MSF Fight Measles Epidemic In Malawi

FIGHTING MEASLES IN THE DEVELOPING WORLD

MSF are fighting a measles epidemic in Malawi. Click here to see how.

MEASLES

Every minute a child dies of measles. Even though a safe and effective vaccine exists, outbreaks occur in many parts of the world because routine immunisation programs are not in place or efficient. In many places Médecins Sans Frontières (MSF) teams are confronted with outbreaks and have to organise emergency immunisation campaigns, which represent a complex logistical challenge.

According to the World Health Organisation (WHO), out of the 30 million children affected by measles every year, about half a million die. Most of those deaths occur in Africa and Asia. This contrasts sharply with the Western world where measles cases have become extremely rare thanks to universal routine immunisation. This leads many people to forget that measles is a major killer.

Measles is highly contagious. Symptoms like runny nose, cough, eye infection, and rash appear about 10 to 14 days after exposure to the virus. There are different levels of severity, and deaths following measles infection are usually due to measles-related complications like diarrhoea, dehydration, and respiratory infections (pneumonia, croup). Those deaths can occur weeks after the acute disease and are not always attributed to measles. Mortality can reach 5 percent to 20 percent of measles cases. Initial health condition, access to health care, and proper treatment provision are factors influencing mortality.

2011 International Symposium on Reducing Child Mortality: Thinking outside the hospital for effective medical care

15/07/2011

In the lead-up to the 7th World Congress of the World Society for Paediatric Infectious Diseases held in Melbourne, Australia, Médecins Sans Frontières and Epicentre are hosting a one-day satellite symposium to re-think...

Category: Upcoming Events (Events), Lectures & Seminars

Médecins Sans Frontières welcomes initiative by UNICEF to make vaccine prices public

31/05/2011

Geneva, 27 May 2011— In a bid to increase transparency and stimulate competition to bring down the prices of vaccines needed in the developing world, UNICEF has decided to publish the prices it pays to vaccine manufacturers.

Category: Press releases

Zambia: Measles vaccination campaign underway to immunise 600,000 children

24/05/2011

Mansa, Zambia – Médecins Sans Frontières teams are currently working alongside the Zambian health authorities to carry out a measles vaccination campaign with a target of almost 600,000 children. Médecins Sans Frontières launched...

Category: Field news

Treating measles in a remote province of the Democratic Republic of Congo

17/05/2011

In March, the measles epidemic that has raged in the Democratic Republic of Congo (DRC) for more than six months reached the remote province of Maniema. Despite the logistical challenges, Médecins Sans Frontières teams are...

Category: Field news

Medical and humanitarian emergency continues as violence persists in Ivory Coast

27/04/2011

21 April 2011: The medical and humanitarian emergency in Ivory Coast persists as violence rages in several neighbourhoods in Abidjan, and security in the west of the country remains critically unstable, with populations hiding in...

Category: Field news

DR Congo: “Measles epidemic spiralling out of control” according to Médecins Sans Frontières

28/03/2011

Over the past six months a measles epidemic has been sweeping through the Democratic Republic of Congo (DRC). Médecins Sans Frontières is raising the alarm and calling for concerted action to halt the spread of the disease.

Category: Press releases

Visit Doctors Without Borders and fight Malaria - 

http://www.msf.org.au/rciyw/

Source: www.msf.org.au

MSF Press Release -31 March 2011

IVORY COAST: CIVILIANS MUST NOT BE TARGETED AND MUST HAVE ACCESS TO MEDICAL CARE
Ivory Coast / 01.04.11
PARIS/BRUSSELS, MARCH 31, 2011 – New outbreaks of fighting in Ivory Coast are severely restricting already-limited civilian access to medical care, the international medical humanitarian organisation Médecins Sans Frontières said today.

An advancing front line has forced thousands of residents to flee in the western region of Ivory Coast over recent days. And in the city of Abidjan, it is now extremely difficult, if not impossible, to move around within certain neighborhoods, especially with armed men looting and firing in the streets.  It has become impossible to obtain access to medical care under these conditions.

"Access to care is critical," said Dr. Mego Terzian, Médecins Sans Frontières emergency coordinator. "Civilians must not be targeted and patients must be able to obtain medical care."

Médecins Sans Frontières has been working with health authorities in Abidjan since early March, treating 450 people, among them 314 victims of violence. The teams are working at the Abobo Sud Hospital, the only health facility still functioning in the city's northern neighborhoods. On March 31, 15 patients with gunshot wounds were taken to the hospital, although ambulances stopped transporting people some time ago.

While masses of people fled Abidjan last weekend, many remain in the city, taking refuge with host families or hiding in their homes. People come to the few medical facilities still operating only as a last resort. Most health care workers have left; many of those who remain do not come to work because of the insecurity. In addition, medicines and medical supplies are lacking.

Over the last three days Médecins Sans Frontières teams have treated more than 230 wounded patients in the towns of Bangolo and Duékoué, in western Ivory Coast.

"The population is yet again suffering the consequences of fighting," said Renzo Fricke, Médecins Sans Frontières emergency coordinator. "Our teams transfer patients who need emergency surgery—for example, three women with gunshot wounds recently—but there are many other patients facing problems, ranging from severe malaria to complicated labor and deliveries. They require urgent treatment too, but the difficulty of moving from one place to another is threatening patients' lives.”

In Duékoué, a town in the west severely affected by fighting, a Médecins Sans Frontières team is treating patients and stabilizing people requiring surgery for transfer to Bangolo, 30 kilometers away, where another Médecins Sans Frontières team is working in the town’s only functioning hospital.

The Catholic mission in Duékoué is housing a camp for displaced persons, where the numbers have doubled in just a few days. Confrontations in the region have also led thousands of people to converge on the western town of Guiglo, where health needs have increased. A Médecins Sans Frontières team there treats patients to the extent it can, but insecurity makes it very difficult to evacuate wounded people to Duékoué and Bangolo.

When wounded patients streamed into hospitals in Yamoussoukro and Bouaké, in the center of Ivory Coast, a Médecins Sans Frontières team contributed medical supplies. "This illustrates a problem resulting from a general paralysis of economic life," said Fricke. "Health care facilities lack medicines and supplies."

Médecins Sans Frontières, an impartial medical humanitarian organisation, observes strict neutrality in its operations. Its activities in Ivory Coast are funded exclusively by private donors, ensuring complete independence.

Related News:
 Ivory Coast: “The Fighting Is Increasing Everywhere” - 01-04-11 15:11
 Ivory Coast: Emergency Trauma Surgery

MSF Slideshow - Treating Malnutrition in Bangladesh

SLIDESHOW: TREATING MALNUTRITION IN BANGLADESH'S CAPITAL

Bangladesh / 21.10.10

Photographer Julie Remy documented life and Médecins Sans Frontières' work in the Dhaka slum of Kamrangirchar, a rapidly expanding settlement on the banks of a badly polluted river where health needs are significant and often go unmet.

Related News:

 Bangladesh: Slum conditions pose a hazard to health - 18-10-10 14:23

Slideshow

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Bangladesh: Slum conditions pose a hazard to health

It is still early in the morning, but the narrow alleyways of Kamrangirchar are already bustling with activity. The screeching sound of wood being sawed, the clunk of metal being hammered into shape, and the cacophony of small...

Hope for Kala Azar Sufferers in Bangladesh

FULBARIA, Bangladesh, June 19, 2010 - Today, a new medical programme bringing hope to thousands of kala azar sufferers in Bangladesh is being launched by humanitarian medical aid organisation Médecins Sans Frontières in...

MORE ON MALNUTRITION

Niger between two seasons of hunger

Despite the large-scale response to the nutritional crisis from Médecins Sans Frontières and many other organisations, tens of thousands of children suffered from malnutrition in Niger in 2010. In spite of better harvests, 2011...

Civilians bearing brunt of increased violence and insecurity in eastern Democratic Republic of Congo says Médecins Sans Frontières

28  January 2011 – The international emergency medical humanitarian organisation Médecins Sans Frontières has provided specialised care to 53 women, men and children who were raped in a series of incidents that occurred between...

Source: MSF 

http://www.msf.org.au/resources/multimedia/photo-galleries/photo-gallery/article/slideshow-treating-malnutrition-in-bangladeshs-capital.html

MSF REPORT - Year In Focus 2010

YEAR IN FOCUS: 2010

In this interactive booklet we provide a month-by-month overview of our medical humanitarian activities throughout last year. From the devastating earthquake that struck Haiti in January through to December with the Kala Azar outbreak in southern Sudan.

View report

Related news:

INTERACTIVE BOOKLET

MSF: Letters From The Field

REACHING OUT TO PEOPLE TRAPPED BY CONFLICT
Democratic Republic of Congo

© JP Amigo / MSF
“I met people whose villages had been burnt to the ground by one military group or another; they had run into the bush and were living with trees over the top of them and no mosquito nets. The malaria – I’d never seen anything like it.”

Tom de Kok’s first field placement for Médecins Sans Frontières was in Pakistan after the earthquake in 2005. Since then he has worked for Médecins Sans Frontières in Darfur and in Iraq and has completed two field missions in the Democratic Republic of Congo.

Tom is an Médecins Sans Frontières project coordinator who has returned from North Kivu, in the east of the Democratic Republic of Congo, where violent conflict persists between government forces and an array of military groups. Around the town of Pinga, the frontlines between different armed actors constantly shift, and local people are trapped in the middle. Those displaced from their villages by the fighting hide in makeshift shelters in the forest, not knowing where the next danger will come from and often cut off from all medical care.

For some, even travelling to town for provisions as basic as salt is too dangerous, as they run the risk of robbery, extortion and harassment. “In one village I came across, people had no salt. We’re a medical organisation, but we can still barely imagine that people are desperate to get salt.”

Huge health needs

In such an insecure and unstable environment, where many lack the most basic necessities, people’s health needs are huge. Despite the enormous challenges of working in a conflict zone, across shifting frontlines, Médecins Sans Frontières is running a therapeutic feeding centre for malnourished children in Pinga town, supporting two health centres in the surrounding area, and running mobile clinics on motorbikes. Médecins Sans Frontières staff in Pinga carried out 40,000 consultations in 2010.

Continual conflict

“Most people – even old people – don’t know what it’s like to live without conflict; it has always been part of daily life. But still, the people who live in Pinga town have a far different experience from somebody who lives just five kilometres away, on the other side of the frontline. Whole villages are often burnt to the ground by non-government militias to deter nearby government forces from advancing and occupying them. When this happens, the villagers are forced to hide in the forest in makeshift shelters, without mosquito nets.”

Malaria is endemic

It is no surprise that in the hot, rainy, densely forested hills around Pinga, malaria is endemic. In 2010, the team in Pinga treated more than 6,500 cases. Children with malaria are particularly likely to have life-threatening complications, but getting these children to a doctor in town is far from straightforward.

Trying to cross the frontline

To get medical care or reach the hospital in Pinga town, villagers “have to cross frontlines and land controlled by different military groups. They are accused by all sides of being sympathisers. If they follow the main road they’ll run into checkpoints. And if they take a back road through the woods, they’re going to run into the military – either government or non-government forces – and then they’ll be forced to explain why they’re travelling on the back road and it will look even more suspicious. When there’s all-out fighting, the military suspects everybody. These are serious cases: these are parents with a dying infant who has got malaria maybe with anaemic complications. They’ll move, they’ll get harassed, they’ll turn around and the result is their child won’t make it.”

Mobile clinic by motorbike

With so many people prevented from going to find a doctor, Médecins Sans Frontières' mobile teams are crossing the frontlines themselves, and travelling on motorbikes into the dense bush to find the sick and traumatised people who are so desperately in need of help. “Road conditions are horrible; we do our mobile clinics with motorcycle convoys because cars can’t go there.”

Transferring patients

For many patients, on-the-spot treatment is not enough, and they need to be transferred to the nearest hospital, which may be across two frontlines and territory controlled by three different warring groups. In these cases, “the endeavour of trying to transfer a patient is about as lifesaving as the medical care itself. We cannot just transport sick patients on motorbikes for hours over rough terrain – children cannot hold on; neither can pregnant women. We fill out a referral form and try to get them to meet us at the checkpoint so we can cross together with them. We tell the armed men at checkpoints the names of those patients who will attempt to cross that day, and we tell them we will follow up on these people. But still, some never arrive at our clinics on the other side of the frontline.” Médecins Sans Frontières teams are trying to find ways around these difficulties.

Treating rape survivors

Médecins Sans Frontières also provides specialised medical care to women and girls who have been raped. Treatment includes post-exposure prophylaxis, which can help protect against the HIV virus and other sexually transmitted infections. Sexual violence is a terrible part of the war in eastern Congo that is perpetrated by military groups on all sides of the conflict. Many women are afraid to seek treatment because of fear of being stigmatised by their families. They also risk further harassment when attempting to cross military checkpoints in search of medical care. In 2010, the team provided specialised medical care to more than 200 women and girls who managed to reach Médecins Sans Frontières’ clinics against all the odds.

Maternal healthcare

Providing maternal healthcare is another major priority, as women living in the bush who suffer complications during pregnancy and childbirth have no access to doctors or trained midwives. In and around Pinga in 2010, Médecins Sans Frontières carried out 4,000 antenatal consultations and 65 babies were delivered within a Médecins Sans Frontières facility.

Médecins Sans Frontières’ added value

Despite the difficulties of travelling by motorbike on muddy jungle tracks, of being held up at checkpoints, of negotiating access across frontlines and having to deal with various armed groups, Médecins Sans Frontières is capable of working in these conditions. “Our reputation on the ground is better than good. We’ve got the maximum amount of space you could have under these difficult circumstances. We are still reaching people in need and our work is respected across the lines.”

  
LOCATION MAP - DEMOCRATIC REPUBLIC OF CONGO -

How the Cholera Outbreak In Haiti Began... MSF

Le Monde Op-Ed: Why It's Important to Know How the Cholera Epidemic in Haiti Began

DECEMBER 23, 2010

By Dr. Marie-Pierre Allié, President, Médecins Sans Frontières in France

Two months after the cholera epidemic began in Haiti, nearly 2,000 people have died and 100,000 have become ill. Médecins Sans Frontières has treated more than 51,000 people to date. The illness surprised observers both because of its breadth and the initial speed with which it spread. It raised important questions that remain unanswered today. Basic data about the source of the illness and the daily case count are among the unknowns that need to be answered in order to understand the course of the epidemic.

The monitoring and information system established by the World Health Organization (WHO) is critical for directing the response, but it has gaps. In addition to lacking specific data on the initial type of contamination, it took nearly two months to finally obtain the figures allowing responders in the field to answer, region-by-region, the questions raised by the development of the epidemic. When did it begin in this region? What are its dynamics? Should we fear a rebound of the disease?

The U.S. Centers for Disease Control has officially refused to investigate the source of the illness. Contrary to its founding principles, the U.S. government's epidemiological investigative and monitoring agency states that "the answer to that question makes no difference in efforts to prevent the disease from spreading."

In fact, the lack of investigations and documentation leaves the field wide open to multiple theories. Briefly, there are two conflicting hypotheses as to the source of the epidemic on the island. One is based on global warming and the other points to a cholera strain imported from Asia.

Johns Hopkins University professor David Sack endorses the "green" hypothesis. He and some of his colleagues believe that rising water temperatures and increased salinity created conditions favorable to the growth of plankton that serve as hosts for cholera vibrio. According to this theory, vibrio can survive long-term in brackish, stagnant water and may thus trigger new epidemic peaks.

Harvard University microbiologist John Mekalanos, working with other researchers, offers a different explanation. Advocates of the "Nepalese" hypothesis have concluded that cholera was brought to Haiti in early October with the arrival of a contingent of U.N. blue helmets (Minustah forces), including soldiers from Kathmandu. In fact, a strain of cholera similar to the one circulating in Haiti today hit Kathmandu last summer. French professor Renaud Piarroux, of Nice University Hospital, conducted an on-site investigation for the French and Haitian governments and supports this hypothesis. He places the first cases close to the Minustah camp in Mirebalais, in the center of the country and far from water that might carry plankton.  This theory may also explain the suddenness with which cholera struck in Haiti.

These two explanatory models imply very different courses of development for an epidemic, so priority should be given to assembling an independent, multidisciplinary team that can confirm or reject one or the other. However, the United Nations' Office for the Coordination of Humanitarian Affairs (OCHA) continues to repeat that "the issue of the origin of the epidemic is actually not important." Minustah has long challenged the need for any investigation, asserting that "experts have emphasized the difficulty, if not the impossibility, of determining precisely how cholera came to Haiti."

MSF cannot support such statements. It is counter-productive to hide epidemiological data and keep investigative reports confidential. Such actions prevent us from establishing a precise diagnosis and can result in misdirected aid efforts. For example, the WHO says that the epidemic continues to worsen, basing those statements on the number of cumulative cases (which, by definition, continue to increase until the epidemic ends). However, based on its activity figures, which correspond to more than half of the number of patients, MSF notes that the number of new daily cases has stabilized over the last two weeks, with the exception of certain disease centers in the Northern Department.

The alarmist—and unconfirmed—predictions of the WHO and the U.N. Secretary-General of up to 650,000 cases serve only to increase fears. Even worse, the refusal to answer Haitians' questions about the source of the cholera reinforces a climate of distrust and suspicion toward foreigners. Confidence is critical to obtaining the population's support for and cooperation with the systems that international NGOs have established.

For these reasons, we must identify the source of the epidemic. The results of the epidemiological investigations must be published and a commission of independent experts must be appointed.

—Dr. Marie-Pierre Allié, President, Médecins Sans Frontières in France

Haiti: An Overview of MSF Operations in 2010

DECEMBER 20, 2010

Haiti 2010 © Frederic Sautereau

MSF staff at work in a makeshift operating room in Port-au-Prince, in the days after the earthquake.

BRIEFING PAPER

Download Briefing Paper: MSF in Haiti, One Year After the Earthquake [128 KB]

Executive Summary:

Doctors Without Borders/Médecins Sans Frontières (MSF) is immensely grateful to the millions of people around the world who have helped finance the organization’s massive relief effort in Haiti and for the thousands of dedicated national and international staff who mobilized in the aftermath of the January 12th earthquake.

At the time of the earthquake, MSF had been providing continuous health care in Haiti for almost 20 years. After the earthquake hit, MSF’s existing deployment of 800 field staff working in three facilities in Port-au-Prince was quickly expanded to 3,400 people working in 26 hospitals and clinics in the capital city and beyond.

During the three-month emergency phase of the earthquake response, these teams treated 165,000 people, distributed 28,000 shelters and 85,000 non-food item kits, rehabilitated 10 hospitals, and constructed four new facilities. MSF devoted a large share of its operational resources to the establishment of emergency trauma and obstetrical surgical care. MSF was the major actor in emergency surgical care among the 30 foreign field hospitals deployed during these first three months. MSF surgeons performed 5,707 major surgical procedures. The Cuban government, which sent five field hospitals, reported 3,562 major operations in the same period, and the staff on USS Comfort performed 800 operations during its 7-week mission.

By mid-December, in the midst of the ongoing cholera outbreak in Haiti, MSF had more than 4,000 Haitian workers are working alongside 315 international staff to maintain existing programs and mount the cholera emergency response. They run seven private, free-of-charge, secondary-level care hospitals and support two Ministry of Health structures in Port-au-Prince, accounting for nearly 1,000 hospital beds in the capital. These facilities provide emergency, trauma, obstetrical, pediatric, maternal, and orthopedic care services. Mental health care and treatment and counseling for victims of sexual violence are also provided by MSF. Outside the capital, MSF supports Ministry of Health hospitals in Jacmel with nearly 100 beds of patient capacity and runs a private, 120-bed container hospital in Leogane that opened in October.

From January 12 to October 31, MSF treated more than 358,000 people, performed more than 16,570 surgeries, and delivered more than 15,100 babies. MSF also uses mobile and fixed-point clinics to provide primary medical care and relief supplies to displaced persons living in various camps in Port-au-Prince and is carrying out water-and-sanitation services to displaced persons in the Cite de Soleil slum. By December 12, MSF teams had treated 62,000 cholera cases in 47 treatment centers located around the country.

Download the full report.

Tags: Haiti Earthquake 2010, Haiti, Cholera

Source: http://www.doctorswithoutborders.org/news/article.cfm?id=4926&cat=field-news

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New Meningitis A Vaccine is a "Revolution"

December 3, 2010 New Meningitis A Vaccine is a "Revolution" Doctors Without Borders/Médecins Sans Frontières (MSF) teams are involved in rolling out a mass vaccination campaign against meningitis in Mali and Niger in Africa’s notorious meningitis belt. Every year, MSF launches mass campaigns but this one is very different; the new vaccine is being employed as a preventive measure and not, as in the past, in response to an actual outbreak of the disease. This brings with it new challenges but many are hoping the new vaccine could help wipe out the devastating meningitis epidemics in the region.  MSF is working closely to support the governments’ work in rolling this vaccine out which, in this initial phase, is also being launched in Burkina Faso.  Dr. Cathy Hewison is a medical advisor and she starts by explaining how meningitis affects the communities in the region. MSF medical staff checks a bottle containing meningitis vaccine during a vaccination campaign in Doutchy. Every year between January and June, people in this region are on tenterhooks because they don’t know if they will be hit by an epidemic or not. Meningitis strikes children and adults across these communities and many who survive the disease will be left with long-term disabilities that can follow meningitis, such as deafness or mental disabilities. A huge amount of energy and resources has to go into combating the disease each year, from sending out teams to detect cases, to treating people and organizing the vaccination campaign, so it’s totally draining. Psychologically, financially, and physically, these epidemics are devastating for the communities involved. Until now, MSF has responded to the outbreak of epidemics by launching vast reactive vaccination campaigns. How effective has that been as a way of managing the disease? We’ve done our best in these situations where we are working in emergency mode, but the impact is limited due to the tools that we’ve had to deal with these epidemics. What that means is that people get ill and die because we can’t reach them on time. First, we have to detect the epidemic, which is not easy in these countries given the time available and resources. Once the epidemic is detected, then we have to import the vaccines because there are not enough vaccines to have them on standby in every country and they are held outside the country. That then leaves us with a limited window of time to vaccinate people in order to have an impact—that period is usually the first five weeks after the outbreak, before the epidemic peaks—and it’s been very difficult to do that in the time allowed. In addition, it’s always much, much more difficult to organize a vaccination campaign in an emergency situation, such as during an outbreak of the disease, rather than carrying out a prevention campaign when we aren’t desperately running against the clock to get people vaccinated. When people are panicking and it’s unpredictable where the next cases will appear, that puts enormous pressures on the medical teams. Is the new vaccine radically different in that it will be used to prevent the outbreak of disease by giving people protection against the disease before meningitis has taken a hold in the community? Yes, with the previous vaccine, because it only gave protection for a short period—up to three years—it wasn’t worth vaccinating the population before an epidemic because we can’t predict when and where an epidemic will attack. But with the new vaccine, because we know protection will last ten years, and that all these countries will be attacked by an epidemic within ten years, we know that we’re investing in a good prevention measure. So, yes, it’s a revolution in the way meningitis will be managed because with the extended protection offered by this vaccine, we can hopefully prevent the epidemics from taking place at all. And there are other advantages too: we can use this vaccine in younger children unlike the previous vaccine that was ineffective in children under the age of two years old. And it gives better protection to individuals than the previous vaccine which wasn’t totally effective. But most importantly, from our perspective, the vaccine will stop transmission of the bacteria that causes the meningitis within the population by eliminating the carriage of the germ. This will give what is called ‘herd immunity’. That means people who are vaccinated will protect those who are not vaccinated because they won’t pass on the bacteria. People are saying this is the end of meningitis epidemics in this region. Is that overstating the case? There’s no doubt it is a revolution, but we can’t say it will completely wipe out meningitis epidemics. In the first place, this vaccine has been developed specifically to protect people against a particular form of meningitis—meningitis A. It’s a specific group of bacteria that cause the major part of the large-scale epidemics across the meningitis belt. However, it doesn’t protect against all types of meningitis, so other types of what we call meningococcal meningitis will still be potentially there and it will be potentially possible to have epidemics due to other types of this kind of meningitis. The vaccine we know is a breakthrough and has been proven in clinical trials, but won’t implementation also be key to the success of wiping out the epidemics? The practical challenges are there. We need to ensure that 90 percent of the population that we target (one- to 29-year-olds) are reached by the vaccination campaign in order to ensure herd immunity and protect the rest of the population.That represents an enormous amount of people to vaccinate in a short space of time. It’s also much harder to mobilize people to come for vaccination if they are not immediately faced by evidence of the disease all around, so we need a very good public information campaign to get people to come forward to get vaccinated. Once the target population is vaccinated, we need to keep that age group vaccinated which means the new children coming into that age group need to be vaccinated either through the regular annual vaccine activities or through other catch-up campaigns and that’s really a challenge we need to deal with in the future. The meningitis belt stretches across 25 countries from west to east. Why have Burkina Faso, Mali, and Niger been the first countries to step forward and implement vaccination with the new vaccine, and why is MSF so closely involved? The first reason is that they are very frequently hit by epidemics, resulting in a high quantity of cases and deaths. In addition, these countries have been very active in meningitis, not only in reacting to meningitis outbreaks, but also in trying to advance science in these areas. MSF, which has also long been involved in innovations of treating the disease in this region, has also worked a great deal with these countries in terms of documentation and developing new treatments. So they’ve always been open to scientific research, to implementing new things that are coming onto the market, and trying to confront this problem head-on. Most of the funding to carry out the vaccinations in the original three countries is in hand, but are there big question marks over who will fund the roll-out of this vaccine across the rest of the meningitis belt? In fact, there’s still a gap in funding for this first phase of implementation in the original three countries. But the enormous gap in funding is indeed for all the other countries across the meningitis belt. There are 25 countries altogether which are hit by these meningitis epidemics. Of these, there are five to 10 big countries in the region with a particularly urgent need for vaccination. Here, roll-out should be done as soon as operationally possible. It’s frustrating to have this fantastic vaccine in our hands that will eventually save money as well as many lives because we will not be chasing after epidemics every year, and yet we don’t have the funds assured to roll it out. Currently, no funding is promised. This vaccine marks a fantastic step on the road to wiping out epidemics in this region. But do we need to be even more ambitious and push for the development of vaccines to protect against other forms of meningitis? This vaccine was developed as a result of a very special project and designed to address specifically the needs of the African meningitis belt. That need was clearly a vaccine against meningitis A, which gives rise to the regional enormous epidemics. The other criterion was that the vaccine needed to be cheap enough that the countries could afford to implement it. And the project has been extremely successful in producing a very effective vaccine for meningitis A at a very reasonable cost of US$0.40, despite the current concerns about overall funding. This cost is much less than the original vaccine we used, which was also less effective. Of course, there are other forms of meningococcal meningitis, and of course, other types of meningitis, but I think it remains to be seen if it’s necessary to have a vaccine that works against other types of bacteria and which could make the vaccine more expensive. We’ll have to see what happens as a result of the introduction of this present vaccine. Ridding the region of epidemics is clearly the priority, but is there the intention to eradicate meningitis completely from this region? No, that has never been a goal or even a discussion because there are so many different types of meningitis—viral, TB, bacterial—and because of the different sub groups within those different types, that makes it extremely difficult to eradicate the disease. We haven’t achieved that even in non-epidemic countries outside Africa, so that’s never been our goal.

© 2010 Doctors Without Borders/Médecins Sans Frontières (MSF)

Haiti: Cholera outbreak - MSF Report

MSF presents the following YouTube update on the Cholera Outbreak in Haiti.

Check out this video on YouTube:


http://www.youtube.com/watch?v=rSVabRZecOQ&feature=youtube_gdata_player

MSF REPORT - Malaria In Mumbai

INDIA: MALARIA INTERVENTION LAUNCHED

India / 20.08.10

© Guillaume Bonnet /MSF

Médecins Sans Frontières launches an intervention in Mumbai to tackle sharp malaria increase

Following a sharp increase in malaria cases in Mumbai, Médecins Sans Frontières today launched a malaria intervention to help the Mumbai health authorities fight the disease.

From today, Médecins Sans Frontières teams already working in an HIV treatment project in Mumbai will provide 100,000 diagnostic kits and 3,700 treatment kits to 64 health centres in the city. Médecins Sans Frontières will also provide training for health centre staff in diagnosing and treating the disease.

Médecins Sans Frontières is responding to a request from the Ministry of Health to reinforce the supply of treatment for the falciparum strand of malaria, which is the most deadly form of the disease and constitutes approximately 10 to 15 percent of all cases in Mumbai. The diagnostic tests that Médecins Sans Frontières provides are an efficient way of identifying which strand of malaria the patient is infected with.

The most affected areas of the city are home to half a million people. There, the 14,724 recorded malaria cases for the first six months of 2010 is nearly equal to the number of cases recorded for the whole of last year. This indicates a marked increase in the number of people infected.

“Last year, Médecins Sans Frontières successfully treated over one million malaria patients in 30 different countries. We are pleased to share our resources and expertise with the Mumbai authorities. It is crucial that health staff can give a correct diagnosis so that patients can be treated appropriately. The diagnostic tests that we provide are reliable, easy to use and require just one drop of blood to give results” said Tiago Dal Molin, Médecins Sans Frontières’ project coordinator in Mumbai.

Despite improvements in the diagnosis and treatment of malaria, the disease continues to kill almost one million people around the world every year.

“The disease is transmitted by infected mosquitoes, and areas with stagnant water are usually ideal breeding grounds. Recent heavy rains in Mumbai are likely to be the cause of the current rise in malaria,” said Médecins Sans Frontières’ Sanjana Maurya, who is supervising the intervention.

“Some of the most vulnerable people are the migrants in Mumbai who work in construction labour. They often sleep close to construction sites where there is a lot of stagnant water following the heavy rains," added Tiago Dal Molin.