• 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.
    • Electronic clinical decision support algorithms incorporating point-of-care diagnostic tests in low-resource settings: a target product profile

      Pellé, KG; Rambaud-Althaus, C; D'Acremont, V; Moran, G; Sampath, R; Katz, Z; Moussy, FG; Mehl, GL; Dittrich, S (The British Medical Journal, 2020-02-28)
      Health workers in low-resource settings often lack the support and tools to follow evidence-based clinical recommendations for diagnosing, treating and managing sick patients. Digital technologies, by combining patient health information and point-of-care diagnostics with evidence-based clinical protocols, can help improve the quality of care and the rational use of resources, and save patient lives. A growing number of electronic clinical decision support algorithms (CDSAs) on mobile devices are being developed and piloted without evidence of safety or impact. Here, we present a target product profile (TPP) for CDSAs aimed at guiding preventive or curative consultations in low-resource settings. This document will help align developer and implementer processes and product specifications with the needs of end users, in terms of quality, safety, performance and operational functionality. To identify the characteristics of CDSAs, a multidisciplinary group of experts (academia, industry and policy makers) with expertise in diagnostic and CDSA development and implementation in low-income and middle-income countries were convened to discuss a draft TPP. The TPP was finalised through a Delphi process to facilitate consensus building. An agreement greater than 75% was reached for all 40 TPP characteristics. In general, experts were in overwhelming agreement that, given that CDSAs provide patient management recommendations, the underlying clinical algorithms should be human-interpretable and evidence-based. Whenever possible, the algorithm’s patient management output should take into account pretest disease probabilities and likelihood ratios of clinical and diagnostic predictors. In addition, validation processes should at a minimum show that CDSAs are implementing faithfully the evidence they are based on, and ideally the impact on patient health outcomes. In terms of operational needs, CDSAs should be designed to fit within clinic workflows and function in connectivity-challenged and high-volume settings. Data collected through the tool should conform to local patient privacy regulations and international data standards.
    • Embedding Telemedicine Quality Assurance Within a Large Organisation

      Wootton, R; Liu, J; Bonnardot, L (Elsevier We regret that this article is behind a paywall., 2016-06-15)
    • Ensuring access to life-saving medicines as countries shift from Global Fund support

      Tatay, M; Torreele, E (World Health Organization, 2019-05-01)
    • Evolving Human Rights and the Science of Antiretroviral Medicine

      Kavanagh, Matthew; Cohn, Jennifer; Mabote, Lynette; Meier, Benjamin Mason; Williams, Brian; Russell, Asia; Sikwese, Kenly; Baker, Brook (Harvard University Press, 2015-06-11)
      Recent years have seen significant advances in the science of using antiretroviral medicines (ARVs) to fight HIV. Where not long ago ARVs were used late in disease to prevent sick people from dying, today people living with HIV can use ARVs to achieve viral suppression early in the course of disease. This article reviews the mounting new scientific evidence of major clinical and prevention ARV benefits. This has changed the logic of the AIDS response, eliminating competition between "treatment" and "prevention" and encouraging early initiation of treatment for individual and public health benefit. These breakthroughs have implications for the health-related human rights duties of States. With medical advance, the "highest attainable standard" of health has taken a leap, and with it the rights obligations of States. We argue that access to early treatment for all is now a core State obligation and restricting access to, or failing to provide accurate information about, it violates both individual and collective rights. In a context of real political and technical challenges, however, in this article we review the policy implications of evolving human rights obligations given the new science. National and international legal standards require action on budget, health and intellectual property policy, which we outline.
    • Expenditure ceilings, multilateral financial institutions, and the health of poor populations.

      Ooms, G; Schrecker, T; Médecins Sans Frontières, Brussels, Belgium. (Elsevier, 2008-01-31)
    • Extractive resources and the Ebola economy

      Calain, Philippe (Oxford University Press, 2015-01-13)
    • The field is ever further: In search of the elusive space of fieldwork

      Stellmach, D (SAGE Publications, 2020-01-07)
      This short reflection considers how humanitarian workers conceptualize and practice “the field” as a site of action. Through the use of narrative ethnography, and drawing on comparisons with the practice of academic anthropology, it attempts to draw out disciplinary assumptions that govern how and where humanitarian action is undertaken. It demonstrates how the field is a central imaginary that underpins the principles and performance of both anthropology and humanitarian action. It highlights how the conceptualization of “the field” is itself a methodological tool in the practice of humanitarian intervention.
    • Fighting Poor-Quality Medicines in Low- And Middle-Income Countries: The Importance of Advocacy and Pedagogy

      Ravinetto, R; Vandenbergh, D; Macé, C; Pouget, C; Renchon, B; Rigal, J; Schiavetti, B; Caudron, JM (BioMed Central, 2016-11-10)
      The globalization of pharmaceutical production has not been accompanied by a strengthening and harmonization of the regulatory systems worldwide. Thus, the global market is characterized today by a situation of multiple standards, and patients in low- and middle-income countries are exposed to the risk of receiving poor-quality medicines. Among those who first raised the alarm on this problem, there were pioneering humanitarian groups, who were in a privileged position to witness the gap in quality of medicines between high-income countries and low- and middle-income countries. Despite an increasing awareness of the problem and the launch of some positive initiatives, the divide in pharmaceutical quality between the North and the South remains important, and insufficiently addressed. More advocacy is needed for universal access to quality-assured medicines. It should target all those who are strongly "involved" with medicines: regulators, international organizations, journalists, purchasers, prescribers, program managers, policy makers, public health actors and the patients. Advocacy should be based on evidence from research and monitoring programs, and technical concepts should be translated in lay language through communication tools that address all the stakeholders. The fight to ensure universal access to quality medicines needs the participation of all, and can only be successful if grounded in common understanding.
    • Financial access to health care in Karuzi, Burundi: a household-survey based performance evaluation.

      Lambert-Evans, Sophie; Ponsar, Frederique; Reid, Tony; Bachy, Catherine; Van Herp, Michel; Philips, Mit; Médecins Sans Frontières (Belgium), 94 rue Dupré, Brussels, Belgium. sophielambertevans@gmail.com. (2009-10-24)
      ABSTRACT: BACKGROUND: In 2003, Médecins Sans Frontières, the provincial government, and the provincial health authority began a community project to guarantee financial access to primary health care in Karuzi province, Burundi. The project used a community-based assessment to provide exemption cards for indigent households and a reduced flat fee for consultations for all other households. METHODS: An evaluation was carried out in 2005 to assess the impact of this project. Primary data collection was through a cross-sectional household survey of the catchment areas of 10 public health centres. A questionnaire was used to determine the accuracy of the community-identification method, households' access to health care, and costs of care. Household socioeconomic status was determined by reported expenditures and access to land. RESULTS: Financial access to care at the nearest health centre was ensured for 70% of the population. Of the remaining 30%, half experienced financial barriers to access and the other half chose alternative sites of care. The community-based assessment increased the number of people of the population who qualified for fee exemptions to 8.6% but many people who met the indigent criteria did not receive a card. Eighty-eight percent of the population lived under the poverty threshold. Referring to the last sickness episode, 87% of households reported having no money available and 25% risked further impoverishment because of healthcare costs even with the financial support system in place. CONCLUSION: The flat fee policy was found to reduce cost barriers for some households but, given the generalized poverty in the area, the fee still posed a significant financial burden. This report showed the limits of a programme of fee exemption for indigent households and a flat fee for others in a context of widespread poverty.
    • First round of payments from the Global Fund.

      Ellman, T; Ford, N; Brugha, R (2002-07-20)
    • French Polynesia: A Nuclear Paradise in the Pacific.

      Veeken, H; Médecins Sans Frontières Netherlands, Amsterdam. (Published by: BMJ Publishing Group Ltd, 1995-08-19)
    • The G8 and access to medicines: no more broken promises.

      Moran, M; Ford, N; Médecins Sans Frontières, EC1N 8QX, London, UK. (Elsevier, 2003-05-10)
    • Generic medicines are not substandard medicines.

      Ford, N; 't Hoen, E (Elsevier, 2002-04-13)
    • A Global Biomedical R&D Fund and Mechanism for Innovations of Public Health Importance

      Balasegaram, Manica; Bréchot, Christian; Farrar, Jeremy; Heymann, David; Ganguly, Nirmal; Khor, Martin; Lévy, Yves; Matsoso, Precious; Minghui, Ren; Pécoul, Bernard; et al. (Public Library of Science, 2015-05-11)
      Bernard Pécoul and colleagues call for the establishment of a global biomedical R&D fund as a key priority of the G7 summit in June 2015.
    • Global Framework on Essential Health R&D.

      Chirac, P; Torreele, E; Médecins Sans Frontières, 75544 Paris cedex 11, France. pierchir@club-internet.fr (Elsevier, 2006-05-13)
    • Global Health Education in Germany: An Analysis of Current Capacity, Needs and Barriers

      Kaffes, I; Moser, F; Pham, M; Oetjen, A; Fehling, M (BioMed Central, 2016-11-25)
      In times of increasing global challenges to health, it is crucial to create a workforce capable of tackling these complex issues. Even though a lack of GHE in Germany is perceived by multiple stakeholders, no systematic analysis of the current landscape exists. The aim of this study is to provide an analysis of the global health education (GHE) capacity in Germany as well as to identify gaps, barriers and future strategies.
    • The Global Health Fund: moral imperative or industry subsidy?

      Ford, N; 't Hoen, E; Médecins Sans Frontières, 124-132 Clerkenwell Road, EC1R 5DJ, London, UK. (11520549, 2001-08-18)
    • Global health training and postgraduate medical education in Australia: the case for greater integration

      Mitchell, Rob D; Jamieson, Jennifer C; Parker, Jake; Hersch, Fred B; Wainer, Zoe; Moodie, A Rob; Emergency Department, Townsville Hospital, Townsville, QLD, Australia. mitchell.rob@me.com (Australian Medical Association, 2013-04-01)
      Global health (GH) training is well established overseas (particularly in North America) and reflects an increasing focus on social accountability in medical education. Despite significant interest among trainees, GH is poorly integrated with specialty training programs in Australia. While there are numerous benefits from international rotations in resource-poor settings, there are also risks to the host community, trainee and training provider. Safe and effective placements rely on firm ethical foundations as well as strong and durable partnerships between Australian and overseas health services, educational institutions and GH agencies. More formal systems of GH training in Australia have the potential to produce fellows with the skills and knowledge necessary to engage in regional health challenges in a global context.