Medicine and public health

To address the political, economic and legal barriers to patients' access to life-saving treatments, MSF created, in 1999, the Access Campaign (the Campaign for Access to Essential Medicines). In these videos, Jean-Hervé Bradol, doctor and crash study director, answers questions from Andrea Bussotti (MSF-France Operational Communication Manager). In the light of the historical background of the early days of the Access Campaign, he analyses the medico-operational context of the Campaign today and asks himself the question of its objectives.

The study The Patient Perspective of Quality of Care: A Review of the Literature, which we present here was carried out by Hannah Barnett a public health student at George Washington University, intern with CRASH from June to August 2018. This work sums up seventy articles from a variety of disciplines including medicine and public health. It is part of a reflection initiated by MSF a few years ago on medical quality and the patient-centered approach.

Rebecca Grais, Research Director at Epicentre, MSF’s epidemiology arm, and Pierre Mendiharat, Deputy Director of Operations for MSF-France, offer their insights on the Ebola outbreak in North Kivu Province in the eastern Democratic Republic of the Congo (DRC). This joint interview in four parts (the outbreak, social context, treatments, and vaccination) aims to show how science and practice interact around each outbreak.

Philippe Lançon works as a journalist for the French satirical magazine, Charlie Hebdo, and Libération newspaper. His book, Le lambeau was published in April. As the author and subject of his narrative, he relates his experience as a hospital patient after surviving the terrorist attack against Charlie Hebdo during its editorial meeting on 7 January 2015. Although a “novice" when it comes to hospitals and operating theatres, he is a seasoned journalist. He is currently writing for Libération’s culture page, but previously reported on armed conflicts (Iraq and Somalia). So he’s no novice when it comes to casualties of war. In 2015, he became a reporter reporting on himself and on hospital surgery.

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.