 Ychydig welcaf hwn am ddod y gallai gweithio a amser ar y Meddalau Rol Llywodraeth Cymru ar gyfer gwell談au ac yn gael y ddechiwch er gweithio ar gyfer gweithio ar gliriaeth ei tael. I dadewch ar gwell o gach o bryd, yn gweithio ar gweithio ar gweithio ar gweithio'r gweithio, y gweithio ar gweithio, ar gyfer gweithio ar gyfer gweithio ar gyfer gweithio ar gyfer gweithio ar gweithio'r gweithio, is really special. We've got a whole day ahead of us on science and research and the intersection with humanitarian medicine. So I want to start the day just by asking you to think about something slightly different for a few minutes. I want to ask you to think about the people that are at the centre of our work. The people that work with the science to bring its benefits to other people, to the people that are affected by humanitarian and medical crisis. In previous years, when opening the scientific day, I've talked about the destruction and targeting of healthcare facilities in conflict zones and the many millions of refugees and migrants displaced from their homes across the world. This year has been marked for MSF by something slightly different. We've been hearing voices from the inside of the organisation. Voices that have been signalling to us, but all is not well. And these voices, of course, they coincide with a period of scrutiny for the humanitarian aid sector. Scrutiny over the way that we behave, the way that we behave towards the people that we assist and the way that we behave towards each other, the people that we work with. We know that MSF is not immune to these issues. We know that we have problems and we know that we have work to do. And that work has to start with listening, listening to the voices of our staff and understanding why some of them have not felt safe with this organisation and have not felt able to previously bring their concerns about that forward. We know we're not always good at listening either to the people that we assist. And a key lesson for MSF from the West Africa Ebola response was how our initial focus on treatment without the accompanying community outreach then hindered the very acceptance of the treatment that we were offering. I was asked by a very wise member of the audience at a panel discussion how many times the humanitarian sector really needed to learn the lesson of the importance of listening to the people that we assist. Subsequent research, which featured at last year's Scientific Day, taught us a lot about Ebola-affected communities' perceptions of the response, their resistance, their initial resistance to treatment and the subsequent acceptance of it. It taught us about their perspectives on control measures, on the role of leaders and the importance of compassion, dignity and respect as central to the response. For the current Ebola outbreak that we're facing in the Democratic Republic of Congo, the lessons learnt from listening to those that we assisted in West Africa will be really important to our work. The increasing emphasis that MSF is putting on anthropology and social sciences indicates a turn towards people and how we can benefit from their stories and their experience to inform and improve our interventions. This year, the Scientific Day agenda puts people right at the heart of it. We're going to be reflecting on patient-centred care. We're going to be reflecting on neglected people, those that are living at the margins of society. We're going to hear about the persecuted Rohingya population, displaced populations affected by climate change, Ebola-affected pregnant women, factory workers working in toxic environments, female sex workers and detainees in prisons and many more. As we consider the data collection and research that we all hope will bring about a small improvement to their situation, let's also remember the individual people, people like you and me that are suffering in the midst of these crises. By listening to both them and by listening to the experiences of our staff and using both of them as a force for change, ultimately, we and other humanitarian organisations will become better, will become better equipped to deliver impactful medical humanitarian programmes with compassion and respect at their centre, with people and for people. On that note, I'm going to hand you over to Claire Mills, medical director in Paris, who will talk about the vital role that research plays in delivering exactly that impact. Thank you and enjoy your day. Good morning. Bonjour to Le Monde. In the room, colleagues and friends and around the world. It's great to be here even on a drippy London day where people from countries like me wonder whether the weather gods in London are a bit British and reserved and don't quite know how to rain properly. But anyway, thanks Vicky for your introduction because I think I'm going to pick up on some of the issues that you've raised. This is a time to share and to celebrate the research we've done over the last year, but also to think a bit to reflect about why we do research. And I think the why is very important because for us in MSF, it's a drive, it's an imperative, which is really based on the needs, the challenges, the real problems and questions that treating our patients in the very messy, conflicted and complex situations in which they live provokes in our field missions. And the scope and breadth of our research is very wide from quite basic, I guess, program monitoring through to clinical trials, qualitative and mixed methods. And whether it's some of the things that we saw presented last year like treatment of young teenagers in Malawi and trying to improve and understand how we could support their adherence, looking for less toxic and more effective drugs for patients with multi-drug resistant TB or searching for a rotavirus vaccine which we could use out of cold chain at low cost, our research has to be purposeful and intentional. So I think even before we embark on research, we need to be asking, is this the right question? Is the research actually needed to answer the question we have? What specific changes do we want and who are we trying to influence? And sometimes this is perhaps apparently straightforward if we do a mortality on nutrition survey to really help direct our operational response. But sometimes I think we really even failed to think through where we place the research in the larger political and national or global policy context. A small example, a few years ago, we did some very good, robust thermostability studies on insulin. Now this would make a huge difference, the outcomes were positive having insulin out of cold chain would make a huge difference to the lives of our patients and the way we could work with people with diabetes. But the research evidence alone has been inadequate. This regulatory requirements and pharmaceutical inertia or deprioritisation which has blocked any steps to really create access for our patients. Was research the right approach? Should we perhaps have taken a more robust lobbying approach to pharmaceutical companies? And in the same way when we publish our research which is clearly an important thing to do to contribute to global knowledge, to disseminate the information, do we as researchers put as much or at least as much thought and effort and resources into ensuring that our findings are effectively communicated to create real change both inside MSF and outside? Of course when we're thinking about the impact of our research, it's not a linear or an exact process or an exact science, the process can be quite iterative. For example when we think about the work we've done around cholera vaccine or nutrition in West Africa, we answer one question and then we find a whole bunch more that need to be answered. Sometimes it's quite serendipitous. Our findings seem to be in the right place at the right time to create change. But I think that our experience from particularly our TB and HIV research shows that if we have a really good understanding of the political, the policy and the operational landscape, that we define some of the key gaps where MSF has an added specificity or an added value and we develop a longer-term research agenda, we actually have a much more influential impact. When we look at the studies carried out with last year's Scientific Day, there was a small study recently done which you can see out on the atrium, asking the presenters about their perceived impact of their research one year on from the presentation. And I think some of the answers are not rocket science and obviously there are limitations to the study. But where the research was seen to be really relevant and timely for our operations, where there was strong collaboration from the beginning with some of the key stakeholders we wanted to influence, like ministries of health, and we saw through the research and where there were robust methods used, we obviously had better impact. If the research was less connected to operations or to topics that had lower priority on the operations agenda, then there was a perceived lower impact. And obviously the inevitabilities of MSF, project handovers, project closures, and operational changes and strategy obviously reduced the potential uptake of some of our findings. So how can we do better? Unlike cell biology, passive diffusion in MSF is not going to work. So I think for example in OCP, we've really been discussing with operations right from the beginning, agreeing on the concept papers for the studies, the development of protocols, working into the key budget and planning moments, updates on the studies that we're doing, and presenting back the studies for discussion at operational meetings. But I think even before this, we are now trying to be more strategic and scoping out some of the key questions and gaps that we think MSF may be able to fill when we're developing new approaches in TB, HIV and cancer, for example. I think there's also a really clear role for our intersectional working groups, and I would advocate that it's not just about collating research ideas from the different sections, but really using that intersectional peer group to fertilise, to stimulate and to refine research questions. So finally, research is critical in MSF, fundamentally to improving the care of the patients, but also to improving our operational approaches and our operational strategies. It is an imperative, given the huge needs, the gaps in knowledge, and the complexity of our context. But it has to be more than intellectual curiosity. It has to be purposeful, it has to recognise the political and the policy context. It doesn't finish at the end of the study. I think that research needs to be in MSF, a radical political act. We need to commit and invest in seeing through the changes we seek. Thanks.