Since the founding of Doctors Without Borders/Médecins Sans Frontières (MSF) in 1971, we have worked continuously to save the lives of those threatened by violence, disease, malnutrition, exclusion from health care, and catastrophic events. We’ve also worked continuously to reflect on our impact with the goal of finding ways to improve the scope and quality of care we can provide.
Accountability is at the core of our identity as an organization. We hold ourselves accountable to the patients we treat, the over 42,000 doctors, nurses, and logisticians who make up our teams worldwide, and to the people who support us. We strive to be as open and transparent as possible when it comes to the work we do as well as the money we spend.
Accountability & self-examination
As an accountable organization, we believe we must be willing to review, analyze, and critique our operations constantly, at all levels.
After responding to a medical crisis—whether it be the unprecedented Ebola outbreak in West Africa or the devastation in the Philippines in the wake of Typhoon Haiyan—MSF closely examines the impact of our response. In regularly published reports, we explore what we got right, what we got wrong, and how we can better reach and treat those who need us most.
We accept that there are instances in which aid can do more harm than good, which is why we are continually examining whether our presence—particularly in conflict zones—is improving and saving lives rather than jeopardizing them.
Our commitment to independence, impartiality, and neutrality allows our teams access to populations and places few other organizations can. Being accountable means that we must constantly measure how these principles are put into practice on the ground.
In 2012, MSF published “Humanitarian Negotiations Revealed,” a frank account of some crucial choices we made as an organization over the previous decade, including the extensive conversations we entered into with the Afghan government, NATO forces, and the Taliban in order to gain access to those in desperate need of medical care. Some of these decisions were hotly contested within MSF, and we continue to encourage debate and discussion, as well as to mine these experiences for future insights.
Accountability & our structure
Constant reflection and evaluation is baked into the institutional structure at MSF. While much of our staff is focused on navigating the day-to-day operations of emergency medical response, we also have dedicated groups that are focused on the long view. In Paris, there is a division known by its French acronym, CRASH, staffed by some of our most senior officers. Their goal is to reflect on projects and offer recommendations on how similar circumstances could and should be handled in later years.
The MSF Association—charged with overseeing and monitoring all of our operations—is also key to our accountability model. The Association is made up of current and former field workers who understand firsthand the challenges of providing care in dangerous, chaotic, and remote contexts. They are charged with electing our board of directors, almost all of whom are also former field workers. The result is an organization driven by people who intimately understand how our mission and principles come into play on the ground.
Accountability & our patients
Our goal is always to improve the quality and scope of medical care that those most in need receive during and in the wake of crises. That’s why we regularly share our research, findings, and data when we believe it will inform international protocols or policies and improve the standards of care people receive worldwide. Over the years, we have helped revolutionize the treatment of HIV in resource-limited countries, prevention and treatment of malnutrition in chronic settings, and the carrying out of mass vaccination campaigns during measles outbreaks.
When we respond to a medical crisis, we’re not only looking to provide immediate treatment; we’re looking to discover the factors and dynamics that led to the crisis. We regularly ask the tough questions: Why are some groups unable to access care? Why are certain tools or medications so difficult to come by? Why are specific agreements or players preventing medicines from getting where they’re needed most? As problem-solvers, we seek to discover and find ways to overcome these obstacles to treatment.
Accountability & finances
Our commitment to openness and transparency extends to our financial operations. In order to maintain our independence, we do not take government funding. It’s individuals donors like you who make it possible for MSF to save lives and adhere to our principles of independence, impartiality, and neutrality.
When emergency strikes—whether an earthquake, epidemic, or conflict—we don’t have to wait for government funds to be released or other outside approvals. Instead, we can focus our energy on getting vital medical treatment to those who need it most as rapidly as possible. In situations where a quicker response often means more lives saved, this independence makes all the difference.
MSF donors fuel the delivery of medical aid to the people who need it most, no matter where they are or whether the crisis they’re experiencing has hit the headlines. Donor funds pay for millions of consultations, operations, treatments and vaccinations every year. Because donors are such a vital part of our mission, we readily make our financial information available.
Every penny spent at MSF is subject to a rigorous accounting system, with all the information logged and shared with headquarters as well as our donors. We’re proud of the way we put your dollars to use. For over 15 years, more than 85 percent of our expenditures have gone to our lifesaving medical programs.