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Estrella Lasry: A more holistic response to malaria is overdue

22 Apr, 16 | by BMJ

World Malaria Day 2016

Since the early 2000s the world has seen considerable success in the fight against malaria, with a significant decrease in overall numbers of cases and deaths. But this success is uneven: there are still contexts where the toll of malaria is worsening and seasonal spikes in patient numbers are getting higher. Teams at projects run by Médecins Sans Frontières (MSF) saw particularly high peaks in 2012, 2014, and 2015—largely in the most difficult to reach areas of Democratic Republic of Congo (DRC), Central African Republic (CAR), and South Sudan, but also in countries like Uganda and Mali, which have stronger health systems. more…

Jay Achar: Drug resistant tuberculosis—not just a precursor to the post-antibiotic apocalypse

24 Mar, 16 | by BMJ

Jay_AcharIn 2015 the world woke up to the idea that the spread of antimicrobial resistance (AMR) will ultimately lead to a post-antibiotic era in which even simple medical treatments will cease to be possible.

Over the past decade the infectious disease medical community has looked on in horror as NDM-1 (New Delhi metallo-beta-lactamase-1—an enzyme rendering bacteria resistant to many antibiotics) has spread across the globe, causing havoc wherever it is detected. Furthermore, last year the first plasmid-meditated resistance mechanism to the antibiotic colistin, active against gram-negative bacteria, was identified in Chinese animals and humans. Since plasmids are efficient vehicles for the rapid transfer of resistance between bacteria, this is a huge threat to the last line of defence against gram-negative infections. more…

Grania Brigden: Step up to stop TB

2 Dec, 15 | by BMJ

Grania Brigden_2015Grania Brigden discusses the findings of the Out of Step report on national tuberculosis (TB) policies. The report is being launched on 2 December at the 46th Union World Conference on Lung Health, Cape Town, South Africa.

TB is winning a deadly race—this year it overtook HIV as the world’s deadliest infectious disease, killing 1.5 million people annually. How has a curable disease won such a title? One reason is the gaps that exist in the TB response. more…

Helen Bygrave: More people, more time, better data—what we need to “treat all” with HIV

1 Dec, 15 | by BMJ

msflogoOn World AIDS Day and with the ICASA conference ongoing, Helen Bygrave discusses the implications of the recently announced World Health Organization (WHO) “treat all” policy.

On the back of the headline studies Temprano, START, and new data from HPTN 052, the WHO recently announced the “treat all” policy: everyone diagnosed with HIV should start antiretroviral therapy (ART), regardless of their immunological status. So no more hanging around waiting for people to get sick and transmit the virus, we now crack right on and start the right medication for the right disease. Great news, we all say, as pre-ART follow-up was an undeniable disaster and the new policy may further simplify how we get treatment to those in need, especially in low coverage or unstable settings. But what are the implications of a policy that increases the number of people now eligible for ART to 37 million? more…

An MSF nurse recounts the horror of the aerial bombardments in Kunduz

5 Oct, 15 | by BMJ

msf_kunduz_hospMSF nurse Lajos Zoltan Jecs was in Kunduz trauma hospital when the facility was struck by a series of aerial bombing raids in the early hours of Saturday morning. He describes his experience.

“It was absolutely terrifying.

I was sleeping in our safe room in the hospital. At around 2am I was woken up by the sound of a big explosion nearby. At first I didn’t know what was going on. Over the past week we’d heard bombings and explosions before, but always further away. This one was different—close and loud. more…

Alison Criado-Perez: From an insecure and dangerous present to an unknown future

16 Sep, 15 | by BMJ

OLYMPUS DIGITAL CAMERAIt’s 10.30pm on board the Phoenix, the search and rescue vessel in the Mediterranean run jointly by @MOAS (Migrant Offshore Aid Station) and @MSF. I joined a few days ago, in a mid-sea midnight transfer. Before I go to bed, I go up on the darkened foredeck and remember how it looked yesterday, packed with people crammed together on their blankets after having been rescued. I wonder how and where they are now, what the future holds for them, these 415 people from 20 different countries, among them Syrians, Eritreans, Somalis and Iraqis? They disembarked this morning in Taranto, Italy, their hopes high, thinking the worst was over. But what problems still lie ahead of them as they seek refuge from their war-torn, repressive, or poverty-stricken countries? more…

Helen Bygrave: Simple but elusive—why are we still talking about HIV drug delivery?

20 Jul, 15 | by BMJ

msflogoAs the International AIDS Society (IAS) Conference takes place in Vancouver, Canada (July 19-22), Helen Bygrave of MSF discusses her frustrations with the lack of implementation of simple, programmatic strategies for improving HIV care.

My main memory of the last IAS conference that I attended, held in Vienna in 2010, was a resounding standing ovation for a presentation (including this video) by one of my colleagues working in Mozambique. In a situation where antiretroviral therapy (ART) had not been extensively decentralised, and where drug supply limitations meant people had to attend a clinic every month to pick up their drugs, a simple idea had transformed the way that patients received their HIV care. In short, people living near each other had got together and agreed to take it in turns to pick up each other’s drugs. This resulted in less time spent at the clinic and lower transport costs for patients and an immediate reduction in workload for clinic staff. more…

Áine Markham: Dismantling gains in global health?

13 Jul, 15 | by BMJ

aineThis month signals a critical moment for the future of global health financing as high-level political representatives meet in Addis Ababa for the Third International Conference on Financing for Development to discuss how the new Sustainable Development Goals (SDGs) will be funded. Current trends in stagnating spending on aid and a finance-driven rhetoric risk abandoning the achievements of recent decades. more…

MSF Scientific Day 2015: A conference without borders

6 May, 15 | by BMJ

msf_scientific_dayAt the time of writing, the west Africa Ebola epidemic at last appears to be under control, and, as the response is scaled down, there is more capacity within Médecins Sans Frontières (MSF) to begin to appraise the evidence collected, technological approaches trialled, and lessons learned. Much of the analysis is yet to come—the work that will be presented at the 2015 MSF Scientific Day on 7 and 8 May is an early snapshot across some of the most important areas of uncertainty in the response. more…

Grania Brigden: Time for a jumpstart—accelerating access to new and promising DR-TB drugs

23 Mar, 15 | by BMJ

Conflict effect on population. Donetsk region, Ukraine JAN 2015World TB Day is an opportunity to reflect on the progress that has been made in beating this ancient disease. At first glance, the news looks good: two new drugs—the first in decades—have been registered for hard-to-treat multidrug-resistant tuberculosis (MDR-TB) and the global rate of new cases of MDR-TB has remained stable at 3.5%.

However, appearances can be deceptive. While the global rate of MDR-TB is stable, on closer examination the data are not complete; many parts of the world are dealing with a serious and growing MDR-TB crisis. In some countries, including Belarus, Kyrgyzstan, and Kazakhstan, up to 35% of people diagnosed with TB for the first time already have MDR-TB, and more than 70% of patients previously treated for TB now have MDR-TB. more…

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