Expanding access to lifesaving new TB tools

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.

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.