Despite having its critics, most clinicians agree that evidence-based medicine is, on the whole, a good thing. But evidence is just one part of what drives policy, and this is nowhere more obvious than in the field of international assistance for HIV/AIDS. more…

A recent report by Médecins Sans Frontières (MSF) of an outbreak of visceral leishmaniasis (VL) in southern Sudan comes at a time when increasing focus is being put on the control and elimination of neglected diseases. However, this outbreak raises questions of how far along we really are in reaching such targets. more…

The high point of the summer, for those involved in HIV-AIDS, was the Vienna AIDS conference – a perfect mix of evidence, policies, and politics. While some of the scientific papers presented were fascinating, what interested me most was the platform the conference provided for different stakeholders to come together and put the tensions that exist between them squarely on the table. more…

Here in Europe, HIV has virtually gone off the radar. It has been reduced to a chronic but eminently treatable disease that affects relatively small numbers of people, neither a major threat nor a major challenge. In Africa, however, it is a completely different story. more…

We arrive in Haiti during the second night after the earthquake, and the scenes of destruction and devastation are overwhelming. We are silent as we went our way through the street rubble and collapsed buildings to set up our emergency surgical facilities. An estimated 200,000 are already dead and a similar number of casualties lie among the rubble. more…

It is sad, it never ceases to be sad, working in hospitals. Working with the mothers, their fatigued, careworn faces, the infrequent tears, the resigned, long-suffering poise, concealing hearts that are heaving with sadness. The world feels sad some days, a palpable sadness like a cloud spreading out from the feverish body of the sick child. more…

It’s hard to contemplate Bunia without MSF. Bon Marché (the MSF hospital) is truly an institution – everyone I meet has either worked there or been a patient there – usually both.  more…

When you are accustomed to living in closed compounds you develop a long-distance stare; a meditative gaze you adopt automatically when left to yourself. This abstracted state serves two purposes. It allows you to take a little break, to escape for a moment without physically leaving the property, and it helps you overlook the razor wire that charmingly adorns the walls of this and other Médecins Sans Frontières (MSF) compounds around the world. This time round though, my view is a little different. Beyond the wire, climbing roses and clumps of deep-green foliage adorn a backdrop of billowy hills. more…

Mr S looked calm and somewhat bemused by the commotion. He had twice unsuccessfully undergone standard treatment for tuberculosis (TB) and had been taking antiretrovirals for HIV for over a year—he was used to medications and health workers. But today was different. It was the first day of his multidrug-resistant tuberculosis treatment, and four staff from the international medical aid organisation Médecins Sans Frontières (MSF) were crowded into his house in varying states of excitement and nervousness. As Mr S swallowed the five different medications that he would have to take for the next two years, followed by the injection that he would undergo daily for at least six months, something vitally important had been achieved. Another programme had integrated treatment of multidrug-resistant TB into its routine HIV and TB care. But in truth the journey was only just beginning for the patient and the programme. more…

The music is loud tonight, layers of competing sounds, horns and wind instruments, a screeching female voice on a tannoy system then a man with a better trained voice, car horns and shouting.  The 11pm train from Patna must be able to sense the competition and is blasting a longer than usual announcement of its presence. Standing on the fenced-in and mosquito net shrouded balcony gazing out I feel like a little female anopheles mosquito unable to get to her prey, the bright lights of the town, Eid celebrations beckon but security rules prevent us from going out to partake in the events. more…