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Combatting antimicrobial resistance | Collections | MSF Science Portal
Combatting antimicrobial resistance

Combatting antimicrobial resistance

Antimicrobial resistance is a growing public health crisis, especially in countries with fragile health systems, population displacement or ongoing conflict. In 2019 antibiotic-resistant bacteria directly caused an estimated 1.27 million deaths, and contributed to 4.95 million deaths, tolls that will continue to increase if no effective action is taken.


MSF’s approach to combatting antimicrobial resistance combines three pillars: infection prevention and control, microbiology and surveillance, and rational use of antibiotics via antibiotic stewardship. Several studies characterize patterns and prevalence of antibiotic resistance among MSF patients, from civilians wounded in Middle East conflicts to hospitalized neonates in Central African Republic and Haiti. New technologies developed by MSF and partners are expanding local capacity for rapid, accurate laboratory diagnosis of infections, so that clinicians can prescribe the right antibiotic for each patient. Other work assesses the practices and challenges related to optimizing rational antibiotic use within health facilities and communities.

If you're interested in learning more about MSF's work in antimicrobial resistance, view the full list of MSF's publications on the topic.

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TB-PRACTECAL Trial—Evidence for a shorter, safer, more effective treatment for drug-resistant tuberculosis

TB-PRACTECAL Trial—Evidence for a shorter, safer, more effect...
Drug-resistant tuberculosis (DR-TB) remains an especially deadly form of the ancient scourge of TB, while current treatments are long, toxic, and ineffective for half of all patients. Aiming to change this unacceptable status quo, in the mid-2010’s MSF and partners launched three clinical trials to test novel regimens containing the first new TB drugs in decades. On 22 December 2022 the New England Journal of Medicine published findings from TB-PRACTECAL, a three-country randomized controlled trial, showing that a shorter regimen is safer and cured 89% of DR-TB patients, compared with 52% on the standard of care. These findings have already been incorporated into the World Health Organization’s new TB treatment guidelines. A separate study shows that the new regimen is also more cost-effective. Alongside these results the content collection linked below highlights other aspects of the trial, from community engagement strategies that helped shape TB-PRACTECAL to setbacks arising from the Covid-19 pandemic. It also examines urgent challenges in scaling up access to these life-saving drugs, including affordability and patent barriers.
Medical and humanitarian harms of restrictive European migration policies

Medical and humanitarian harms of restrictive European migrat...
Safe abortion care at MSF

Safe abortion care at MSF
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Conflict, persecution, poverty, food insecurity and natural disasters—increasingly fueled by climate change—continue to drive migration globally. Yet many wealthy countries are doubling down on hostile policies to prevent people from seeking safety within their borders, thereby subjecting them to a wide range of harms. In a newly-published report MSF focuses on European Union and member state policies that intensify exposure to violence, exploitation, risk of drowning at sea, disease, and lack of access to basic health care and shelter, both within European Union borders and beyond. The Collection linked below presents this report alongside selected publications illustrating the broader context, based on quantitative studies and accounts from MSF patients and medical teams over nearly a decade of operational experience along the European migration route. From violent, squalid detention centers in Libya— where people intercepted by the EU-supported Libyan coast guard are forcibly returned —to perilous Mediterranean crossings in flimsy rubber boats and often abysmal reception centers and camps within the EU, it documents how these policies and practices further harm highly vulnerable people seeking safety and protection.

Unsafe abortion is a major cause of maternal death, and the only one that is completely preventable. Yet over 30 million unsafe abortions occur each year, leading to at least 29,000 deaths and millions of serious complications—nearly all in low- and middle-income countries. MSF teams see these tragic consequences first-hand, treating thousands of patients every year with severe, potentially life-threatening effects from unsafe abortion.


To mark International Safe Abortion Awareness Day (28 September 2024), this Collection presents highlights of MSF’s work on safe abortion care (SAC) as a way to reduce maternal death and injury. By re-assessing and reshaping how our projects deliver SAC in fragile and conflict-affected settings, we have been able to significantly expand services in those contexts and across MSF projects globally. In parallel, we also conducted in-depth studies of abortion complications and their contributing factors in fragile settings, where a dearth of evidence limits understanding of women's needs in accessing comprehensive care. These findings are helping to identify gaps in service delivery and inform operational decision-making.

Journal Article
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Research

Antibiotic consumption in hospitals in humanitarian settings in Afghanistan, Bangladesh, Democratic Republic of Congo, Ethiopia and South Sudan

Skender K, Versace G, Lenglet AD, Clezy K
2024-08-15 • Antimicrobial Resistance and Infection Control
2024-08-15 • Antimicrobial Resistance and Infection Control

BACKGROUND

Antimicrobial resistance is of great global public health concern. In order to address the paucity of antibiotic consumption data and antimicrobial resistance surveil...

Conference Material
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Abstract

Antibiogo as an innovative solution to detect antimicrobial resistance: from an operational need to a CE-marked diagnostic test available for low-income and middle-income countries

Rapoud D, Cramer E, Al Asmar M, Sagara F, Ndiaye B,  et al.
2024-05-16 • MSF Scientific Day International 2024
2024-05-16 • MSF Scientific Day International 2024
INTRODUCTION
Antimicrobial resistance (AMR) is a major threat to public health and could cause 10 million deaths per year by 2050. Access to high-quality diagnostic tests is a key in...
Journal Article
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Review

Antimicrobial resistance in bacterial wound, skin, soft tissue and surgical site infections in Central, Eastern, Southern and Western Africa: A systematic review and meta-analysis

Monk EJM, Jones TPW, Bongomin F, Kibone W, Nsubuga Y,  et al.
2024-04-16 • PLOS Global Public Health
2024-04-16 • PLOS Global Public Health
Antimicrobial resistance (AMR) is a major global threat and AMR-attributable mortality is particularly high in Central, Eastern, Southern and Western Africa. The burden of clinically inf...
Journal Article
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Letter

Antimicrobial resistance in the ongoing Gaza war: a silent threat

Moussally K, Abu-Sittah G, Gomez FG, Fayad AA, Farra A
2023-11-09 • Lancet
2023-11-09 • Lancet
Journal Article
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Commentary

Antimicrobial stewardship in primary health care programs in humanitarian settings: the time to act is now

Truppa C, Alonso B, Clezy K, Deglise C, Dromer C,  et al.
2023-09-04 • Antimicrobial Resistance and Infection Control
2023-09-04 • Antimicrobial Resistance and Infection Control
Fragile and conflict-affected settings bear a disproportionate burden of antimicrobial resistance, due to the compounding effects of weak health policies, disrupted medical supply chains...
Journal Article
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Research

Practices and challenges related to antibiotic use in paediatric treatment in hospitals and health centres in Niger and Uganda: a mixed methods study

Mambula G, Nanjebe D, Munene A, Guindo O, Salifou A,  et al.
2023-07-11 • Antimicrobial Resistance and Infection Control
2023-07-11 • Antimicrobial Resistance and Infection Control
BACKGROUND
Antibiotic resistance is a significant public health problem and is responsible for high mortality in children and new-borns. Strengthening the rational use of antibiotics...
Journal Article
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Research

When first line treatment of neonatal infection is not enough: blood culture and resistance patterns in neonates requiring second line antibiotic therapy in Bangui, Central African Republic

Nebbioso A, Ogundipe OF, Repetto EC, Mekiedje C, Sanke-Waigana H,  et al.
2021-12-13 • BMC Pediatrics
2021-12-13 • BMC Pediatrics
BACKGROUND
Infectious diseases account for the third most common cause of neonatal deaths. Globally, antibiotic resistance (ABR) has been increasingly challenging neonatal sepsis tre...
Journal Article
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Review

The socioeconomic burden of antibiotic resistance in conflict-affected settings and refugee hosting countries: a systematic scoping review

Kobeissi L, Menassa M, Mousally K, Repetto EC, Soboh I,  et al.
2021-04-06 • Conflict and Health
2021-04-06 • Conflict and Health
BACKGROUND
Antibiotic resistance (ABR) is a major global threat. Armed and protracted conflicts act as multipliers of infection and ABR, thus leading to increased healthcare and soci...
Journal Article
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Commentary

The Mini-Lab: accessible clinical bacteriology for low-resource settings

Natale A, Ronat JB, Mazoyer A, Rochard A, Boillot B,  et al.
2020-06-01 • Lancet Microbe
2020-06-01 • Lancet Microbe