Posts Tagged ‘Doctors Without Borders’

What does flat funding for PEPFAR and other global AIDS programs mean on the ground in places like the Democratic Republic of Congo? Fewer new treatment slots. Uncertainty about access to lifesaving drugs. An unfolding crisis.

That’s one snippet in a bigger, disturbing picture painted by a new report from Doctors Without Borders, or MSF. The medical humanitarian group conducted an in-depth field analysis in 8 countries to determine the ramifications of an international pullback from the global AIDS fight.

“The findings confirm our concerns in terms of donor backtracking on commitments to scale up the fight against the HIV/AIDS epidemic,” the report states. “Today, this disengagement is starting to become visible in the field and the level of HIV care is beginning to deteriorate.”

The situation in the DRC is one of MSF’s case studies. The report notes that currently, only about 12 percent of HIV-infected persons in that country are getting the lifesaving drugs they need. And that’s according to the old WHO guidelines, which have been updated to recommend earlier initiative of HIV therapy. Furthermore, only 2 percent of pregnant women in the DRC have access to prevention of mother-to-child HIV transmission services.

Despite the clear need, many donors now working in the DRC are cutting back. For example, the report says that PEPFAR is going to stop purchasing drugs for opportunistic infections, needed by those with HIV due to their compromised immune systems, and hand over this expense to the Global Fund. But the Global Fund may not be equipped to take on this and other burdens as PEPFAR, the World Bank, and others seek to transition their roles.

“In 2009, the Global Fund was supporting 1,000 new initiations per month,” the report says. “now the revised availability of funds for initiation has been cut six-fold to 2000 per year. The consequence is that in DRC—in spite of the acute crisis situation—dramatically fewer patients can start ARV.”

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“Please save my baby!” Jeudy Francia, a woman in her 20s, shrieked outside the St.-Esprit Hospital in the city on Wednesday. Her child, a girl about 4 years old, writhed in pain in the hospital’s chaotic courtyard, near where a handful of bodies lay under white blankets. “There is no one, nothing, no medicines, no explanations for why my daughter is going to die.”

That gut-wrenching scene is from this morning’s New York Times, one snipet among thousands demonstrating the urgent desperation facing residents of Haiti’s capital city in the wake of Tuesday’s earthquake. Tens of thousands dead. Three million people affected. Those are initial estimates of the terrible damage wrought by the 7.0 quake.

What can you do? The U.S. Agency for International Development, with its newly confirmed chief, is heading up the US response. Two leading nonprofit medical groups are also deeply involved in the relief effort—Partners in Health and Doctors without Borders. Both are seeking immediate financial help.

Here’s some info from each group about what they are doing and how you can help.

From Partners in Health:

“We have already begun to implement a two-part strategy to address the immediate need for emergency medical care in Port-au-Prince. First, we are organizing the logistics to get the medical staff and supplies needed for setting up field hospital sites in Port-au-Prince where we can triage patients, provide emergency care, and send those who need surgery or more complex treatment to our functioning hospitals and surgical facilities. To do this, we are creating a supply chain through the Dominican Republic. Second, we are ensuring that our facilities in the Central Plateau are ready to serve the flow of patients from Port-au-Prince. Operating and procedure rooms are staffed, supplied, and equipped for surgeries and we have converted a church in Cange into a large triage area. Already our sites in Cange and Hinche are reporting a steady flow of people coming with medical needs from the capital city. In the days that come we will need to make sure our pharmacies and supplies stay stocked and our staff continue to be able to respond.”

To donate click here and for more info click here.

From Doctors without Borders:

“There are hundreds of thousands of people who are sleeping in the streets because they are homeless,” MSF coordinator, Hans van Dillen, said. “We see open fractures, head injuries. The problem is that we cannot forward people to proper surgery at this stage.” First reports are now emerging from MSF’s teams who were already working on medical projects Haiti when an earthquake measuring 7.0 on the Richter Scale struck the country early January 12. MSF staff immediately started treating hundreds of people injured and have been setting up clinics in tents to replace their own damaged medical facilities.

To donate click here and to learn more click here.

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In this compelling blog post from Nathan Ford, a leading physician working in South Africa with Doctors Without Borders, outlines fears of a “u-turn” in the battle against the global AIDS epidemic.

“As Western donors prevaricate, African countries, which were pressed by the international community to do more for AIDS, now must wait to see if they will continue to receive the support they were promised,” Ford writes. “And health workers warn about early signs of a return to the desperate past, when they had to ration a simple and cost-effective life-saving medicine, and in so doing make the impossible choice of who lives and who dies.” 

It’s a must read: http://blogs.bmj.com/bmj/2009/12/01/nathan-ford-losing-momentum-in-the-fight

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 A new documentary film featuring the work of four Doctors Without Borders physicians could not come at a better time, as the Obama Administration has begun to focus more intensely on global health policies and its USAID nominee wends his way through the Senate confirmation process.

“Living in Emergency,” the 90-minute film set to unveiled Dec. 14 in a live interactive event, should help connect the dots between US policy and on-the-ground reality in resource-poor countries for those making key decisions in Washington.

The film features the experiences of four doctors working in war-torn Congo and post-conflict Liberia. “These stories are their intensely personal experiences, which are emblematic of the hard choices, dilemmas, and, sometimes, bitter realities that Doctors Without Borders medical teams grapple with every day in more than 60 countries around the world,” says Sophie Delaunay, executive director of Doctors Without Borders-USA, in a news release about the film. “We are giving Americans across the nation a first, in-depth look at our field operations.”

Here’s more from the release, how to tune in, and view the trailer:

On Monday, December 14, 2009, Elizabeth Vargas of ABC News 20/20 and Emmy-award winning investigative journalist, will host an exclusive, one-night LIVE event featuring the critically acclaimed documentary “Living in Emergency.”  Following the documentary, Vargas will moderate a town hall discussion that will go beyond the headlines of today’s humanitarian crises and go behind the scenes of one of the leading international medical emergency organizations. The panelists will include Sebastian Junger, best-selling author of The Perfect Storm and Vanity Fair contributing editor, Dr. Krueger and Dr. Brasher who are featured in the documentary, along with Sophie Delaunay, executive director of Doctors Without Borders-USA, and other special guests.

This LIVE event will be broadcast via satelite from the Skirball Center stage in New York City to thousands of Americans seated in nearly 450 movie theaters across the country. Click here, http://doctorswithoutborders.org/events/public/2009-livinginemergency/, to learn more.

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A new report out today from Doctors Without Borders (Medecins Sans Frontieres) highlights concerns that donor countries’ commitment to combating the deadly HIV/AIDS epidemic is wavering.

“MSF teams working to treat HIV/AIDS are witnessing worrying signs of waning international support to combat HIV/AIDS,” the report says. “In some high-burden countries, patients are being turned away from clinics, and clinicians are once again being forced into the unacceptable position of rationing life-saving treatment. At the same time, more robust and better-tolerated treatments – widely prescribed in wealthy countries – are not reaching patients.”

The report, called “Punishing Success: Early Signs of a Retreat from Commitment to HIV/AIDS Care and Treatment,” says that the Global Fund to Fight AIDS, Tuberculosis and Malaria Board is considering a move to cancel Round 10 funding for 2010, which would mean no new grant proposals could be considered until 2011. The document also says that the Obama Administration plans to provide only level funding for the US President’s Emergency Plan for AIDS Relief (PEPFAR) for the next two years.

Both these moves would have dire consequences, the report says, putting at risk the gains made in HIV/AIDS treatment and prevention. Click here to read the full document, which calls on the donor community to provide robust funding for AIDS, among other recommendations.

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Doctors Without Borders needs HIV and TB specialists to work in 35 countries, doing patient care, training and management.

Here’s the posting and a link for more info:


Doctors Without Borders provides assistance to people whose survival is threatened by epidemics, violence, neglect, or catastrophe. HIV/AIDS and TB treatment and management are essential components of many projects. Doctors Without Borders urgently seeks experienced HIV/AIDS and TB specialists to provide quality care in more than 35 countries.

Responsibilities: program management, training, direct patient care

Requirements: Minimum availability of 9 to 12 months.

To apply: http://www.doctorswithoutborders.org/work/field

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Just before the 2009 International AIDS conference got underway, Doctors Without Borders (Médecins Sans Frontières) released a report detailing HIV drug shortages in Africa that could threaten to unravel the fragile gains made in recent years putting patients on treatment across the developing world.

The MSF report says that “disruptions in the supply of anti-retroviral (ARV) drugs and other essential medical items in at least six African countries are putting HIV patients’ lives at risk. Funding gaps and supply management problems have led to the delay, suspension, or risk of suspension of the supply of life-saving HIV drugs.”

Those findings confirm reports we have highlighted on this blog before—that the global economic crisis threatens to cause treatment interruptions for HIV patients across the developing world.  This development could put millions of lives at risk and raises the prospect of increased drug-resistance.

“All around us, clinics stop enrolling patients because there are just not enough ARV supplies,” says Eric Goemaere, MSF Head of Mission in South Africa. “The waiting lists are growing by the day, risking that patient die before they start ARVs. It’s unbelievable that a relatively well-functioning ARV programme has been allowed to be crippled in the space of just a few weeks.”

Click here to read the full report or here for an AP story on the issue.

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