Dear Friends,

Last year, a host of newspaper articles, blogs, and TV reports questioned the efficacy of the international aid system, particularly with regard to its role in the crises in Haiti and Pakistan. At Doctors Without Borders/Médecins Sans Frontières (MSF), we welcome this debate. Some of the criticisms leveled are valid, some are not. But it’s a conversation that should be had. In this issue of Alert, we discuss core underpinnings of our work, principles that have evolved over 40 years of delivering medical humanitarian aid in some of the world’s most complex humanitarian crises. We are constantly re-examining our humanitarian medical practice in light of our core tenets of independence, neutrality, and impartiality in highly politicized contexts. Today, that includes places such as Haiti, Afghanistan, and Pakistan. In years gone by, it might have been Rwanda, North Korea, or Angola. It’s in the organization’s DNA to work this way, to continuously seek ways to improve our programs.

The same instincts inform our desire to be accountable to the public and transparent about how we use the funds with which donors generously entrust us—as evidenced by the reports on our operations in Haiti in the year after the earthquake there and in Pakistan after last summer’s floods (available on doctorswithoutborders.org). It also compels us to openly discuss what we could and could not do following the horrific earthquake in Japan, and why, given our limited role in the immediate aftermath, we were not accepting earmarked donations for the relief effort.

At the same time, we will continue to express our own dissatisfaction with aspects of the international aid system: the close relationship between government funders and aid actors, for example, and the misuse of the word “humanitarian.” This approach yields tangible effects, we believe. It was a critical examination of the aid system—and the drug development system—that led MSF to co-found the Drugs for Neglected Diseases initiative to stimulate the production of treatments for diseases doctors and nurses were seeing but were unable to treat because the relevant drugs were ineffective, toxic, or nonexistent. In this issue, Rachel Cohen, the new executive director of DNDi North America, talks about DNDi’s promising work with Chagas disease, sleeping sickness, and pediatric AIDS. You’ll also find updates from southern Sudan and Papua New Guinea, examples of the medical care our teams are providing—and re-examining—in more than 60 countries. We hope you find this informative and that you, too, will join in this discussion. Please send thoughts to AlertEditor@newyork.msf.org.

Sincerely,

Sophie Delaunay

Executive Director, MSF-USA