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International Activity Report 2021

2021 in figures

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Activity highlights

This data groups together direct, remote support and coordination activities. These highlights give an overview of most MSF activities but cannot be considered complete or exhaustive. 

Facts and figures

MSF is an international, independent, private and non-profit organisation. It comprises 23 main national offices under the MSF International Statutes and nine specialised organisations, which provide specific activities to the benefit of the MSF movement and/or MSF entities, such as humanitarian relief supplies, epidemiological and medical research, fundraising, facility management and research on humanitarian and social action. As these entities are controlled by MSF, they are included in the scope of the MSF International Financial Report and the figures presented here. 

These figures describe MSF’s finances on a combined international level for the 2021 calendar year. 

All amounts are presented in millions of euros and are rounded for purposes of the tables and graphs below. This may result in apparent inconsistencies in totals. 

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International Financial Report 2021

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Annual Report

Where did the money come from? 

As part of MSF’s effort to guarantee our independence and strengthen our link with society, we strive to maintain a high level of private income. In 2021, 97.4 per cent of MSF’s income came from private sources. Almost 7 million individual donors and private foundations worldwide made this possible. Public institutional agencies providing funding to MSF included, among others, the governments of Canada and Switzerland, the World Health Organization, the Global Fund and the International Drug Purchase Facility (UNITAID).

The result for 2021, after adjusting for financial results, extraordinary results and exchange gains/losses, shows a surplus of €169 million (surplus of €192 million for 2020). MSF’s funds have been built up over the years by surpluses of income over expenses. At the end of 2021, the remaining available reserves (excluding permanently restricted funds and capital for foundations) represented 9.1 months of the preceding year’s activity.

The purpose of maintaining funds is to meet the following needs: working capital needs over the course of the year, as fundraising traditionally has seasonal peaks while expenditure is relatively constant; swift operational response to humanitarian needs that will be funded by forthcoming public fundraising campaigns and/or by public institutional funding; future major humanitarian emergencies for which sufficient funding cannot be obtained; the sustainability of long-term programmes (e.g. antiretroviral treatment programmes); and a sudden drop in private and/or public institutional funding that cannot be matched in the short term by a reduction in expenditure. 

Where did the money go?

Programme expenditure by continent


Largest country programmes by programme expenditure

The total budget for our programmes in these 10 countries was €570 million, 49.6 per cent of MSF’s programme  expenses in 2021 (see Facts and Figures for more details).


How was the money spent?

Total expenditure

Social mission - 80.5% of total expenditure

Programme expenses by nature

The biggest category of expenses is dedicated to personnel costs: 50% of expenditure comprises all costs related to locally hired and international staff (including plane tickets, insurance, accommodation, etc). 

The medical and nutrition category includes drugs and medical equipment, vaccines, hospitalisation fees and therapeutic food. The delivery of these supplies is included in the category of transport, freight and storage. 

Logistics and sanitation comprise building materials and equipment for health centres, water and sanitation and logistical supplies. Other includes grants to external partners and taxes, for example. 

Human resources statistics


Staff positions

International departures

Notes on tables and graphs 

Other funds include foundations’ capital and translation adjustments arising from the translation of entities’ financial statements into euros.

Outpatient consultations do not include specialist consultations.

Programme expenses represent expenses incurred in the field or by headquarters on behalf of the field. All expenses are allocated in line with the main activities performed by MSF according to the full cost method. Therefore all expense categories include salaries, direct costs and allocated overheads (e.g. building costs and depreciation).

Staff numbers represent the number of full-time equivalent positions averaged out across the year. Field positions include programme and programme support staff. International departure figures represent the number of times international staff left on field missions.

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