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James Smith

Dilemmas in access to medicines: a humanitarian perspective

We challenge the assertion made by Govind Persad and Ezekiel Emanuel (Aug 27, p 932) that “expanding access to less effective or more toxic [antiretroviral] treatments rather than requiring the worldwide best treatment in all settings” is ethically justifiable.

When free is not fair: the case of vaccine donations

Le 10 octobre 2015, Médecins Sans Frontières (MSF) a refusé le don de Pfizer de 1 million de doses du vaccin antipneumococcique conjugué (VPC). La nouvelle a suscité l’émoi dans la communauté internationale de la santé. Après tout, les biens de santé essentiels gratuits pourraient être quelque chose à célébrer.

Palliative care in humanitarian medicine

Historiquement, les soins palliatifs ont été négligés dans la pratique de la médecine humanitaire. Cela paraît surprenant, car la sombre réalité est que le personnel médical est souvent confronté à la mort lors des interventions en réponse aux crises humanitaires.

Palliative Care in Humanitarian Crises

Medical humanitarian organizations don’t generally deal well with death. This may come as a surprise, since it’s a sombre reality of this line of work that frontline staff are often witness to death and dying. Contrary to the humanitarian’s general propensity for self-aggrandizement, it’s not always possible to save lives. So what then of the oft-cited dual imperative to alleviate suffering and preserve dignity?

Voices in global health: present realities, future challenges

2016 will already be remembered as a year of great setbacks in the pursuit of global health and wellbeing; mass social upheaval in the Middle East and north Africa, driven by conflict and a legacy of persistent structural violence, continues to challenge the notion of our shared humanity, while the end of the world's worst Ebola virus outbreak in west Africa has prompted sombre reflection and fierce critique of systemic failures in global outbreak response.

Borders and migration: an issue of global health importance

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.

Deplorable conditions in French ‘Refugee Camp’

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.

Cancer care for refugees

Along with other non-communicable diseases, cancer is now recognised as a major challenge for humanitarian health providers and for those who finance their programmes. The recent Policy Review of cancer treatment requests submitted to UN High Commissioner for Refugees (UNHCR) Exceptional Care Committees (ECC), by Paul Spiegel and colleagues, makes a valuable contribution to a sparse evidence base.

Exploring alternative narratives: the prioritisation of polio in northern Nigeria

Tara Mangal and colleagues present compelling evidence that lends support to the suggestion that the efficacy of the oral poliovirus vaccine varies depending on its composition, thus reinforcing similar findings reported by Jenkins and colleagues in 2008. However, the persistence of polio in the northern states of Nigeria cannot be adequately explained by the chemical properties of the vaccine and therefore warrants further exploration.

“From the American People”: the US Farm Bill and the reform of emergency food aid

On Nov 8, 2013, Typhoon Haiyan made landfall in the Philippines. Winds of up to 235 km/h cut through the province of Eastern Samar as the storm progressed westwards and further towards the centre of the island archipelago. In the immediate aftermath of the storm, a myriad of humanitarian stakeholders scrambled to provide basic services including health care, shelter, and food to the affected population.

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