While noting the difficult situation experienced by the country, the Committee notes with deep concern that the Government’s reports, which have been due since 2013, have not been received. In light of the urgent appeal made to the Government in 2019, the Committee is proceeding with the examination of the application of the Conventions on the basis of the information at its disposal.

In order to provide a comprehensive view of the issues relating to the application of the ratified Conventions on social security, the Committee considers it appropriate to examine Conventions Nos 12 (workers’ compensation, agriculture), 17 (workers’ compensation, accidents), 24 (sickness insurance, industry), 25 (sickness insurance, agriculture) and 42 (revised, workers’ compensation, occupational diseases) together.

Article 1 of Conventions Nos 12, 17 and 42, application in practice. Guaranteeing effective coverage and the right of workers and their dependants to compensation in the event of employment accidents and occupational diseases. In its previous comments, the Committee noted that most agricultural workers are excluded from the scope of application of social security legislation, including the Act of 28 August 1967 establishing the Employment Injury, Sickness and Maternity Insurance Office (OFATMA), due to the absence of formal agricultural enterprises. The Committee also noted difficulties in the application of the legislation, even in relation to workers in the formal economy. Moreover, the Confederation of Public and Private Sector Workers (CTSP), in its observations received in 2019, alleges that the legislation in force does not cover apprentices and that, in practice, municipal and State workers and domestic workers are not covered by employment accident insurance.

In this regard, the Committee observes that, according to the information contained in the National Social Protection and Promotion Policy (PNPPS) adopted by the Government in April 2020, employment accident and occupational disease insurance only covers the formal economy, and mainly workers in the textile and apparel industries. The Committee also notes from the PNPPS, that these industries are still characterized by a high rate of non-conformity with occupational safety and health standards (an average of 76.5 per cent), even though there is a high risk of accidents. Indeed, the last report of the OFATMA, published in 2014–15, and quoted in the PNPPS, indicates that 2,522 employment accidents were processed (2,030 men), 42 per cent of which were in the textile and apparel industries and in construction. According to the same report, employment accident benefits, paid to 1,365 persons, amounted to HTG 17.6 million. In the agricultural sector, the PNPPS reports that 94.7 per cent of the workers are paid below the minimum wage and that the work is still principally informal.

Finally, the Committee notes with concern the indications contained in the PNPPS that the OFATMA does not cover occupational diseases, as required by the law.

On the basis of the information at its disposal, the Committee is bound to conclude that the significant gaps in coverage reported previously by the Government continue to exist and that the great majority of workers in Haiti, and their dependants, are not covered by compensation in the event of employment accidents and occupational diseases, and that effect is not therefore given to Article 1 of Conventions Nos 12, 17 and 42. However, the Committee notes that, with a view to remedying the gaps in protection, the PNPPS sets as a specific objective the protection of all men and women workers against the risks of employment injury and economic dependence related to invalidity as a result of an employment accident, as well as cases of occupational diseases, through the extension of insurance within the framework of the reform of social security institutions. With reference to the coverage of agricultural workers, the PNPPS provides for insurance subsidies for livelihoods as a financial support mechanism for the resilience of self-employed workers and small enterprises and undertakings in the agricultural and fishing sectors.

Observing that the objectives of the PNPPS are in line with the objectives of Conventions Nos 12, 17 and 42, and that the measures envisaged will reinforce the application of Article 1 of these Conventions, the Committee requests the Government to provide information on the progress achieved in their implementation, and particularly with reference to the extension of coverage of compensation for employment accidents and occupational diseases to the workers covered by these Conventions. The Committee also requests the Government to provide information on any other measures adopted or envisaged to ensure the effective entitlement of these workers to compensation in the event of employment accidents and occupational diseases.

Articles 1, 2 and 6 of Conventions Nos 24 and 25. Establishment of a system of compulsory sickness insurance for the effective protection of workers and their families in the event of sickness. In its previous comments, the Committee noted the Government’s intention to continue its efforts to progressively establish a sickness insurance branch covering the whole of the population. In this regard, the Committee emphasized the need to the Government to envisage as a priority the establishment of mechanisms to provide the population as a whole, including workers in the informal economy and their families, with access to basic health care and to a minimum income in cases where their earnings capacity is affected as a result of sickness, an employment accident or an occupational disease, and it drew attention to the relevance of the guidance provided in this regard in the Social Protection Floors Recommendation, 2012 (No. 202).

The Committee notes the information contained in the PNPPS reporting the limited coverage of social protection, with the exception of sickness insurance, with 500,000 persons being covered directly by the OFATMA. The Committee notes that, despite the existence of sickness insurance, the PNPPS indicates that the sick, and particularly the poorest, make very little use of health services because of the high cost of direct payments for health care, which are paid by users, and the prevalence of private profit-making institutions in the provision of health care and services. The Committee recalls in this respect that Conventions Nos 24 and 25 require the establishment of a system of compulsory sickness insurance (Article 1) for the provision of medical care and sickness benefits to all manual and non-manual workers, including apprentices, employed in industrial, commercial and agricultural undertakings, as well as homeworkers and domestic workers (Article 2), and medical benefit for members of their families, as appropriate (Article 5). Article 6 of the Conventions adds that sickness insurance shall be administered by self-governing institutions under the administrative and financial supervision of the public authorities and shall not be carried out with a view to profit, and that private institutions must be specially approved by the public authorities.

As it emphasized in previous comments, and taking into account the situation experienced in Haiti, the Committee considers that it is still necessary for the Government to envisage as a priority the establishment of mechanisms to provide the population as a whole, including workers in the informal economy and their families, with access to basic health care and a minimum income when their earnings capacity is affected as a result of sickness, an employment accident or occupational disease, in line with the guidance contained in Recommendation No. 202. In this regard, while reiterating its concern at the absence of a Government report, the Committee takes due note that, according to the information contained in the PNPPS, health insurance is currently being set up progressively, with a view to the extension of coverage to self-employed workers in the informal economy on the basis of a subsidy which would make it possible to collect contributions from workers, in accordance with their contributory capacity.

In light of the above, the Committee requests the Government to report on the progress achieved in extending statutory and effective coverage of compulsory sickness insurance and the sickness insurance scheme to workers in Haiti and the members of their families, as appropriate, and any specific measures taken for this purpose.

Article 8, in conjunction with Articles 6, 7, 10 and 11 of Convention No. 17, and Article 6 of Conventions Nos 24 and 25. Responsibility of the State for the establishment, control and administration of the compensation scheme for employment accidents and sickness insurance. The Committee notes the allegations made by the CSTP, in its 2019 observations, according to which there are failings in the application of several Articles of Convention No. 17, due to problems related to the management and organization of the OFATMA. The CSTP indicates, more specifically, that: (i) Article 6 of Convention No. 17 is not applied in practice due to the delays in the provision by the OFATMA of the benefits payable as from the fifth day: (ii) the additional compensation required by Article 7 of the Convention is not paid; (iii) the supply and renewal of artificial limbs and surgical appliances, envisaged in Article 10 of the Convention, is not implemented; and (iv) the payment of compensation to workers who are victims of accidents and their dependants is not ensured in the event of the insolvency of the employer or insurer, as required by Article 11 of the Convention, due to the very weak system for the enforcement of the legislation. The CSTP also alleges a lack of transparency in the administration of the OFATMA. Finally, the CSTP alleges that the Board of Directors of Social Security Organizations (CAOSS), a tripartite body administering State social protection and social security institutions, is dysfunctional, which is affecting the methods of controlling employment accidents. In view of the above, the CSTP therefore emphasizes the need to deal at a higher level in a framework of social dialogue, with ILO support, with the situation of tripartite social protection and social security bodies, while carrying out actuarial studies and audits of the OFATMA and discussing once again a deep-rooted reform of the Ministry of Social Affairs and Labour (MAST). The Committee also notes the information provided by the Confederation of Haitian Workers (CTH) and the Confederation of Public and Private Sector Workers (CSTP) to the International Trade Union Confederation (ITUC), and received in 2020, indicating that, in practice, contributions are not paid to the social security system by employers or the authorities and that workers who dare to present claims are dismissed.

The Committee notes that the Decent Work Country Programme (DWCP) 2015–20, approved by the ILO tripartite constituents, should have resulted in the reform of the social security legislation, as well as an improvement in the effectiveness of the contributions system and the sound operation of the tripartite administration of social protection institutions. The Government also made a commitment in this framework to strengthen the role and technical capacities of the CAOSS, the National Office of Old-Age Insurance (ONA), the OFATMA and other key institutions with a view to the progressive extension of social protection coverage. The Committee notes that these objectives are taken up, at least in part, in the 2020 PNPPS, which indicates that the provisions of social security laws and regulations will be extended with a view to rationalizing the administration of schemes that is currently undertaken by several institutions and facilitating the transfer of the rights of contributors. The strengthening of the CAOSS is also planned alongside the reforms of the ONA and the OFATMA envisaged in the PNPPS in relation to social protection. The Committee observes that these objectives are in line with the improved application of Article 6 of Conventions Nos 24 and 25 and Article 8 of Convention No. 17 which establish, respectively, the responsibility of the State for the administration of sickness insurance schemes and for the adoption of the measures of supervision necessary for the effective implementation of employment accident compensation schemes.

In light of the above, the Committee expresses the firm hope that the objectives set out in the DWCP and the PNPPS in relation to the strengthening of social security and social protection institutions and their sound governance will be achieved and emphasizes the importance of social dialogue in this respect. It requests the Government to provide information on any progress achieved in this respect. In particular, the Committee requests the Government to report any measures adopted or envisaged to improve the administration of social security bodies and institutions, the collection of contributions and in general to ensure the establishment in practice of social insurance schemes, particularly for employment accidents and occupational diseases, in conformity with Article 8 of Convention No. 17 and Article 6 of Conventions Nos 24 and 25.

The Committee has been informed that, based on the recommendations of the Standards Review Mechanism Tripartite Working Group (SRM Tripartite Working Group), the Governing Body has decided that Member States for which Conventions Nos 17 and 42 are in force should be encouraged to ratify the Employment Injury Benefits Convention, 1964 [Schedule I amended in 1980] (No. 121), and/or the Social Security (Minimum Standards) Convention, 1952 (No. 102), and accept the obligations in its Part VI (GB.328/LILS/2/1). Member States for which Conventions Nos 24 and 25 are in force should be encouraged to ratify the Medical Care and Sickness Benefits Convention, 1969 (No. 130), and/or the Social Security (Minimum Standards) Convention, 1952 (No. 102), and accept the obligations in its Parts II and III. Conventions Nos 121, 102 and 130 reflect the more modern approach to employment injury benefit and medical care and sickness benefit. The Committee therefore encourages the Government to follow up the Governing Body’s decision at its 328th Session (October–November 2016) approving the recommendations of the SRM Tripartite Working Group and to consider ratifying Convention No. 121 and/or Convention No. 102 (accepting the obligations in Part VI), and Convention No. 130 and/or Convention No. 102 (accepting the obligations in Parts II and III), as the most up-to-date instruments in these subject areas.

The Committee reminds the Government of the possibility to avail itself of ILO technical assistance in relation to the matters raised above.