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Ethics | Collections | MSF Science Portal
Ethics

Ethics

MSF has published dozens of peer-reviewed articles that touch on humanitarianism and ethics. The articles range from rigorous peer-reviewed research on the health of humanitarian workers, to commentaries about the ethics of conducting research in conflict settings, to various approaches on how patients should be treated.

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Noma

Noma

Noma, also known as cancrum oris, is a rapidly progressing life-threatening infection that affects the mouth and face. Noma is preventable and easy to treat if addressed in the early reversible stages, but most often deadly if untreated. The disease most commonly affects children who are chronically malnourished or whose immune systems are otherwise compromised. Noma affects an estimated 140,000 children annually. Noma was added to the WHO's list of Neglected Tropical Diseases in 2023.


MSF is working to discover more about noma. This collection highlights MSF's mixed methods research on treatment outcomes, burden of disease, attitudes towards the disease and other aspects of noma.


For more information on MSF's work on noma, you can also visit https://noma.msf.org/.

Combatting antimicrobial resistance

Combatting antimicrobial resistance
World NTD Day

World NTD Day
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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.

Neglected tropical diseases (NTDs) impact nearly 1.7 billion people each year, causing serious illness or lifelong disability among many—often leading to stigma and exclusion—and killing an estimated 200,000. The vast majority of sufferers live in the world’s poorest countries.


The World Health Organization’s NTD roadmap 2021-2030 aims to address 20 tropical diseases through prevention, control, elimination, and/or eradication. But despite some progress, reaching all its targets will take better, far more accessible diagnostics and treatments along with more robust strategies, political commitment and resources.


To mark World NTD Day, this collection spotlights work by MSF and collaborators on improving approaches to snakebite envenoming, kala azar and noma. One study presents an innovative artificial intelligence-based snakebite diagnostic tool, while others evaluate shorter, less toxic drug regimens or different models of care. Several commentaries advocate for national/regional strategies adapted to contexts ranging from remote villages to active conflict zones. Another crucial factor is the climate crisis, which is intensifying the transmission and geographic spread of many NTDs.

Journal Article
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Commentary

Mixing methods: How listening to researchers, healthcare workers, and community members can improve the design of studies testing medical innovations for Neglected Tropical Diseases

Erber AC, Ablordey A, Addissie A, Ahortor EK, Burtscher D,  et al.
2025-09-30 • PLOS Neglected Tropical Diseases
2025-09-30 • PLOS Neglected Tropical Diseases
Journal Article
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Review

Dignity-based practice in global health research: a framework of expectations

Bayingana A, Bhakuni H, van de Kamp J, Lariat J, Rathod L,  et al.
2025-09-13 • Lancet Global Health
2025-09-13 • Lancet Global Health
Conference Material
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Video

Application of the Médecins Sans Frontières clinical trial transparency policy: cost analysis of TB-PRACTECAL, a multicentre phase 2–3 trial in drug-resistant tuberculosis

Gotham D
2024-05-16 • MSF Scientific Day International 2024
2024-05-16 • MSF Scientific Day International 2024
Journal Article
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Review

Imperfect relief: Challenges to the impartiality and identity of humanitarian action

DuBois M, Healy S
2024-03-25 • International Review of the Red Cross
2024-03-25 • International Review of the Red Cross
One of the four core humanitarian principles, impartiality's substantive ethical and deeply operational nature directs aid agencies to seek and deliver aid on the basis of non-discrimina...
Journal Article
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Protocol

Responsible exit of humanitarian aid agencies at the end of programmes: a scoping review protocol

Bahati D, Sy H, Kalhor A, Marchal B
2023-08-23 • BMJ Open
2023-08-23 • BMJ Open
INTRODUCTION
In humanitarian settings, aid agencies are constantly challenged by difficult decisions such as when and how to terminate aid without harming the aid recipients, local i...
Journal Article
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Research

Health trajectories of international humanitarian aid workers: growth mixture modelling findings from a prospective cohort study

de Jong K, Martinmäki SE, te Brake H, Komproe IH, Kleber RJ,  et al.
2023-05-17 • BJPsych Open
2023-05-17 • BJPsych Open
BACKGROUND
Most staff stay healthy during humanitarian work, although some worsen. Mean scores on health indicators may be masking individual participants struggling with health...
Journal Article
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Commentary

Striving towards true equity in global health: A checklist for bilateral research partnerships

Hodson DZ, Etoundi YM, Parikh S, Boum Y
2023-01-18 • PLOS Global Public Health
2023-01-18 • PLOS Global Public Health
Interest in “global health” among schools of medicine, public health, and other health disciplines in high-income countries (HIC) continues to rise. Persistent power imbalances, racism, ...
Journal Article
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Research

Ethical guidance or epistemological injustice? The quality and usefulness of ethical guidance for humanitarian workers and agencies

Sheather J, Apunyo R, DuBois M, Khondaker R, Noman A,  et al.
2022-03-16 • BMJ Global Health
2022-03-16 • BMJ Global Health
This paper explores the quality and usefulness of ethical guidance for humanitarian aid workers and their agencies. We focus specifically on public health emergencies, such as COVID-19. ...
Journal Article
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Research

Preparing humanitarians to address ethical problems

McGowan CR, Baxter LM, DuBois M, Sheather J, Khondaker R,  et al.
2020-11-04 • Conflict and Health
2020-11-04 • Conflict and Health
Infectious disease outbreaks represent potentially catastrophic threats to those affected by humanitarian crises. High transmissibility, crowded living conditions, widespread co-morbidit...
Journal Article
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Review

The ethical imperative to relieve suffering for people with tuberculosis by ensuring access to palliative care

Harding R, Snyman L, Ostgathe C, Odell S, Gwyther L
2020-05-01 • International Journal of Tuberculosis and Lung Disease
2020-05-01 • International Journal of Tuberculosis and Lung Disease
Patients diagnosed with tuberculosis (TB) continue to
experience clinical uncertainty and high mortality and to
bear a high burden of symptoms and other concerns.
Addition...
Journal Article
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Commentary

A Médecins Sans Frontières ethics framework for humanitarian innovation

Sheather J, Jobanputra K, Schopper D, Pringle J, Venis S,  et al.
2016-09-06 • PLOS Medicine
2016-09-06 • PLOS Medicine
SUMMARY POINTS

• Humanitarian organisations often have to innovate to deliver health care and aid to populations in complex and volatile contexts.

• Innovation projec...
Journal Article
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Commentary

The Ebola clinical trials: a precedent for research ethics in disasters

Calain P
2016-08-29 • Journal of Medical Ethics
2016-08-29 • Journal of Medical Ethics
The West African Ebola epidemic has set in motion a collective endeavour to conduct accelerated clinical trials, testing unproven but potentially lifesaving interventions in the course o...
Journal Article
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Commentary

Ethics and images of suffering bodies in humanitarian medicine

Calain P
2012-07-27 • Social Science and Medicine
2012-07-27 • Social Science and Medicine
Media representations of suffering bodies from medical humanitarian organisations raise ethical questions, which deserve critical attention for at least three reasons. Firstly, there is ...
Journal Article
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Commentary

Ethics of conducting research in conflict settings

Ford NP, Mills EJ, Zachariah R, Upshur R
2009-07-10 • Conflict and Health
2009-07-10 • Conflict and Health
Humanitarian agencies are increasingly engaged in research in conflict and post-conflict settings. This is justified by the need to improve the quality of assistance provided in these se...