Clinical research and humanitarian work: the role of Medecins sans Frontieres in the fight against malaria

In the 1990s and in the absence of data, Medecins sans frontiers (MSF) initiated a series of in vivo clinical studies to measure antimalarial efficacy and optimise treatment strategies within its missions. Between 1996 and 2004, more than 12.000 patients were enrolled in 43 studies in 18 countries of Asia and Africa. These studies were conducted in insecure and difficult-to-access sites, usually conflict-affected countries of sub-Saharan Africa. The data were used by MSF to improve treatments within its missions. In several countries they were considered by health authorities for adapting treatment guidelines at a country level. They had an effect on international policy. The high number of publications in peer-reviewed journals shows that research of high quality can be performed despite the important logistical difficulties encountered in the field. These studies are essential to adapt treatments for MSF programs. They need to be rigorous enough to be scientifically valid but also have to be adapted to specific field conditions. Although this work demonstrates the potential role of medical NGOs (non governmental organisations) such as MSF in collecting scientific data, national malaria programs, WHO and other international disease control partnerships hold the primary responsibility in initiating such studies. lozenge