As humanitarian systems come under increasing pressure, how does Doctors Without Borders/Médecins Sans Frontières (MSF) continue to respond to people caught in conflict, disease outbreaks and other humanitarian emergencies?
On a winter’s day in Paris, nearly 55 years ago, Médecins Sans Frontières/Doctors Without Borders (MSF) was founded by 300 volunteers – doctors, nurses and other staff, including 13 founding doctors and journalists. Their mission was straightforward: to provide medical humanitarian care to people who need it most, wherever they are in the world.
“It’s simple really: go where the patients are. It seems obvious, but at the time it was revolutionary,” says Dr Bernard Kouchner, one of MSF’s founders.
Today, that principle remains at the heart of MSF’s work. But the humanitarian landscape has changed dramatically. Aid is increasingly politicised, funding for humanitarian organisations is under pressure, and attacks on humanitarian workers and healthcare are being reported in many parts of the world.
This raises an important question: is independent humanitarian action still relevant – and how can organisations like MSF continue to respond to growing humanitarian needs?
With the United Nations estimating that 239 million people need humanitarian assistance, the answer is yes. Independent medical humanitarian action remains essential. But maintaining that independence is becoming increasingly important.
Why independence matters in humanitarian aid
Doctors Without Borders was founded on the principles of neutrality, impartiality and independence. More than 97% of MSF’s funds come from individual donors. To protect our independence and ability to respond according to medical needs, MSF generally does not accept funding from governments.
We also decline funding from industries whose activities or products may conflict with our medical and humanitarian principles, including tobacco, alcohol and pharmaceutical companies.
This financial independence helps MSF provide medical care in some of the world’s most unstable, underserved and difficult-to-access settings.
For MSF, independence means providing healthcare based on medical needs, regardless of a person’s race, religion or political affiliation. It enables us to launch emergency responses, withdraw when our ethical principles are compromised, and continue working in places where few other organisations can.
Independence also allows MSF to remain neutral in armed conflicts and not take sides. It is a fundamental part of how we continue to provide medical humanitarian assistance in more than 70 countries.
For people living through conflict, displacement, disease outbreaks and natural disasters, this ability to respond according to need – rather than political interests – remains critical.
The power of bearing witness
The creation of Doctors Without Borders was partly driven by the growing ability of television and journalists to expose atrocities and humanitarian suffering around the world. There was a growing sense among the organisation’s founders that more needed to be done – both to provide humanitarian assistance and to speak publicly about what was happening.
Journalists were therefore an essential part of MSF from the beginning. Alongside medical action, the organisation adopted the principle of témoignage – bearing witness.
Since 1971, MSF’s commitment to speaking out has continued, even as humanitarian organisations face increasing censorship and misinformation.
MSF documents attacks on healthcare facilities and the consequences of conflict in places including Palestine, Sudan, Myanmar and Ukraine. We highlight the humanitarian consequences of restrictive migration policies, including policies affecting migrants and refugees in Libya and Central America.
We also advocate for civilians affected by conflict and draw attention to crises that receive limited political or media coverage, including humanitarian emergencies in Mozambique and the Democratic Republic of Congo.
Throughout MSF’s 55-year history, combining medical humanitarian action with public testimony has remained one of the organisation’s defining characteristics.
As Dr James Orbinski said during MSF’s Nobel Peace Prize acceptance speech in 1999: “We speak not into the wind, but with a clear intent to assist, to provoke change, or to reveal injustice.”