An international, independent medical humanitarian organisation
Médecins Sans Frontières (MSF) translates to Doctors without Borders. We provide medical assistance to people affected by conflict, epidemics, disasters, or exclusion from healthcare. Our teams are made up of tens of thousands of health professionals, logistic and administrative staff - bound together by our charter. Our actions are guided by medical ethics and the principles of impartiality, independence and neutrality. We are a non-profit, self-governed, member-based organisation.
MSF was founded in 1971 in Paris by a group of journalists and doctors. Today, we are a worldwide movement of nearly 68,000 people.
The MSF Charter
All of its members agree to honour the following principles:
Médecins Sans Frontières provides assistance to populations in distress, to victims of natural or man-made disasters and to victims of armed conflict. They do so irrespective of race, religion, creed or political convictions.
Médecins Sans Frontières observes neutrality and impartiality in the name of universal medical ethics and the right to humanitarian assistance and claims full and unhindered freedom in the exercise of its functions.
Members undertake to respect their professional code of ethics and maintain complete independence from all political, economic or religious powers.
As volunteers, members understand the risks and dangers of the missions they carry out and make no claim for themselves or their assigns for any form of compensation other than that which the association might be able to afford them.
Complementary to the Charter, two core documents define our ways of working and guiding principles by exploring the concepts of proximity to patients, quality medical care, and témoignage - or bearing witness.
Our actions are guided by medical ethics
MSF’s actions are first and foremost medical. The notion of quality care for the individual patient is central to our humanitarian objective. We seek to provide high-quality care and to act always in the best interest of patients; to respect their confidentiality, their right to make their own decisions and above all, to do them no harm. When medical assistance alone is not enough, we may provide shelter, water and sanitation, food or other services.
We offer assistance to people based on need. It doesn’t matter which country they are from, which religion they belong to, or what their political affiliations are. We give priority to those in the most serious and immediate danger.
Our decision to offer assistance is based on our evaluation of medical needs, independent of political, economic or religious interests. Our independence is rooted in our funding; 97 per cent comes from individual private donors giving small amounts. We strive to freely evaluate needs, access populations without restriction, and to directly deliver the aid we provide.
We do not take sides in armed conflicts nor support the agendas of warring parties. Sometimes we are not present on all sides to the conflict; this may be because access is denied to us, or due to insecurity, or because the main needs of the population are already covered.
Neutrality is not synonymous with silence. Our proximity to people in distress implies a duty to raise awareness on their plight to ultimately help improve their situation. We may seek to bring attention to extreme need and suffering, when access to lifesaving medical care is hindered, when our teams witness extreme acts of violence, when crises are neglected, or when the provision of aid is abused.
We take responsibility of accounting for our actions to our patients and donors, and being transparent on the choices we make. Evaluations, critical reviews and debate on our field practices, our public positioning and on wider humanitarian issues, are necessary to improve what we do.
We are a global movement, with staff from over 160 countries
Our strength lies in our teams, from health staff, to logisticians and administrative staff. In 2022 we employed over 40,000 staff locally and thousands more left on field assignments abroad.
MSF rejects the idea that resource-limited countries deserve third-rate medical services. We strive to provide high-quality care to patients and we advocate for affordable, high-quality medicines.
We count on the generous support of more than 7 million individual donors worldwide. Ninety-seven per cent of our funds comes from private donations, allowing us to act fast to save lives.
Why we started
From a group of doctors to an international movement: how has the MSF movement developed over the years? Learn about the creation of MSF and the major chapters of our history through the animated film, Once Upon a Time the MSF Movement.
Médecins Sans Frontières (MSF) was founded in 1971 in France by a group of doctors and journalists in the wake of war and famine in Biafra, Nigeria. Their aim was to establish an independent organisation that focuses on delivering emergency medicine aid quickly, effectively and impartially.
Three hundred volunteers made up the organisation when it was founded: doctors, nurses and other staff, including the 13 founding doctors and journalists.
MSF was created in the belief that all people should have access to healthcare regardless of gender, race, religion, creed or political affiliation, and that people’s medical needs outweigh respect for national boundaries. MSF’s principles of action are described in our charter, which established a framework for our activities.
- Dr Jacques Beres
- Philippe Bernier
- Raymond Borel
- Dr Jean Cabrol
- Dr Marcel Delcourt
- Dr Xavier Emmanuelli
- Dr Pascal Greletty-Bosviel
- Gérard Illiouz
- Dr Bernard Kouchner
- Dr Gérard Pigeon
- Vladan Radoman
- Dr Max Recamier
- Dr Jean-Michel Wild
A Charter for the new MSF
MSF is officially created on 22 December 1971. At the time, 300 volunteers make up the organisation: doctors, nurses and other staff, including the 13 founding doctors and journalists.
MSF's first mission
MSF’s first mission in 1972, is in Managua, Nicaragua's capital, and follows an earthquake which destroyed most of the city and killed between 10,000 and 30,000 people.
In 1974, MSF sets up a relief mission to help the people of Honduras after Hurricane Fifi causes major flooding and kills thousands of people.
In 1975, MSF establishes its first large-scale medical programme during a refugee crisis, providing medical care for the waves of Cambodians seeking sanctuary from Pol Pot’s oppressive rule. In these first missions, the weaknesses of MSF as a new humanitarian organisation become readily apparent: preparation is lacking, doctors are left unsupported and supply chains are tangled. It marks a turning point and the movement begins to fracture.
Learning to work in a war context
From 1976 and until 1984, MSF is present in Beirut and other cities in Lebanon to treat all war-wounded. Each day, the team treats patients injured by shrapnel or bullets. Broken limbs and burns are also looked after. Materials and tools are insufficient or inadequate for the medical teams; there are no X-rays, no electric instruments, no ventilator, and no possibility to conduct extensive medical exams. The capacity to do blood transfusions is also limited.
Competing visions lead to split
Throughout the 1970s and led by Dr Claude Malhuret and Dr Francis Charhon, MSF begins to move beyond sending doctors to crisis zones in favour of creating a more structured organisation. Co-founder Dr Bernard Kouchner doesn't agree with the evolution and leaves MSF to start another organisation called Médecins du Monde.
From this point, the new "realist" leadership of MSF - spearheaded by Claude Malhuret and Rony Brauman - helps transform MSF into the professional organisation it is today.
A first "témoignage"- or speaking out, bearing witness - on the international scene is organised with the "March for Survival of Cambodia".
Ethiopia - Famine and speaking out
In August, 50 people die each day of hunger, while thousands wait for food distribution. It takes months for the government to call it a "famine". When the government starts to forcibly displace populations and divert humanitarian aid, MSF teams know that there is no other possible choice but to speak out. In December 1985, one of the two MSF sections working in the country is expelled.
50,000 dead in Armenia
A first large-scale intervention is planned by the then-six Operational Centres (France, Belgium, Spain, Luxembourg, Holland and Switzerland).
Civil war in Somalia
More than 300,000 Somalis die in the conflict. On 9 December 1992, the US army lands on the beaches of Mogadishu to restore order and distribute food aid. Faced with the prospect of getting stuck in an endless conflict, the US hands over to the UN blue helmets. MSF condemns the inconsistency of this strategy, as well as the excesses committed by the military. In 1992, MSF alerts the international community to the widespread famine in the country.
War in Yugoslavia
On 14 December 1995, the signing of the Dayton Peace Accords ends the separatist war in the former Yugoslavia and creates the state of Bosnia-Herzegovina. MSF claims that mass distributions of aid are a ‘humanitarian alibi’ of an international community that lacks the will to take political and military measures to end the conflict. Some MSF leaders even call for an armed intervention against the Bosnian-Serb artillery bombing of Sarajevo.
During the Bosnian war, MSF's medical programmes in the region are extended to the UN's supposed "protected zones" of Goradze and Srebenica. In December 1992, MSF publishes a report describing the Bosnian Serb policy of ethnic cleansing. The report denounces the Bosnian Serbs for hindering supplies to Srebrenica and Gorazde, two Muslim besieged enclaves. In 1995, MSF raises awareness and denounces the lack of protection of the population in these enclaves.
"Doctors cannot stop a genocide"
The genocide in Rwanda erupts. MSF teams witness the massacre of patients and staff members. In May, MSF asks the French government to help put a stop to the massacre. On 24 May, MSF appears at the Human Rights Commission of the UN, hoping to trigger a reaction from the member states. Following the massacre of more than 800,000 Tutsis and Hutus, MSF takes an unprecedented decision and requests an international military intervention.
MSF is the only international presence during the fall of the enclave of Srebrenica (Bosnia), theoretically protected by troops under UN mandate.
In August 1995, MSF denounces the massacre of 8,000 civilians at the hands of the Serbian troops.
War in Chechnya
In December 1994, Russian tanks enter the capital, Grozny. A million people are trapped under a barrage of bombs, rockets and machine-gun fire. The city is razed to the ground. An MSF team provides medical support in highly unstable conditions. Two years later, MSF calls on the international community to get the Russian government to stop the massive violation of human rights in Chechnya and the systematic attacks against the civilian population.
Famine in Sudan
MSF provides assistance while denouncing the shortcomings of the United Nations aid system, which does not help the most vulnerable but instead benefits the most powerful. MSF’s complaint is primarily aimed at the UN Children’s Fund (UNICEF) and the World Food Programme (WFP).
Famine in North Korea
MSF pulls out after three years, unable to ensure that medical aid will reach the most vulnerable, but continues to assist refugees fleeing to China.
Crisis in Kosovo
MSF provides medical care to displaced civilians in Kosovo and in refugee camps in Albania, Macedonia, and Montenegro, as well as to civilians in Serbia.
Second War in Chechnya
MSF calls for access to Grozny and denounces the massive use of violence against civilians by Russian forces.
Nobel Peace Prize
In October 1999 MSF is awarded the Nobel Peace Prize “in recognition of the organisation’s pioneering humanitarian work on several continents” and to honour our medical staff who have treated tens of millions of people. Using his acceptance speech, Dr James Orbinski, president of the then-MSF International Council, speaks directly to the then-Russian leader Boris Yeltsin and condemns Russian violence against civilians in Chechnya.
MSF establishes medicines campaign
The proceeds from MSF’s Nobel Peace prize award are used to set up The Campaign for Access to Essential Medicines (today known as the Access Campaign), designed to support pilot projects for the clinical development, production, procurement and distribution of treatments for neglected diseases.
The HIV/AIDS pandemic
MSF starts treating people with HIV with antiretroviral therapy in seven countries.
Famine in Angola
In the spring of 2002, MSF conducts an exploratory mission in Bunjei; one in three children suffers from acute malnutrition and more than a thousand fresh graves are found.
MSF calls for other humanitarian organisations, donors and the government to help. More than 9,000 severely malnourished children and 20,000 moderately malnourished children are treated. Some 200 international volunteers and more than 2,200 national staff take part in this intervention.
Work in Lampedusa, Italy
MSF teams start providing assistance to people crossing the Mediterranean to Europe in Lampedusa reception centre, providing new arrivals with medical care.
MSF continues to assist civilians in Afghanistan following the US-led military action.
Growing resistance to malaria treatment
MSF starts using artemisinin combination therapy, and urges national protocol changes in Africa.
US Invasion of Iraq
MSF teams remain in Baghdad during the war and challenge the US government on its failure to provide adequate medical care to civilians.
Creation of DNDi
MSF is a founding partner in a new initiative to undertake drug development for neglected diseases, the Drugs for Neglected Diseases initiative (DNDi).
Five MSF workers are killed in Afghanistan
In June, five MSF staff are attacked and killed while on the road in Afghanistan. The subsequent lack of response from authorities in the wake of this event illustrates the authorities’ passivity and lack of commitment to ensuring the security of humanitarian workers. As a result, MSF withdraws completely from the country after 20 years of presence.
Tsunami in Southeast Asia
The first MSF team arrives within 72 hours of the disaster, on 26 December 2004, and evaluations are carried out in Indonesia, Malaysia, India, Myanmar, Sri Lanka and Thailand. Faced with the wave of unprecedented solidarity and after establishing the scope of its intervention in the area, MSF asks donors to stop making donations for the crisis, having received more funding than needed for its medical programmes in the region.
Nutritional crisis in Niger
MSF responds to an overlooked and neglected malnutrition crisis in Niger, treating 63,000 severely malnourished children on an outpatient basis with a new therapeutic ready-to-use-food. It is the first time this treatment protocol is used on such a massive scale. MSF subsequently revises its guidelines for treating malnutrition to include this innovative approach.
Sri Lanka returns to war
As tens of thousands of people flee renewed fighting in the north of the country, MSF reopens surgical programmes in north and central Sri Lanka after facing a series of setbacks from the authorities.
In order to cope with the constant growth of its activities, budgets and sections, MSF devotes an entire year to a series of internal consultations and debates. The result is a series of plans to improve MSF’s decision-making processes and governance structures as a movement and as an association. La Mancha Agreement outlines aspects of our action on which we agree and feel are indispensable.
With the proven success of ready-to-use therapeutic food in treating severely and moderately malnourished children, MSF campaigns for others in the field to scale up their programmes and to adopt similar protocols. Through the Campaign for Access to Essential Medicines, MSF pushes for food aid and nutritional programmes to include ingredients that are appropriate for the most vulnerable children—those between six months and two years of age.
Nutritional emergency in Ethiopia
After detecting alarming rates of malnutrition in children under five years old, MSF initiates an emergency response in the south of the country. The teams treat over 72,000 children with acute malnutrition and distribute food to another 14,000 who are at risk.
Return to Afghanistan
Following a five year absence (see 2004), MSF returns to the country and begins supporting hospitals in Kabul and in Lashkargah, the capital of Helmand Province.
A difficult year in Sudan
MSF launches emergency interventions in the south in response to escalating violence and outbreaks, while in Darfur, the government expels two MSF sections and four staff members are kidnapped. Some projects are closed, but MSF nonetheless provides nearly 129,000 consultations and supports numerous local health centres.
Earthquake and cholera in Haiti
MSF launches the largest emergency intervention in its history, just one day after the earthquake on 12 January. Hundreds of thousands of people are either wounded or dead and millions have lost their homes. In October, after cholera hits Haiti, MSF mobilises hundreds of staff members to respond. We open more than 50 cholera treatment centres across the country, launch widespread public education campaigns, and tend to more than 100,000 patients.
The war in Syria
The humanitarian situation is deteriorating across the region. Millions of Syrians seek refuge, but the aid and medical assistance they receive is not sufficient. In early 2014, five MSF employees are kidnapped in Syria. Later that year, MSF decides to withdraw from territories controlled by the Islamic State group. Since 2011, MSF supports a growing number of medical facilities in some of the areas worst affected by conflict.
On 14 August, MSF closes all of its programmes in Somalia, following several attacks against its team members including the kidnapping of two staff. The indifference towards, or even acceptance of, these attacks by different actors we were negotiating safe access with, put an end to 22 years of medical care by MSF in the country.
The largest outbreak of Ebola in history is officially declared on 22 March in Guinea. It claims more than 11,300 lives in six affected countries in West Africa, including more than 500 healthcare staff.
At the peak of the epidemic, MSF employs nearly 4,000 national staff and over 325 international staff. MSF admits a total of 10,376 patients to its Ebola management centres, of which 5,226 are confirmed Ebola cases. The outbreak ends in June 2016.
War in Yemen
In the second half of 2014, a multi-sided civil war breaks out in Yemen, with armed men from the Ansar Allah party opposing a Saudi-Arabia-led coalition of Islamist groups, jihadist forces and a southern Yemeni independence movement. Already a poor country, the war further devastates the country, shattering the already-fragile healthcare system. Ordinary Yemenis struggle to access, and pay for, medical care; a massive cholera outbreak in 2017 further ravages the country, killing thousands of people.
Search and Rescue operations in the central Mediterranean sea
Tens of thousands of migrants and refugees embark on perilous sea journeys through the Central Mediterranean to Europe. In May, MSF and other NGOs start running Search and Rescue (SAR) operations in the Central Mediterranean.
Hospitals are #NotATarget
On 3 October, a sustained US airstrike kills 42 people and destroys MSF's Kunduz trauma care centre in Afghanistan. In 2016, some 75 MSF-run and MSF-supported medical facilities are attacked in Syria and Yemen.
On 3 May 2016, Dr Joanne Liu, MSF International President calls on members of UN Security Council to protect civilians and hospitals in war zones.
MSF stops taking EU and Member States funding
In June MSF announces that it will no longer take funds from the European Union and Member States, in opposition to their damaging deterrence policies against refugees and migrants and intensifying attempts to push people and their suffering away from European shores. This decision takes immediate effect and is applied to our projects worldwide.
Euro governments feeding the business of suffering
MSF International President, Joanne Liu, sends an open letter to European government leaders: "The detention of migrants and refugees in Libya is rotten to the core. It must be named for what it is: a thriving enterprise of kidnapping, torture and extortion. And European governments have chosen to contain people in this situation."
The return to Somalia
After our withdrawal from the country in 2013, MSF opens a nutrition programme in the Puntland region. Although security has not improved, our commitment to the people of Somalia, who face extreme suffering, led us to dial up activities again. The scale of our activities remains limited and our ability to operate depends largely on the acceptance and active support we receive from the authorities and host communities.
The Rohingya refugee crisis
Since 25 August, more than 655,000 Rohingya have fled to Bangladesh, following targeted violence against them in neighbouring Rakhine state, Myanmar.
Most are living in dire conditions in the refugee camps. In response, MSF expands its operations in the area, covering water, sanitation and medical activities for refugees.
Successive Ebola outbreaks in DRC
An outbreak of Ebola in Équateur province, northwestern Democratic Republic of Congo (DRC), in May, is the start of two and a half years of multiple epidemics of the deadly disease in the country. Responders struggled to contain a long-lasting outbreak starting in August 2018 in North Kivu, South Kivu and Ituri provinces, due to the complexities of working in a conflict zone and the inability to gain the trust of communities. The three outbreaks collectively claim the lives of over 2,300 people.
March of Return in Palestine
Starting in March 2018 and lasting until December 2019, the Israeli army fires on nearly 8,000 Palestinians protesting weekly the right to access their ancestral lands at the fence that separates Gaza from Israel. People are left with shattered bones, and the need for specialised treatment of the complex injuries greatly exceeds the capacity of local authorities and MSF. We massively scale up our surgical and rehabilitative activities, but difficulties persist in an area that’s been blockaded for a decade.
Punished for needing to leave
Governments around the world reinforced their borders and migration policies, increasing a trend to keep migrants and refugees out. Those trying to leave Libya via the Mediterranean Sea were repeatedly intercepted. People on the route through Central America faced unimaginable levels of violence. We scaled up our migration response but not without setbacks; we were forced to end search and rescue operations due to Italy closing its ports, and Nauru expelled our teams trying to provide support to migrants trapped on the tiny South Pacific island.
Large-scale measles outbreaks across Africa
The highest number of people with measles in 25 years was recorded, with multiple countries across the African continent experiencing outbreaks of the highly contagious disease. Thousands of children around the world died. DRC was especially hard-hit, where MSF teams used boats to find villages up and down the rivers to provide vaccines in outbreak vaccination campaigns. MSF teams also responded to outbreaks in Cameroon, Nigeria and Chad, among other countries.
HIV 90-90-90 targets reached in KwaZulu-Natal
A year ahead of the deadline set by UNAIDS, MSF’s HIV project in Eshowe, KwaZulu-Natal province, South Africa, achieves the 90-90-90 targets. The targets aim to have 90 per cent of people knowing their HIV status, 90 per cent of HIV positive people on treatment; and 90 per cent of people on treatment be virally suppressed. The result was achieved with consistent community engagement.
Mothers killed in Dasht-e-Barchi, Afghanistan
On 12 May, a group of armed gunmen stormed our maternity wing of Kabul’s Dasht-e-Barchi hospital, Afghanistan, deliberately targeting women in the throes of giving birth and new mothers. The attackers killed 16 women, 2 boys and an MSF midwife. Due to the insecurity and the inability to guarantee the safety of patients, we make the difficult decision to withdraw, leaving women in the area without comprehensive maternity care.
An outbreak of a new coronavirus turns into a worldwide pandemic, with COVID-19 infecting nearly 85 million people and claiming nearly 2 million lives in 2020 alone. Amid mounting challenges, MSF teams race to ensure access to healthcare is maintained for people, and respond to the pandemic – in both the countries we work in and countries we’ve never had to respond in before. We also urge pharmaceutical companies not to profit off the pandemic and ensure fair and equitable vaccine allocation.