MSF Scientific Day 2014
The annual MSF Scientific Days epitomise the ideals of applied clinical research. MSF is in principle a humanitarian organisation that delivers 'emergency medical aid to people affected by conflict, epidemics, disasters or exclusion from healthcare,' and yet integrates scientific research into its ethos. This is in itself a remarkable feat considering its primary aim, especially in comparison with other humanitarian organisations. But then MSF is not your stereotypical humanitarian organisation. The fact that scientific research is integrated into how they deliver emergency healthcare provides all organisations with a way of thinking that all should aspire to emulate; that is where organisations are driven by evidenced based research. Many organisations speak of evidenced based policy, while MSF actually applies this ideal because for MSF it really is about fulfilling their vision and principles, it is about saving and transforming lives. MSF realise that evidenced-based research is central to delivering the best service possible, and one can see that in their annual Scientific Day. They live the vision and ideals of scientific thinking, and how science transforms lives.
Research themes this year encompassed testing strategies and treatment outcomes of HIV and TB, research in emergency settings of violence and conflict, technological innovation in humanitarian programmes, disease outbreaks and eradication, and research for policy and treatment change. Each session highlighted research by multidisciplinary teams, which highlights another outstanding feature of MSF scientific research, which is the interdisciplinary nature of their research. Again MSF live up to the promise and aspirations of interdisciplinary research, which was summarised rather nicely by Marian Turner, from Nature, when she tweeted, 'Lots of conferences talk about wanting to increase interdisciplinarity. It's here in action at #MSFSci'. There is quite clearly much that can be learned from MSF in how to both conduct scientific research and translate that research into practice with speed and efficacy.
The keynote speech by Jennifer Leaning on the role of evidence in humanitarian decision-making encapsulated much of the challenges facing humanitarian organisations and the difficult challenges facing MSF, from Syria to the Central African Republic. Her speech highlighted the complexity of humanitarian aid and the various dimensions that must be considered when making decisions, which ultimately require an integrated approach to delivering effective humanitarian aid. This could be put in another way, a complexity approach to humanitarian aid, which recognises that there is no single cause or solution to the complex challenges faced by MSF, rather what is required is a host of solutions that work at different scales, combined in an integrated way to deliver effective aid in the most complex and challenging environments.
Jennifer who is director of the Francois-Xavier Bagnoud Center for Health and Human Rights at Harvard quoted Rudolf Virchow, a German physician from the nineteenth century. Rudolf Virchow wrote a report on the typhus epidemic in Upper Silesia of 1848, in which he identified and understood that medical solutions alone were insufficient to tackle the epidemic. It is cited as one of the classics of social medicine, and highlights how far we need to go to realise some of what Rudolf Virchow articulated back then.
In the programme introduction, the organisers mark the 20th anniversary of the Rwandan genocide
The international community failed to act and MSF concluded that "you can't stop genocide with doctors". The aftermath of the genocide included analysis of the failures of humanitarian aid and led to moves to improve its quality and accountability. But how far has humanitarian aid moved since then?
The question exemplifies the difference between MSF and many humanitarian organisations. It highlights how organisations need to think about the humanitarian challenges facing us around the world. Research is fundamental to both answering that question and in formulating strategies that deliver humanitarian aid effectively. There is much that organisations can learn from MSF, and one hopes that policymakers are taking note.