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.

No description available

Viral hepatitis is a major cause of disease and death globally. To mark World Hepatitis Day (July 28th) we present a selection of recent MSF research exploring how to effectively deploy powerful medical tools that could turn the tide on hepatitis C and E—but now reach only a tiny fraction of people who desperately need them, especially in low-resource and emergency settings. For hepatitis C, where groundbreaking new antiviral drugs can cure nearly all patients, MSF is piloting simplified, community-based models of care that offer rapid screening, diagnosis, and treatment under one roof. Some programs focus on the complex needs of highly vulnerable, hard-to-reach populations, such as people co-infected with HIV or TB or who inject drugs. Turning to prevention, an ongoing vaccination campaign against hepatitis E in an outbreak setting is showing early signs of short-term protection. Final results from this South Sudanese refugee camp, where poor sanitation and water quality regularly lead to outbreaks, should help plug a key evidence gap that—along with other barriers discussed in a commentary article—impedes widespread uptake of the vaccine.