MSF engages bilaterally with many US government offices in both the executive and legislative branches. We are in contact mostly with the State Department, the White House, and the Department of Defense on the executive side. Within the State Department there are different offices that are in charge of funding humanitarian assistance on behalf of the US government, like USAID.
On the legislative side it’s mostly with Congress— sometimes specific representative offices, sometimes the specialized foreign affairs committees. We also engage with people in the embassies of the countries in which we work.
The US is one of the main donors in terms of humanitarian assistance worldwide, so they are key players in any humanitarian crisis. We engage for many different reasons—to alert, to inform about specific humanitarian situations that we’re witnessing. We also sometimes engage to get a sense of what their policies are, so we can adapt our operations on the ground if need be.
Another important aim of our engagement is to keep certain global health issues on the agenda, such as access to medicines and vaccines and better treatments for diseases like HIV and drug-resistant TB. We also share our views on the impact of specific decisions a political actor makes; sometimes we agree, sometimes we disagree, but we maintain that dialogue. We do not request funding from the US government, and this plays a major role in ensuring that we are able to have open discussions that are not biased by the exchange of funding.