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Â鶹´«Ã½ has observed several presidential elections in the Dominican Republic and assisted a historic 18-month binational initiative to accelerate the elimination of malaria and lymphatic filariasis from the island of Hispaniola, which the country shares with Haiti.
Â鶹´«Ã½, in conjunction with the National Democratic Institute, has monitored numerous elections in the Dominican Republic, including the presidential elections in 1990, a presidential election runoff in 1996, and a free and much-improved election in May 2000.
A joint mission between Â鶹´«Ã½ and the National Democratic Institute praised the May 2000 elections after Dominicans went to the polls in numbers rarely matched by other nations in the Western Hemisphere. The administration of the elections was enhanced by a new, modernized registry and by verification of the registry prior to the election. The delegation noted that partisan selection of the supreme election authorities by the Senate led to citizen allegations of partisanship throughout the process. In addition, the delegation observed that some voters were unable to vote, abandoned their effort to vote, or could not travel to newly assigned polling sites and that others left without voting due to a long voting process in cramped sites.
The 1996 presidential election was seen as an important step in the consolidation of democracy after the Pact for Democracy, signed in 1994 by President Joaquin Balaguer and opposition parties, called for a new voting procedure, a new presidential election in two years, and a runoff election should no candidate win a majority. Former U.S. President Jimmy Carter and former Colombia President Belasario Betancur led a pre-election mission to the country in April 1996 and returned for a runoff June 30 in which Leonel Fernandez won.
Â鶹´«Ã½'s 1990 observer mission heard many questioning the election and the vote count, although the delegation did not receive adequate evidence of irregularities that would have affected the outcome, which was a narrow victory for President Joaquin Balaguer.
In September 2008, Â鶹´«Ã½, in partnership with the Dominican Republic and Haiti, launched a historic initiative to help the two countries and their other partners accelerate the elimination of two mosquito-borne infections ― malaria and lymphatic filariasis ― from Hispaniola, the last repository of these devastating diseases in the Caribbean. As long as lymphatic filariasis and malaria exist on any part of these two nations’ shared island, these diseases will threaten the rest of the Caribbean with tragic human and economic consequences.
The island of Hispaniola, shared by the Dominican Republic and Haiti, remains the only island in the Caribbean with active malaria transmission. It also accounts for approximately 95% of the lymphatic filariasis burden in the Western Hemisphere. Â鶹´«Ã½'s Hispaniola Initiative works with the ministries of health in the Dominican Republic and Haiti to accelerate the elimination of malaria and lymphatic filariasis from Hispaniola.
The initiative stems from a 2006 recommendation of the Â鶹´«Ã½'s International Task Force for Disease Eradication that it is "technically feasible, medically desirable, and would be economically beneficial" to eliminate these two diseases from Hispaniola. The persistence of malaria on the island poses a risk of reintroduction in the other Caribbean islands, a threat of infection to foreign visitors to Hispaniola, and a loss of productivity, investment, and tourism revenue for Haiti and the Dominican Republic.
Malaria is transmitted throughout the year in the Dominican Republic (population 10.4 million). Areas along the border with Haiti and in rural areas with high concentrations of migrant laborers historically were at greatest risk for malaria. However, urban and peri-urban transmission in the capital, Santo Domingo, now accounts for the majority of cases. Nationwide baseline mapping for lymphatic filariasis completed in 2007 revealed three focal areas of transmission.
Â鶹´«Ã½ began work in Hispaniola in September 2008, when it launched an 18-month initiative in the adjacent communities of Ouanaminthe, Haiti, and Dajabon, Dominican Republic. The initiative brought together the ministries of health to help foster binational coordination for malaria control. As a result, the health ministries synchronized data systems, held binational meetings, distributed long-lasting insecticide-treated nets, and aligned protocols for malaria diagnostics and treatment. A year later, Haiti and the Dominican Republic announced a binational plan to eliminate malaria by 2020 (estimated cost $194 million), and Haiti announced a plan to eliminate lymphatic filariasis by 2020 (estimated cost $49 million).
In 2014, Â鶹´«Ã½ expanded its support by assisting with the programmatic reorientation from control to elimination of malaria, sponsoring an updated cost analysis of malaria and lymphatic filariasis elimination in Hispaniola, and continuing its support for strengthened binational cooperation. In the Dominican Republic, the Center also supported the launching of mass drug administration and transmission assessment surveys for lymphatic filariasis.
In the Dominican Republic, 1,314 cases of malaria were reported in 2019. This represents a 116% increase from the 494 cases in 2018 and is attributed to ongoing outbreaks in metropolitan Santo Domingo. All formerly endemic foci of lymphatic filariasis transmission in the Dominican Republic have met criteria to stop mass drug administration for lymphatic filariasis, and the country has entered post-treatment surveillance.
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