Epicentre Scientific Day Paris 2023

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.

Resistance to antibiotics is a growing public health crisis, especially in countries with fragile health systems and in regions at war. The World Health Organization has estimated that antibiotic-resistant bacteria caused nearly 1.3 million deaths in 2019, a toll that will increase significantly in the coming years if effective action is not taken. To mark World Antimicrobial Awareness Week 2022 (18-24 November) we present a snapshot of MSF’s recent work on responding to this growing threat. Since many humanitarian settings lack laboratory capacity to diagnose these infections, MSF and partners have developed two new technologies with the potential to dramatically expand the availability of accurate diagnosis—allowing clinicians to then tailor antibiotic treatment accordingly. Other work from diverse contexts describes practices and challenges related to optimizing rational antibiotic use within health facilities and communities. Lastly, several studies characterize the patterns and prevalence of antibiotic resistance among MSF patients, from hospitalized neonates in Central African Republic to acute trauma patients in Haiti and Yemen.

Resistance to antibiotics is a growing public health crisis, especially in countries with fragile health systems and in regions at war. One key limitation in most of these settings is a lack of clinical bacteriology laboratory capacity, which leaves medical providers without ways to accurately diagnose patient infections and to tailor antibiotic treatment accordingly. To help fill this critical gap, MSF and partners have developed the Mini-Lab—a small-scale, standalone lab that is easy to transport, set up and operate by staff after only a short training. Its six modules are stocked with everything needed to diagnose common bloodstream and urinary tract infections and to perform antibiotic sensitivity testing using methods adapted to extremely hot climates and remote settings. With Mini-Lab now being rolled out to selected MSF projects, here we highlight the background to its development and some of the research behind the bacteriological tests it incorporates.