In the MSF 2025 Foreword, MSF's International President Dr Javid Abdelmoneim and Secretary General Christopher Lockyear reflect on a year marked by failures of accountability and solidarity.
Key Takeaways
- In 2025, MSF witnessed a widening "deficit of accountability," from negligence to violations of international humanitarian law, in places including El-Fasher (Sudan), Gaza, and South Sudan.
- MSF received only 0.96% of its funding from governments in 2025, while budget and border cuts by political leaders reduced access to essentials such as drinking water, HIV medication, and maternal care in countries including Haiti, Honduras, and South Sudan.
- Italy's "distant port" practice forced MSF to halt search-and-rescue operations on the Geo Barents; in November 2025, MSF relaunched activities using a smaller, faster vessel, Oyvon.
- A collaborative Ebola outbreak response in the Democratic Republic of Congo, involving MSF, the World Health Organization, local health authorities, and the community, brought the outbreak under control, with the outbreak declared over in December.
- MSF's International President, Dr Javid Abdelmoneim, and Secretary General Christopher Lockyear thank humanitarians who continue to stand in solidarity, noting MSF's work is made possible by people who share its values.
A Year of Growing Gaps
In moments of crisis and exclusion, Doctors Without Borders (MSF) teams strive to save lives and alleviate people's suffering. We provide the care that we can with our colleagues, collaborators, and supporters, but in 2025, we saw growing gaps that are not ours to fill. When people with power renege on their responsibilities and shared humanity, the communities we serve pay a high price.
A Deficit of Accountability: Sudan, Gaza, and South Sudan
In many of the places where we worked, we saw a deficit of accountability that ranged from negligence to flagrant violations of international humanitarian law. At the end of October, we appealed for civilians in El-Fasher, Sudan, to be spared from a Rapid Support Forces-led massacre that Sudanese people, MSF, and other organisations had warned about. This appeal went unheeded. As did our repeated calls for the protection of humanitarian personnel in Gaza, Palestine, prompted by the Israeli forces killing six of our colleagues during the year. Meanwhile, in South Sudan, the worst cholera outbreak in the country's history entered its second year – a grim milestone for a disease that is both easily preventable and treatable.
MSF cannot stop a massacre or an airstrike, nor equip a nationwide outbreak response. But we do bring care to the communities who bear the consequences of this lack of accountability in lost lives, homes, and opportunities. Our work around the world reminds us that systems, laws, and protocols can only protect people from harm and disease when they are respected.
People across the globe have had their options reduced through these inhumane policy choices. However, we do not have to accept them as a 'new normal.Dr Javid Abdelmoneim, International President, and Christopher Lockyear, Secretary General, Doctors Without Borders (MSF)
A Deficit of Solidarity: Funding Cuts and Their Human Cost
People in positions of political leadership matched this deficit of accountability with a deficit of solidarity, making choices that ignored our shared humanity, seen in the tightening of budgets and borders. In 2025, every cut to a humanitarian organisation's budget meant more than just a line on a spreadsheet; it was people going without drinking water in Haiti, HIV medication in Honduras, and maternal care in South Sudan.
While MSF received only 0.96 per cent of our funding from governments in 2025, we worked in places where the effects of withdrawn funding were clear. In one hospital in Somalia, our team met parents who had travelled for 190 kilometres to seek malnutrition care for their children after local health facilities closed. This is not an isolated example. People across the globe have had their options reduced through these inhumane policy choices. However, we do not have to accept them as a 'new normal'.
Adapting at Sea: From Geo Barents to Oyvon
When Italy implemented policies, such as their 'distant port' practice, designed to hinder humanitarian organisations' search and rescue work in the central Mediterranean Sea, we were forced to stop our activities on our vessel the Geo Barents. In November 2025, we relaunched operations on a smaller, faster boat, Oyvon, enabling us to return to open sea from port more quickly and save more lives. MSF teams the world over find strategies to deliver care in spite of inhumane policies.
A Collaborative Response: Ebola in the Democratic Republic of Congo
When an Ebola outbreak was declared in September in Democratic Republic of Congo, MSF swiftly mobilised, alongside the World Health Organization, local health authorities, and the community, to bring the outbreak under control. This collaborative effort, and the quality of care provided, saved lives and reminded us that protocols protect people from disease when they are put into practice. The outbreak was declared over in December.
Closing Reflection: Solidarity Beyond Politics
The world we live in is not devoid of accountability and solidarity. In an emergency, it is neighbours who assist first. And MSF can only step in to help because we are staffed and funded by people who share our values. While we are unable to fill the gaps left by leaders with political power, we are making a difference with every act of care. Our work is only possible because millions are practising their shared commitment to humanitarianism.
We send a heartfelt thank you to every humanitarian who continues to stand in solidarity against inhumanity.
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