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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…

Christmas Appeal: Hitting the ground running—surgical transfer in South Sudan

20 Jan, 15 | by BMJ

Lanice JonesI arrived in Juba, the capital of South Sudan, on 2 January for two whirlwind days of being briefed on my new role as medical specialist in Yida refugee camp, which is at the northern edge of South Sudan. On Sunday, my rest day before flying north, I was asked to help arrange care for a young boy who was arriving by MSF plane from a project not far from my own.

Lanice Jones, MSF medical specialist © Lanice Jones/MSF more…

Christmas Appeal: The 12 days of constructing an Ebola management centre

12 Jan, 15 | by BMJ

OLYMPUS DIGITAL CAMERASunday: As soon as you touch down in Freetown, Sierra Leone, Ebola hits you—or the awareness of it. Health forms to fill in, chlorine handwashes before you even enter the terminal building, zapped with a temperature gun before you step outside.

Public health messages and precautions continue throughout the city: big posters announcing that “Ebola is Real so ABC: Avoid Body Contact!” dominate the main thoroughfares. Chlorine handwashes are at the entrance to restaurants and supermarkets—but even so, I’m careful not to touch the doors with my hand. Even as medics, we have never been so clean, so hygiene aware. And we’re all getting acclimatised to the no touch policy: no touching even among the team, no handshaking when you meet someone. Instead, a crossed arm against your chest. more…

Christmas Appeal 2014: A silent hunger

23 Dec, 14 | by BMJ

Nikola MortonI have been in Pakistan for six months, two thirds of the way through my nine month mission. Before working in Pakistan, I had spent some time working in the north of Australia with the Aboriginal community. In the Northern Territory of Australia, there is a big issue with malnutrition in the Aboriginal population, especially in the remote communities. Having worked there for some time, I thought it would prepare me for working here . . . but it does not even compare. more…

Christmas Appeal 2014: Gibson Chijaka—I cannot hold back my joy

19 Dec, 14 | by BMJ

Gibson_Chijaka_grandmotherMy name is Gibson Chijaka, and for the last two years I have endured dozens of nauseating tablets every day. Today, I am so happy and cannot hold back my joy; I am cured of multidrug-resistant tuberculosis (MDR-TB).

Me with my grandmother, Margaret Kadzere, October 2014. © Stambuli Kim/MSF more…

Christmas Appeal 2014: An intensive care unit in a conflict zone

12 Dec, 14 | by BMJ

MSF OCA Staff PortraitsTwo people with gunshot wounds are brought to the MSF hospital in Leer. They were at a celebration the previous evening when someone entered and started shooting. Five people were seriously injured. Two of them managed to reach our hospital, but the other three died on the way. more…

Thomas Nierle and Bruno Jochum: MSF should not replace governmental responsibilities on Ebola

9 Dec, 14 | by BMJ

Thomas Nierle_2Bruno Jochim_2MEP Charles Goerens, rapporteur on Ebola to the European Parliament’s Committee on Development, recently declared in a European Council meeting that this epidemic is “the first major international crisis in which the lead should be given to an NGO [non-governmental organisation]—in this case, Médecins Sans Frontières.”

Given that we have repeatedly called for greater leadership from the international community, including the European Union, this proposal took us by surprise. We have interpreted this appeal, coming from an MEP who has also publicly criticised the inadequate reactions of European states in the face of the epidemic, as a symptom of the failure of existing public response mechanisms and, even more so, of the huge collective difficulty in taking action. more…

Christmas Appeal 2014: Benjamin Black on Ebola through his eyes

5 Dec, 14 | by BMJ

Benjamin BlackWhen I begin each day I feel like I know what to expect. I have been in and out of west Africa since June, and watched this sad story developing both as a direct witness on the inside, and as an observer from afar when back home.

In the Ebola treatment centre where I work, I always go to look at the large board of patients’ names at the start of my day. How many have died overnight, and how many will be discharged to singing and clapping as “cured?” more…

Grania Brigden: Mind the deadly gaps in the TB response

11 Nov, 14 | by BMJ

grania_brigdenThe 45th Union World Conference on Lung Health, recently held in Barcelona, opened with the health ministers of South Africa and India making bold commitments to address and reverse the tuberculosis epidemics in their countries. Five other countries also committed to ending TB, resulting in the birth of the Barcelona Declaration on TB.

This political commitment is desperately needed. The recently published World Health Organization Global TB Report 2014 highlighted not only the increasing number of cases, but also the growing crisis in tackling drug resistant TB. The reality for those infected with multidrug resistant TB (MDR-TB) is that they have only a one in eight chance of being identified, correctly diagnosed, started on treatment, and cured. This is not acceptable. more…

The price of joining the middle income country club: reduced access to medical innovation

10 Oct, 14 | by BMJ

When people think about medical humanitarian aid, the usual association is with war zones and natural disasters, and the assumption is that the most critical medical needs are concentrated in the world’s poorest countries. That’s mostly right, but not entirely.

While the needs of low income countries remain huge, there are large—and growing—populations excluded from access to healthcare who now live in countries classified as middle income countries (MIC). This shift presents enormous challenges, particularly in accessing new lifesaving drugs and vaccines for diseases that take a disproportionately high toll on poor, marginalized populations. more…

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