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In 1987, members of the Carter Center's Council of Presidents and Prime Ministers of the Americas, an informal group of current and former leaders from the Western Hemisphere, met to discuss the electoral process in Haiti. A presidential candidate had been assassinated, which threatened to undermine the entire process. Former U.S. President Jimmy Carter, former Belize Prime Minister George Price, and Dr. Robert Pastor, then director of the Center's Latin America and Caribbean Program (formerly known as the Americas Program), flew to Haitito try to steer the elections back on track. They succeeded at the time, but in December, the military intervened and prevented the election.

In July 1990, the council was invited by President Ertha Pascal-Trouillot and opposition leaders to monitor the election. President Jean-Bertrande Aristide won in Haiti's first credible election in its history, but less than a year later, he was overthrown in a military coup.

The Carter Center became actively involved in assisting the international community to restore constitutional government to Haiti. 

In September 1994, when President Carter was asked by Haitian General Raoul Cédras to help avoid a U.S. military invasion of Haiti. President Carter relayed this information to President Clinton, who asked him to undertake a mission to Haiti with Sen. Sam Nunn, D-Ga., and former Joint Chiefs of Staff Chairman Colin Powell. The team successfully negotiated the departure of Haiti's military leaders, paving the way for the restoration of Jean-Bertrande Aristide as president.

In February 1995, the negotiating team returned to Haiti to assess the country's progress. Their visit focused on the transfer of authority from American-led forces to the United Nations and on preparations for parliamentary and presidential elections. They found signs of progress but warned of pitfalls that could mar the June 1995 elections.

Visiting Haiti during the June 1995 election, The Carter Center found the vote flawed by technical and administrative problems, and its results were widely disputed.

The Carter Center was again called on after the 2000 elections to serve as adviser to  a Caribbean Community and Organization of American States mission seeking solutions to an impasse on disputed election results and to develop plans to fortify Haiti's democratic institutions.

Although Latin America and the Caribbean spend relatively less on defense than most other regions, expenditures on expensive weapons systems divert scarce foreign exchange from more effective investments, including education. They also compel neighbors to spend more on defense and, by doing so, generate international tensions. Concerned about an arms race in Latin America, the Carter Center's Council of Presidents and Prime Ministers of the Americas urged governments in the region to pause before embarking on major arms purchases. Between April 1997 and March 1998, 28 current and 14 former heads of government signed a written pledge to accept a moratorium of two years on purchasing sophisticated weapons. Among the signatories was Haiti President René Preval.

The island of Hispaniola, shared by Haiti and the Dominican Republic, 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. The Carter Center's Hispaniola Initiative works with the ministries of health in Haiti and the Dominican Republic to accelerate the elimination of malaria and lymphatic filariasis 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.

In Haiti, the entire population (11.1 million) is at risk of malaria. Of the nearly 87,000 cases of malaria reported in Hispaniola in 2010, 97% occurred in Haiti. Most areas of Haiti are also at risk for lymphatic filariasis transmission.

The Carter Center began work on Hispaniola in September 2008. 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 Haiti, cases of malaria have steadily declined from 84,153 cases in 2010 to 9,340 cases in 2019 (an 89% decline). All areas at risk for lymphatic filariasis have received five or more rounds of mass drug administration, and 86% of those areas no longer require treatment.

The Haitian and Dominican ministries were awarded the in 2017 for their commitment to their binational project.