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Diabetes in humanitarian settings 2022 | Collections | MSF Science Portal
Diabetes in humanitarian settings 2022

Diabetes in humanitarian settings 2022

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World NTD Day

World NTD Day

Neglected tropical diseases (NTDs) impact nearly 1.7 billion people each year, causing serious illness or lifelong disability among many—often leading to stigma and exclusion—and killing an estimated 200,000. The vast majority of sufferers live in the world’s poorest countries.


The World Health Organization’s NTD roadmap 2021-2030 aims to address 20 tropical diseases through prevention, control, elimination, and/or eradication. But despite some progress, reaching all its targets will take better, far more accessible diagnostics and treatments along with more robust strategies, political commitment and resources.


To mark World NTD Day, this collection spotlights work by MSF and collaborators on improving approaches to snakebite envenoming, kala azar and noma. One study presents an innovative artificial intelligence-based snakebite diagnostic tool, while others evaluate shorter, less toxic drug regimens or different models of care. Several commentaries advocate for national/regional strategies adapted to contexts ranging from remote villages to active conflict zones. Another crucial factor is the climate crisis, which is intensifying the transmission and geographic spread of many NTDs.

TB-PRACTECAL Trial—Evidence for a shorter, safer, more effective treatment for drug-resistant tuberculosis

TB-PRACTECAL Trial—Evidence for a shorter, safer, more effect...
Snake envenoming: a neglected crisis

Snake envenoming: a neglected crisis
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Drug-resistant tuberculosis (DR-TB) remains an especially deadly form of the ancient scourge of TB, while current treatments are long, toxic, and ineffective for half of all patients. Aiming to change this unacceptable status quo, in the mid-2010’s MSF and partners launched three clinical trials to test novel regimens containing the first new TB drugs in decades. On 22 December 2022 the New England Journal of Medicine published findings from TB-PRACTECAL, a three-country randomized controlled trial, showing that a shorter regimen is safer and cured 89% of DR-TB patients, compared with 52% on the standard of care. These findings have already been incorporated into the World Health Organization’s new TB treatment guidelines. A separate study shows that the new regimen is also more cost-effective. Alongside these results the content collection linked below highlights other aspects of the trial, from community engagement strategies that helped shape TB-PRACTECAL to setbacks arising from the Covid-19 pandemic. It also examines urgent challenges in scaling up access to these life-saving drugs, including affordability and patent barriers.

Every year 2 million or more people fall victim to snakebite envenoming, mostly in poor, rural communities of Africa, Asia and Latin America. Between 83,000—138,000 of them die, while hundreds of thousands more suffer debilitating long-term complications or disabilities.


Although some antivenom medicines are highly effective when used promptly and appropriately, many snakebite victims get no treatment at all. Those who do may receive antivenoms which don’t work against the type of snake that bit them, or were not rigorously tested for safety and effectiveness.


To mark World Snakebite Awareness Day on September 19th, the Collection linked below brings together recent MSF work on this highly neglected disease. Several articles and conference presentations help fill evidence gaps on the burden of disease and its impacts or on treatment outcomes with specific antivenoms in specific regions. Others examine how to tackle the formidable challenges of availability and affordability, the absence of regulatory oversight for making, testing and registering antivenoms, and the anemic R&D pipeline for new products—all of which impede access for patients to safe, effective treatment tailored to local snake species.

Journal Article
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Research

Socioeconomic and medical vulnerabilities among Syrian refugees with non-communicable diseases attending Médecins Sans Frontières services in Irbid, Jordan

Carrion-Martin AI, Alrawashdeh A, Karapanagos G, Mahmoud R, Ta’anii N,  et al.
2022-10-22 • Journal of Immigrant and Minority Health
2022-10-22 • Journal of Immigrant and Minority Health
Non-communicable diseases (NCDs) are high-prevalence health problems among Syrian refugees. In 2014, Médecins Sans Frontières (MSF) identified unmet NCD care needs and began providing fr...
Conference Material
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Poster

Decentralization of insulin treatment through nurses and clinical officers in nine health centres in a rural county, Kenya: descriptive study

Borum Mølskov Bech M, Otieno Khisa A, Ndoca K, Ayuaya T, Kajuju P,  et al.
2022-05-09 • MSF Scientific Days International 2022
2022-05-09 • MSF Scientific Days International 2022
Journal Article
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Letter

An inter-humanitarian agency study of diabetes care and surveillance in humanitarian settings

Kehlenbrink S, Mahboob O, Al-Zubi S, Boulle P, Aebischer-Perone S,  et al.
2022-02-07 • Lancet Diabetes and Endocrinology
2022-02-07 • Lancet Diabetes and Endocrinology
Journal Article
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Letter

Diabetes and the WHO model list of essential medicines

Reddy A
2022-01-01 • Lancet Diabetes and Endocrinology
2022-01-01 • Lancet Diabetes and Endocrinology
Journal Article
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Research

“I try the one that they say is good.” - factors influencing choice of health care provider and pathways to diabetes care for Syrian refugees in Lebanon

Haderer F, Venables E, Van Olmen J, Orcutt M, Ghassibe-Sabbagh M,  et al.
2021-06-05 • Conflict and Health
2021-06-05 • Conflict and Health
BACKGROUND
Navigating health systems in host countries can be a challenge for refugees, particularly in a multi-provider system such as Lebanon. Syrian refugees in Lebanon face a hig...
Journal Article
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Research

MSF experiences of providing multidisciplinary primary level NCD care for Syrian refugees and the host population in Jordan: an implementation study guided by the RE-AIM framework

Ansbro É, Homan T, Qasem J, Bil K, Tarawneh M,  et al.
2021-04-26 • BMC Health Services Research
2021-04-26 • BMC Health Services Research
BACKGROUND
In response to the rising global NCD burden, humanitarian actors have rapidly scaled-up NCD services in crisis-affected low-and-middle income countries. Using the RE-AIM i...
Journal Article
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Review

Operational considerations for the management of non-communicable diseases in humanitarian emergencies

Bausch FJ, Beran D, Hering H, Boulle P, Chappuis F,  et al.
2021-02-25 • Conflict and Health
2021-02-25 • Conflict and Health
Non-communicable diseases (NCD) represent an increasing global challenge with the majority of mortality occurring in low- and middle-income countries (LMICs). Concurrently, many humanita...
Journal Article
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Research

Heat-stability study of various insulin types in tropical temperature conditions: new insights towards improving diabetes care

Kaufmann B, Boulle P, Berthou F, Fournier M, Beran D,  et al.
2021-02-03 • PLOS One
2021-02-03 • PLOS One
Strict storage recommendations for insulin are difficult to follow in hot tropical regions and even more challenging in conflict and humanitarian emergency settings, adding an extra burd...
Journal Article
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Research

Clinical outcomes in a primary-level non-communicable disease programme for Syrian refugees and the host population in Jordan: A cohort analysis using routine data

Ansbro É, Homan T, Jobanputra K, Qasem J, Muhammad S,  et al.
2021-01-11 • PLOS Medicine
2021-01-11 • PLOS Medicine
BACKGROUND
Little is known about the content or quality of non-communicable disease (NCD) care in humanitarian settings. Since 2014, Médecins Sans Frontières (MSF) has provided prima...
Journal Article
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Research

Setting up a nurse-led model of care for management of hypertension and diabetes mellitus in a high HIV prevalence context in rural Zimbabwe: a descriptive study

Frieden M, Zamba B, Mukumbi N, Mafaune PT, Makumbe B,  et al.
2020-06-01 • BMC Health Services Research
2020-06-01 • BMC Health Services Research
BACKGROUND
In the light of the increasing burden of non-communicable diseases (NCDs) on health systems in low- and middle-income countries, particularly in Sub-Saharan Africa, contex...