Source: "A time to sow"
Quick recap on Haitian history. Current president is Jovenal Moise, who succeeded "Sweet Micky" Martelly in February of 2017 after a contested November 2016 election. Haiti has undergone 18 regime changes since Duvalier left in 1986.
From the article: "A small business elite has supported fragile governments in exchange for low taxes and oligopolistic control of key industries, keeping the economy uncompetitive and obliging the government to finance itself through regressive taxes on imports. Perennially short both of cash and professional civil servants, the state has failed to provide infrastructure, the rule of law and services such as health and education. The earthquake made the weak state even weaker, killing many civil servants and destroying their records. Most Haitians who have escaped poverty have done so by emigrating. Many of those who stay resort to crime. Violent protests are common, sometimes toppling presidents and starting the vicious cycle anew."
More Haiti facts: their GDP per person has declined 40% since 1981. The 2012 earthquake killed 200,000 people. Infrastructure is falling apart. Example: the Artibonite Valley, capable of growing enough rice to feed all Haitians, has lain fallow since 2015 when marsh grasses clogged the irrigation and drainage canals in the valley.
Moise is using a utilitarian approach to prioritize reforms. The Copenhagen Consensus Center (CCC) with a $2 million grant from the Canadian government, scored and ranked proposed reforms by their return-on-investment. Example: cholera epidemic kills 10,000 in 2010. By looking at ROI, it is determined that vaccinating just schoolchildren will have a better result than trying to vaccinate the entire population. It will be cheaper, easier to manage and once vaccinated, the schoolchildren will be sufficient in number to achieve herd immunity. This schoolchildren-only approach has a benefit-to-cost ratio of 6.
More from CCC: fortifying the flour in Haiti would save 150 infants a year and prevent 250,000 cases of anaemia at very little cost. It has an ROI of almost $25, meaning that for every $1 in cost, Haiti gets $25 in benefits. Also high up, training more first responders and improving access to contraception.