Every year, our annual report provides us with the opportunity to explain to our supporters how we’ve allocated your generous donations and to give you details about the lifesaving programs Doctors Without Borders/Médecins Sans Frontières (MSF) is running in clinics, hospitals, and feeding centers all across the globe. In short, it gives us the opportunity to be accountable to the people who make our work possible.
This year, we’re taking it one step further and focusing on accountability—in practice and principle throughout the publication. You’ll see our usual overviews of the field projects supported by donors like you, along with breakdowns of where we directed our resources, how many patients were treated, in what context, and for what conditions. We also show that, for the seventeenth consecutive year, at least 85 percent of all money raised was spent on program activities (as opposed to fundraising or administrative costs). And, as in years past, we provide a financial case study of a single program, a very busy surgical hospital in Port Harcourt, Nigeria.
What’s different this year is an essay that further delves into the question of what accountability means to MSF and describes the steps we take to ensure our accountability to patients, local authorities, donors, our own medical and humanitarian principles, and our association of past and current MSF staff, which plays an active role in both our governance and our decision-making processes.
The essay features excerpts from evaluations carried out and shared publically in recent years—on the response to the 2010 earthquake in Haiti, for instance, or the nutritional crisis in Somalia and the greater Horn of Africa last year. It also includes information about books MSF produced last year to stimulate reflection on the negotiations we conduct in order to open and operate projects in a given country, and on the ways our work is seen by people, patients, and communities in those countries.
All of these—the books, the project evaluations, this annual report—were designed as critical examinations of our work undertaken with the aim of improving the care we deliver to patients, finding ways to better prepare for future crises, and being transparent about the choices we make. They also allow us to promote best practices for others working in the same field. Last year, for example, our Paris-based epidemiological branch, Epicentre, released the results of its evaluation of MSF’s nutritional programs in Niger, showing that supplementary feeding programs using nutrient-rich supplementary food had cut child mortality in half—a remarkable outcome that can be replicated by others working on this often chronic and far too frequently fatal condition.
Looking ahead, we anticipate staying involved in places such as Sudan, South Sudan, Somalia, Democractic Republic of Congo, and many others, as well as in the shifting, tumultuous events evolving across the Arab world. In these and other contexts, we strive to bring high-quality medical care to our patients and to implement lessons learned over the years of our existence, while also preparing for the unexpected. To that end, we have developed an ambitious four-year international plan that includes improvements in human resources, logistics, medical data, and diagnostics—all designed to improve patient care.
It is thanks to the generosity of millions of private donors around the world that MSF was able to respond quickly and effectively to multiple crises in 2011, and to do so independently and impartially, in accordance with our medical and humanitarian principles. We hope this report illustrates our gratitude and our commitment to accountability, while also doing justice to the hard work of our medical teams and the courage and resilience of our patients.
Matthew Spitzer, President
Sophie Delaunay, Executive Director