New tools and approaches to drug-resistant TB

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.

The climate crisis is also a health and humanitarian crisis, disproportionately impacting people in the world’s most climate-sensitive regions—mainly low- and low-middle income countries with the least capacity to respond. MSF and other humanitarian organizations witness the consequences daily. More frequent, intense weather events and a warming planet contribute to food and water scarcity, more severe and widespread disease outbreaks, and more injuries and preventable deaths. They also drive massive population displacement, with over 32 million people fleeing their homes in 2022 alone due to floods, drought, storms and fire—nearly triple the number displaced by violence and conflict. As global leaders convene in Dubai for the UN climate conference (COP28, 30 Nov-12 Dec 2023) we present this cross-section of work by MSF and collaborators, drawing from first-hand experience at our medical projects. Emphasizing the urgency of adapting humanitarian operations to the climate crisis, the collection also explores loss and damage through a health lens, proposes policies and practices for creating climate-resilient health organizations, and advocates for embedding fair, just ethics perspectives into humanitarian action and research on climate.