epidemic

Stopping HIV in Ndhiwa Wairimu Gitau/MSF Interview

Controlling an HIV Hotspot. A Realistic Ambition?

11/30/2022 Pierre Mendiharat Elba Rahmouni Léon Salumu Luzinga

This article was published on December 22nd, 2021, in the Journal of Humanitarian Affairs (Issue 3, Volume 3).
Despite a concerted international effort in recent decades that has yielded significant progress in the fight against HIV/AIDS, the disease continues to kill large numbers of people, especially in certain regions like rural Ndhiwa district in Homa Bay County, Kenya. Although there is still no definitive cure or vaccine, UNAIDS has set an ambitious goal of ending the epidemic by 2030, specifically via its 90-90-90 (treatment cascade) strategy – namely that 90 per cent of those with HIV will know their status; 90 per cent of those who know their status will be on antiretroviral therapy and 90 per cent of those on antiretroviral therapy will have an undetectable viral load. These bold assumptions were put to the test in a five-year pilot project launched in June 2014 by Médecins Sans Frontières (MSF) and Kenya’s Ministry of Health in Ndhiwa district, where an initial NHIPS 1 study by Epicentre (MSF’s epidemiology centre) in 2012 revealed some of the world’s highest HIV incidence and prevalence, and a poor “treatment cascade”. Six years later a new Epicentre study, NHIPS 2, showed that the 90-90-90 target had been more than met. What explains this ‘success’? And given the still-high incidence, is it truly a success? What follows is an interview on the political, scientific, and operational challenges of the Ndhiwa project with MSF Deputy Director of Operations Pierre Mendiharat and physician Léon Salumu, Head of MSF France Kenya programs, conducted by Elba Rahmouni.

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MSF and Ebola in Nord Kivu MSF Analysis

MSF and Ebola in Nord Kivu. Positioning, Politics and Pertinence

11/04/2022

This article was published on December 22nd, 2021 in the Journal of Humanitarian Affairs (Issue 3, Volume 3).
In this article, Natalie Roberts analyses the actions and positioning of MSF during the Ebola outbreak in Nord Kivu (Democratic Republic of Congo, 2018-2020).

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Jean-Christophe Nougaret/MSF Jean-Christophe Nougaret/MSF Analysis

About the possibility of controlling an HIV epidemic hotspot

11/14/2021 Elba Rahmouni Pierre Mendiharat Léon Salumu Luzinga

This article was first released in the 18th volume of the Humanitarian Alternatives magazine. Designed to reduce the incidence of HIV/AIDS in a Kenyan district, a Médecins Sans Frontières project successfully exceeded the “90-90-90” target set by UNAIDS. A look back on the results that the authors of this article - Pierre Mendiharat, Deputy director of operations at MSF France and Léon Salumu Luzinga, Program manager at MSF France, interviewed by Elba Rahmouni - believe are encouraging but by no means a guarantee that the epidemic will be over by 2030.

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MSF medical mobile teams vaccinating Elderly people and frontline Healthcare workers in a nursing home in Tripoli. Mohamad Cheblak/MSF Review

Covid-19 Reading List : the vaccines special edition

05/07/2021 Michaël Neuman

We can all agree that the emergence of Covid-19 vaccine is “an absolutely astonishing development”, but vaccines are unlikely to completely halt the spread of the virus, let alone eradicate it. Yet even without achieving herd immunity, the ability to vaccinate vulnerable people seems to be reducing hospitalizations and deaths from Covid-19. 

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José Rodrigues Emergency Unit (UPA) in Manaus, Brazil, where the Covid situation remains critical. Mariana Abdalla/MSF Opinion

What to think, do and say about the Covid-19 vaccination? 

02/19/2021 Jean-Hervé Bradol Isabelle Defourny

Blog written by Jean-Hervé Bradol, director of studies at the Crash.

Today, in order to obtain supplies of vaccines against Covid-19, there is neither a major difficulty related to price, nor a major obstacle related to intellectual property rules, nor a deficit in bio-medical research. However, these three topics are generally at the heart of MSF's communication in the area of access to medical care for those in most need. Our discourse must therefore evolve.
With the emergence of worrying variants of the virus present in the early stages of the pandemic and, as a consequence, the need to vaccinate on a global scale as quickly as possible, the world is facing a double challenge: biological engineering and ultra-industrial production – “ultra” echoing the need to produce on a global scale in a short period of time.

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MSF intervention in care homes Olmo Calvo/MSF Opinion

I do not clap at 8 o’clock

05/10/2020 Jean-Hervé Bradol

The biggest oversight in the response to this epidemic has been the EHPADs. For the staff, the directive was clear: continue to work and provide an alternative to hospitalisation. No matter the conditions. For the residents, it was to die alone without treatment to alleviate their suffering.

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Sanitation activities in urban slum, Haiti MSF/Lauranne Grégoire Review

About "Choléra, Haïti, 2010-2018, Histoire d’un désastre" by Renaud Piarroux

12/23/2019 Rony Brauman

The cholera outbreak in Haiti in October 2010 was among the deadliest in modern history, with 800,000 people infected and 10,000 fatalities. And these are just the official figures. The actual death toll was far higher, as evidenced by numerous retrospective mortality surveys, and can only be expressed as an order of magnitude: to wit, several tens of thousands.   
This book recounts eight years of struggle on two fronts that the author shows to be closely linked: the field, with the implementation of measures of prevention and case management; the scientific debate, in the form of a shattering of the dominant environmental theory concerning the origin of the epidemic.

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