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Cholera intervention in South Kivu

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Médecins Sans Frontières brings medical humanitarian assistance to victims of conflict, natural disasters, epidemics or healthcare exclusion.

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MSF Measles Vaccination in DRC

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Aden besieged

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COVID-19 Project in Mons, Belgium

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In more than 70 countries, Médecins Sans Frontières provides medical humanitarian assistance to save lives and ease the suffering of people in crisis situations.

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Our offices around the world

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MSF Association

Our staff “own” and manage MSF, making sure that we stay true to our mission and principles, through the MSF Associations.

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We set up the MSF Access Campaign in 1999 to push for access to, and the development of, life-saving and life-prolonging medicines, diagnostic tests and vaccines for people in our programmes and beyond.

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CRASH

Based in Paris, CRASH conducts and directs studies and analysis of MSF actions. They participate in internal training sessions and assessment missions in the field.

UREPH

Based in Geneva, UREPH (or Research Unit) aims to improve the way MSF projects are implemented in the field and to participate in critical thinking on humanitarian and medical action.

ARHP

Based in Barcelona, ARHP documents and reflects on the operational challenges and dilemmas faced by the MSF field teams.

MSF Analysis

Based in Brussels, MSF Analysis intends to stimulate reflection and debate on humanitarian topics organised around the themes of migration, refugees, aid access, health policy and the environment in which aid operates.

MSF Supply

This logistical and supply centre in Brussels provides storage of and delivers medical equipment, logistics and drugs for international purchases for MSF missions.

MSF Logistique

This supply and logistics centre in Bordeaux, France, provides warehousing and delivery of medical equipment, logistics and drugs for international purchases for MSF missions.

Amsterdam Procurement Unit

This logistical centre in Amsterdam purchases, tests, and stores equipment including vehicles, communications material, power supplies, water-processing facilities and nutritional supplements.

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SAMU provides strategic, clinical and implementation support to various MSF projects with medical activities related to HIV and TB. This medical unit is based in Cape Town, South Africa.

Kenya Supply Unit

Regional logistic centre for the whole East Africa region

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BRAMU specialises in neglected tropical diseases, such as dengue and Chagas, and other infectious diseases. This medical unit is based in Rio de Janeiro, Brazil.

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Manson Unit

The Manson Unit is a London, UK-based team of medical specialists who provide medical and technical support, and conduct research for MSF.

Epicentre

Providing epidemiological expertise to underpin our operations, conducting research and training to support our goal of providing medical aid in areas where people are affected by conflict, epidemics, disasters, or excluded from health care.

Evaluation Units

Evaluation Units have been established in Vienna, Stockholm, and Paris, assessing the potential and limitations of medical humanitarian action, thereby enhancing the effectiveness of our medical humanitarian work.

LGBTQI+ Inclusion in Health Settings

MSF works with LGBTQI+ populations in many settings over the last 25-30 years. LGBTQI+ people face healthcare disparities with limited access to care and higher disease rates than the general population.

LUXOR

The Luxembourg Operational Research (LuxOR) unit coordinates field research projects and operational research training, and provides support for documentation activities and routine data collection.

Intersectional Benchmarking Unit

The Intersectional Benchmarking Unit collects and analyses data about local labour markets in all locations where MSF employs people.

MSF Academy for Healthcare

To upskill and provide training to locally-hired MSF staff in several countries, MSF has created the MSF Academy for Healthcare.

Humanitarian Law

This Guide explains the terms, concepts, and rules of humanitarian law in accessible and reader-friendly alphabetical entries.

MSF Paediatric Days

The MSF Paediatric Days is an event for paediatric field staff, policy makers and academia to exchange ideas, align efforts, inspire and share frontline research to advance urgent paediatric issues of direct concern for the humanitarian field.

MSF Foundation

The MSF Foundation aims to create a fertile arena for logistics and medical knowledge-sharing to meet the needs of MSF and the humanitarian sector as a whole.

DNDi

A collaborative, patients’ needs-driven, non-profit drug research and development organisation that is developing new treatments for neglected diseases, founded in 2003 by seven organisations from around the world.

Clinical trial of a new vaccine against Rotavirus in Maradi / Niger

Innovative vaccine against rotavirus

War in Gaza:: find out how we're responding

War in Gaza: find out how we're responding

Photo Story21 March 2017

This slideshow explains the challenges posed by rotavirus and the existing constraints of the existing vaccines. It shows the story of the Epicentre study in Maradi district, Niger. The vaccine is now proven safe and effective. Last step: prequalification by the World Health Organization (WHO).

Clinical trial of a new vaccine against Rotavirus in Maradi / Niger — Today, diarrhoea is still the second biggest killer of infants and children in the world. Rotavirus infection is the leading cause of severe diarrhoea, which kills an estimated 1,300 children globally each day.

Clinical trial of a new vaccine against Rotavirus in Maradi / Niger — Most of these deaths occur in low-income countries, in places where access to water and sanitation is limited and people can't access life-saving medical care for their children. In such situations, preventive measures such as vaccinations have an enormous impact.

Clinical trial of a new vaccine against Rotavirus in Maradi / Niger — Aziz Adoulay, coordinator of a team of 122 field workers, carries out awareness-raising activities in Madarounfa, one of the 200 villages participating in the clinical study. More than 4,000 children were initially included in this study after their parents had provided informed and written consent.

Clinical trial of a new vaccine against Rotavirus in Maradi / Niger — The vaccine is made by the Serum Institute of India, using five strains of the virus collected exclusively in sub-Saharan Africa. It has a special characteristic: it is heat-resistant (thermostable at 37°C for between six months and a year). Unlike the majority of vaccines, which must be kept in refrigerators at between 2°C and 8°C, this new vaccine can be kept at room temperature and can tolerate temperatures up to 37°C (for between six months and one year) without losing its properties. At the Epicentre office in Maradi, the vaccines are stored in the pharmacy before being sent out to the health centres where the study is taking place.

Clinical trial of a new vaccine against Rotavirus in Maradi / Niger — To guarantee the effectiveness of the existing vaccines against rotavirus, they must be stored and transported in strict conformity with cold-chain rules, like many other vaccines. They must be kept in freezers at between 2°C and 8°C. This requires a considerable logistical effort, as well as equipment that can be costly and uses electricity or fuel. This is a major obstacle in a country such as Niger, where the health centres in rural areas do not have all of this equipment.

Clinical trial of a new vaccine against Rotavirus in Maradi / Niger — Every weekend, the five health centres report on their stock levels and requirements so that all of the necessary vaccines can be delivered to them in simple insulated boxes. The vaccine dose and syringe are quick to prepare: they come packaged in a single box measuring just over 5cm. Thanks to the small size of the packaging, the vaccines are very easy to store and transport.

Clinical trial of a new vaccine against Rotavirus in Maradi / Niger — Mohamed Zakari receives his first dose of the oral rotavirus vaccine (or the placebo). He is eight weeks old, the cut-off age for participants in the clinical trial. If his mother, Hadiza Souley, had brought him one day later, Mohamed would have been excluded from the trial in order to comply with the medical protocol. Mohamed will receive the second and third doses of the vaccine at 10 and 14 weeks respectively. During the course of the clinical trial, from birth to the age of two years, Mohamed will be monitored 12 times. At these scheduled medical appointments, various blood, urine and stool specimens will be taken. At his 10-week appointment, Mohamed will also be vaccinated against eight antigens: polio, Pentavalent 2, whooping cough, hepatitis B, diphtheria and tetanus. His mother has been participating in the clinical study since she was 20 weeks pregnant and was monitored by the medical team at four scheduled appointments during her pregnancy. She is still being monitored and the quality of her breast milk is checked to lower the risk of the newborn being malnourished. Here, Hassan, a nurse at the Madarounfa health centre, collects the various specimens.

Clinical trial of a new vaccine against Rotavirus in Maradi / Niger

Clinical trial of a new vaccine against Rotavirus in Maradi / Niger — The files of the patients undergoing treatment are stored at the health centre itself. For data protection reasons, a special coding system is used.

Clinical trial of a new vaccine against Rotavirus in Maradi / Niger — If there are inconsistencies in the data, the monitoring team can send somebody out to the communities or to one of the five health centres, where teams of archivists also check that the information in the files is consistent. Anomalies are rare, but they can comprise inconsistencies regarding a patient's height versus his or her weight, or the dates of the scheduled appointments versus the age of the child, or missing data. Every correction is documented and explained.

Ten-week-old Nana Hanissa receives her second dose of the rotavirus vaccine (or placebo). She will be given the third and final dose at 14 weeks of age.

The quicker this new vaccine is prequalified by the WHO, the sooner it can be used to prevent the deaths of thousands of children in the countries where it is most needed.

Clinical trial of a new vaccine against Rotavirus in Maradi / Niger — In the laboratory of Maradi, a team of a dozen people receive about 1,200 specimens (blood, urine, stools, mothers' breast milk...) every week, to be analysed for the trial. The specimens are taken in the morning, either by the medical teams at the five health centres involved in the study, field workers or assistant nurses at the patients' homes. They arrive at the laboratory in Maradi in the early afternoon. Four samples are necessary to meet the requirements of the protocol. One sample is for the rotavirus test, another is for the laboratory in Cincinnati, USA (only if it tests positive for rotavirus) and the other two samples are kept in freezers (at between -85°C and -72°C) for the archives, in case they are needed later.

Up Next

Niger

Innovative vaccine could prevent thousands of child deaths from diarrhoea

Press Release 23 March 2017