Thema : Ethik und Legitimität

In search of the ‘New informal legitimacy’ of Médecins Sans Frontières

For medical humanitarian organizations, making their sources of legitimacy explicit is a useful exercise, in response to: misperceptions, concerns over the ‘humanitarian space’, controversies about specific humanitarian actions, challenges about resources allocation and moral suffering among humanitarian workers. This is also a difficult exercise, where normative criteria such as international law or humanitarian principles are often misrepresented as primary sources of legitimacy.

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High prevalence of multidrug-resistant tuberculosis, Swaziland, 2009–2010

In Africa, although emergence of multidrug-resistant (MDR) tuberculosis (TB) represents a serious threat in countries severely affected by the HIV epidemic, most countries lack drug-resistant TB data. This finding was particularly true in the Kingdom of Swaziland, which has the world’s highest HIV and TB prevalences. Therefore, a national survey was conducted in 2009–2010 to measure the prevalence of drug-resistant TB.

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Research Ethics and International Epidemic Response: The case of Ebola and Marburg Hemorrhagic Fevers

Outbreaks of filovirus (Ebola and Marburg) hemorrhagic fevers in Africa are typically the theater of rescue activities involving international experts and agencies tasked with reinforcing national authorities in clinical management, biological diagnosis, sanitation, public health surveillance and coordination. These outbreaks can be seen as a paradigm for ethical issues posed by epidemic emergencies, through the convergence of such themes as: isolation and quarantine, privacy and confidentiality and the interpretation of ethical norms across different ethnocultural settings.

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Public health driven restrictions versus individual patients’ right: Is it the role of MSF to enforce public health regulations?

In public health practice, some circumstances may lead to a clash between individual patients’ rights and measures aimed at safeguarding the security of populations. The dilemma is classically illustrated by a number of severe communicable diseases with high potential of transmission, such as SARS, viral haemorrhagic fevers (VHF) and pneumonic plague. National public health regulations are expected to provide legal and technical guidance over intrusive or restrictive measures applied to communicable diseases control.

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Humanitarian Stakes No.1: Humanitarian Borders

Humanitarian Stakes No.1 is a compilation of articles prepared by the panellists who participated in a day of conferences debates on “Humanitarian Borders” in Geneva on 13 December 2007. The articles are organized by topic to reflect the original program of the day. MSF Switzerland also has also produced a DVD of the day containing panelists’ presentations and the debate portion of the sessions, in addition to the electronic versions of the articles published.

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XDR Tuberculosis, the New International Health Regulations, and Human Rights

Extensively drug-resistant tuberculosis (XDR-TB) is the latest emerging disease recognized as a global health threat. It has so far been identified in at least 27 countries covering all regions of the world except Oceania. A cohort of patients was investigated in 2005-2006 in the KwaZulu-Natal province of South Africa, revealing an exceedingly high mortality rate and a rapidly fatal evolution among identified XDR-TB cases. Such alarming features of this new form of tuberculosis seem to relate at least partly to HIV co-infection.

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High mortality in an internally displaced population in Ituri, Democratic Republic of Congo, 2005: Results of a rapid assessment under difficult conditions

The ongoing conflict in Ituri, Democratic Republic of Congo (DRC), has led to more than 50,000 deaths, more than 500,000 displaced civilians and continuing, unacceptably high, mortality since 1999. In February 2005, after a resurgence of violence and further displacements, Médecins Sans Frontières (MSF) launched an emergency response in three internally displaced persons (IDP) camps in Ituri. We performed a rapid health assessment in April 2005 in one of the IDP camps to evaluate mortality (due to violence or disease) and camp living conditions.

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Can oral cholera vaccination play a role in controlling a cholera outbreak?

Control measures to limit the spread of a cholera outbreak in Pohnpei Island (Micronesia), included mass vaccination with the single-dose live-attenuated oral cholera vaccine CVD 103-HgR as a potential adjunct measure. The outbreak provided a unique opportunity to evaluate the practicality of use and effectiveness of this vaccine. Under field conditions encountered in Pohnpei, crude vaccine efficacy was estimated at 79.2% (95% CI: 71.9–84.6%) in the target population.

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