Aid shift: Standing up for global health in a time of turmoil

Kavita Menon: 
Hello, welcome. Thank you for joining us for this conversation today on the massive funding cuts and policy changes that are reshaping international aid and the impacts for the people we treat at our medical projects. I'm Kavita Menon, and I am the head of Communications for Doctors Without Borders in the United States, joining you from New York. Some of you may know us by our French name, Médecins Sans Frontières, or MSF, so you may hear us use that acronym today. At Doctors Without Borders, we have many decades of experience responding to all kinds of emergencies, wars, natural disasters, and disease outbreaks. But this year was different. 

On top of all of the other emergencies, the US effectively gutted its international assistance programs, and now they're starting to promote a new America-first global health strategy. And a lot happened really fast. I want to note that MSF is not directly affected by the US funding cuts. We don't accept US government funding, and in fact, we're really lucky to count on generous support from independent donors, including many of you who have joined us here today for this conversation. But we don't work alone, we work hand in hand with many local and international organizations that were really badly affected by these cuts, and many of them were forced to scale back activities or stop altogether. 

So today you'll hear from a few Doctors Without Borders colleagues from around the world who are here to bear witness and tell you what they're seeing firsthand.  I want to give a warm welcome to Dr. Javid Abdelmoneim, who is an emergency physician and our new International President. Welcome Javid.

Dr. Javid Abdelmoneim: 
Thank you for having me.

Kavita Menon: 
Thank you. And Dr. Brennan Bollman, who is an emergency physician as well, and currently serving as the Medical Activities Manager in Central African Republic. Welcome, Brennan.

Dr. Brennan Bollman: 
Thank you so much for having me.

Kavita Menon: 
And we are having some tech issues, but we're really, really hoping to welcome Diana Manilla Aroyo, who is working as Doctors Without Borders’ head of mission in Haiti. So, fingers crossed, she'll join us, but otherwise we will wing it. So, thank you all for joining the conversation, which will run for about 60 minutes. And, for supporters tuning in, you can submit questions for the speakers via the chat or the comments section, and there are also live captions available. So, with that, we'll just get right into it. 
Javid, I'm going to start with you. I know you were in Sudan when the US first announced a freeze on foreign aid and later gutted USAID. The US has long been the top contributor to global health and humanitarian programs responsible for around 40 percent of all related funding. So, what was the reaction like on the ground in Sudan at the time?

Dr. Javid Abdelmoneim: 
Yes, I was working in Sudan as a medical team leader. In our projects in Omdurman, which is part of the tri-city area of Khartoum, there was a front line running through the city at that time. So, it was an active conflict zone, but there was a civilian population very much living in Omdurman. And we worked [on] projects in cholera, in the emergency room of the surgical hospital, but also nutrition in the pediatric hospital, maternity in the maternity hospital. And they were the only three hospitals open in the entire city. That was in the territory of the Sudanese Armed Forces where we worked. So I was there through November, December, January, and until the beginning of February, that was really when, I think it was in January, if I recall, when the cuts were made.

Kavita Menon: 
Yeah, January 20th.

Dr. Javid Abdelmoneim: 
Okay. So, the dates are seared in your minds. But as they should be, it really was dramatic and overnight, I had in the space of the next seven days, three different organizations come to me, requesting us to step in, to step in to support them because they overnight lost their funding. One of those was emergency response rooms. You may have heard of that phrase, the ERR, the famous Sudanese ERR, which are civil society groups, really forming the backbone of a lot of the humanitarian response across the entire nation. They were providing the food in the kitchen. So, you also would've heard of the aid kitchens. They lost all their funding overnight, and they came to us, and that kitchen was the kitchen for the entire surgical hospital in which we were working. I also received requests from the Sudanese Family Planning Association, which actually had a lot of really good sexual reproductive health services. And one of those was a large group of community midwives doing community sexual reproductive health work through the city, bearing in mind that the front line meant that the population trapped in the territory of the Rapid Support Forces. Then, the other side of the war couldn't come to the hospitals and SFPA were one of the only organizations doing crossline work in that vicinity. 

So that falling away is dreadful, especially when you're in a scenario of sexual violence being used as a coercive tool and a control tool on the population. Another group came and couldn't now support the primary health care center they were supporting, and at the time, there were only about four or five functional [health care centers] across the whole city. And you imagine the capital city of a nation would have a lot more than four primary health care centers working, and yet there was one of them having to drop their services. I would love to be able to say we were able to immediately step in, [but] we were not. And that posed us, you know, a lot of difficulty because having to say no for such critical services is very difficult. I do know we were subsequently able to pick up and support the SFPA Community Midwife program, but that came later. I mean, I think in a place like Sudan, there are already multiple overlapping emergencies and too few actors, too few organizations to respond. And so, on top of that existing, you know, problem, you have these new challenges and, and it does take time to adapt and to respond.

Kavita Menon: 
I'm going to go to Brennan to get the view from Central African Republic. I think people need to understand what international aid does. What does it mean for people in a place like Central African Republic?

Dr. Brennan Bollman:
Of course. Thanks, Kavita. So, where we work in the Central African Republic, the people we serve have already faced decades of civil conflict that actually only recently started to improve in the last year or two. But the Ministry of Health still is extremely underfunded and just can't provide basic services without international partnership and support. So, the hospital where we're supporting in Bangassou is the only comprehensive public hospital in the entire region. 

It's very remote and far from the capital and the only place where people can seek care. And since I arrived in August, actually even before then, we have just been overflowing, more than 70 percent of our patients are children, and every bed has been full. We've had to double the capacity of our intensive care unit, which is full of adults with advanced HIV, children with severe malaria, severe malnutrition, and tuberculosis (TB) also, which we're seeing in very high rates and even in children under five. We had one boy who came, a 10-year-old boy who came to us in early September, and he weighed 33 pounds. When I first saw him, I thought that he had died already. For days he was too weak to open his eyes. It took him weeks to gain the strength to be able to sit up. We diagnosed him with a condition called miliary TB and started him on treatment. And after weeks of pains taking care from our nurses and doctors, he was able to walk out of the hospital a couple of weeks ago. But, you know, the medication that he's taking at home to fully be cured from his illness, and in fact, all of the medications to treat conditions like TB, HIV, malaria, malnutrition, and too many of the vaccines that we use, come from what are called vertical programs, where they're supplied through funding mechanisms like the Global Fund and through UN (United Nations) agencies and NGOs. 

So by and large, you know, these large efforts have still existed this year because their funding cycles had been planned prior to the 2025 cuts. But they're already under-budgeted and over a sort of slow downturn in support for global health. We're already seeing financial or medication stockouts and shortages. And honestly, my Central African colleagues are terrified about what might happen in the next one or two years. So tomorrow the Global Fund is starting its next planning cycle, and we don't know what could happen if the United States remains completely disengaged, if other countries follow suit. Because what would happen is that in the next one or two years, we might not have the medications to save this boy's life. And it's not an exaggeration to feel like we're sort of staring and looking at the edge of a cliff.

Kavita Menon: 
Thank you Brennan for kind of bringing home what this means in terms of people's lives. I think we do have Diana with us now. I'm so glad you were able to connect. Welcome. We have talked before about, you know, this is not only about funding cuts. There were also a number of very deliberate policy decisions made by this administration that have pretty far-reaching impacts for people around the world. And we know for instance, that within days of taking office, one of the first executive orders that President Trump issued was to reinstate the Mexico City policy, which is also known as the Global Gag Rule. And that prevents organizations abroad from using their own funds, so not even US government funds, to provide or even talk about safe abortion care. And that's a condition in order to receive other US global health assistance. So, can you talk about, you know, some of the impacts of these policies in Haiti?

Diana Manilla Aroyo:
Yeah, sure. So, the first thing that I would like to say is that the only thing that can be banned when abortion is banned is safe abortion, because unsafe abortions are going to continue. When a woman decides to end her pregnancy, she's going to do it regardless of what the law says. It is one place where I think it's important to start saying that while women and girls may use contraception for various reasons around the world—to space children, to plan families, to enjoy sex—Haiti is a place where many women and girls use contraception in order to prevent pregnancies from the continuous threat of rape. When contraception access decreases, then unsafe abortions increase. And the recent changes, we see them through various of our programs, where we see a very clear cycle between sexual violence and unsafe abortion.

Kavita Menon:
I'm going to move to Javid. We have a question from one of our donors, Reid, which was submitted in advance, asking what are the health efforts that are most affected by the aid cuts?

Dr. Javid Abdelmoneim:
Oh, okay. Good question. I mean, there are… I almost feel like saying it's across the board, but because actually, if you look at, say, the United Nations system, you've got the World Food Program, UNICEF, which is the children's agency, UN Aids, you've got the Office of Coordination of Humanitarian Affairs, the World Health Organization (WHO) itself, all cut, you know, to varying degrees, 20, 30, 40, 40 50 percent. And, you know, that's a through and through cutting. 

But actually, more specifically, there's also vaccinations, therapeutic foods as Dr. Brennan was saying, HIV, TB, and malaria. And, some of those are because of the organizations that are, that have been cut or have, are coming up short. And we, and as Dr. Brennan mentioned, you have the Global Fund looking for its replenishment tomorrow.  
Germany has pledged, but pledged lower than usual. And the worry is that the other major countries, UK, US, coming forward would cut that, and that means HIV, TB, and malaria care would fall away. Another example is that with UNICEF, the United Nations Children's Agency, their cuts have meant that the provision, the in-kind donation of therapeutic, ready-to-use therapeutic food, or RUTF, a little bit like the Plumpy’Nut, some of you may have heard of that peanut paste. It's a medication that's therapeutic, it’s used [to treat] acute to severe malnutrition. So that’s going away essentially. 
And even for MSF, that having used those donations in the past, we already saw in a couple of countries, Yemen and I think Ethiopia, if I remember the second one, where we've had to then purchase that [RUTF] just to do the same, just to do what we've always done. It's now costing us in an order of half a million dollars extra in each of those countries. And another example is GAVI, which is the Global Access to Vaccines Initiative. They’ve had a reduction in their funding in approaching approximately 20 percent. And again, it's not necessarily that we as MSF would've been taking donations, but the Ministry of Health, the way we work would have, and they would do vaccination campaigns. And that was something that we would either support with logistics or not have to worry about, so to speak. So, we're in a health ecosystem, and when these other sort of organizations, actors, and ministries fall away, that means that we either have to aim to fill the gap or work in a very different way. And we have to also be clear that we can't fill the gap when the global health system is being gutted in this way as we can't do it alone.

Kavita Menon: 
Yeah. I mean, and that's a really important point about just costing more to stay in place. And these emergency food orders, I read that we've made emergency, kind of increased emergency orders of nutritional supplies in at least nine countries. Some of the worst-affected countries hit by, you know, where malnutrition is on the rise, including Central African Republic, Chad, Nigeria, South Sudan, these are all places with already acute emergencies. And, you know we can only stretch the budget so thin. I think, Brennan, you want to add your experience from Central African Republic.

Dr. Brennan Bollman:
Just that yes, exactly. In the last weeks even, our work in Bangassou, we plan for having an emergency stock of things like therapeutic milk to treat severe malnutrition or Plumpy’Nut or medications for TB. And we've had to use these more and more and more. Our ministry colleagues have run out in just the last weeks of HIV tests and adult formulations of TB medications. 

And the more that we plan to need to even temporarily fill some of those gaps, [it] becomes less sustainable than for the other things that we're trying to offer as well. Like regular antibiotics, IV fluids, and supplies to perform lifesaving surgery. So, this always has needed to be a major partnership to make the advances that we've made in treating these conditions over the last decades. And we're very concerned about what is happening as that is becoming more difficult.

Kavita Menon: 
Diana, can I come back to you to talk about the impacts on sexual and reproductive health care in Haiti?

Diana Manilla Aroyo: 
So, the impacts are not only, as you were saying, on access to abortion, but also on access to basic commodities such as contraceptive injections or contraceptive pills. And Haiti is a country where uptake for family planning is actually high, which is not the case in all of the countries where we work. And while understanding the impact is very difficult amongst other organizations. And that's something that we saw at the beginning of the year because we experienced a series of severe security incidents in late 2024 and [the] beginning of 2025. And, we saw what happens when we are unable to provide care. So, we work in gang-controlled areas. Gangs exert control over women's bodies and lives in every single way in where they go, what time they go to certain places, whether they can live [in] gang-controlled areas or not. And these are women and girls that come regularly to access contraception. Some of them are as young as 11 years old.

Kavita Menon: 
I'm going to go back to Javid to ask if you can explain a little bit, you know, we were talking about all of the competing pressures on Doctors Without Borders, but also other organizations now that the needs are so acute and so widespread, how do we make choices? And maybe could you talk to us a little bit about, in general, how MSF does needs assessments? How do we assess the needs and where to intervene?

Dr. Javid Abdelmoneim:
Yes, absolutely. I mean, you know, when, when you, you're confronted with choices every day in our work, both in the sense of at the patient bedside, but also in the sense of building your program or project planning, which is an annual cycle. So, at that time, teams would've assessed the needs that are in front of them, decided who are the most vulnerable, who are the most neglected or violated, which needs we can respond to best.

And usually it's about a gaps analysis, unmet needs, or who else is there doing what. Let us compliment, you know, let's make sure there's no duplication and so forth. And that's why in an ecosystem, so to speak, with ministries of health, with the WHO, the UN Agency for Health, and with other organizations, you do your mapping and you assess. With them falling away, that doesn't necessarily change the process for assessing needs, but it presents you with more unmet needs, and then you have to go through a prioritization. Now, and the point there was that in Sudan, at least in my time, it's just by virtue of timing. We'd finished our annual planning process, we'd made all our orders, we'd signed all our renegotiations with the hospitals. Right. I'd put out my recruitment for staff because we were pivoting towards a little bit more quality of care within the ER and so on and so forth. You know, the machine was in place. And starting, it was January, and then it's like, bam, everything, the whole needs assessment changed. You know that's a big deal. 

I argue now in my role as international president [it’s] what we need to look at programmatically at institutional level, that might take away some of that risk of moral injury for you know, Dr. Brennan and Diana who were there having to do this and potentially say no to communities in front of you or requests that are being made. But that might then actually, although it could take away some of the injury, it might pose us with a moral dilemma. Because if we say it's a silly example, but if we say, we're not going to do vaccinations, for example, right? Just as a thought exercise. It's a very bad example, we're never going to say that, but if we did, if you presented with an outbreak, which is now much more likely, if the whole health ecosystem falls away, then you are telling your teams not to respond to the most dire need they're being met [with] in that moment. So actually, it's really a rock and a hard place, and there's a tension there.

Kavita Menon: 
Absolutely. Brennan, I think you've, you've thought a lot about kind of how to build resilient health systems. Like what, what is needed to support local health systems. Can you talk a little bit about that?

Dr. Brennan Bollman: 
Sure. Absolutely. So in Bangassou, in the public hospital that we support, we have approximately 400 staff. And, actually, the vast majority of them have not been able to benefit from a sort of conventional, professional, formal education to become a licensed nurse, for instance. So, most of their expertise in the truly excellent work that they're doing every day has come from these years of on-the-job training, and accompaniment from partners like MSF and certainly many others as well. So, you know, when I told the story about the boy who we saved from severe TB earlier, if you think about that effort that requires the skill of the lab technicians who were able to do his diagnosis tests. The nurses who cared for him day and night, the people who do logistics, who make sure that the electricity and the oxygen supplies and our biomedical equipment keep running in the hospital. We also do a lot of outreach work in Bangassou. So, we support vaccination and other essential basic health services in areas that are up to a hundred miles away from the hospital on very difficult roads that we reach by motorcycle and canoes. And we help support the ministry in what's called catch-up vaccination because we know that one in three children in the Central African Republic have never had a single vaccine and only 16 percent of children have had their full essential vaccines. 

So, we've been able to, through these massive mobilization efforts, been able to support vaccinating thousands and thousands of children. And if you just think about the skill and the coordination that comes from that level of community mobilization and engagement. It's really humbling to think about the way that human resource capacity has developed over decades in areas like the rural Central African Republic. And you know, global health has made so much progress in these last decades, the systems are here, we have the systems to deliver not just basic care, but even more advanced care like surgeries. Nobody should die of appendicitis. And, we're at risk of losing so much of that if we continue, if we abandon my colleagues here.

Kavita Menon: 
Yeah, absolutely. I think that's such an important story also to tell, I mean, so much of the time we're talking about all of the challenges, and I think we also need to talk about some of the impact and some of the progress we've been able to make in improving health outcomes around and why this work is so important. And it's important to maintain that momentum.

I'm going to come back to Diana, I wonder if you could talk to us from your perspective about what are the needs for the kind of the local health system in Haiti? What, where do you see the kind of the most acute needs?

Diana Manilla Aroyo: 
Well, it's really difficult to know where to even begin, when it comes to the health system as a whole because the country has been experiencing severe levels of violence since at least 2021 with an increase of gang control. We work, for example, in a maternity hospital that was built in the forties and at the beginning of 2024, was abandoned completely because of gang violence in the surrounding area. 

We are investing in rehabilitating the structure, in building [the] capacity of the few staff that are willing to come back to work in a very violent area where there's many risks in leaving their homes and crossing front lines between state control and gang-controlled areas. We are one of the very few actors that works in gang-controlled areas at a great cost because we've experienced a number of security incidents as a result. But when it comes to sexual and reproductive health specifically, there has been a lot of progress.
Contraception has been free as part of the health system structure for many, many years. But one point that I was trying to make before, is that in one public maternity where we provide the service for sexual violence contraception [it] used to be free, but in the last few months, now women and men have to pay for basic contraception services. And, this is an enormous obstacle for many people. There's also shortages in HIV care, something that we have never seen. And there are changes also in services that many of our patients absolutely need, and that we are not in a position to provide, because that's not our place. 

The most important service that is requested by sexual violence survivors since at least 2015, which is when we started to provide that service in Port-au-Prince, the capital of Haiti, is shelter. And some of the organizations working in sexual and reproductive health that need resources to run shelters are seeing reductions. So, this means that they can take fewer women, or that women cannot come with their children, for example. So that means that women have to go back to the place where the aggressor lives.

Kavita Menon: 
That's a really clear illustration, I think, of this aid ecosystem that we talk about. Like no one organization can really fill all of the needs. So, being aware, and also, you know, some organizations have asked us to advocate, you know, on their behalf, because they know that we are not directly affected by these cuts. So, we can be a little bit more outspoken. You know, that other organizations can be more vulnerable because they are so dependent on US funding or other government funding. So, actually, on that point, we have a question and I want to encourage people to submit questions. You can submit questions via the comment or chat function. And we do have one that came in from Kurt asking what are MSF’s main funding sources? So Javid, I'll ask you to respond to that question.

Dr. Javid Abdelmoneim:
Ah, well, it's from donors. It's from private donors and private meaning individuals. So, I think we're in the region of 7 million, you know, Mr. And Mrs. Smiths around the world who donate monthly. And that's what's so valuable, it's one of the main features of our independence. And that's why we're able to go where need is most, really. And I mean, I forget the figure right now, but it's over 90 percent. 
It's over 90 percent of our funding is of that nature. The remainder comes from philanthropies or organizations or companies. Right now, in terms of governments, I don't know of any government donations, but then I can't remember, actually, I should know if it's, it's something that's negligible, certainly not from the EU or the United States. Yeah. I think it's less than 1 percent. And it is for programs like TB care that are kind of funded by these consortia, really. Yeah, it's a very small proportion our overall funding. So just good to, for people to have that picture and also know that that enables the kind of independence of being able and, and the kind of agility that is critical.

Kavita Menon: 
We have another question from Helen watching live. This is not related to the aid cuts, but kind of related to this, the kind of humanitarian landscape that we're facing now. There have been a lot of attacks on aid and the concept of aid, both politically [and] rhetorically, but also really physically, like less respect for the humanitarian space, more attacks on humanitarian personnel, medical staff. How is that affecting our ability to provide care where it's needed? I think, Javid, you have some information about this. We could also talk about in Haiti some of the security risks that our staff are facing and even in Central African Republic. So, feel free, whoever wants to take that first.

Diana Manilla Aroyo: 
I can start. Yeah. So, I mean I'm not quite sure if this is specific to this question, but Haiti is one place where have been experiencing severe incidents. And that's related to the principle of impartiality. So everywhere we provide care to whoever presents, and we don't ask who they are, what they've done, whether they belong to one side or the other. 

And this is a population that has been experiencing very high levels of violence, primarily from gangs, though, not only. And so, there is a growing tension because we provide care to people who sometimes do belong to gangs. But again, it is not the role of any of our medical personnel to ask whether they belong to a gang or not. But we have, we have experienced aggressions from formal security forces because of this reason. However, I think and another point, related to this question on the changing humanitarian landscape and more related to sexual and reproductive health, I think I really want to emphasize this, it's not only about defunding. It's also about the political forces behind this. So, when I look at sexual and reproductive health, I think it's important to think about what is being cut. Abortion is being cut, contraception is being cut, maternal health is not being cut. Why is that now? Why are the services that perhaps reinforce roles that we attribute to women? You know, motherhood stereotypes that perhaps value women for their reproductive ability are the ones that are not being attacked. I think it's important when we analyze all of these changes in, in the humanitarian landscape, not only where is the money being cut, but also what are the things that are being prioritized?

Kavita Menon: 
Yeah, absolutely. That's a really important point. And I think a related point is that cutting any one of these things actually does affect, it has other consequences as well. But there is definitely a very clear agenda that we should also be conscious of and calling out when we see it. Does anybody else want to add on how we're facing some of the security threats to our medical personnel?

Dr. Brennan Bollman
I think just in the brief sense that I was also in Haiti last year and in Gaza earlier this year, and for so long, the humanitarian efforts have depended on believing that humanitarian work should be allowed to occur safely because we're providing impartial, neutral care to people who need it. And that's clearly not happening anymore. And I think the more that we see examples in Gaza, in Haiti and Sudan where health structures themselves, whether it's MSF ambulances, public hospitals are becoming the targets of attacks, and we're failing to respect the Geneva conventions and international humanitarian law. It's that it is becoming increasingly, just immeasurably, more difficult to do our work.

Dr. Javid Abdelmoneim:
Yeah. I mean just to compliment, I mean, I think internally we're starting to look at or describe it. I mean, look, we’re in an era of policy crises. And you can put in that antibiotic resistance, AMR (anti-microbial resistance), the climate breakdown. I mean, COP has just passed, and 1.5 [degrees] is a certainty, and seven of the 16 tipping points are about to go. And the planet's literally on its last legs, let alone all the number of conflicts. 

And then you look at whole regions that have societal upheavals, the entirety of the Sahel from east to west, you know, really profound, complex policy crises that compound each other. But underneath that, there's a little bit of this new term or a term that we're taking up called the meta crisis, which is a crisis of the values and the beliefs. And in between there are structures. So, you can see the gutting of the global health infrastructure and below that, that gutting is underpinned by a little bit of an abandonment of the values and beliefs, right, of solidarity, multilateralism. We're all in this together. I feel it's existential for our sector, actually. And, then as Dr. Brennan said, and I too worked in Gaza and Sudan at this time, attacks on health care this year so far are highest in Sudan, actually. But the Gaza issue for me is that, you know, the selective application of the law really means there is no law anywhere. And, that's what's quite so worrisome about seeing the so-called western up upholders of law and order, double standard, the application of the law vis-a-vis Israel.

Kavita Menon: 
Yeah. No, absolutely. We have a question from SJ who's watching live and wondering, picking up on this question about how does MSF, Doctors Without Borders, work with local groups and leaders to build capacity and resilience in the communities where we work? Brennan, if you want to take that.

Dr. Brennan Bollman: 
Yeah, I'm happy to take it. Okay so for example in Haiti, we work with various local feminist organizations and the reason is that they have a very good understanding of the power dynamics that lead to women experiencing certain conditions. Because many of the health issues that they come with to our health facilities are not only the result of, you know, an infection, maybe the reason of the fact that they are unable to choose who to have sex [with], when, or if at all. So, many of these organizations are helping us a lot to understand the specific dynamics in which women and girls in Port-au-Prince live the day to day. Some of them also run shelters to the point that I was making earlier. And one of them in particular that is being very affected by the courts, they provide pre-exposure prophylaxis to sex workers. So, supporting sex workers is an area that has really affected by the US funding. And so, we work with them in the sense that, I mean, we for sure have very little to teach them, quite the opposite. We have a lot to learn from them. We have a partnership in the sense that if any victim of sexual violence, then they can come to our clinic to access free services. I think sometimes we have a tendency to think that it is up to organizations like MSF to build the capacity of local organizations, when in fact, many of them have a much broader understanding of local dynamics, and it's up to us to listen and consult them. So that's one thing that we're trying to improve for sure in Haiti. Going with some humility, and I think we've talked a lot more about centered community centered care and really work like, what does it mean to have these more respectful partnerships, working with communities.

Kavita Menon:
I'm going to bring us to our final question. We got this question from so many different audience members, which is what else, aside from financial support for MSF, which is always welcome, can people do about these challenges? And I would like each of you to take it from, from your perspective. Javid, I'll start with you.

Dr. Javid Abdelmoneim:
For me, it's about an attitude. I think it's about being informed, challenging these narratives that are, I think negative really, and reemphasizing the basic principles of solidarity, each of our own dignity, and humanity. And so, in that sense, yeah. And if you vote, I always come back to voting. I mean, I vote in the UK. I look in at what they're saying they'll do about overseas development assistance, what they'll commit to in terms of funding and so forth. I write to my member of Parliament anytime that is relevant for them to put pressure on, really. So it's that, that's what I think of. Thank you.

Kavita Menon: 
Yeah, I mean, standing up for these humanitarian values and principles is really important. So, thank you for emphasizing that. Diana, what would you say people can do?

Diana Manilla Aroyo: 
Yeah, I think, I think one important thing is to understand is what is the impact? What does this mean? I mean, if we have viewers that are right now living in the US, there are many impacts also in just within the US, particularly in sexual and reproductive health. So how does it translate into the area where I live? I will give perhaps a small idea, but an idea of how it would be for a woman who has never had sustained access to sexual reproductive health in a country like Haiti or Central African Republic, or in Gaza. I think trying to keep ourselves informed of what do these changes mean? Even in the area where I live is one thing. And then the other thing is understanding what is it not, not only what is being taken away, but what is being put in place of this code. So, you know, if abortion and contraception are being deprioritized, what is being prioritized and what does it look like? Is it a new scheme that talks about family? Is it about encouraging or rather discouraging the use of contraception? I think this is something that we are going to start to see more and more in many of the places where we work. So, I think it's very important to stay informed and alert of how this will continue evolving.

Kavita Menon:
Absolutely. Informed and alert. I think that's a good call. Brennan.

Dr. Brennan Bollman: 
Yes. So just building on what Diana said, you know, I have no doubt that every single person on this call also has any number of local issues in your community that you care deeply about. And honestly, when I speak to family and friends, I acknowledge it can feel overwhelming to try to think about all of this and to care about all of this at once. So, you know, step one is just recognizing that we all really do have a limitless capacity for compassion and engagement. And so, as we've said, staying informed, sharing, keeping this in the forefront and also doing things. I mean, I think we've made it clear that it can't just be MSF. We need support with MSF, but it can't just be MSF here and in anything that you all do in your lives, I mean, we need academic institutions, for instance, to increase their engagement with the global south and not cut it. The same applies for businesses in any other sector. And so, I think just believing that improving the health for people around the world is just, it's the right thing to do, is where we start. And I really sincerely want to thank everybody here for believing that.

Kavita Menon: 
Wow. Well, thank you so much, Brennan, Diana, Javid. I mean, this has been such an insightful conversation and you've brought all of your expertise, but also these kinds of human insights on this very complex topic. So really thank you so much for sharing that. We are going to switch gears for just this last segment and bring in our Chief Development Officer, Deb Garcia to join the conversation. Deb, welcome. I wonder if you could talk to us about, you know, kind of just the urgency of this moment we're in right now.

Deb Garcia: 
Yeah, definitely. Thanks for that question. You know, as Dr. Javid was saying, medical humanitarian aid, the ecosystem funding for it has completely been gutted. And so many of you know, a few times you said we're not directly impacted. The reality is this has been a seismic shift, and so funding all work, the type of work we do, other players and partners in the ecosystem are literally having to revisit their strategies. And we've been able, thanks to many of the people on this call, to remain steady in the countries that we work in. And so we are really wanting to step up and to be able to, we're not going to be able to fill the gap, but we certainly want to be able to be responsive, and we're trying to mobilize as much support. What has happened to the funding of aid is not going to be fixed in a year. It's not going to be fixed in a decade. And so, we're really asking for all of our supporters to support as much as possible this year and beyond.

Kavita Menon: 
And, what is giving like in today's market?

Deb Garcia: 
So, the philanthropic market mirrors the economic landscape and the wealth divide, you know, is larger than ever, right? People are losing their jobs here in the US at a significant rate. Uh, you know, the cost of just basic things, eggs, et cetera, is up. So, what we're seeing is that many of our supporters are unable to financially support our work. We're seeing less donors step up, but we're actually seeing that we're trying to encourage people who have the means to give because the wealth divide is larger, the financial markets are up right now, and we're seeing people really step up and we're seeing people step up, not just with cash gifts, but also with stocks. And so definitely encouraging everyone to think about, you know, different giving vehicles and be mobilized to support because the needs are larger than ever and we want to make sure that our teams are able to step up, like Javid was saying.

Kavita Menon: 
And can you talk a little bit more about these different giving vehicles?

Deb Garcia: 
Yes. So many of our donors want to give through donor advised funds. This is a great time if you have a donor advised fund to support us, set it up, even in a recurring manner. If you're working at an organization that matches your gifts, some organizations do matches one-to-one, two-to-one, three-to-one. We want to make sure that you are tapping into those resources. And also even bunching this year, if you want to, if for donors who have philanthropic advisors, really exploring the benefits of, you know, doubling down on your giving this year, it would be really advantageous for us.

Kavita Menon: 
Okay. And what about longer-term support, other kinds of meaningful ways that people can contribute to MSF’s work now, but also into the future?

Deb Garcia: 
Definitely. So, like I said, the gaps for this type of work are significant and we're not going to be able to, to fill a gap this year, right? One of the most powerful things that our donors could do or supporters can do is actually think about their giving long term. I'm always so inspired by people who decide to leave us alongside their families and their estates. That is a level of commitment to our patients and the communities we serve that we don't take for granted. And in fact, our former CEO Avril Benoît even joined the Legacy Society because she's so convinced that we want to make sure that this work continues to be resourced in the long term. So, if you want to think about leaving us in your estate charitable remainder trust, charitable gift annuities, thinking about giving to us in a long-term manner, we are really grateful.

Kavita Menon: 
Thank you for that. And then, I think before we wrap up, can you walk us through how people can take action today to support MSF’s work?

Deb Garcia: 
Yes, absolutely. So, I believe that there should be a QR code to be shared. And I want to encourage everyone, this is our kind of mantra as we go into end of year giving: “Now more than ever”, if you can support our organization or patients and the communities we serve, please do so. Needs are greater than ever.

Kavita Menon:
Thank you so much, Deb, and we really appreciate you taking the time to be with us today, and all of you for joining us. Shout out to all of our colleagues around the world who are working day in and day out under extremely tough conditions to provide medical care. Thank you all for joining us. Apologies if we did not get to your question, but please stay in touch and stay connected with MSF. You can visit our website, doctorswithoutborders.org, follow us on social media, you can also email us at event.rsvp@newyork.msf.org. Really, thank you all so much, and we hope to hear from you again. Thank you. Bye.