SIU Newsletter December 2020 - TB Patient Voices, Planetary Health & Digital Ecosystems

Patient Centricity

There is no denying that there is a lot of jargon in the health innovation space. Many consider the term 'patient centricity' to be a part of this noise. Surely as a medical organisation MSF are naturally patient centred, and surely this translates to our innovation efforts? We'd argue there is still more to be gained from continuing the conversation around patient centred health innovation and not quite yet time to throw in the towel.

Defined in a BMJ ARTICLE as 'Putting the patient first in an open and sustained engagement to respectfully and compassionately achieve the best experience for the patient and their family.' - it all sounds relatively straight forward? It's not. In reality, it is clear from numerous cases of failed innovation that this is often an item on the innovators to-do list that get de-prioritised due to inconvenience or simply thinking that 'innovators' know best when designing new interventions. A simple rule of thumb on this - always ask the patient from the outset and make sure to listen to what they tell you! Never assume. This conversation may take different forms in different innovation efforts but ongoing patient engagement needs to be non-negotiable. After all, the patients are ultimately the experts in the problem you are trying to solve.

Looking for some hard evidence of our dedication to patient centred innovation? You're in the right place. Read on for insight into MSF India's amplification of multi-drug resistant TB patient voices, the consensus-based MSF Innovation Principles underpinning our HQ and field activity, and more.

Innovation Highlights from the MSF Movement

MSF Innovation Highlight 1 - TB Patient voices

Overview: MSF TB patients undergo treatment for 1-3 years and often face stigma and intense hardship. A recent MSF study was conducted in India using PARTICIPATORY ACTION RESEARCH METHOD, WHEREIN THE 9 PARTICIPANTS WERE RECOGNISED AS ‘EXPERTS’ and given the ownership for the study as well as to disseminate their stories.

When consulted, one of the ways in which the participants wished to have their stories known to the outside world was through a book containing a collection of their photos and written experiences. The intended audience for the book is other TB patients, their family members, policy makers, health care workers.

Status: The book was been officially launched in October, on the MSF India page with the launch of the hard copy with the participants and the MSF Mumbai staff shortly after. The study report is in the final stages of being completed. The study was also presented as a poster in the Union Conference.

Next steps: We would like to share this book with patients, governmental and non governmental health workers in an effort to bring to the forefront the conversation around TB stigma. Feel free to share with your networks and consider how you can amplify patient voices in your own innovation efforts.

Throughout treatment and recovery TB patients face stigma. Hamari Awaaz gives a voice to 9 women with multi-drug resistant TB. Learn more about their experience HERE.

MSF Innovation Highlight 2 - MSF Innovation Principles

Overview: Innovation has been central to MSF’s medical work and culture since the organisation’s inception nearly 50 years ago. As the organisation has grown and become more complex in recent years, more effort has been made to ‘professionalise’ MSF’s innovation work; people and units with specific innovation mandates and expertise are now part of the ecosystem, as is a thriving innovation network (known as the Innovation Club).

Status: With this it was recognised that innovation work had sometimes happened without a proper appreciation of field realities and context and without an understanding of the end users (or those who could be considered the eventual beneficiaries). In order to tackle this issue a survey was sent to field and HQ teams to gain an insight into where our shared priorities lay when it came to the underpinning principles of MSF innovation.

Next steps: A BLOG WAS RECENTLY PUBLISHED ON THIS EFFORT DOCUMENTING THE TOP 10 SHARED PRIORITIES, shown below. These principles are now being widely discussed and woven into innovation activities and will inform the ongoing refinement of MSF innovation aspirations and objectives.

Over 80 field and HQ staff at MSF were surveyed on what they believe the most crucial innovation principles are as we strive for impact. There was a high level of alignment between the groups with the final 10 driving principles show above. Read the blog HERE.

MSF Innovation Highlight 3 - COVID-19: A Catalyst for Digital Health at MSF?

Overview: MSF, and others in the healthcare space, are facing increasing proximity challenges in the wake of the current COVID-19 pandemic - particularly in low-resource and humanitarian settings. It is becoming clear that digital health interventions may help address some of these pressing issues if scaled effectively.

Status: MSF is by no means new to digital health, however there is a new momentum in the past year which is leading to increased scale-up of such efforts. Read our DIGITAL HEALTH BLOG for a snapshot of MSF's digital health activity (including digitally support TB treatment and the MSF Telehealth Toolkit) and an insight into the most significant barriers we are currently facing in navigating digital health.

Next steps: There are a number of next steps in progress including transversal collaborations to explore the potential of digital health for patients with chronic conditions and more macro level strategic research. At present a number of groups and individuals are working to established shared understanding and mature a coherent ecosystem. WATCH THIS SPACE FOR NEW INSIGHTS!

Get an overview of the activities and challenges of digital health for MSF HERE.

External Resource Highlight

With recent preliminary data announcements from Pfizer and Moderna a cautious optimism is growing globally. Could the end of this pandemic be within reach, and within record time just 10 months after the identification of COVID-19?

However, optimism and awe over the recent scientific innovations aren't the only sentiments associated with these early vaccine candidates. We will still need to find a way to manufacture and distribute at a colossal scale; to navigate potential needs for ultra-cold chains; to insist on equity of access; and to tackle misinformation and disinformation.

The VACCINE CONFIDENCE PROJECT was established as a collaboration between the London School of Hygiene and tropical Medicine and the University of Antwerp to:

monitor public confidence in immunisation programmes by building an information surveillance system for early detection of public concerns around vaccines
determine the risk level of public concerns in terms of their potential to disrupt vaccine programmes
provide analysis and guidance for early response and engagement with the public to ensure sustained confidence in vaccines and immunisation

It is important that health system actors listen closely to the concerns of populations as we near closer to distribution of a COVID-19 vaccine. In addition to working to understand public sentiment, there is an onus on pharma companies and associated academic institutions to practice radical transparency. Innovations only matter if the can successfully scale to address a real need.

Read on below for a collection of resources exploring vaccine confidence:

Explore resources and insights from the Vaccine confidence Project HERE.

What We're Listening to

Lancet Countdown 2020 Report Launch Webinar: The links between health and climate change are undeniable. On December 3rd the Lancet Countdown 2020 Report was launched globally online exploring latest global health profile of climate change composed by leading global experts. On December 11th the Irish launch took place featuring MSF Planetary Health expert Dr Maria Guevara describing how the global health and humanitarian sector has approached mitigation and adaptation. You can listen back to the full webinar HERE.
LSHTM Viral Podcast: The links between environmental change and infectious diseases are complex and, at times, surprising. in this LSHTM podcast episode the hosts discuss planetary health links between mosquitos, rice irrigation, and infectious disease understanding and control. Listen to the full podcast episode HERE.

Until Next Time 👋

Any burning thoughts you would like to share on the above? Anything you would like to feature in the next newsletter? Reach out with any questions or comments on siu@stockholm.msf.org or simply reply to this email - we'd be delighted to continue the conversation!

The MSF Sweden Innovation Unit Team