Unsafe abortion is a leading cause of maternal death, and the only one that is completely preventable. Yet over 30 million unsafe abortions occur each year, leading to at least 28,000 deaths and millions of serious complications—nearly all in low- and middle-income countries. MSF teams see these tragic consequences first-hand, treating thousands of patients every year with severe, potentially life-threatening effects from unsafe abortion. So in 2016 we launched a program to systematically implement safe abortion care (SAC), starting with ten pilot sites and then applying the lessons learned to scale up at projects across the globe. This Collection presents highlights of these efforts. Since our first publication on the need to provide SAC as a way of reducing maternal death and injury, several studies assessed the role of unsafe abortion in driving this suffering in specific contexts. Others described internal obstacles to providing SAC, operational solutions developed, and outcomes achieved. And we advocated for shifting towards community-led and self-managed SAC, particularly given new obstacles that emerged during the Covid-19 pandemic.

Resistance to antibiotics is a growing public health crisis, especially in countries with fragile health systems and in regions at war. One key limitation in most of these settings is a lack of clinical bacteriology laboratory capacity, which leaves medical providers without ways to accurately diagnose patient infections and to tailor antibiotic treatment accordingly. To help fill this critical gap, MSF and partners have developed the Mini-Lab—a small-scale, standalone lab that is easy to transport, set up and operate by staff after only a short training. Its six modules are stocked with everything needed to diagnose common bloodstream and urinary tract infections and to perform antibiotic sensitivity testing using methods adapted to extremely hot climates and remote settings. With Mini-Lab now being rolled out to selected MSF projects, here we highlight the background to its development and some of the research behind the bacteriological tests it incorporates.

Each year hundreds of millions of people suffer from chronic or acute liver disease caused by hepatitis viruses, and over one million die. To mark World Hepatitis Day (July 28th) we bring you a selection of MSF research exploring how to better prevent, identify and treat hepatitis infection in lower-income countries and emergency contexts where the burden is heaviest. For example, in a South Sudanese camp for displaced people—a type of setting where poor sanitation and water quality regularly lead to hepatitis E outbreaks—MSF and the Ministry of Health (MoH) are conducting the world’s first reactive vaccination campaign against this disease, and evaluating the process and outcomes. In Cambodia, MSF and MoH collaborators found that a simplified community-based model of care for hepatitis C was safe and highly effective in diagnosing patients and in curing them with new antiviral drugs. It was also cost-effective, according to studies in several countries and patient populations. And these new drugs were safe and effective even in patients also being treated for drug-resistant tuberculosis.