In September 2015, the photo of the drowned body of 3-year-old Alan Kurdi, who was found dead on a beach in Türkiye, stirred emotions worldwide. It also raised the question of how to protect people fleeing the civil war in Syria. Instead of finding solutions to protect those fleeing conflict, in March 2016, the European Union (EU) finalized an agreement with Türkiye to limit arrivals at Europe’s shores in exchange for nearly $7 billion.
In a new report, Doctors Without Borders/Médecins Sans Frontières (MSF) outlines how agreements made between the EU and third countries to prevent refugees, migrants, and asylum seekers from seeking safety within their borders have led to the deaths of tens of thousands of people in the last decade, as migration routes have become longer and more dangerous.
Over the past 10 years, the EU has made several agreements with third nations, including Türkiye, Libya, Niger, Sudan, Egypt, and Tunisia. It measures the success of these agreements by a drop in migration flows, regardless of the humanitarian, political, or security costs.
The report, "Fortress in the Sand: EU Externalisation Policies and Trans-Saharan Migration Routes," highlights the most harmful of these agreements and their human toll. MSF urges the EU to urgently review existing cooperation agreements, programs, and activities outsourcing border control to third countries, to ensure they respect the human rights of all migrants, regardless of their legal status.
Blocking migration routes makes the journey more dangerous
The March 2016 "border externalization" agreement between the EU and Türkiye was not the first of its kind; it was preceded by the Treaty on Friendship, Partnership, and Cooperation between Italy and Libya in 2008 and the Khartoum Process for the Horn of Africa in 2014. Nevertheless, it marked the beginning of a massive acceleration in similar partnerships, which continues to this day.
"The European Union considers these partnerships—established with countries of departure and transit countries—to be a success in terms of the number of people arriving in its territory via a given route," says Jérôme Tubiana, MSF operational advisor on migration issues. "But what [EU] representatives are accepting are the tragic human consequences that result from this: thousands of deaths and devastation to the physical and mental health of people forced to constantly take new, more dangerous routes to avoid blockages."
After an agreement between the EU and Libya was signed in 2017—against a backdrop of increasing obstacles to rescue operations in the Central Mediterranean Sea—arrivals that had departed from the country fell from 165,000 in 2016 to 7,000 in 2019. However, they rose again the following year and have stabilized since 2021. Now there are around 40,000 to 50,000 arrivals per year, despite increased European material (e.g., trainings) and financial support for the Libyan Coast Guard.
In 2023, a total of 157,000 migrants arrived in Italy. This figure is close to the 2016 peak, which can be explained by the shift in departures from Libya to Tunisia—where the majority of migrants departed from. Despite many migrants from sub-Saharan experiencing mass violence in the country, Tunisia remained a significant port of departure until 2023, when the government signed an agreement with the EU to curb migration. Numbers have sharply decreased since, but people desperate to seek safety continue to depart.
An increasing number of people are now also attempting the perilous Atlantic crossing to the Canary Islands, with more than 46,000 arrivals to the Spanish archipelago in 2024.
As a result of these blockages and longer routes, thousands of people lose their lives every year. Between 2015 and September 2025, at least 27,000 people lost their lives drowning in the Mediterranean, including more than 20,000 in the Central Mediterranean, according to the International Organization for Migration. Similarly, in Niger, migrant deaths increased fivefold from 2016 to 2017, when a 2015 law—inspired by the EU’s harmful migration policies—criminalizing the transport of migrants was enforced.
“Partnerships with states outside the EU have multiplied over the last 10 years as people on the move have taken new routes,” says Tubiana. “[These partnerships are created] without regard for human rights, and sometimes even when partner governments are guilty of or complicit in violence against migrants. The changes in routes have only provided further justification for the EU to relentlessly pursue its externalization policies with new partner countries, in a deadly vicious cycle, thereby completing its attempt [to block people from its shores]."
Interceptions have led to exploitative detention of migrants
The 2017 partnership between the EU and the internationally recognized Libyan government—which controls only part of the country—led to an increase in the number of people intercepted at sea. Today, one in three people taking the route are intercepted. The partnership has also contributed to militias exploiting the detention of migrants for profit. Still, migrants in Libya who cannot access safe and legal routes out of the country continue to attempt the deadly sea crossing.
Countries entering agreements with the EU are also impacted by the consequences of harmful policy. In Niger, migration policies stemming from an agreement with the EU were highly unpopular among Nigeriens, many of whom saw the policies as mostly benefiting Europe. Reports say this disapproval weakened the position of Niger’s president, Mohammed Bazoum, before he was ousted in a coup d'état in July 2023. The new authorities quickly repealed the partnership.
MSF witnesses the consequences of externalizing border policies on the health and lives of migrants throughout the migration journey—from departure countries, during the sea crossing, and upon arrival in Europe.
European governments must ensure agreements do not harm migrants
There is an urgent need to suspend or abandon existing agreements on migration management and border control in third countries. These policies do not guarantee sufficient precautionary measures, respect for human rights, and protection for all migrants regardless of their legal status. Strengthened monitoring and evaluation mechanisms that are regular, financially independent, transparent, and binding must be implemented to ensure respect for human rights.