MSF Scientific Days 2025: evidence as resistance

By guest contributors Madeleine Baxter and Holly Baker

“If we don’t conduct – or at least stimulate – certain types of research to better understand the needs of our patients then no one else will.” – Djoen Besselink, Operations Coordinator, MSF

The start of 2025 has been defined by escalating crises, deep cuts to humanitarian funding, and growing geopolitical instability. These pressures have brought not only an operational strain but a deep distress across the humanitarian sector. Frontline teams are witnessing the consequences firsthand: rising malnutrition, neglected populations, and a global inflection point for immunisation, where years of progress risk being undone. In today’s humanitarian context of rising needs and shrinking resources, there is an urgent imperative to deliver more effective care with less, relying on evidence and insights that only research can provide. Operational research in fragile settings is not neat or linear, yet it remains critical to how we learn and evolve our treatment programmes.

In May 2025, MSF held its annual Scientific Day conference, where selected pieces of operational research showcased evidence-based responses to some of the most pressing challenges in humanitarian settings. This year’s body of research reaffirmed MSF’s ongoing responsibility and commitment, demonstrating that, even under strain, research remains one of the most powerful tools we have to adapt, respond, and improve care.

“MSF has a unique position, a unique voice, and a unique standing.” — Matthew Coldiron, Director of the Manson Unit, MSF

This year’s event featured research that few others can conduct, grounded in operational realities and made possible by MSF’s proximity to populations in hard-to-reach settings. A presentation on a mass screen-and-treat campaign for hepatitis C in Machar Colony, a slum settlement in Karachi, Pakistan, demonstrated feasibility at scale in a context long excluded from such interventions. Findings from a nationwide malaria survey conducted across ten sites in South Sudan were shared, highlighting how teams overcame enormous logistical and operational barriers to detect diagnostic-resistant strains. Work from the Democratic Republic of the Congo mapped zero-dose and under-vaccinated children, providing critical insights into immunisation gaps in highly underserved areas.

Critical evidence surfaced on diseases that global health systems routinely ignore. Pioneering microbiological research identified the likely causative agent of noma—a disfiguring and often fatal disease affecting some of the world’s most neglected children. This breakthrough follows over a decade of effort to bring noma into the global health spotlight. From Mali, research on paediatric melioidosis raised urgent questions about its possible endemic presence in regions where MSF operates, despite this disease still not being recognised on WHO’s list of neglected tropical diseases (NTDs). These diseases disproportionately impact the most vulnerable, and MSF is committed not only to treating patients but also challenging the systemic inequities that sustain their neglect.

“Failures are generative, information-rich, and how we grow and make our projects better.” – Janet Ousley, Clinical Research Advisor, MSF

Uniquely, this year’s event also made space for research that evaluated interventions which did not achieve their intended impact, recognising that such experiences are vital for organisational learning. One example came from South Sudan, where teams explored the integration of presumptive schistosomiasis treatment into primary health care in Old Fangak, a hyperendemic area with 88% prevalence among school-aged children. Despite staff training across inpatient, outpatient, maternity, and outreach services, and the use of a simplified presumptive treatment protocol, the number of diagnosed cases remained lower than anticipated, revealing the complexity and challenges of delivering NTD care in such environments.

While the intervention fell short of expectations, the research yielded valuable insights. It informed protocol adjustments, generated greater awareness of schistosomiasis among staff and communities, and shaped the direction of future MSF research on neglected tropical diseases. By showcasing this kind of work, the event reinforced that understanding what doesn’t work and why is just as important as sharing success, especially when developing care models for diseases long overlooked by global health systems.

“People facing crisis, who could benefit the most from participating in research and from its outcomes, are still too often excluded” – Natalie Roberts, UK General Director, MSF

Once again, this year’s presentations reinforced that community engagement is not an optional extra, but an essential element of quality care – highlighted in two major operational rollouts. In Honduras, a study on the introduction of Wolbachia-infected mosquitoes to prevent dengue combined implementation data with qualitative insights, deepening understanding of local perceptions and their influence on feasibility and acceptance. In Kule refugee camp, Ethiopia, the rollout of the R21 malaria vaccine depended heavily on systematic follow-up visits and vaccination support. Both presentations demonstrated that operational success requires trust, ongoing engagement, and a multidimensional approach from the onset.

“Science alone is sometimes insufficient. Resistance also demands solidarity.” – Criag Spencer, Brown University School of Public Health

In our final session of the day, Craig Spencer of Brown University urged the audience to push back against uncertainty and the erosion of compassion. Global funding cuts don’t just threaten the future of science; they risk fragmenting the communities and teams that make it possible. Yet, even in an increasingly fragile humanitarian landscape, shared knowledge and collective effort enable MSF, and its partners to remain connected in purpose, bridging gaps between evidence and action, and between communities and care. Keynote speaker Sania Nishtar, CEO of Gavi, the Vaccine Alliance, reinforced this message, highlighting the urgent need for collaboration across sectors to meet today’s most pressing health challenges.  

In this climate of shrinking support for knowledge production, producing evidence becomes an act of defiance. Research within MSF and beyond is not just a tool for learning; it is an expression of solidarity and a form of resistance, grounded in the belief that even the most neglected deserve rigorous, context-driven, evidence-based, and compassionate care.

About the authors

Madeleine Baxter is currently a Research and Communications Intern with the Manson Unit, Médecins Sans Frontières UK. She graduated in Biomedical Sciences from the University of Edinburgh, with honours concentrations in global health and medical anthropology, and completed an exchange year specialising in Public Health at the University of New South Wales.

Holly Baker, Research Uptake and Analysis Advisor, Manson Unit, Médecins Sans Frontières UK, is the second author.

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