Adapting essential care programs to Covid-19 pandemic times

As the ongoing Covid-19 pandemic grips the world, one of its most devastating indirect effects is the disruption to medical services for preventing and treating other life-threatening diseases—especially in countries with already-fragile health systems. For MSF and other global health actors this means not only responding to Covid-19 directly but also assessing its impact on other essential care and then adapting programs so they can keep serving patients despite the enormous obstacles.

In this Collection you will find a selection of published articles and conference content from this year’s MSF Scientific Days 2021 conference content, encompassing a range of approaches, settings and medical challenges—from malaria, TB and HIV/AIDS prevention and care to digital health promotion and sexual and reproductive health.

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The endTB project

The endTB project aims to find shorter, less toxic and more effective treatments for ‘multidrug-resistant TB’ (MDR-TB) through:

access to new drugs
two clinical trials
advocacy at national and global levels

Covering 18 countries, the project is a partnership between Partners In Health, Médecins Sans Frontières, Interactive Research & Development and financial partners Unitaid and the Transformational Investment Capacity (TIC) of MSF. This collection contains the final and intermediate results of the studies, advocacy reports, and study presentations. For more information about the endTB project, visit https://endtb.org/.

Diabetes affect hundreds of millions of people worldwide, a large majority of them living in low- and middle-income countries. Yet finding effective strategies, tools and policies for effectively managing this chronic illness—especially amid war, displacement or exclusion from care—is a neglected area of humanitarian medicine. Here we present a cross-section of work on this front by MSF and collaborators. Several studies assess the shift towards community-based, nurse-led models of care in rural settings. Others explore obstacles to diabetes care for war refugees living in camps in Jordan or Lebanon, highlighting how health programs can adapt to their needs. The demonstration that insulin retains potency for 30 days if cooled without refrigeration is opening doors to more patient self-management, as a case study in remote South Sudan shows. At the same time, MSF and others call for regulatory and financing policies that make diabetes medications and supplies cheaper, better adapted to humanitarian settings, and far more available to patients whose lives depend on them.

Unsafe abortion is a major cause of maternal death, and the only one that is completely preventable. Yet over 30 million unsafe abortions occur each year, leading to at least 29,000 deaths and millions of serious complications—nearly all in low- and middle-income countries. MSF teams see these tragic consequences first-hand, treating thousands of patients every year with severe, potentially life-threatening effects from unsafe abortion.

To mark International Safe Abortion Awareness Day (28 September 2024), this Collection presents highlights of MSF’s work on safe abortion care (SAC) as a way to reduce maternal death and injury. By re-assessing and reshaping how our projects deliver SAC in fragile and conflict-affected settings, we have been able to significantly expand services in those contexts and across MSF projects globally. In parallel, we also conducted in-depth studies of abortion complications and their contributing factors in fragile settings, where a dearth of evidence limits understanding of women's needs in accessing comprehensive care. These findings are helping to identify gaps in service delivery and inform operational decision-making.

BACKGROUND
'Tele-Mental Health (MH) services' are an increasingly important way to expand care to underserved groups in low-resource settings. In order to continue providing psychiat...

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The endTB project

Diabetes care in humanitarian settings

Safe abortion care at MSF

TACTiC - Implementation du nouvel algorithme oms pour le diagnostic de la tuberculose pulmonaire chez les enfants au Niger

Shifting to tele‑mental health in humanitarian and crisis settings: an evaluation of Médecins Sans Frontières experience during the COVID‑19 pandemic

Impact of COVID-19 on HIV/ AIDS service delivery in Philippines and Pakistan

Video/Virtually Observed Therapy for patients with drug-resistant tuberculosis in Eswatini: a rapid response to COVID-19 lockdown measures

Overcoming lockdown restrictions by digitising health promotion

Feasibility of large-scale mass drug administration for malaria in Angumu health zone, Ituri, Democratic Republic of Congo

Tuberculosis preventive therapy for children and adolescents: an emergency response to the COVID-19 pandemic

Now is the time: a call for increased access to contraception and safe abortion care during the COVID-19 pandemic