The Charter of Médecins Sans Frontières (MSF), the guiding document for all of the organization's members, states in the final paragraph that volunteers "understand the risks and dangers of the missions they carry out". Through a review of the different periods in the history of MSF, this article analyzes the changing interpretations that the organization's successive leaders have given to this reference to the acceptance of risk by individuals.
Ebola virus disease (EVD) is a highly lethal condition for which no specific treatment has proven efficacy. In September 2014, while the Ebola outbreak was at its peak, the World Health Organization released a short list of drugs suitable for EVD research. Favipiravir, an antiviral developed for the treatment of severe influenza, was one of these. In late 2014, the conditions for starting a randomized Ebola trial were not fulfilled for two reasons.
The movement of people has featured throughout human history; so substantial is the legacy of migration that the freedom of movement within and across borders was enshrined in article 13 of the UN Universal Declaration of Human Rights in 1948.
The suffering endured by refugees and other exiles in the northern port town of Calais, France, has been the subject of significant media attention in recent months. Renewed interest in the plight of Calais' encamped population began to peak in April 2015, at the same time that the French authorities forcibly closed the largest settlement, situated in woodland adjacent to an active titanium oxide factory. Residents of this settlement were relocated to a nearby segment of sandy grassland that was once both a waste disposal site and a local shooting range.
The 2014–2015 Ebola crisis in West Africa has highlighted the practical limits of upholding human rights and common ethical principles when applying emergency public-health measures. The role of medical teams in the implementation of quarantine and isolation has been equivocal, particularly when such measures are opposed by communities who are coerced by the temporary suspension of civil liberties. In their encounters with Ebola victims, outreach teams face moral dilemmas, where the boundaries are unclear between coercion, persuasion and appeals for self-sacrifice.
Read the letter by Caroline Abu Sa'Da and Christine Jamet, a response to the briefing by Welz “Crisis in the Central African Republic and the international response” published in African Affairs (Vol. 113, No. 453, pp. 601-610).
In 2014, the World Health Organization (WHO) declared two "public health emergencies of international concern", in response to the worldwide polio situation and the Ebola epidemic in West Africa respectively. Both emergencies can be seen as testing moments, challenging the current model of epidemic governance, where two worldviews co-exist: global health security and humanitarian biomedicine.
Distrust and suspicion that public health programmes are being used to advance foreign interests have contributed to the increase in murders and violent attacks on vaccination workers. There have been setbacks to polio eradication efforts and other public health objectives. Counterterrorism policies and practices can have unintended health impacts, especially where health programmes are co-opted or undermined, in countries where health systems are strained and population health indicators are poor.
The impact of the 2010 earthquake in Haiti was devastating for a country whose history was already marked by poverty, natural disasters, environmental degradation and political instability. An outbreak of cholera several months later further hampered reconstruction efforts. At the same time, this presented an opportunity to rebuild and develop the country, including an already extremely fragile and inequitable health system.
As of the 31st of March 2015, 418 out of 815 infected health care workers had died from the Ebola virus in Guinea, Liberia and Sierra Leone, according to a recent WHO report. 217 recovered and the fate of the remaining 181 is unknown. These figures alone attest to the heavy price paid by medical staff responding to the crisis.