Journal Article > ResearchFull Text
PLOS One. 2014 September 24; Volume 9 (Issue 9); DOI:10.1371/journal.pone.0108591
Horter SCB, Stringer B, Venis S, du Cros PAK
PLOS One. 2014 September 24; Volume 9 (Issue 9); DOI:10.1371/journal.pone.0108591
In 2011, Médecins Sans Frontières (MSF) established a blogging project, "TB&Me," to enable patients with multidrug-resistant tuberculosis (MDR-TB) to share their experiences. By September 2012, 13 MDR-TB patients had blogged, either directly or with assistance, from the UK, Australia, Philippines, Swaziland, Central African Republic, Uganda, South Africa, India, and Armenia. Due to the lack of research on the potential for social media to support MDR-TB treatment and the innovative nature of the blog, we decided to conduct a qualitative study to examine patient and staff experiences. Our aim was to identify potential risks and benefits associated with blogging to enable us to determine whether social media had a role to play in supporting patients with MDR-TB.
Journal Article > ResearchFull Text
Trans R Soc Trop Med Hyg. 2013 September 29; Volume 107 (Issue 11); DOI:10.1093/trstmh/trt090
Liddle KF, Elema R, Thi SS, Venis S
Trans R Soc Trop Med Hyg. 2013 September 29; Volume 107 (Issue 11); DOI:10.1093/trstmh/trt090
Médecins Sans Frontières (MSF) provides TB treatment in Galkayo and Marere in Somalia. MSF international supervisory staff withdrew in 2008 owing to insecurity but maintained daily communication with Somali staff. In this paper, we aimed to assess the feasibility of treating TB in a complex emergency setting and describe the programme adaptations implemented to facilitate acceptable treatment outcomes.
Journal Article > ResearchFull Text
Confl Health. 2010 June 17; Volume 4; 12.; DOI:10.1186/1752-1505-4-12
O'Brien DP, Venis S, Greig J, Shanks L, Ellman T, et al.
Confl Health. 2010 June 17; Volume 4; 12.; DOI:10.1186/1752-1505-4-12
INTRODUCTION
Many countries ravaged by conflict have substantial morbidity and mortality attributed to HIV/AIDS yet HIV treatment is uncommonly available. Universal access to HIV care cannot be achieved unless the needs of populations in conflict-affected areas are addressed.
METHODS
From 2003 Médecins Sans Frontières introduced HIV care, including antiretroviral therapy, into 24 programmes in conflict or post-conflict settings, mainly in sub-Saharan Africa. HIV care and treatment activities were usually integrated within other medical activities. Project data collected in the Fuchia software system were analysed and outcomes compared with ART-LINC data. Programme reports and other relevant documents and interviews with local and headquarters staff were used to develop lessons learned.
RESULTS
In the 22 programmes where ART was initiated, more than 10,500 people were diagnosed with HIV and received medical care, and 4555 commenced antiretroviral therapy, including 348 children. Complete data were available for adults in 20 programmes (n = 4145). At analysis, 2645 (64%) remained on ART, 422 (10%) had died, 466 (11%) lost to follow-up, 417 (10%) transferred to another programme, and 195 (5%) had an unclear outcome. Median 12-month mortality and loss to follow-up were 9% and 11% respectively, and median 6-month CD4 gain was 129 cells/mm3. Patient outcomes on treatment were comparable to those in stable resource-limited settings, and individuals and communities obtained significant benefits from access to HIV treatment. Programme disruption through instability was uncommon with only one program experiencing interruption to services, and programs were adapted to allow for disruption and population movements. Integration of HIV activities strengthened other health activities contributing to health benefits for all victims of conflict and increasing the potential sustainability for implemented activities.
CONCLUSIONS
With commitment, simplified treatment and monitoring, and adaptations for potential instability, HIV treatment can be feasibly and effectively provided in conflict or post-conflict settings.
Many countries ravaged by conflict have substantial morbidity and mortality attributed to HIV/AIDS yet HIV treatment is uncommonly available. Universal access to HIV care cannot be achieved unless the needs of populations in conflict-affected areas are addressed.
METHODS
From 2003 Médecins Sans Frontières introduced HIV care, including antiretroviral therapy, into 24 programmes in conflict or post-conflict settings, mainly in sub-Saharan Africa. HIV care and treatment activities were usually integrated within other medical activities. Project data collected in the Fuchia software system were analysed and outcomes compared with ART-LINC data. Programme reports and other relevant documents and interviews with local and headquarters staff were used to develop lessons learned.
RESULTS
In the 22 programmes where ART was initiated, more than 10,500 people were diagnosed with HIV and received medical care, and 4555 commenced antiretroviral therapy, including 348 children. Complete data were available for adults in 20 programmes (n = 4145). At analysis, 2645 (64%) remained on ART, 422 (10%) had died, 466 (11%) lost to follow-up, 417 (10%) transferred to another programme, and 195 (5%) had an unclear outcome. Median 12-month mortality and loss to follow-up were 9% and 11% respectively, and median 6-month CD4 gain was 129 cells/mm3. Patient outcomes on treatment were comparable to those in stable resource-limited settings, and individuals and communities obtained significant benefits from access to HIV treatment. Programme disruption through instability was uncommon with only one program experiencing interruption to services, and programs were adapted to allow for disruption and population movements. Integration of HIV activities strengthened other health activities contributing to health benefits for all victims of conflict and increasing the potential sustainability for implemented activities.
CONCLUSIONS
With commitment, simplified treatment and monitoring, and adaptations for potential instability, HIV treatment can be feasibly and effectively provided in conflict or post-conflict settings.
Journal Article > CommentaryFull Text
PLOS Med. 2016 September 6; Volume 13 (Issue 9); e1002111.; DOI:10.1371/journal.pmed.1002111
Sheather J, Jobanputra K, Schopper D, Pringle J, Venis S, et al.
PLOS Med. 2016 September 6; Volume 13 (Issue 9); e1002111.; DOI:10.1371/journal.pmed.1002111
SUMMARY POINTS
• Humanitarian organisations often have to innovate to deliver health care and aid to populations in complex and volatile contexts.
• Innovation projects can involve ethical risks and have consequences for populations even if human participants are not directly involved. While high-level principles have been developed for humanitarian innovation, there is a lack of guidance for how these should be applied in practice.
• Médecins sans Frontières (MSF) has well-established research ethics frameworks, but application of such frameworks to innovation projects could stifle innovation by introducing regulation disproportionate to the risks involved. In addition, the dynamic processes of innovation do not fit within conventional ethics frameworks.
• MSF developed and is piloting an ethics framework for humanitarian innovation that is intended for self-guided use by innovators or project owners to enable them to identify and weigh the harms and benefits of such work and be attentive towards a plurality of ethical considerations.
• Humanitarian organisations often have to innovate to deliver health care and aid to populations in complex and volatile contexts.
• Innovation projects can involve ethical risks and have consequences for populations even if human participants are not directly involved. While high-level principles have been developed for humanitarian innovation, there is a lack of guidance for how these should be applied in practice.
• Médecins sans Frontières (MSF) has well-established research ethics frameworks, but application of such frameworks to innovation projects could stifle innovation by introducing regulation disproportionate to the risks involved. In addition, the dynamic processes of innovation do not fit within conventional ethics frameworks.
• MSF developed and is piloting an ethics framework for humanitarian innovation that is intended for self-guided use by innovators or project owners to enable them to identify and weigh the harms and benefits of such work and be attentive towards a plurality of ethical considerations.
Research & Publication Guidance > Guidelines/How-Tos
McConnell R, Roll S, van der Kam S, Shanks L, Venis S, et al.
2012 February 1
Journal Article > ResearchFull Text
PLOS Med. 2008 August 5; Volume 5 (Issue 8); DOI:10.1371/journal.pmed.0050169
Guthmann JP, Checchi F, van den Broek IVF, Balkan S, Van Herp M, et al.
PLOS Med. 2008 August 5; Volume 5 (Issue 8); DOI:10.1371/journal.pmed.0050169
Journal Article > CommentaryFull Text
Lancet. 2008 February 23; Volume 371 (Issue 9613); 682-684.; DOI:10.1016/S0140-6736(08)60307-4
Phillips M, Zachariah R, Venis S
Lancet. 2008 February 23; Volume 371 (Issue 9613); 682-684.; DOI:10.1016/S0140-6736(08)60307-4
Journal Article > ResearchFull Text
Confl Health. 2013 September 16; Volume 7 (Issue 1); DOI:10.1186/1752-1505-7-19
de Jong K, Shanks L, Ariti C, Denault M, Siddiqui R, et al.
Confl Health. 2013 September 16; Volume 7 (Issue 1); DOI:10.1186/1752-1505-7-19
Medecins Sans Frontieres (MSF) provides individual counselling interventions in medical humanitarian programmes in contexts affected by conflict and violence. Although mental health and psychosocial interventions are a common part of the humanitarian response, little is known about how the profile and outcomes for individuals seeking care differs across contexts. We did a retrospective analysis of routine programme data to determine who accessed MSF counselling services and why, and the individual and programmatic risk factors for poor outcomes.
Journal Article > CommentaryFull Text
PLOS Med. 2016 July 1; Volume 13 (Issue 9); e1002111.; DOI:10.1371/journal.pmed.1002111
Sheather J, Jobanputra K, Schopper D, Pringle J, Venis S, et al.
PLOS Med. 2016 July 1; Volume 13 (Issue 9); e1002111.; DOI:10.1371/journal.pmed.1002111
SUMMARY POINTS
-- Humanitarian organisations often have to innovate to deliver health care and aid to populations in complex and volatile contexts.
-- Innovation projects can involve ethical risks and have consequences for populations even if human participants are not directly involved. While high-level principles have been developed for humanitarian innovation, there is a lack of guidance for how these should be applied in practice.
-- Médecins sans Frontières (MSF) has well-established research ethics frameworks, but application of such frameworks to innovation projects could stifle innovation by introducing regulation disproportionate to the risks involved. In addition, the dynamic processes of innovation do not fit within conventional ethics frameworks.
-- MSF developed and is piloting an ethics framework for humanitarian innovation that is intended for self-guided use by innovators or project owners to enable them to identify and weigh the harms and benefits of such work and be attentive towards a plurality of ethical considerations.
-- Humanitarian organisations often have to innovate to deliver health care and aid to populations in complex and volatile contexts.
-- Innovation projects can involve ethical risks and have consequences for populations even if human participants are not directly involved. While high-level principles have been developed for humanitarian innovation, there is a lack of guidance for how these should be applied in practice.
-- Médecins sans Frontières (MSF) has well-established research ethics frameworks, but application of such frameworks to innovation projects could stifle innovation by introducing regulation disproportionate to the risks involved. In addition, the dynamic processes of innovation do not fit within conventional ethics frameworks.
-- MSF developed and is piloting an ethics framework for humanitarian innovation that is intended for self-guided use by innovators or project owners to enable them to identify and weigh the harms and benefits of such work and be attentive towards a plurality of ethical considerations.
Journal Article > CommentaryFull Text
Trans R Soc Trop Med Hyg. 2013 October 10; Volume 107 (Issue 11); 669-671.; DOI:10.1093/trstmh/trt085
du Cros PAK, Venis S, Karunakara U
Trans R Soc Trop Med Hyg. 2013 October 10; Volume 107 (Issue 11); 669-671.; DOI:10.1093/trstmh/trt085
Data on the elderly are rarely collected in humanitarian emergencies. During a refugee crisis in South Sudan, Médecins Sans Frontières developed a prospective mortality surveillance system collecting data for those aged ≥50 years and found that the elderly were dying at five times the rate of those aged 5-49 years. Practical and ethical issues arose. Were reported ages accurate? Since no baseline exists, what does the mortality rate mean? Should programmatic changes be made without evidence that these would reduce the elderly mortality rate? We outline issues to be addressed to enable informed decisions on response to elderly populations in emergency settings.