On June 7th, the MSF Scientific Days International 2023 conference provided a platform for researchers, innovators, and advocates in humanitarian global health to come together. This event showcased and discussed research conducted by MSF, its partners and beyond, and featured four sessions on topics ranging from tuberculosis and operational strategies to reproductive health and outbreaks.
“It is a fallacy that the health of humans can be sustained without a healthy planet, and vice versa” - Sakib Burza, Health In Harmony
Sakib Burza, Medical & Research Director at Health In Harmony, discussed the link between human and planetary health in a presentation on deforestation in Borneo. Calling for organisations to commit from the outset to design programmes around problems and solutions that communities identify, such as increased healthcare access and sustainable livelihoods, his presentation subsequently demonstrated how average deforestation rates were significantly lower in villages provided with these resources. On the role of MSF in sustainability, Sakib noted that more populous, urban sites are often prioritised over lower density, rural sites, but that providing healthcare and livelihoods support in ecologically critical areas is essential from a planetary health perspective, as the resilience of these communities is tied to the environment. On the desired impact of the study, he explained: “I’d be happy if it made people who are interested in humanitarian work more aware of the links between human health and that of the rainforest, and try to see things at least in part through a planetary health lens”. Outside-the-box solutions to operationalise planetary health were also discussed, noting an example from The Upstream Alliance at Stanford University, who restored native freshwater prawn to lower the population of snails carrying the schistosomiasis parasite, which could in turn be used as a sustainable source of protein.
The importance of community participation in developing lasting, sustainable interventions that benefit population health was a theme that continued throughout the conference. This was well illustrated by Sohana Saddique’s presentation on a successful collaboration between MSF and two factories in Bangladesh, which improved workplace safety. Here, active participation from the factory owners and workers helped in co-creating effective interventions and infrastructure changes that could be sustained in the absence of MSF. On the other hand, the conference also highlighted situations in which MSF, as an emergency medical organisation, could not deliver lasting support to communities. Epicentre’s Matthew Coldiron presented findings from a follow-up examining the long-term effects of a meningitis epidemic that occurred in Niger in 2022, emphasising the great need for aftercare – an important service MSF was unable to provide.
Antimicrobial resistance was also a recurring subject at the conference and is intrinsically linked with discussions of sustainable healthcare. This concern was noted in various presentations exploring emerging resistance in tuberculosis, sexually transmitted infections (STIs) and urinary tract infections. MSF’s Esther Mukooza presented on the inadequacies of the symptom-based approach to diagnose STIs in Eswatini, which is still used by MSF in many settings, noting that it is resulting in over/under prescription of antibiotics, potentially contributing to antimicrobial resistance, as well as allowing continued transmission of uncured infections.
“Whatever choices we make have an impact. If we are bringing in a lot of medications that are not working, at some point we will have people returning to facilities with similar or worse symptoms. This may lead us to wrongly assume disease prevalence and procure treatments that we don’t need and that will be wasted” – Esther Mukooza, MSF
These practices are unsustainable, contributing both to the procurement of unnecessary medicines that will expire and be wasted, as well as to the increasing concern of antimicrobial resistance, which leads to new treatments needing to be developed and procured. Still, the difficulty comes from the capacity to increase the use of more accurate diagnostic tools in resource-limited settings. On this topic, Christine Al-Kady’s presentation on the overprescription of antibiotics among pregnant refugees in Lebanon finds that adding an additional diagnostic step leads to a minimal cost difference, as expenses are reduced from lower rates of antibiotic prescription. However, whether it is feasible to incorporate these extra tests in operations is setting-dependent, where both monetary and time costs need to be considered.
“The experience of participating and presenting in MSF SciDays was enriching. It was a place to share knowledge and innovations in a professional way.” – Christine Al Kady, MSF
A lot of work went into the MSF Scientific Days conference, and it couldn’t have happened without our fantastic chairs, speakers, moderators, translators, organisers and participants. Recordings of the sessions can still be found on the event platform and will be stored after a period on the MSF Science Portal.
See you all next year!