used in the treatment and prevention of cholera. The program has launched 5 flights totaling over 230 metric tons of health, WASH, and food assistance. Through a combination of private sector donations from aviation and logistics companies and leveraging economies of scale through charter flights to help the aid community gain access to fast, free transportation, Airlink has added more than $450,000 in value to the supply chain and helped 8 aid agencies and their in-country partners, including Hopital Universitaire de la Paix, DINEPA, and PAHO, reach affected populations with critical aid supplies. In total, the project has saved the aid community more than $1M in transportation costs, thanks to the combination of USAID/BHA funding and Airlink’s private sector airline partners and corporate and foundation donors — at a time when air freight costs are at their highest and sea freight continues to be nonviable due to security challenges. Through responses from the NGO community collected in our baseline study regarding ongoing logistical challenges with Haitian seaports (also submitted with this application), Airlink has been urged to continue the project until April 31, 2023. This will support lingering health- and WASH-related needs in the country resulting from and exacerbated by the cholera outbreak, as well as providing a predictable transition between Airlink’s air service and a resumption of their sea freight pipelines. Data Collection Methods In January, Airlink convened a call with its NGO partners and other air bridge participants to understand the ongoing need for airlift. Representatives from NGOs Convoy of Hope, Food For The Poor, GlobalMedic, Heart to Heart International, Heart Equity International, IMA World Health, Konbit Sante, Off The Grid Missions, Partners in Health, and Water with Blessings were present. Data was collected on partners’ ongoing and planned activities, current challenges, and desire for the air bridge to continue. Call notes from this meeting can be found in Annex 1. Following this call, Airlink disseminated a survey in English and French to its LAC regional community (42 organizations); this survey was also shared with Haiti Logistics Sector Working Group Members and members of the Pan-American Development Foundation for their feedback. Airlink has received 17 responses over the course of one week, with more responses still being received daily. Study Findings Transportation challenges: The survey asked respondents to identify challenges related to the cost and availability of modes of transport, availability of necessary items in the country, and challenges faced in program delivery once goods are received at the ports in Haiti. Key findings are as follows: ● 81% reported challenges related to the cost of airfreight ● 62% reported challenges with long customs clearance processes at Lafito port and other seaports ● 62% reported challenges with low stock of necessary supplies in the country, leading them to procure internationally ● 56% reported a total inability to procure necessary supplies, leading them to procure internationally ● 56% reported an inability to secure bookings on commercial airfreight Some NGOs remarked that sea freight was also costly and difficult to procure, but that the main drivers behind the choice to use airfreight were the inability to clear customs at the seaport (see above) and the inability to safely transport shipments from the port to program sites (94% of respondents), making sea freight nonviable. Local availability of goods: Some NGOs remarked in a free-text section of the survey that the cost of goods that were available to procure locally continues to rise, making international procurement more cost-effective as long as the air bridge is available. Despite receiving some recent reports that suggest WHO/PAHO facilities have sufficient in-country stock of lactated ringers and infection prevention and control (IPC) supplies, during Airlink’s January coordination call, some NGOs reported continued stock-outs of IV fluids and other health supplies at their facilities. NGO community need for HAB Program continuation: When asked if discontinuation of the air bridge program at this time would negatively impact partners’ programs, 81% of respondents answered affirmatively. The following are offered as additional testimonials on the necessity of the air bridge program and negative impact of discontinuation: - “The high cost of goods and difficulty of obtaining safe transport would limit access to any and all supplies needed for treatment and prevention of cholera infections.” - Global Birthing Home Foundation - “Without the help of Airlink, our lifesaving work in Haiti would be severely compromised. Air cargo shipping via Airlink means that we can more quickly get desperately needed household water filtration systems to communities that are threatened by waterborne cholera. The significant savings incurred allows us to bring in more equipment, thereby saving more Haitian children and their families.” - Water With Blessings - “Given the current situation of insecurity, the fragility of the local market and the lack of response from government agencies (Customs), the import of goods will suffer a very high price increase and will make it impossible for us to meet the objectives set out our program.” - Project HOPE - “The backlog of containers makes it difficult and unreliable to send health-related items by sea, and the items’ weight make them costly to ship by air. Transportation was especially difficult when ports closed, making the HAB program critical in supplying programs.” - Partners in Health - “Currently there is a big backlog of containers at the ports awaiting clearance that, along with the challenges listed above, will continue to exacerbate the situation on the ground. The loss of the program will negatively impact our organization and our partners in reducing the amount of lifesaving resources available causing the cholera outbreak to increase. We are also at risk of losing donations earmarked for Haiti from the inability to secure transportation to the country resulting in the donated goods being diverted to organizations in other countries. If the airbridge program stops, it would affect us in terms of safety, time, and money.” - Food for the Poor Haiti Respondents were asked to approximate their usage of the air bridge if service continued through spring 2023. 77% of respondents reported that they would utilize the air bridge in the next 3 months. In total, the estimated pipeline in the event of the program’s extension is approximately 193 metric tons, including WASH, health, and food supplies to support cholera response and recovery. Prevailing conditions in Haiti Aid agencies have struggled to send aid supplies to the country owing to transport costs and escalating gang violence. The usual sea-focused supply chains for medicines and medical supplies have become severely constrained due to the main seaport’s closure and ongoing gang violence that has made transit between the ports and their program areas difficult; many containers with needed programmatic supplies have been stuck at the seaport for months due to the blockades. At the same time, air charter prices have increased 160 percent in the last six years (with the offloading cost alone increasing by 600% to more than $30,000 USD) and commercial airfreight rates are at an all-time high ($3.50/kg from the US and $5.90/kg from the EU); lead times to book commercial cargo even at these rates can be lengthy. Many NGOs have been left without viable, affordable options to send the large amounts of supplies necessary to sustain the emergency response as well as their ongoing programs. This situation has remained unchanged since the beginning of the air bridge in November 2022. One thing that has changed, however, is the security situation that organizations face as they attempt to transport supplies from the main seaport in Port-au-Prince to their warehouses and program sites. In early February, Airlink received the following security update from one of the Haiti HAB participant organizations: “[Our country team is] reporting that two of their drivers were caught and later released by armed men returning from the Port of CPS last Wednesday, February 1st. They were transporting a container to the [country office’s] facility when they were stopped at gun point. By some miracle they came out of the situation unharmed, and the container was not taken. However, they are distressed and due to security concerns, [country office] has halted operations to the ports for the time being. We are further grateful for the Airbridge program because it has facilitated the ability to receive goods to our partners through safer platforms.” The most recent PAHO report from January 30, 2023, indicates that Haiti is seeing an overall decline from peak positivity rates in November and December. However, during the week of January 28, PAHO reported week-over-week increases in the numbers of suspected cases, confirmed cases, and deaths. As of the end of January, all 10 departments still have confirmed cases. The ongoing situation in Haiti must be factored into both the assessment of the cholera situation and the need for ongoing support via the air bridge program. In the aforementioned report, PAHO notes: “Epidemiological surveillance is affected due to the complex humanitarian and security crisis, added to the limited access to fuel throughout the country, resulting in limited access to health services and laboratories. Moreover, most of the population in the country is in a highly vulnerable situation in the face of established cholera transmission chains in the departments and municipalities. The humanitarian crisis and insecurity have exacerbated in recent months. This has considerably undermined the efforts of the MSPP and other organizations to implement prevention and control measures, including epidemiological surveillance, leading to underreporting of cases.” In this report, PAHO also urges Member States to continue to support the cholera surveillance, treatment, and care programs, as well as supporting access to adequate basic sanitation and clean drinking water for the people of Haiti in order to avert another spike in cases. Conclusions The survey results and verbal feedback received from NGOs during coordination calls and one-on-one consultations indicate that the air bridge continues to play an important role in the delivery of cholera supplies. Testimonials from NGO partners indicate a need for Airlink and USAID/BHA to continue to support transportation for necessary WASH, health, and food supplies. Furthermore, the January 31 PAHO report describes a complex crisis in which the organization’s November 2022 recommendations of “a coordinated multidisciplinary approach…for prevention, preparedness, and response” that includes “the implementation of prevention activities in the medium and long term” must continue to be followed to ensure an end to this cholera outbreak. In light of the PAHO report, as well as the consultations Airlink has conducted with partners and the ongoing pipeline of supplies requested by the NGO community, the organization will apply for additional funding to support the continuation of the air bridge.