Journal Article > CommentaryAbstract Only
Role of Anesthesiology in Global Health. 2014 November 19; DOI:10.1007/978-3-319-09423-6_9
Trelles M, Kahn P, Cone J, Teicher CL
Role of Anesthesiology in Global Health. 2014 November 19; DOI:10.1007/978-3-319-09423-6_9
Médecins Sans Frontières/Doctors Without Borders (MSF) has been running surgical programs since the early 1980s. This chapter provides an overview of the anesthesia component of these programs and explores some lessons learned from the experience of one of MSF’s five Operations Centers—in this case, the Belgium-based unit (MSF-Belgium). During the period from 2010 until the end of 2013, these projects provided surgical care to more than 56,000 surgical patients in 23 countries and performed over 73,000 surgical procedures. This experience has shown that surgeons and anesthetists need to discard preconceived notions of an inevitable link between the technical complexity of surgical and anesthesia techniques and the ability to reduce morbidity and mortality. On the contrary, MSF has found that keeping our interventions simple, accessible and sustainable within a given context is often the most effective way to best serve the needs of the many.
Conference Material > Video
Kahn P, Burgess B, Leader C, Chaudhuri J
MSF Scientific Days International 2022. 2022 May 10; DOI:10.57740/4q7j-xg61
Conference Material > Slide Presentation
Kahn P, Burgess B, Leader C, Chaudhuri J
MSF Scientific Days International 2022. 2022 May 10; DOI:10.57740/ak50-t791
Journal Article > CommentaryFull Text
Bull World Health Organ. 2019 October 28; Volume 97 (Issue 12); 851-853.; DOI:10.2471/BLT.18.228585
Elder K, Saitta B, Ducomble T, Alia M, Close R, et al.
Bull World Health Organ. 2019 October 28; Volume 97 (Issue 12); 851-853.; DOI:10.2471/BLT.18.228585
Vaccination is an effective intervention to reduce disease, disability, death and health inequities worldwide. Over the last two decades, vaccines have become more accessible in low-income countries; however, significant gaps remain, particularly in humanitarian emergencies, where populations face increased risks of many diseases. In 2013, the World Health Organization (WHO) published "Vaccination in acute humanitarian emergencies: a framework for decision-making," to provide guidance on which vaccines to prioritize during emergencies. However, substantial obstacles, especially high prices for new vaccines, hinder implementation of this framework and of critical vaccination activities in emergency settings.
In response to these challenges, global health stakeholders held a series of consultations in 2016 and proposed a WHO-based mechanism, the Humanitarian Mechanism, for the rapid procurement of affordable vaccines during emergencies, to be used by nongovernmental organizations (NGOs), civil society organizations, United Nations (UN) agencies and governments. Here we present the background of the creation of the mechanism from the perspective of Médecins Sans Frontières (MSF), including a description of our past challenges in accessing affordable pneumococcal conjugate vaccine (PCV), a critical vaccine during many emergencies. We then describe how the mechanism has so far facilitated access to more affordable PCV and outline steps that could increase its potential for saving lives.
In response to these challenges, global health stakeholders held a series of consultations in 2016 and proposed a WHO-based mechanism, the Humanitarian Mechanism, for the rapid procurement of affordable vaccines during emergencies, to be used by nongovernmental organizations (NGOs), civil society organizations, United Nations (UN) agencies and governments. Here we present the background of the creation of the mechanism from the perspective of Médecins Sans Frontières (MSF), including a description of our past challenges in accessing affordable pneumococcal conjugate vaccine (PCV), a critical vaccine during many emergencies. We then describe how the mechanism has so far facilitated access to more affordable PCV and outline steps that could increase its potential for saving lives.
Conference Material > Video
Kahn P, Brooks JR, Leader C, Hoyt O
MSF Scientific Days International 2021: Innovation. 2021 May 20
Conference Material > Slide Presentation
Kahn P, Brooks JR, Leader C, Hoyt O
MSF Scientific Days International 2021: Innovation. 2021 May 20
Journal Article > EditorialFull Text
Bull World Health Organ. 2016 April 1; Volume 94 (Issue 4); 236–236A.; DOI:10.2471/BLT.16.172650
Delaunay S, Kahn P, Tatay M, Liu J
Bull World Health Organ. 2016 April 1; Volume 94 (Issue 4); 236–236A.; DOI:10.2471/BLT.16.172650
Other > Pre-Print
bioRxiv. 2019 February 1; DOI:10.1101/533851
Saran K, Masini T, Chikwanha I, Paton G, Scourse R, et al.
bioRxiv. 2019 February 1; DOI:10.1101/533851
BACKGROUND
Tuberculosis (TB) poses a global health crisis requiring robust international and country-level action. Adopting and implementing TB policies from the World Health Organization (WHO) is essential to meeting global targets for reducing TB burden. However, many high TB burden countries lag in implementing WHO recommendations. Assessing the progress of implementation at national level can identify key gaps that must be addressed to expand and improve TB care.
METHODS
In 2016/2017, Médecins Sans Frontières and the Stop TB Partnership conducted a survey on adoption and implementation of 47 WHO TB policies in the national TB programs of 29 countries. Here we analyze a subset of 23 key policies in diagnosis, models of care, treatment, prevention, and drug regulation to provide a snapshot of national TB policy adoption and implementation. We examine progress since an analogous 2015 survey of 23 of the same countries.
RESULTS
At the time of the survey, many countries had not yet aligned their national guidelines with all WHO recommendations, although some progress was seen since 2015. For diagnosis, about half of surveyed countries had adopted the WHO-recommended initial rapid test (Xpert MTB/RIF). A majority of countries had adopted decentralized models of care, although one-third of them still required hospitalization for drug-resistant (DR-)TB. Recommended use of the newer drugs bedaquiline (registered in only 6 high-burden TB countries) and delamanid (not registered in any high-burden country) was adopted by 23 and 18 countries, respectively, but short-course (9-month) and newer pediatric regimens by only 13 and 14 countries, respectively. Guidelines in all countries included preventive treatment of latent TB infection for child TB contacts and people living with HIV/AIDS, but only four extended this to adult contacts.
CONCLUSION
To reach global TB targets, greater political will is needed to rapidly adopt and implement internationally recognized care guidelines.
Tuberculosis (TB) poses a global health crisis requiring robust international and country-level action. Adopting and implementing TB policies from the World Health Organization (WHO) is essential to meeting global targets for reducing TB burden. However, many high TB burden countries lag in implementing WHO recommendations. Assessing the progress of implementation at national level can identify key gaps that must be addressed to expand and improve TB care.
METHODS
In 2016/2017, Médecins Sans Frontières and the Stop TB Partnership conducted a survey on adoption and implementation of 47 WHO TB policies in the national TB programs of 29 countries. Here we analyze a subset of 23 key policies in diagnosis, models of care, treatment, prevention, and drug regulation to provide a snapshot of national TB policy adoption and implementation. We examine progress since an analogous 2015 survey of 23 of the same countries.
RESULTS
At the time of the survey, many countries had not yet aligned their national guidelines with all WHO recommendations, although some progress was seen since 2015. For diagnosis, about half of surveyed countries had adopted the WHO-recommended initial rapid test (Xpert MTB/RIF). A majority of countries had adopted decentralized models of care, although one-third of them still required hospitalization for drug-resistant (DR-)TB. Recommended use of the newer drugs bedaquiline (registered in only 6 high-burden TB countries) and delamanid (not registered in any high-burden country) was adopted by 23 and 18 countries, respectively, but short-course (9-month) and newer pediatric regimens by only 13 and 14 countries, respectively. Guidelines in all countries included preventive treatment of latent TB infection for child TB contacts and people living with HIV/AIDS, but only four extended this to adult contacts.
CONCLUSION
To reach global TB targets, greater political will is needed to rapidly adopt and implement internationally recognized care guidelines.
Conference Material > Poster
Zhao A, Lewis CB, Kahn P
MSF Scientific Day International 2024. 2024 May 16; DOI:10.57740/JcLCnFc7y
Français
Journal Article > LetterFull Text
N Engl J Med. 2015 March 19; Volume 372 (Issue 12); 1181-1182.; DOI:10.1056/NEJMc1413930
Sanchez-Padilla E, Merker M, Jochims F, Dlamini T, Kahn P, et al.
N Engl J Med. 2015 March 19; Volume 372 (Issue 12); 1181-1182.; DOI:10.1056/NEJMc1413930