Doctors Without Borders News

Syria: Medicine as a Weapon of Persecution

Wed, 08 Feb 2012 14:42:00 GMT

Syria 2012 © MSF

A Syrian patient treated by MSF

Paris, February 8, 2012 – The Syrian regime is conducting a campaign of unrelenting repression against people wounded in demonstrations and the medical workers trying to treat them, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) said today.

While MSF cannot work directly in Syria, it has collected testimonies from wounded patients treated outside the country and from doctors inside Syria. The testimonies, collected from several people from various parts of the country, point to a crackdown on the provision of urgent medical care for people wounded in the ongoing violence in Syria.

"In Syria today, wounded patients and doctors are pursued, and risk torture and arrest at the hands of the security services," said Marie-Pierre Allié, MSF president. "Medicine is being used as a weapon of persecution."

Most of the wounded do not go to public hospitals for fear of being arrested or tortured. When a wounded person is admitted to a hospital, a false name is sometimes provided to hide his or her identity. Doctors will provide false diagnoses to help patients elude security forces, which search for patients with wounds consistent with those sustained in protests and demonstrations.

"It is critical that the Syrian authorities reestablish the neutrality of healthcare facilities," said Marie-Pierre Allié. "Hospitals must be protected areas, where wounded patients are treated without discrimination and are safe from abuse and torture, and where medical workers do not risk their lives by choosing to comply with their professional code of ethics."

The injured are largely treated in clandestine treatment facilities by doctors trying to fulfill their commitment and duty to provide medical assistance. Improvised health clinics have been established in apartments, on farms, and elsewhere. Simple rooms outfitted as makeshift operating theaters, known as "mobile hospitals," are used for surgical procedures. Hygiene and sterilization conditions are rudimentary and anesthesia is in short supply. Furthermore, the mere possession of drugs and basic medical materials, such as gauze, is considered a crime.

"The security services attack and destroy the mobile hospitals," said a doctor who requested anonymity. "They enter houses looking for drugs and medical supplies."

Security is the key concern for doctors working in the parallel underground networks. In the prevailing climate of terror, treatment must be provided rapidly since medical workers and patients must constantly change location to avoid detection.

"We are constantly being pursued by the security forces," said another physician. "Many doctors who treated wounded patients in their private hospitals have been arrested and tortured."

It is extremely difficult to treat major trauma cases and provide post-operative care. Furthermore, the clandestine health workers cannot obtain blood from the central blood bank, which is controlled by Syria’s Ministry of Defense -- the only blood supplier in the country.

Only a few wounded patients have managed to find refuge in neighboring countries, where they can receive proper—albeit delayed—medical care.

"I was wounded in the thigh and the soldiers caught me,” recounted a patient treated by MSF. “They beat me on the head and on my wound, but I managed to get away with help from people in the neighborhood. In the end, I found someone who could treat me—a nurse, not a doctor. He didn't even have anesthetic."

Under the current circumstances, MSF’s assistance to Syrians requiring medical care is limited. For months, MSF has been seeking official authorization to aid the wounded in Syria, so far without success. The organization is treating patients outside Syria and is supporting doctors' networks inside the country, through the provision of medicine, medical supplies, and surgical and transfusion kits.

New Doctors Without Borders Book Reveals Perils of Negotiating Access to Crisis Zones

Mon, 30 Jan 2012 17:21:00 GMT

Angola 1999 © H.J. Burkard

Live webcast
Please join us for a live, online discussion of these issues featuring several experienced MSF aid workers.

Tuesday, January 31, 2012
8:00 PM (ET)

More information.

#AnyPrice

NEW YORK, NY, JANUARY 30, 2012 - In a new book launched in the United States today, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) takes readers behind the scenes of humanitarian action, revealing the complicated negotiations and precarious compromises required to negotiate access to populations trapped by armed conflicts and health crises.

Inspired by MSF’s fierce internal debates on the evolution of its independence as a humanitarian organization, Humanitarian Negotiations Revealed: The MSF Experience offers a candid, self-critical examination of MSF’s decision-making processes in a dozen countries, including Afghanistan, Myanmar, Somalia, Sri Lanka, and Yemen.

The book, released in conjunction with MSF’s fortieth anniversary, reflects on MSF’s medical humanitarian efforts over several decades—some successful, some less so—and aims to ignite wider discussions of humanitarian ambitions and the best ways of fulfilling them.

“Humanitarian negotiations have life-or-death consequences for people in need,” said Sophie Delaunay, executive director of MSF-USA. “As MSF weighs the risks of delivering humanitarian aid in precarious situations, such as Somalia, it seems more important than ever to lift the veil that often obscures the difficult choices our teams confront on a daily basis.”

The book consists of a series of case studies, followed by thematic essays, which examine the delicate balance between upholding MSF’s founding principles of independence, neutrality, impartiality, and speaking out; and the practical realities of delivering humanitarian aid in complex and dangerous political environments.

The authors—MSF veterans with many decades of collective field experience—chronicle MSF’s experience in 12 countries: Afghanistan, Ethiopia, France, the Gaza strip, India, Myanmar, Nigeria, Pakistan, Somalia, South Africa, Sri Lanka, and Yemen. Journalist David Rieff contributes an afterword in the book.

In conjunction with the launch, MSF will present a live, interactive webcast, “At Any Price? Negotiating Access to Crisis Zones,” free and open to the public, on Tuesday, January 31, at 8:00 p.m. EST. A panel of experienced MSF aid workers, including Michael Neuman, one of the authors and editors of the book, will discuss their experiences in conducting humanitarian negotiations in the field.

Panel discussions, featuring editors of the book and other guest speakers, will be held at the Boston Public Library on Wednesday, February 1, at 7:00 pm, and at The New School’s Tishman Auditorium in New York City on Thursday, February 9, at 7:00 pm. Both events are free and open to the public; register online a here.

Humanitarian Negotiations Revealed: The MSF Experience follows MSF’s 2004 publication In the Shadow of Just Wars, and continues the “Populations in Danger” series produced by MSF’s research center in Paris, CRASH (Centre de Reflexions sur l’Action et les Savoirs Humanitaires) (Center for Reflection on Humanitarian Action and Knowledge).

Humanitarian Negotiations Revealed: The MSF Experience (ISBN 978-0-231-70315-4) is being published by Columbia University Press. The book can be pre-ordered online from Amazon.com or Columbia University Press, and will be available in bookstores by the end of February.

Advance praise for Humanitarian Negotiations Revealed: The MSF Experience:

“With a refreshing honesty, it explores the thin line that humanitarian agencies tread between saving lives and supporting oppressors. This brave and informative book reconfirms MSF as an organization that thinks as well as acts.”

—Mark Duffield, Professor of Development Politics and Director, Global Insecurities Center, University of Bristol

“This is a very valuable book. It shows one of the world's great humanitarian organizations thinking aloud about the difficult choices it faces as it struggles to save and protect human life.”

—Dr. Hugo Slim, Oxford Institute of Ethics, Law and Armed Conflict, University of Oxford

As Global Fund Turns Ten, Lack of Political Support to Health Threatens Gains Against AIDS, TB, and Malaria

Mon, 30 Jan 2012 07:24:00 GMT

South Africa 2011 © Chelsea Maclachlan/Le Monde

A woman receives antiretroviral medication at an MSF clinic in Cape Town. While MSF relies solely on private donors, a loss of funding from the Global Fund will leave thousands without treatment.

NAIROBI, JANUARY 30, 2012 - As the Global Fund to Fight AIDS, Tuberculosis, and Malaria marks its tenth anniversary—and on the heels of its leadership changes—people living with HIV/AIDS and those delivering and supporting HIV and TB treatment took to the streets as they warned that the political commitment made 10 years ago to address global health is evaporating, and that drastic funding shortfalls could cause an unraveling of a decade’s progress against the three diseases. The Global Fund Board in November took the unprecedented decision to cancel its eleventh round of funding because of a dramatic resource shortfall, and will not make grants for scale-up of HIV or drug-resistant TB treatment until 2014.

“Ten years ago, there was a landmark decision to support the roll out of HIV, TB, and malaria prevention and treatment in countries that couldn’t completely support programs on their own,” said Dr. Jennifer Cohn, of the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières’s (MSF) Access Campaign in East Africa. “MSF has been part of the effort over the last decade to treat patients, introduce new treatments, and develop simple ways to deliver them. We have seen the positive impact of the Global Fund and other international health initiatives on individuals and communities, with deaths and sickness plummeting.”

The progress achieved is critical: nearly half of all people in need of HIV treatment in developing countries now have access, and in sub-Saharan Africa, treatment coverage increased by 30 percent in 2010 alone. MSF provides HIV treatment in 19 developing countries, and in at least eight of them, more than 80 percent of the people on HIV medicines receive them through programs funded by the Global Fund. The Global Fund’s cancellation of its latest funding round is especially detrimental at a time when scientific research has shown that HIV treatment itself can be a decisive tool for pushing back the pandemic: a person put on treatment earlier is 96 percent less likely to transmit the virus.

In several countries affected by HIV, plans to implement treatment strategies that have the biggest impact on the epidemic are at risk because of the funding crisis. In Malawi, for example, the government is attempting to find funding to pay for a plan to provide all HIV-positive pregnant women with life-long treatment. They have also been forced to put on hold plans to switch people to a newer World Health Organization–recommended treatment that has far fewer side effects. In the Democratic Republic of Congo, where already only 15 percent of people in need have access to HIV treatment, waiting lists have grown and some clinics have had to close their doors as funding declines.

Two years ago in Uganda, a lack of funding forced serious delays in starting people on HIV treatment.

“I am gravely concerned that people living with HIV and TB in countries affected by these epidemics are being told to wait for another two years before they can get the treatment they urgently need today,” said Dr. Peter Mugyeni, in Uganda. “I don’t want to see a return of the situation we faced in Uganda two years ago, when we couldn’t give people the treatment they needed to stay alive because there wasn’t the money to pay for it. If this happens again, it will again result in unnecessary deaths.”

TB will also be impacted. Although numbers of people with TB have been slowly falling since 2006, barely 10 percent of the global annual estimate of 440,000 new patients with multidrug-resistant tuberculosis (MDR-TB) receive treatment. Just as treatment expansion for MDR-TB seemed to be gaining momentum, the evaporation of political commitment is undermining the response.Enrolment of new patients on MDR-TB treatment will slow down in countries heavily reliant on the Global Fund.

“Pledges last week for funds from Japan and the Gates Foundation should serve as a wake-up call,” said Nelson Otwoma, National Coordinator of NEPHAK, Kenya’s largest network of people with HIV. “Now that it has new leadership, the Global Fund needs to hold an emergency donor conference so it can ensure countries can apply this year for grants to provide life-saving treatment to those with HIV, TB, and malaria. A Global Fund that is downsizing is a bitter pill to swallow. We’re beginning to see light at the end of the tunnel with the HIV epidemic, so now is not the time to shift into a lower gear.”

Countries such as Belgium, Denmark, the Netherlands, and the United States need to pay their full and outstanding pledges or reverse reductions in contributions, and recipient countries must also focus on increasing funding for critical diseases such as HIV and TB. A change from ad hoc voluntary funding to a more predictable mechanism—such as the financial transaction tax currently being debated in Europe—is needed, with part of funds generated to be dedicated to global health, including the Global Fund.

Libya: Detainees Tortured and Denied Medical Care

Thu, 26 Jan 2012 14:42:00 GMT

Libya 2011 © MSF

An MSF physiotherapist works in one of Misrata's detention centers, where MSF is suspending operations.

TRIPOLI/BRUSSELS/NEW YORK, JANUARY 26, 2012 – Detainees in the Libyan city of Misrata are being tortured and denied urgent medical care, leading the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) to suspend its operations in detention centers in Misrata, MSF announced today.

MSF teams began working in Misrata’s detention centers in August, 2011, to treat war-wounded detainees. Since then, MSF doctors had been increasingly confronted with patients who suffered injuries caused by torture during interrogation sessions. The interrogations were held outside the detention centers. In total, MSF treated 115 people who had torture-related wounds. The organization reported all the cases to the relevant authorities in Misrata. Since January, several of the patients returned to interrogation centers were again tortured.

“Some officials have sought to exploit and obstruct MSF’s medical work,” said MSF general director Christopher Stokes. “Patients were brought to us in the middle of interrogation for medical care, in order to make them fit for further interrogation. This is unacceptable. Our role is to provide medical care to war casualties and sick detainees, not to repeatedly treat the same patients between torture sessions.”

MSF medical teams were also asked to treat patients inside the interrogation centers, which the organization categorically refused.

The most alarming case occurred on January 3, when MSF doctors treated a group of 14 detainees who returned to a detention facility from an interrogation center. Despite previous MSF demands for the immediate end of torture, 9 of the 14 detainees had suffered numerous injuries and displayed obvious signs of torture.

The MSF team informed the National Army Security Service—the agency responsible for interrogations—that a number of patients needed to be transferred to hospitals for urgent and specialized care. All but one of the detainees were again deprived of essential medical care and were subjected to renewed interrogations and torture outside the detention centers.

After meeting with various authorities, MSF sent an official letter on January 9 to the Misrata Military Council, the Misrata Security Committee, the National Army Security Service, and the Misrata Local Civil Council, again demanding an immediate stop to any form of ill treatment of detainees.

“No concrete action has been taken,” said Christopher Stokes. “Instead, our team received four new torture cases. We have therefore come to the decision to suspend our medical activities in the detention centers.”

MSF has been present in Misrata since April 2011, following the outbreak of conflict in Libya. Since August 2011, MSF has worked in Misrata’s detention centers, treating war-wounded, performing surgeries, and providing orthopedic follow-up care to people who had suffered bone fractures. MSF medical teams have carried out 2,600 consultations, including 311 for violent trauma.

MSF will continue its mental health activities in schools and health facilities in Misrata, and will continue to assist 3,000 African migrants, refugees, and internally displaced persons in and around Tripoli.

MSF is an international medical humanitarian organization that has worked in Libya since February, 2011. To ensure the independence of its medical work, MSF relies solely on private donations to finance its activities in Libya and does not accept any funding from governments, donor agencies, or military or political groups.

DRC: Majority of People Living with HIV Denied Treatment

Wed, 25 Jan 2012 15:57:00 GMT

DRC 2011 © Robin Meldrum

Michel Kongawi, head lab tech, prepares a CD4 test in the laboratory at Lubutu hospital, Maniema Province.

KINSHASA, JANUARY 25, 2012 – The vast majority of people living with the AIDS virus in the Democratic Republic of Congo (DRC) are deprived of lifesaving treatment, due to a withdrawal of international donor support and the lack of national prioritization of the crisis, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) said today.

The number of HIV-positive people in DRC is currently estimated at more than one million, 350,000 of whom could benefit from antiretroviral (ARV) treatment. However, only 44,000 people are currently receiving treatment, translating into a 15 percent ARV coverage rate, one of the lowest in the world. Of all African countries, only Somalia and Sudan have similar rates.

The conditions surrounding access to care for people living with HIV/AIDS in DRC are horrific. At the Centre Hospitalier de Kabinda (CHK) in Kinshasa, the capital, MSF has observed an excessively high number of patients arriving with serious complications resulting from lack of treatment. Their advanced illness creates unacceptable suffering.

"I have worked with HIV-positive patients in many countries in central and southern Africa, but what I'm seeing in DRC has not existed elsewhere for years," said Anja De Weggheleire, MSF's medical coordinator in DRC."The situation here reminds me of the time before any antiretroviral (ARV) treatment was available.Our doctors face serious complications every day that could be prevented if patients received early ARV treatment."

The alarming situation for HIV/AIDS patients in the Democratic Republic of Congo (DRC), coincides with the tenth anniversary of the Global Fund to Fight AIDS, Malaria, and Tuberculosis, which is struggling to meet its funding commitments.

The DRC is also one of the two lowest-ranked countries in western and central Africa in terms of prevention of mother-to-child transmission of HIV (PMTCT). Only 1 percent of pregnant women estimated to be HIV-positive in DRC have access to PMTCT treatment. Without treatment, approximately one-third of babies who are exposed to the virus will be born with HIV.

Despite these disastrous indicators, donors have not given DRC the priority it deserves. What is worse, some donors, such as the Global Fund, are withdrawing or sharply reducing their funding. While the Global Fund is the leading supplier of ARV drugs in the DRC, the countries that finance the Fund have not kept their promises. As a result, the Global Fund is having to lower its sights.

This pull-back by donors is directly threatening the lives of thousands of people in DRC.

"If nothing is done, it is highly likely that the 15,000 people currently on the waiting list and in urgent need of ARV drugs will be dead within three years,” said De Weggheleire.“As horrifying as that number is, it represents only the tip of the iceberg when you realize that most people living with HIV/AIDS in DRC do not know their HIV status. Many will die in silence and neglect."

It is crucial that Congolese authorities meet their commitment to provide free prevention services and free treatment for people living with HIV/AIDS. It is also critical that donors immediately mobilize the necessary resources to ensure that patients waiting for ARV treatment are not condemned to die.

MSF has been working in DRC for more than 30 years, operating HIV/AIDS programs since 1996. In October 2003, MSF was the first organization to provide free ARV treatment to patients in DRC. Through its healthcare support programs and its AIDS project in Kinshasa, MSF treats more than 5,000 patients in six provinces, more than 10 percent of the number receiving ARV treatment throughout the country. In Kinshasa, MSF is treating 20 percent of the total number of patients on ARV treatment in the Congolese capital.

Today, MSF is launching a communications and advocacy campaign that will continue throughout 2012 to raise public awareness of the very serious situation facing people with HIV/AIDS in DRC and to encourage all actors to expand ARV coverage.

"Even Running Away Is Not Enough": Attacks in Jonglei, South Sudan, Perpetuate Extreme Violence

Tue, 24 Jan 2012 16:07:00 GMT

South Sudan 2012 © Heather Whelan/MSF

An MSF doctor examines a baby in Pibor, in Jonglei State in South Sudan, where people who went into hiding following recent attacks continue to come in for urgently needed medical care at MSF's re-opened facilities.

"Our team here in Pibor was evacuated on 23 December ..."

January 23, 2012
Listen to an interview with MSF field coordinator in Pibor, Karel Janssens, about returning to villages where MSF has been working in Pibor to find them destroyed, the MSF staff that are still missing, and the patients affected by the attacks.

Patient Testimonies

"I Don't Even Know What Happened To My Child"
Testimonies given by people who were injured or whose family members were injured, killed, or adbucted during attacks in South Sudan's Jonglei State.

JUBA, JANUARY 24, 2012 - Civilians continue to bear the brunt of extreme inter-communal violence in Jonglei state in South Sudan, with their resources and lifelines, including hospitals and water supplies, also deliberately targeted, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) said today.

Wounded people are still arriving at the MSF hospital in the town of Pibor, three weeks after a violent attack on the town and outlying villages in Pibor County. Many people were injured in the bush, where thousands remain, too afraid to come out of hiding. The hospital was also targeted during the attack.

“We are seeing a cycle of attacks and reprisals throughout this area of northern Jonglei,” said MSF head of mission Jose Hulsenbek. “For the civilians in this part of South Sudan, the fear of having to flee their homes or being killed is very real.”

A recurring characteristic of the attacks in Jonglei is their extreme violence. One woman suffering from a gunshot wound and treated by MSF in Pibor said she had fled to the bush with her husband, children, and 15 other family members. After running for eleven hours, they were found by a group of men who shot at them. “We scattered. They shot me in my thigh and my baby was hanging on my back. I tried to hide in the high grass but they found me because my baby was crying. They started beating my daughter until she kept quiet. They left us behind thinking we were dead.” Her son was also treated by MSF for a bullet wound to the chest that remarkably did not kill him.

“After these attacks many women and children are coming to us shot, stabbed, and beaten,” said Colette Gadenne, MSF operations coordinator for South Sudan. “They try to keep safe by hiding in the bush, but it seems that even running away is not enough.”

A deeply worrisome pattern is emerging, where people and their scarce resources are deliberately targeted by all the armed groups involved in inter-communal violence. Hospitals, health clinics, and water sources are all targets, suggesting a tactic of depriving people of life’s basic essentials, precisely when they need them most.

The village of Lekwongole, north of Pibor town, scarcely exists today after coming under attack. All that exists of the MSF clinic there are concrete floors and walls, although medical activities resumed there on January 18.

“The people explained that during the day they dare to come out of hiding to search for food or to seek medical care,” said Karel Janssens, MSF project coordinator. “But at night they return to their hiding places in the bush where they are at risk of contracting malaria or respiratory infections.”

MSF medical teams are now treating serious wound infections, some several weeks old. Since re-launching emergency medical activities in Pibor on January 7, MSF has treated 47 patients with gunshot wounds, among them 16 women and 8 children. An additional 43 patients have been treated for stab wounds, beatings, or wounds sustained while fleeing in the bush. Since January 7, approximately half of MSF’s patient consultations in Pibor have been for malaria; people sleeping in the bush are more vulnerable to contracting the disease.

MSF is extremely concerned for the health and well-being of civilians forced to flee, either from fighting or from fear of an attack. They hide in the bush, with little to no shelter and limited access to food. If they are able to return home, they often only find ashes where their houses once stood.

In the wake of the Pibor attack, MSF has learned that Allan Rumchar, an MSF watchman, and his wife were killed. Of 156 locally recruited MSF staff members, 25 are still unaccounted for and MSF remains deeply concerned for them.

The violence in Pibor is not isolated. After a January 11 attack on the village of Wek in northern Jonglei State, MSF evacuated 13 patients by air, mostly women and children in need of urgent surgical care at MSF’s hospital in Nasir. That followed an August 2011 attack on the town of Pieri and surrounding villages, during which scores of villagers were killed. In the past six months, 185 people with serious wounds have sought care from MSF teams in Lankien, Pieri, and Yuai.

In a December 2009 report, Facing Up to Reality: Health Crisis Deepens as Violence Escalates in Southern Sudan, MSF documented the escalation of inter-communal violence in Jonglei and Upper Nile states, and its increasing impact on civilian populations. MSF treated 392 people wounded by violence that year, and estimated that 86,000 people were displaced. The situation has not improved. In the past six months, MSF has treated more than 250 people wounded in violence in Jonglei State, the majority of whom are women and children.

#MSF outpatient dept full to the brim with women & thr sick children this morn in Pibor #SouthSudan - malaria, diarrhea, respiratry infectns
— Heather Whelan (@HPWhelan) January 20, 2012

Follow Heather Whelan, UK Senior Press Officer for MSF, currently tweeting from South Sudan.

MSF has been working in South Sudan since 1983, and currently runs more than a dozen projects in eight states. MSF runs its own medical facilities and supports Ministry of Health facilities in six locations in Jonglei State, providing basic health care, therapeutic nutrition, and kala azar and tuberculosis treatment, serving a total population of some 285,000 people. In 2011 the MSF medical facilities in Lekwongole, Pibor, and Pieri were targeted and either destroyed or ransacked during inter-communal violence. MSF condemns the targeting of unarmed civilians and of medical assets by any armed group.

MSF Closes Two Large Medical Centers in Mogadishu after Killings of Staff

Thu, 19 Jan 2012 15:36:00 GMT

Somalia 2011 © Martina Bacigalupo

Houses lie in ruin in Mogadishu's Hodan district, where MSF has been forced to end activities.

January 19, 2012 - Following the tragic killings of Philippe Havet and Dr. Karel Keiluhu, staff members of the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) in Mogadishu, Somalia, on December 29, 2011, MSF has been forced to end all activities in the Hodan district of the capital, including the closure of two separate 120-bed medical facilities for the treatment of malnutrition, measles, and cholera.

The closure of activities in the Hodan district reduces by half the assistance MSF is providing in Mogadishu. The facilities were MSF’s largest in the city. For now, MSF projects will continue to provide medical care in other districts of the city, as well as in 10 other locations in Somalia.

However, the continuation of MSF’s assistance to Somalis in need of medical care is dependent upon the respect for personnel, patients, and medical facilities. Where these conditions prevail, MSF remains committed to continue its activities in Somalia.

“It is hard to close health services in a location where the presence of our medical teams is genuinely life-saving,” said Christopher Stokes, MSF general director. “But the brutal assassination of our colleagues in Hodan makes it impossible for us to continue working in this district of Mogadishu.”

In Hodan, MSF had been assisting 200,000 Somalis who fled to the capital in recent months. Since August 2011, MSF treated 11,787 malnourished children, 1,232 people with acute watery diarrhea, and 861 people suffering from measles. MSF teams also vaccinated 67,228 children against measles.

MSF also strongly reiterates its call to all parties, and to the leadership and people of Somalia, to facilitate the safe release of Montserrat Serra and Blanca Thiebaut, MSF aid workers abducted in the Dadaab refugee camp in Kenya on October 13, 2011 while providing emergency assistance to the Somali population.

MSF has been working in Somalia continuously since 1991 and currently operates 13 projects in the country, including medical activities related to the ongoing emergency, vaccination campaigns, and nutritional interventions. MSF also assists Somali refugees in camps in Dadaab, Kenya, and Dolo Ado, Ethiopia.

South Sudan: MSF Responds to Latest Wave of Violence in Jonglei

Fri, 13 Jan 2012 16:40:00 GMT

South Sudan 2012 © Parthesarathy Rajendran/MSF

The pharmacy at the MSF-run hosptail in Pibor, Jonglei state, lies in ruin after it was ransacked in inter-communal violence.

JUBA, SOUTH SUDAN/NEW YORK, JANUARY 13, 2012—Following inter-communal violence on January 11 in northern Jonglei State, South Sudan, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) is treating several people with serious wounds, including women and children.

Thirteen severely wounded people were medically evacuated by air from the MSF clinic in Yuai, Jonglei State, to the MSF hospital in Nasir, Upper Nile State, where they have received urgent surgical care. Five adult women and two adult men suffered gunshot wounds. The remaining patients are children under five, who suffered beatings or gunshot wounds.

“We are very concerned that the majority of the wounded in this latest wave of violence are women and children,” said MSF head of mission Jose Hulsenbek. “The 13 patients have survived the night, but some of the children are still in critical condition with severe head trauma ” she said.

MSF supports a small outreach clinic in Yuai, about two hours outside of Wek, Uror County, where the latest violence took place. MSF is continuing to monitor the situation; if more severely wounded people arrive at the Yuai clinic they will be referred to the MSF-run hospital in Nasir.

This latest round of inter-communal violence follows attacks in late December and early January in Pibor County, where the MSF-run hospital in Pibor town was looted and ransacked. MSF emergency teams resumed medical activities in Pibor town on Sunday, January 8.

MSF has demonstrated its complete impartiality and neutrality over the years, working in many different communities in South Sudan. In 2011, three MSF medical facilities were targeted in Jonglei State. MSF condemns the targeting of medical facilities by any armed group. The organization remains committed to providing humanitarian aid and medical assistance to the population of Jonglei State.

MSF Condemns Attacks On Aid Workers And Calls For Release Of Abducted Colleagues in Somalia

Sat, 07 Jan 2012 15:21:00 GMT

January 7, 2012 – One week ago, a gunman killed Phillipe Havet and Andrias Karel Keiluhuo, two Doctors Without Borders/Médecins Sans Frontières (MSF) aid workers, while they were implementing emergency assistance projects in Somalia’s capital, Mogadishu. Three months ago, MSF staff members Montserrat Serra and Blanca Thiebaut were abducted in the Dadaab refugee camp in northern Kenya while providing emergency assistance for the Somali population there.

These attacks on aid workers must be condemned in the strongest terms, MSF said today. They jeopardize life-saving medical projects that are already far from adequate in addressing the vast medical needs of the Somali population.

MSF is confronting the difficult dilemma of working in a context like Somalia, where the needs are not only extremely great, but the risks are exceptionally high for the safety and security of all staff. As we consider this dilemma, MSF is requesting that all people—especially the authorities in control of areas in Somalia where our kidnapped colleagues are being detained—do everything possible to facilitate the safe release of Blanca and Montserrat.

MSF has been working in Somalia continuously since 1991, assisting Somalis in need on all sides of ongoing conflict. Over the last six months, MSF has treated 225,000 patients in Somalia, vaccinated 110,000 children and cared for 30,000 malnourished children in 14 projects. Additionally, MSF provides assistance to Somali refugees in nine projects in Kenya and Ethiopia, where finding the balance between the massive medical needs of the population and the risks that MSF teams are forced to endure is increasingly challenging. The net result is that the Somali population—extremely vulnerable after 20 years of civil war, international interventions, and institutional collapse—receives less assistance than it needs.

“To effectively continue our medical humanitarian work for populations affected by violence in Somalia, MSF needs all parties to the conflict, the leadership as well as the people of Somalia, to support us in this work and help ensure the safety and security of humanitarian workers,” said Dr.Unni Karunakara, international president of MSF. “For our colleagues Philippe and Kace, this failed tragically. For Blanca and Mone, the leadership and people of Somalia have the responsibility to facilitate the safe and prompt resolution of their abduction.”

South Sudan: Thousands of Civilians Flee for Their Lives

Tue, 03 Jan 2012 15:41:00 GMT

South Sudan 2011 © Liang Zi

An MSF staff member attends to a patient at a hospital in Pibor County, which was looted and damaged during intercommunal violence this week.

Juba, South Sudan/Brussels/New York, January 3, 2012—Renewed intercommunal violence in Jonglei State, South Sudan, has forced thousands of families to flee into the bush, where they have no access to assistance, including medical care.

Two healthcare facilities operated by the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) were targeted in attacks in Jonglei, leaving much-needed medical activities temporarily suspended in Pibor County.

“Thousands of people in Lekwongole and Pibor fled in the last week and are now hiding in the bush, frightened for their lives,” said Parthesarathy Rajendran, MSF head of mission in South Sudan. “They fled in haste and have no food or water, some of them doubtless with wounds. Now they are hiding on their own, beyond the reach of humanitarian assistance.”

The village of Lekwongole was razed to the ground and an MSF team that assessed the situation in Pibor on December 28 described it as a ghost town. Virtually everyone fled into the surrounding countryside. While people are hidden in the bush, they cannot be reached, meaning they cannot have wounds cleaned and dressed, be treated for diseases, or access general healthcare.

During the violence, two of MSF’s medical facilities were looted and damaged: the clinic in the village of Lekwongole on December 27 and the small hospital in the town of Pibor on December 31. A third MSF clinic in the nearby village of Gumuruk has apparently not been affected. The three medical facilities are the only healthcare options for the 160,000 people in Pibor County. The nearest alternative medical facility is more than 62 miles (100 kilometers) away.

MSF condemned the targeting of neutral and impartial medical facilities. The organization has provided neutral medical aid in South Sudan for the last three decades, working in many different communities in the country and treating anyone requiring medical care, irrespective of their ethnicity, religion, or political affiliation. These most recent attacks follow the August 2011 looting and burning of MSF medical facilities in Pieri, further north in Jonglei State. MSF subsequently treated 157 wounded people, mostly women and children.

Ten MSF international staff members were relocated to Juba on December 23, just before the latest violence erupted, and 156 locally hired staff were strongly advised to leave their town or village and seek refuge in the area. Although MSF has established contact with a few of them, many cannot be reached after taking flight along with their families and neighbors. Their precise whereabouts are unknown and MSF is deeply concerned about their safety.

MSF is ready to return and recommence providing emergency care as soon as possible.

“There are several crisis situations evolving in different parts of South Sudan right now,” said Rajendran. “Our medical teams are also currently responding to the crisis of refugees fleeing conflict in neighboring Sudan. These are staunch reminders that despite independence, acute emergencies are still all too present in South Sudan and the capacity for emergency humanitarian response remains an absolute priority.”

UPDATE: JANUARY 10, 2011

A 12-person MSF team returned to Pibor town on Saturday, January 7, following inter-communal violence, which included the looting and destruction of MSF facilities in Pibor. MSF is rehabilitating the facilities in order to resume medical activities. More than one ton of supplies, including drugs and logistics materials, have been airlifted to Pibor town.

As of January 10, 60 of the 155 locally hired MSF staff in Pibor county remain unaccounted for.

MSF has been working in Sudan since 1978 and began activities in the area that is now South Sudan in 1983. MSF works in 8 of 10 states in South Sudan today, providing healthcare in 15 projects via roughly 2,500 national staff and 200 international staff.

MSF and MSF-supported clinics serve a variety of communities, are free of charge, and are open to all. In 2010 MSF teams across the country carried out 588,000 outpatient consultations, treated 37,000 people with malaria, delivered 20,000 babies, cared for 18,000 hospitalized patients, and cured almost 26,000 malnourished children under 5 years of age.

MSF Shocked And Deeply Saddened By The Killing Of Two Staff Members In Mogadishu, Somalia

Thu, 29 Dec 2011 11:36:00 GMT

MSF Emergency Coordinator Philippe Havet

MSF Doctor Andrias "Kace" Karel Keiluhu

MOGADISHU/NAIROBI/BRUSSELS, DECEMBER 29, 2011 - It is with great sadness that the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) confirms that two of its staff members were killed this morning as a result of a shooting at the MSF compound in Mogadishu, Somalia.

While one of the aid workers died during the shooting, the other was transferred to a hospital and died following surgery this evening. The victims are Belgian and Indonesian nationals.

Philippe Havet, a 53-year-old from Belgium, was an experienced emergency coordinator who had been working with MSF since 2000 in many countries, including Angola, the Democratic Republic of Congo, Indonesia, Lebanon, Sierra Leone, South Africa, and Somalia.

Andrias Karel Keiluhu, better known as "Kace," was a 44-year-old medical doctor who had worked with MSF since 1998 in his native Indonesia, as well as in Ethiopia, Thailand, and Somalia.

The exact circumstances of the shooting are not yet clear. MSF’s immediate priority is to take care of those most affected by this tragedy, in particular the families and colleagues of the victims.

MSF will be relocating some staff from Somalia for security reasons but remains committed to continuing its humanitarian work in Mogadishu and elsewhere in Somalia.

Philippe and Kace were in Mogadishu working with the MSF teams to provide emergency medical assistance to displaced persons and residents of the city.

We are deeply shocked by this tragic event and we will greatly miss Philippe and Kace. We extend our heartfelt sympathy and condolences to their families and friends.

MSF has been working in Somalia continuously since 1991 and currently operates 13 projects in the country, including medical activities related to the ongoing emergency, vaccination campaigns, and nutrition interventions. MSF also assists Somali refugees in camps in Dadaab, Kenya, and Dolo Ado, Ethiopia.

MSF Releases 'Ten Stories That Mattered in Access to Medicines in 2011'

Tue, 20 Dec 2011 17:14:00 GMT

Geneva/New York, December 20, 2011—A list of "Ten Stories that Mattered in Access to Medicines in 2011" was released today by the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF). The list looks at developments in 2011 that had an impact—whether positive or negative—on people’s ability to access needed drugs, diagnostics, and vaccines in developing countries.

Access to Essential Medicines: Ten Stories That Mattered
in 2011

Download full report [1989 KB]

For the diseases our medical teams encounter every day in places where we work, 2011 was a year of both critical progress and dangerous backsliding,” said Dr. Tido von Schoen-Angerer, executive director of MSF’s Access Campaign. “At a time of so much promise, it is crucial to continue pushing forward, and refuse to accept a double standard in care between rich and poor countries.

The list covers key developments regarding diseases MSF confronts in developing countries: landmark findings about HIV treatment as HIV prevention; the strikingly low number of people receiving treatment for more lethal, drug-resistant forms of tuberculosis; a new subsidy intended to lower the price of malaria treatments that is headed in the wrong direction; a dangerous global shortage of the drug needed to treat the parasitic slow killer Chagas disease; slow progress on better adapting food aid to meet children’s needs; vaccine prices finally becoming more transparent; and the first-ever guidelines to treat an HIV/AIDS ‘opportunistic infection,’ cryptococcal meningitis.

It also looks at key policy developments of the year, including unprecedented funding shortfalls at the Global Fund to Fight AIDS, Tuberculosis and Malaria; drug companies cutting across-the-board discounts in middle-income countries; and the continued struggle to ensure that affordable generic medicines can be produced in India, the ‘pharmacy of the developing world.

MSF Marks 40th Anniversary with First International General Assembly

Tue, 20 Dec 2011 16:06:00 GMT

Paris © Bruno De Cock/MSF

Dr. Unni Karunakara, international president of MSF, speaks at the organization's first ever International General Assembly. Paris © Bruno De Cock/MSF

Paris/Geneva, December 20, 2011—Doctors Without Borders/Médecins Sans Frontières (MSF) concluded its first ever International General Assembly in Paris last weekend. Members of MSF gathered from all over the world to discuss the future of its medical humanitarian assistance, medical innovation, speaking out, advocacy, and logistical support. The Assembly welcomed four new associations and elected a new International Board.

On the same occasion, MSF also marked its 40th anniversary in the presence of several founding members.

The first International General Assembly (IGA) is the culmination of a process undertaken by MSF over recent years to review its governance structure. Until recently, only national associations based in Western Europe, North America, Japan, Hong Kong, and Australia comprised the international movement, working together with MSF’s International Council. Recognition that this structure does not represent the global movement that MSF has become was at the heart of the governance change. With the new set-up, MSF hopes to be better prepared for future challenges by allowing for greater participation by current and former staff around the world in shaping the organization’s way forward.

Four new associations were welcomed into the international movement: Brazil, East Africa, Latin America, and South Africa.

“It’s a great moment for MSF when we see our long-term decision-making open up to the reality of being a more global movement,” said Dr. Unni Karunakara, MSF’s international president. “It is confirmation of our determination to invite a broad variety of experiences and ideas to contribute to our future direction. And it is a crucial change for allowing our medical humanitarian action to remain as informed, innovative, and relevant as it has become over the past 40 years.”

The IGA also elected six members to the new International Board, which oversees MSF’s general direction throughout the year on behalf of the IGA. The new members include Michalis Fotiadis, Dr. Jean-Marie Kindermans, Colin McIlreavy, Dr. Clair Mills, Dr. Darin Portnoy, and Dr. Morten Rostrup. They join the presidents of MSF’s five operational centers: Dr. Marie-Pierre Allié, Dr. Jose Antonio Bastos, Dr. Pim de Graaf, Meinie Nicolai, and Dr. Abiy Tamrat. Dr. Karunakara and Martin Aked, MSF’s international treasurer, also sit on the board.

The first MSF IGA coincided with the organization’s fortieth anniversary. In his President’s Report, Dr. Karunakara paid tribute to MSF’s founders.

“Today, we recognize the band of volunteers who started our sans frontières movement 40 years ago, here in Paris,” he said. “We have since become more professional, more international, and gained recognition in large parts of the world. Yet the core values first developed in 1971 continue to drive and inspire us.”

Several of MSF’s founders were present at the IGA and shared some of their early experiences with well over 300 participants, who collectively represented the organization’s development through the years.

Central African Republic Mortality Rate Reaches Emergency Levels

Mon, 12 Dec 2011 11:16:00 GMT

Carnot,CAR/Paris/New York, December 13, 2011—The Central African Republic (CAR) is in the grips of a chronic medical emergency, according to a report released today by the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) .

Four mortality studies carried out by MSF over the past 18 months reveal crude mortality rates in some regions of CAR at three times the emergency threshold of one death per 10,000 people per day, which, according to the World Health Organization, is considered a humanitarian crisis. These rates constitute an “out of control” situation, even though the areas with the highest mortality rates are not affected by conflict or a high number of displaced people.

Special Report

Download Special Report
[2.30 MB]

The MSF report, “Central African Republic: State of Silent Crisis,” concludes that existing levels of medical assistance are not enough to meet the scale of CAR's medical needs. The report outlines the need for more actors to conduct larger medical operations that reach more of the population and devise new models of care.

"A health system torn apart by years of political and military instability, major organizational problems, and a lack of security in the northern and eastern regions of the country have had a catastrophic effect on the health of the population and show, to a large extent, how the extremely high mortality rates have come about,” said Olivier Aubry, MSF head of mission in CAR.

At just 48 years, the Central African Republic has the second lowest life expectancy in the world, and it features the fifth highest death rate from infectious and parasitic diseases. In much of CAR, mortality rates are the result of seasonal epidemics, economic downturns, as well as conflict, displacement, and a poor health system.

“In Carnot, the under-five mortality rate last July was three times as high as the under-five mortality rate in Kenya’s Dadaab refugee camp, where people who have fled from Somalia live in dire conditions. In Carnot, the crisis was unknown.”

And yet, the report argues, the commitment by the government and by the international community is going in the wrong direction. The government has been scaling back its investments in health, as have international donors, while humanitarian assistance has failed to reduce the widespread medical crisis.

“If I had not been treated with the help of MSF, I would be dead by now,” said Monkoj Pascal, a patient. “I had diarrhea and a migraine so I went to a doctor in Batangafo and he referred me to the lab for clinical tests. The result confirmed I was HIV-positive. With treatment I am no longer a sick person. I am happy, and I no longer worry about anything.”

Despite the great need, both the government and international donors appear to be disengaging from health provision in the country. And the need for more medical assistance is great.

MSF calls on all actors, including the government and the international community, to expand assistance to healthcare.

MSF’s programs in Central African Republic

Doctors Without Borders/Médecins Sans Frontières (MSF) has been working in the Central African Republic since 1997. At the end of 2010, 1,243 staff members were present in the country. MSF programs support nine hospitals and 36 health centers and health posts. In almost all cases, MSF works in Ministry of Health facilities, seeking as close cooperation as possible. In 2010, 582,253 people were treated as outpatients and 24,185 people as inpatients.

MSF Statement in Response to Gilead Donation of AmBisome for Visceral Leishmaniasis

Thu, 08 Dec 2011 10:15:00 GMT

December 8, 2011--“This agreement is significant in that it helps address immediate treatment needs in some countries for one of the world’s most neglected diseases. But it can not be seen as a global solution as it only covers a small proportion of patients worldwide. We have doubts about whether this is a sustainable solution: more needs to be done to ensure treatment is affordable and available worldwide in the long-term, and that means encouraging competition from similar products to bring down the price of treatment.”

—Dr. Koert RITMEIJER, health advisor, Doctors Without Borders/Médecins Sans Frontières (MSF)

Context

The US pharmaceutical company Gilead Sciences has announced that it has signed an agreement with the World Health Organization (WHO) on a donation of AmBisome for the treatment of 50,000 patients with visceral leishmaniasis (VL) in eligible countries in South Asia and East Africa for a period of five years, starting in 2012.

Liposomal amphotericin B (L-AmB), which Gilead markets under the brand name AmBisome, is indicated for treatment of visceral leishmaniasis, a neglected parasitic tropical disease, and for the treatment of fungal infections, including severe AIDS-related opportunistic infections such as cryptococcal meningitis. WHO considers L-AmB the preferred option for elimination of visceral leishmaniasis in the Indian subcontinent, and has recently included it in its latest treatment guidelines for cryptococcal meningitis.

But L-Amb is also marketed in both wealthy and middle-income countries for lucrative indications such as for immuno-suppressed cancer or transplant patients.

The Gilead donation has a limited scope as it will only serve the needs of a small proportion of patients with visceral leishmaniasis. There are between 250,000 and 300,000 new cases every year, but only an average of 10,000 patients will benefit from the donation annually. In addition, the donation does not apply to AIDS-related fungal infections.

Gilead has not yet disclosed which countries will be eligible. It is unlikely that the donation applies to India, the country with by far the highest burden of visceral leishmaniasis.

MSF has asked Gilead to further bring down the price of AmBisome for visceral leishmaniasis in developing countries. Gilead offers AmBisome for visceral leishmaniasis at US$18 per vial for the public sector and for not-for-profit organisations such as MSF. Because several vials are needed, that comes in at around $200 per treatment course. A study has shown that if the price of AmBisome was reduced to under $10 per vial in India, then using the drug would become the most cost-effective strategy to treat the disease.

There are also questions surrounding the sustainability of donations, and particularly long-term sustainable access to affordable liposomal amphotericin B in light of this donation. As demand increases over time, it will not be possible to rely on a donation for worldwide supply. AmBisome is so far the only version of L-AmB to have been validated by a stringent drug regulatory authority, but generic manufacturers are currently working on competing versions.

First-Ever Treatment Guidelines Released for Major Cause of Death of People Living with HIV

Wed, 07 Dec 2011 16:41:00 GMT

Addis Ababa, December 7, 2011—The World Health Organization (WHO) has issued the first-ever guidelines for the treatment of cryptococcal meningitis—a disease ranking among the top causes of death among people living with HIV/AIDS. However, access to some of the WHO-recommended medicines ranges from difficult to non-existent in developing countries.

According to data presented by the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) at the ICASA AIDS conference in Addis Ababa, cryptococcal disease is a major cause of illness and death in many parts of Africa. The study looked at the cause of death among 36,664 people started on antiretroviral therapy (ART) in 25 MSF treatment programs in Africa, Asia, and Eastern Europe between 2002 and 2010. In this study, patients infected with extrapulmonary cryptococcosis were 3.5 times more likely to die in the first six months after antiretroviral therapy was started; the greatest risk of all opportunistic infections associated with HIV.

"Our findings show that people living with HIV/AIDS are frequently contracting and dying of cryptococcal disease," said MSF's HIV/AIDS Advisor Dr. Daniel O’Brien, who is also an author of the study. "It's very good news there are finally clear guidelines for how to diagnose early and treat this disease, but access to the needed drugs remains a big challenge."

The main drugs recommended by WHO include amphotericin B and flucytosine as first choice, with amphotericin B and fluconazole as alternatives when the first regimens are unavailable or unaffordable. Access to flucytosine is restricted by the fact that it is not registered in most countries in sub-Saharan Africa, where the HIV burden is highest. Registration barriers also exist for amphotericin B, and there have been global shortages of the drug, with South Africa and other countries likely to face stock-outs this year. In South Africa’s KwaZulu Natal Province, researchers found that only 35 percent of patients received any amphotericin B at all, with only eight percent receiving the recommended two-week treatment course.

"To address HIV/AIDS properly depends on being able to prevent, diagnose, treat and cure the opportunistic infections that are ultimately causing the AIDS deaths," Dr. O’Brien said.

At African AIDS Conference, MSF Calls For Increased Funding for HIV Treatment

Fri, 02 Dec 2011 18:15:16 GMT

NAIROBI/ADDIS ABABA, Dec. 2, 2011 – As Africa’s AIDS Conference convenes in Addis Ababa, efforts to combat HIV in sub-Saharan Africa are under serious threat because of a massive funding crisis at the Global Fund to Fight AIDS, Tuberculosis and Malaria, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) said today. At the same time, recent scientific evidence shows that this is a time of great promise, with HIV treatment itself having been proven to not only save lives, but also to dramatically reduce the spread of the virus from one person to another.

Africa is home to countries with the world’s highest HIV prevalence, where the social and economic impact of the pandemic is the highest in the world. The ‘International Conference on AIDS and Sexually-transmitted Diseases in Africa’ (ICASA) is the main gathering of scientists, health professionals and policy makers to take stock of the AIDS pandemic that continues to ravage the continent.

“The recent medical advances around HIV and the progress achieved in scaling up treatment to half the people in need today are pointing us in the right direction,” said Dr. Leslie Shanks, MSF Medical Director. “But this will all be meaningless if there is not enough funding to match the political promises we've accrued to date. All governments should fund further treatment scale-up to both save lives while reducing transmission of the virus.”

Last week, the Global Fund Board announced its decision to cancel the most recent round of funding because of a lack of resources, stating that no new funding opportunity will be possible until 2014. Its contingency Transition Funding Mechanism will only support continuity of programs, which does not include treatment for any new patients in need of HIV or DR-TB treatment. This decision comes at a time when global HIV/AIDS funding has been on the decline for two years in a row, a fact that is already seriously endangering the continuity of people’s treatment and plans for scale-up of life-saving treatment to hundreds of thousands of people living with HIV.

MSF calls on the Global Fund Board to provide a new funding opportunity and convene an emergency donor conference within 200 days, before the International AIDS Conference in Washington, DC in July 2012.

This year has brought critical political commitments: all governments meeting at the UN High Level Meeting in June committed to having 15 million people on HIV treatment by 2015, and the US government committed on World AIDS Day to put an additional two million people on treatment over the next two years. This is a critical step in the midst of a bleak outlook for global HIV/AIDS programs, but these commitments need to be backed up with the necessary funding to turn them into reality – the Global Fund must be funded. Affected governments need to step up to avoid gaps, help expand treatment and reverse the epidemic.

“We have been seeing the impact of the funding crisis in countries where we work,” said Dr. Shanks.

“Some countries have to cap the number of new people allowed to start treatment, others have to delay the start of improved treatment protocols, and many are forced to put critical plans on hold to roll out treatment strategies that can have a serious impact on the epidemic.”

At the ICASA conference, MSF will present field research that quantifies and documents examples of the effects of funding shortfalls in African countries over the last two years. Other presentations will demonstrate significant progress in field research related to opportunistic infections that worsen the conditions of people living with HIV/AIDS in Africa, such as the neglected tropical diseases visceral leishmaniasis and cryptococcal meningitis. These conditions will also be impacted by a lack of funding for HIV/AIDS.

MSF’s Briefing Document, "Reversing AIDS? How advances are being held back by funding shortages," can be found at www.msfaccess.org

Response to Obama's HIV/AIDS Speech: "Now It Is Time For All Governments To Step Up"

Thu, 01 Dec 2011 15:30:00 GMT

Response by Doctors Without Borders/Médecins Sans Frontières (MSF) to President Obama’s December 1 speech on World AIDS Day, during which he committed to reach two million more people with US-funded HIV treatment by the end of 2013, bringing the total number of people on treatment under US funding to nearly 6 million:

“This commitment today is the shot in the arm that the global HIV/AIDS response needs right now. We hope this marks the end of donors walking away from supporting global HIV/AIDS, despite evidence that the epidemic can be reversed. People living with HIV around the world will be watching closely to make sure this commitment is turned into reality. Now it is time for all governments – both donors and affected countries alike – to step up, fund the Global Fund, and increase the pace of HIV treatment scale-up, so that the effort to end AIDS is not derailed.

Our doctors and nurses started treating people with HIV in developing countries a decade ago, in the face of widespread skepticism, and yet today half of the people who need treatment now have it. This is the best time to charge full speed ahead and get treatment to everyone who needs it so we can save lives and get ahead of the wave of new infections.”

– Dr. Tido von Schoen-Angerer, Executive Director, Access Campaign, Doctors Without Borders/Médecins Sans Frontières

Turkey: MSF Extends Activities, Provides Mental Health Care In Earthquake's Aftermath

Tue, 29 Nov 2011 10:12:00 GMT

Van,Turkey/Barcelona, November 28, 2011-- In the aftermath of the strong earthquakes that struck eastern Turkey on October 23 and November 9, Doctors Without Borders/Médecins Sans Frontières (MSF) is extending its activities in the region and will begin providing mental health services. In collaboration with the Ministry of Health of Turkey and the Van Crisis Coordination Centre, MSF teams will start addressing urgent needs for mental health support in Van.

“Many people are still in shock after the terrible experience of the quakes,” explains Patrick Wieland, MSF head of mission. “Many of them have lost family members and friends, and some have no one left. Their houses have collapsed, they have lost all their belongings and they have to deal with a harsh new reality and extremely cold weather conditions, which will take months to improve. Every day we see that there is a clear need to address the psychological consequences of this earthquake, which has taken a significant toll on the local population.”

A team of five psychologists and three psycho-educators will start working in the villages around Van, carrying out group and individual counselling sessions for both adults and children. MSF will also offer psychological care to refugees and asylum seekers that have been affected by the earthquake and are living in camps and settlements in Van. At Van district hospital, the team will establish a mental health emergency preparedness plan so that the hospital will be better equipped to deal with a future incident involving mass casualties.

An MSF emergency team arrived at the earthquake-affected areas of Van and Ercis on October 25. Since then, in collaboration with two Turkish organizations, Hayata Destek, Helsinki Citizens’ Assembly (hCa), and other local partners and authorities, MSF has distributed 2,000 tents suitable for winter conditions and 2,000 cooking kits to 12,000 people in 37 villages in Van region.

MSF is an international medical humanitarian organization that provides emergency medical assistance to populations in danger in more than 60 countries. In Turkey, MSF also supports a mental healthcare project for migrants, refugees and asylum seekers in Istanbul in collaboration with Helsinki Citizens’ Assembly (hCa).

MSF Response To Global Fund Board Meeting

Tue, 22 Nov 2011 12:31:00 GMT

November 22, 2011 -- Because donor funding for global HIV/AIDS and the Global Fund has been declining, the Fund is in the most dire financial situation it has ever seen since its creation ten years ago. As a result, the Global Fund board today decided to effectively cancel its 11th funding round due to lack of resources – an unprecedented act in its history.

The Global Fund will provide for a "transitional funding mechanism," whereby countries known to be facing a disruption of programs for HIV, TB and malaria before 2013 will be offered a chance to apply for funding to cover their most essential needs. For HIV, this funding can cover medicines for people already on treatment, but does not provide for scale-up of HIV treatment. Funding will also be restricted for treatment of drug-resistant forms of TB.

MSF calls on the Global Fund and donors to immediately raise the resources necessary for the minimum lifeline the Fund has extended to countries otherwise facing disruptions this year, as well as providing a new regular funding opportunity.

The dramatic resource shortfall comes at a time when the latest HIV science shows that HIV treatment itself not only saves lives but is also a critical form of preventing the spread of the virus, and governments are making overtures that there could be an end to the AIDS epidemic.

Yet on the ground in hard-hit countries where MSF works, the devastating effects of the overall funding crunch are becoming apparent – for example, Cameroon and Zimbabwe are facing shortfalls in the near future to support people already on treatment, and the Democratic Republic of Congo severely caps the number of people able to start on life-saving HIV treatment. In other countries, such as Mozambique, funding problems have prevented the country from providing earlier treatment and better drugs, per WHO-recommended guidelines.

And further countries may have to put important plans on hold, such as Malawi, which in addition to wanting to scale up HIV treatment, wants to provide earlier and life-long treatment for all HIV-positive pregnant women to not only protect their babies, but keep themselves healthy. Some countries, including Kenya, Lesotho, and South Africa, had already been told by the Global Fund that they weren't eligible to apply for funding from Round 11 because of lacking funding. In those countries, HIV treatment coverage lies at 52 percent, 66 percent and 49 percent, respectively.

“There’s a shocking incongruence between both the new HIV science and political promises on one hand, and the funding reality that is now hitting the ground on the other,” said Dr. Tido von Schoen-Angerer, executive director of MSF’s Access Campaign. “Donors are really pulling the rug out from under people living with HIV/AIDS at precisely the time when we need to move full steam ahead and get life-saving treatment to more people. All governments must chip in to the effort to curb HIV, but especially those with the capacity to really make a difference must urgently step up and support a new funding opportunity for countries by the Global Fund.”