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Humanitarian ethics in Médecins Sans Frontières/Doctors Without Borders: Discussing dilemmas and mitigating moral distress

As a humanitarian medical organization, Médecins Sans Frontières (MSF) intervenes in places around the world affected by conflict and crisis. Although we are guided by humanitarian principles, our medical teams are often confronted with complicated dilemmas. In a chapter from a new book called Humanitarian Action and Ethics (Zed Books), current and former MSF field workers consider some of the ethical challenges that form an inevitable part of MSF's medical humanitarian action, and how the organization can better enable our staff and front-line field workers to address them.

Gold, Fire and Gallows: Quarantine in History

As the Ebola outbreak in West Africa continues its dreadful march, Duncan McLean looks at the 600-year-old practice of isolating individuals and communities in order to bring an end to epidemics and assesses the effectiveness of such measures.

Challenges of Instituting Effective ‘Medevac’ Policies

The 2014-2015 Ebola epidemic in West Africa was an unprecedented medical and political emergency that cast an unflattering light on multiple corners of government and international response.

The Politics behind the Ebola Crisis

West Africa is still paying the price for its poor response to the Ebola epidemic. Where an early response could have prevented the worst, failures on all levels allowed Ebola to spread, exposing a deep rift between the population and political class of the countries affected. Unless all actors learn from the crisis, a similar disaster may be just a matter of time.

Engaging with National Authorities: Médecins Sans Frontières’s experience in Guinea during the Ebola epidemic

The  Ebola  epidemic  continues  to  be  instructive.  This  was  indeed  the  conclusion  of  the  "Focus"  on  this subject  in  our  inaugural  issue:  the  magnitude  of  this  unprecedented  crisis,  its  failures  and  successes, required  that  there  were  lessons  to  be  learned.  This  is  what  Marc  Poncin,  the  former  coordinator  for Doct

Debate on "Ebola 3 years afterwards"

8 November 2016: Participation of Marc Poncin in the roundtable on "How to do better next time?”.

Treating, Containing, Mobilizing: The Role of Médecins Sans Frontières in the West African Ebola Epidemic Response

With 28,639 cases and 11,316 deaths, the 2014–2016 Ebola epidemic in West Africa stunned the world, revealing the global health community’s collective shortcomings in the face of a virulent and deadly disease. It was also among the largest responses in MSF’s history with more than 5,000 staff deployed to care for patients and help contain the outbreak.

The Ebola clinical trials: a precedent for research ethics in disasters

The West African Ebola epidemic has set in motion a collective endeavour to conduct accelerated clinical trials, testing unproven but potentially lifesaving interventions in the course of a major public health crisis. This unprecedented effort was supported by the recommendations of an ad hoc ethics panel convened in August 2014 by the WHO.

Defective interfering genomes and Ebola virus persistence

Michael Jacobs and colleagues (The Lancet, 2016, Vol. 388, p. 498-503) provide clinical and virological evidence of a relapse of Ebola virus disease (EVD) presenting as acute meningo-encephalitis 9 months after recovery from an acute infection. However exceptional, this case adds to an increasing number of reports suggesting that Ebola virus can persist for months in immune-privileged anatomical sites, such as semen, ocular tissues, breastmilk, and the central nervous system.

Experimental Treatment with Favipiravir for Ebola Virus Disease (the JIKI Trial): A Historically Controlled, Single-Arm Proof-of-Concept Trial in Guinea

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.