• Data Sharing in a Humanitarian Organization: The Experience of Médecins Sans Frontières

      Karunakara, Unni (Public Library of Science, 2013-12-10)
      Open data and data sharing are essential for maximizing the benefits that can be obtained from institutional and research datasets [1]. In 2012, the medical humanitarian organization Me´decins Sans Frontieres (MSF) decided to adopt a data sharing policy for routinely collected clinical and research data (http://www.msf.org.uk/msf-data-sharing). Here we describe the policy’s principles, practicalities,and development process. We hope this paper will encourage and help other humanitarian and nongovernmental organizations to share their data with public health researchers for the benefit of the populations with which they work.
    • Demand Forecasting and Order Planning for Humanitarian Logistics: An Empirical Assessment

      van der Laan, E; van Dalen, J; Rohrmoser, M; Simpson, R (Elsevier, 2016-07-15)
      Humanitarian aid organizations are most known for their short-term emergency relief. While getting aid items to those in need can be challenging, long-term projects provide an opportunity for demand planning supported by forecasting methods. Based on standardized consumption data of the Operational Center Amsterdam of Médecins Sans Frontières (MSF-OCA) regarding nineteen longer-term aid projects and over 2000 medical items consumed in 2013, we describe and analyze the forecasting and order planning process. We find that several internal and external factors influence forecast and order planning performance, be it indirectly through demand volatility and safety markup. Moreover, we identify opportunities for further improvement for MSF-OCA, and for humanitarian logistics organizations in general.
    • DFID's health strategy.

      Ooms, G; Ford, N; MSF Brussels (Elsevier, 2007-08-25)
    • The 'diagonal' approach to Global Fund financing: a cure for the broader malaise of health systems?

      Ooms, G; Van Damme, W; Baker, B; Zeitz, P; Schrecker, T; Médecins Sans Frontières Belgium, Dupréstraat 94, 1090 Brussels, Belgium. gorik.ooms@brussels.msf.org. (2008)
      ABSTRACT: BACKGROUND: The potentially destructive polarisation between 'vertical' financing (aiming for disease-specific results) and 'horizontal' financing (aiming for improved health systems) of health services in developing countries has found its way to the pages of Foreign Affairs and the Financial Times. The opportunity offered by 'diagonal' financing (aiming for disease-specific results through improved health systems) seems to be obscured in this polarisation.In April 2007, the board of the Global Fund to fight AIDS, Tuberculosis and Malaria agreed to consider comprehensive country health programmes for financing. The new International Health Partnership Plus, launched in September 2007, will help low-income countries to develop such programmes. The combination could lead the Global Fund to fight AIDS, Tuberculosis and Malaria to a much broader financing scope. DISCUSSION: This evolution might be critical for the future of AIDS treatment in low-income countries, yet it is proposed at a time when the Global Fund to fight AIDS, Tuberculosis and Malaria is starved for resources. It might be unable to meet the needs of much broader and more expensive proposals. Furthermore, it might lose some of its exceptional features in the process: its aim for international sustainability, rather than in-country sustainability, and its capacity to circumvent spending restrictions imposed by the International Monetary Fund. SUMMARY: The authors believe that a transformation of the Global Fund to fight AIDS, Tuberculosis and Malaria into a Global Health Fund is feasible, but only if accompanied by a substantial increase of donor commitments to the Global Fund. The transformation of the Global Fund into a 'diagonal' and ultimately perhaps 'horizontal' financing approach should happen gradually and carefully, and be accompanied by measures to safeguard its exceptional features.
    • Dilemmas in Access to Medicines: a Humanitarian Perspective

      Smith, J; Aloudat, T (Elsevier, 2017-03-11)
    • Discrimination in the Discretionary Points Award Scheme: Comparison of White with Non-white Consultants and Men with Women.

      Esmail, A; Abel, P; Everington, S; Medical Practitioners Union, MSF Centre, London EC1V 8HA. aneez.esmail@man.ac.uk (Published by: BMJ Publishing Group Ltd, 2003-03-29)
    • Disparity in Market Prices for Hepatitis C Virus Direct-Acting Drugs

      Andrieux-Meyer, Isabelle; Cohn, Jennifer; de Araújo, Evaldo S Affonso; Hamid, Saeed S (Elsevier, 2015-11)
    • Do Aid Agencies Have an Ethical Duty to Comply with Researchers? A Response to Rennie.

      Zachariah, R; Janssens, V; Ford, N; Médecins sans Frontières, 68 Rue de Gasperich, L-1617, Gasperich, Luxembourg. rony.zachariah@brussels.msf.org (2006-05)
      Medical AID organisations such as Médecins Sans Frontières receive several requests from individuals and international academic institutions to conduct research at their implementation sites in Africa. Do AID agencies have an ethical duty to comply with research requests? In this paper we respond to the views and constructed theories (albeit unfounded) of one such researcher, whose request to conduct research at one of our sites in the Democratic Republic of Congo was turned down.
    • Do we need a world health insurance to realise the right to health?

      Ooms, G; Derderian, K; Melody, D; Médecins Sans Frontières, Brussels, Belgium. gorik.ooms@brussels.msf.org (Public Library of Science, 2006-12)
    • Does ratification of human-rights treaties have effects on population health?

      Palmer, Alexis; Tomkinson, Jocelyn; Phung, Charlene; Ford, Nathan; Joffres, Michel; Fernandes, Kimberly A; Zeng, Leilei; Lima, Viviane; Montaner, Julio S G; Guyatt, Gordon H; et al. (2009-06-06)
      Human-rights treaties indicate a country's commitment to human rights. Here, we assess whether ratification of human-rights treaties is associated with improved health and social indicators. Data for health (including HIV prevalence, and maternal, infant, and child [<5 years] mortalities) and social indicators (child labour, human development index, sex gap, and corruption index), gathered from 170 countries, showed no consistent associations between ratification of human-rights treaties and health or social outcomes. Established market economy states had consistently improved health compared with less wealthy settings, but this was not associated with treaty ratification. The status of treaty ratification alone is not a good indicator of the realisation of the right to health. We suggest the need for stringent requirements for ratification of treaties, improved accountability mechanisms to monitor compliance of states with treaty obligations, and financial assistance to support the realisation of the right to health.
    • Don't Spin the Pen: Two Alternative Methods for Second-Stage Sampling in Urban Cluster Surveys.

      Grais, R; Rose, A; Guthmann, J P P; Epicentre, 8, rue Saint Sabin, 75011 Paris, France. rebecca.grais@epicentre.msf.org (Published by BioMed Central, 2007)
      In two-stage cluster surveys, the traditional method used in second-stage sampling (in which the first household in a cluster is selected) is time-consuming and may result in biased estimates of the indicator of interest. Firstly, a random direction from the center of the cluster is selected, usually by spinning a pen. The houses along that direction are then counted out to the boundary of the cluster, and one is then selected at random to be the first household surveyed. This process favors households towards the center of the cluster, but it could easily be improved. During a recent meningitis vaccination coverage survey in Maradi, Niger, we compared this method of first household selection to two alternatives in urban zones: 1) using a superimposed grid on the map of the cluster area and randomly selecting an intersection; and 2) drawing the perimeter of the cluster area using a Global Positioning System (GPS) and randomly selecting one point within the perimeter. Although we only compared a limited number of clusters using each method, we found the sampling grid method to be the fastest and easiest for field survey teams, although it does require a map of the area. Selecting a random GPS point was also found to be a good method, once adequate training can be provided. Spinning the pen and counting households to the boundary was the most complicated and time-consuming. The two methods tested here represent simpler, quicker and potentially more robust alternatives to spinning the pen for cluster surveys in urban areas. However, in rural areas, these alternatives would favor initial household selection from lower density (or even potentially empty) areas. Bearing in mind these limitations, as well as available resources and feasibility, investigators should choose the most appropriate method for their particular survey context.
    • The drug and vaccine landscape for neglected diseases (2000-11): a systematic assessment.

      Pedrique, Belen; Strub-Wourgaft, Nathalie; Some, Claudette; Olliaro, Piero; Trouiller, Patrice; Ford, Nathan; Pécoul, Bernard; Bradol, Jean-Hervé (2013-12-01)
      In 1975-99, only 1·1% of new therapeutic products had been developed for neglected diseases. Since then, several public and private initiatives have attempted to mitigate this imbalance. We analysed the research and development pipeline of drugs and vaccines for neglected diseases from 2000 to 2011.
    • Drug development for neglected diseases: a deficient market and a public-health policy failure.

      Trouiller, P; Olliaro, P; Torreele, E; Orbinski, J; Laing, R; Ford, N; Centre Hospitalier Universitaire, BP 217, 38043 Grenoble cedex 9, France. PTrouiller@chu-grenoble.fr (Elsevier, 2002-06-22)
      There is a lack of effective, safe, and affordable pharmaceuticals to control infectious diseases that cause high mortality and morbidity among poor people in the developing world. We analysed outcomes of pharmaceutical research and development over the past 25 years, and reviewed current public and private initiatives aimed at correcting the imbalance in research and development that leaves diseases that occur predominantly in the developing world largely unaddressed. We compiled data by searches of Medline and databases of the US Food and Drug Administration and the European Agency for the Evaluation of Medicinal Products, and reviewed current public and private initiatives through an analysis of recently published studies. We found that, of 1393 new chemical entities marketed between 1975 and 1999, only 16 were for tropical diseases and tuberculosis. There is a 13-fold greater chance of a drug being brought to market for central-nervous-system disorders or cancer than for a neglected disease. The pharmaceutical industry argues that research and development is too costly and risky to invest in low-return neglected diseases, and public and private initiatives have tried to overcome this market limitation through incentive packages and public-private partnerships. The lack of drug research and development for "non-profitable" infectious diseases will require new strategies. No sustainable solution will result for diseases that predominantly affect poor people in the South without the establishment of an international pharmaceutical policy for all neglected diseases. Private-sector research obligations should be explored, and a public-sector not-for-profit research and development capacity promoted.
    • Drugs for 'neglected diseases': a bitter pill.

      Veeken, H; Pécoul, B; Médecins sans Frontières, Amsterdam, The Netherlands. hansvveken@amsterdam.msf.org (Wiley-Blackwell, 2000-05)
    • Drugs for neglected diseases: a failure of the market and a public health failure?

      Trouiller, P; Torreele, E; Olliaro, P; White, N J J; Foster, S; Wirth, D; Pécoul, B; Centre Hospitalier Universitaire de Grenoble, Grenoble, France. (Wiley-Blackwell, 2001-11)
      Infectious diseases cause the suffering of hundreds of millions of people, especially in tropical and subtropical areas. Effective, affordable and easy-to-use medicines to fight these diseases are nearly absent. Although science and technology are sufficiently advanced to provide the necessary medicines, very few new drugs are being developed. However, drug discovery is not the major bottleneck. Today's R&D-based pharmaceutical industry is reluctant to invest in the development of drugs to treat the major diseases of the poor, because return on investment cannot be guaranteed. With national and international politics supporting a free market-based world order, financial opportunities rather than global health needs guide the direction of new drug development. Can we accept that the dearth of effective drugs for diseases that mainly affect the poor is simply the sad but inevitable consequence of a global market economy? Or is it a massive public health failure, and a failure to direct economic development for the benefit of society? An urgent reorientation of priorities in drug development and health policy is needed. The pharmaceutical industry must contribute to this effort, but national and international policies need to direct the global economy to address the true health needs of society. This requires political will, a strong commitment to prioritize health considerations over economic interests, and the enforcement of regulations and other mechanisms to stimulate essential drug development. New and creative strategies involving both the public and the private sector are needed to ensure that affordable medicines for today's neglected diseases are developed. Priority action areas include advocating an essential medicines R&D agenda, capacity-building in and technology transfer to developing countries, elaborating an adapted legal and regulatory framework, prioritizing funding for essential drug development and securing availability, accessibility, distribution and rational use of these drugs.
    • Duty of care and health worker protections in the age of Ebola: lessons from Médecins Sans Frontières

      McDiarmid, M; Crestani, R (BMJ Publishing Group, 2019-08-31)
      Health workers were differentially infected during the 2014 to 2016 Ebola outbreak with an incidence rate of 30 to 44/1000 depending on their job duties, compared to the wider population’s rate of 1.4/1000, according to the WHO. Médecins Sans Frontières (MSF) health workers had a much lower incidence rate of 4.3/1000, explained as the result of MSF’s ‘duty of care’ toward staff safety. Duty of care is defined as an obligation to conform to certain standards of conduct for the protection of others against an unreasonable risk of harm. The duty of care was operationalised through four actions: performing risk assessments prior to deployment, organising work and work practices to minimise exposure, providing extensive risk communication and training of staff and providing medical follow-up for staff exposures. Adopting and consistently enforcing these broader, duty of care safety policies in deployed teams augments and fortifies standard infection prevention practices, creating a more protective, comprehensive safety programme. Prioritising staff safety by taking such actions will help avoid the catastrophic loss of the health work force and assist in building resilient health systems.
    • Ebola: a failure of international collective action

      Philips, Mit; Markham, Áine (Elsevier, 2014-09-10)
    • Educating Nurses in Resource-Poor Areas

      Defranciscis, J (Australian Nursing and Midwifery Federation, 2017-07)
      Jai Defranciscis is an Australian nurse with a passion for paediatrics and education in resource-poor settings. Last year she joined the international medical aid organisation M decins Sans Fronti res (MSF) - also known as Doctors Without Borders - heading to South Sudan for a year, working with refugees fleeing fighting between armed groups. This is her account.