Medicine and public health

The crude mortality rate (CMR) is one of the most widely used indicators at MSF and the humanitarian sector to evaluate the severity of a health crisis within a given population. It is widely recognized that a CMR equal to or greater than one death per 10,000 persons a day signifies an emergency situation requiring an immediate response. However, the usage of the standard emergency threshold as “1/10,000/day” is very questionable: it goes against the official recommendations endorsed by humanitarian organizations and ignores the worldwide decline in mortality rates over the last 30 years.

An article entitled "Médecines du corps noir" [Medicine and the black body], published on the La vie des idées website on 27 April, discusses three American history books on the origins of medicine in the United States in the context of slavery in the 18th and 19th centuries. Between experimentation and resistance, the history of relationships between race and health illustrates the decisive role played by African slaves.    

A selection of books chosen by members of Crash. Happy summer and happy reading !

Michaël Neuman's review of "Medical Humanitarianism: Ethnographies of practice" edited by Sharon Abramowitz and Catherine Panter-Brick (Philadelphia: University of Pennsylvania Press, 2015)

The question of quality in the work of Médecins Sans Frontières has been asked from the very beginning of MSF's existence. On the one hand, the issue of improving the quality of practice is a part of ordinary professional activity; on the other hand, Médecins Sans Frontières' work involved working in distant lands and very specific environments, which demanded adjustments to medical practice as a result.

If MSF has held a preponderant position in the response to the Ebola crisis, it owes it just as much to its intervention capacities as to its capacity for criticism. The following article by Jean-Hervé Bradol embodies perfectly the latter in pointing to the issues that appeared on the occasion of this epidemic.

The Drugs for Neglected Diseases initiative (DNDi) and other researchers, including MSF-Crash Dr. Jean Hervé Bradol, report a persistent deficiency in truly new therapeutics for neglected diseases, despite nominal progress and an acceleration in research and development (R&D) efforts. 

In the 1980s, a global commitment was made to eradicate polio in the wake of the eradication of smallpox. As far as the world health community was concerned, this successful experience made it an example model on which to base future campaigns against infectious diseases.

Our survey bears something of a resemblance to a study carried out by Vanja Kovacic in Homa Bay, Kenya, in which she investigated patients’ disease coping mechanisms and their “dependence on medical institutions”.

Three years after it occurred, Haiti's cholera epidemic is still in the news.

In this chronicle "Alternatives Internationales", Rony Brauman discusses the return of using community health workers as primary access points for healthcare, in the recommendations of the WHO and practices of some governments.

Epidemiological studies estimate that nearly nine million people were suffering from active tuberculosis (TB) in 2010, causing upwards of one and a half million deaths. More than 90% of these deaths took place in low- or middle-income countries, thus reinforcing an old idea that TB and poverty are strongly linked.