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Reports

We believe in the principal of témoignage - or 'bearing witness' - which means being willing to speak out about what we see happening in front of us.

In MSF, this means willingness to speak on behalf of the people we assist: to bring abuses and intolerable situations to the public eye.

We also believe in openness, honesty and self-reflection as a way to improve our work and world of humanitarian action.

These reports are available to download, please feel free to read, share and let us know what you think.

2023 reports

Invisible wounds: MSF's findings on sexual violence in CAR between 2018 and 2022

Between 2018 and 2022, Médecins Sans Frontières (MSF) took care of nearly 20,000 survivors of sexual violence in Central African Republic (CAR), which represents more than half of the cases across the country for that period. Despite some positive developments over the past five years, the number of patients seen is still just the tip of the iceberg. 

In the report “Invisible Wounds”, MSF analyses quantitative data obtained through stable projects and emergency interventions and decries numerous gaps in terms of assistance for the victims, as well as huge challenges for them to access care, and calls for urgently scale up support.

2022 reports

"Between two fires: danger and desperation in Syria's Al Hol camp"

On November 7, MSF released a report detailing the deteriorating situation at Al-Hol camp in Syria: “Between two fires: danger and desperation in Syria’s Al Hol camp”. The report draws from testimonies and includes first-hand observations of MSF frontline humanitarian staff, and medical data from MSF health facilities in the camp collected between July 2021 and March 2022.

It provides rare access into the lives of an abandoned population, the majority of whom are children, and are born into a world of criminality, violence and exploitation, and trapped indefinitely in prison-like conditions with no end in sight.

Mental Health in Honduras

The physical and mental health of the Honduran population is constantly affected by multiple factors of violence, poverty, natural disasters and the aftermath of the COVID-19 pandemic. Present in Honduras for 48 years, MSF has witnessed firsthand the negative consequences that these events have on people's mental health, as well as the challenges in responding to these needs.

In light of this, we have prepared and presented to the Honduran health authorities the report Mental Health in Honduras: Challenges and Strategies to Fill the Gaps. This document reiterates that mental health is a fundamental right, which in the case of Honduras requires an immediate and more robust response to confront these urgent needs. The more time passes without action, the more people will fall into the mental health care gap.

2021 reports

South Sudan at 10 

July 2021

On 9 July 2021, the Republic of South Sudan marked its tenth birthday.

This significant milestone is also marred by the bloody legacy of its first decade, including a five-year civil war.

Médecins Sans Frontières (MSF) has worked in the area that today constitutes South Sudan since 1983. South Sudan at 10: an MSF record of the consequences of violence, offers a consolidated account of MSF’s experience in South Sudan since 9 July 2011. 

 In so doing, it seeks to serve as a record and reminder of the human toll of violence, since independence, as seen by MSF – through its staff and patients.

Since independence, 24 of MSF’s South Sudanese staff have been killed by violence, five while on duty. All of MSF’s patients, staff and their communities have been impacted directly and indirectly by conflict and violence. 

Sexual violence in the Democratic Republic of Congo

July 2021

Year after year, Médecins Sans Frontières (MSF) teams are first-hand witnesses of the scale and impact of sexual violence in the Democratic Republic of Congo (DRC)

In 2020, 10,810 survivors of sexual violence received medical and/or psychological care in MSF-supported medical facilities throughout the country. 


While movements of armed actors and fighting clearly increase the risk and number of sexual assaults, such violence persists outside the context of weapon bearers, including family and partner violence.

Sexual violence is a medical emergency that requires immediate medical and psychological care to limit the consequences for survivors. 

Given the magnitude of the problem and its consequences, MSF believes that emergency and long term support programmes must be put in place as soon as possible, with significant and continuous funding, to accompany survivors until they have made a full medical, psychological and socioeconomic recovery.

Constructing crisis at Europe's borders: The EU plan to intensify its dangerous hotspot approach on Greek islands 

June 2021 

Over the past five years, an entirely avoidable and predictable policy-driven humanitarian crisis has been unfolding in the  Greek islands of Lesvos, Samos, Chios, Leros, and Kos, with devasting consequences for the people trapped there.

After fleeing their homes and surviving harrowing journeys to Europe, the indefinite containment, limbo, and systematic violence in Greece further traumatises people seeking protection.

Nearly 10,000 people are currently being held in five Greek islands ‘hotspots’, also known as Reception and Identification Centres (RICs).

In this report, MSF takes stock of five years of providing medical care on the Greek islands. The report’s analysis is based on documentation and medical data from MSF operations on Lesvos, Samos, and Chios, as well as testimony from patients and MSF staff. 

MSF once again calls on European leaders and the Greek government to take accountability, recognise the harm caused and end this deadly and dangerous approach.

The Continued Struggle to Access Medical Care in Afghanistan

June 2021 

After 40 years of conflict, Afghanistan faces yet another period of instability in 2021. Peace negotiations between the Afghan government and the Islamic Emirate of Afghanistan (IEA, also known as the Taliban) have made little to no progress since they began in September 2020.

Fighting between government forces and armed opposition groups continues to claim thousands of civilian lives each year while crippling public infrastructure. Violence and insecurity are pervasive throughout the country and show no sign of abating.

Healthcare facilities in Afghanistan are attacked more often than almost anywhere in the world, forcing their temporary or permanent closure and depriving millions of access to vital medical services.

The humanitarian crisis, compounded by the health and socioeconomic shocks of the COVID-19 pandemic, is worsening throughout the country.

This briefing paper, produced by Médecins Sans Frontières (MSF), features new medical data and accounts from patients, caretakers and MSF clinical staff in Helmand, Herat, Kandahar and Khost provinces.

Responding to COVID-19: Global Accountability Report 3 - September to December 2020

April 2021

Over the course of 2020, COVID-19 thrust the world into a severe global health crisis. The rapid spread of the novel coronavirus SARS-CoV-2 put a tremendous strain on healthcare systems in low- and high-resource settings alike, as large numbers of patients with potentially life-threatening respiratory disease required specialised care.

From March to December 2020, Médecins Sans Frontières (MSF) responded to the pandemic through our existing programmes and dedicated COVID-19 interventions in more than 300 projects in 70 countries. Our global COVID-19 activities focused on delivering medical care and other assistance to vulnerable people at risk of being left behind, including remote communities, people on the move, homeless people, and elderly people living in long-term care facilities.

The third Global Accountability Report complements the first two editions and includes both a continued operational overview from September to December 2020, as well as an annual summary and analysis of key indicators. 

Overcoming Neglect

January 2021

The report, Overcoming Neglect, details Médecins Sans Frontières’ (MSF) involvement with neglected tropical diseases (NTDs) over the last three decades. Our work includes treating patients, carrying out operational research, supporting efforts to identify new treatments and diagnostics; and playing an active role in reducing their incidence.

We call for an improved global response to NTDs, better access to diagnosis and safe, effective treatment and care for patients.

With this report, we aim to show the devastating impact NTDs have on millions of the world’s poorest people. We hope that by highlighting the main issues facing their treatment and control, and sharing MSF’s experience, will result in more attention for NTDs, and an improvement in the lives of NTD patients.

2020 reports

Left behind in the time of COVID-19

July 2020

In our report, Left behind in the time of COVID-19, MSF gives a detailed account of our intervention in nursing care homes in Belgium during the coronavirus COVID-19 pandemic, describing the situation a real humanitarian crisis. The report contains a list of concrete recommendation to avoid the repetition of this drama if a second wave of the new coronavirus hits the country.

“If we want to be better prepared for a second wave, we need to learn lessons from the past months,” says Dr Bertrand Draguez, President of MSF Belgium and coordinator of the intervention.

There was a real fear that hospitals would be overwhelmed, as had happened in Italy and Spain, and therefore Belgian authorities focused solely on preserving hospital capacity. As a result, nursing care homes were neglected. They suffered from a lack of protective equipment, material, staff and expertise to fight the pandemic. Consequently, care homes paid a high price: by the end of June, 6,200 care home residents had died of COVID-19, which is 64 per cent of all COVID-19 deaths in Belgium.

2019 MSF Iraq annual report

July 2020

In 2019, Médecins Sans Frontières (MSF) continued to provide essential healthcare services in Iraq, where people are suffering from the effects of years of conflict and ongoing instability.

Although displaced people continued to return to their homes in 2019, more than a million still face significant barriers that prevent them from doing so. Some have been living ‘temporarily’ in camps for years, with little access to basic services. At the end of the year, the violent crackdown on protests in various cities across the country put additional pressure on the health system.

Many healthcare facilities have been destroyed and there is an overall shortage of healthcare specialists. These services are vitally needed to address primary and secondary healthcare needs and the traumas resulting from ongoing violence. Our teams have observed an increase in mental health needs caused by the prolonged suffering of both internally displaced
people and host communities.

This annual report provides an overview and the highlights of our activities across Iraq during 2019.

COVID-19 and economic downfall unveil migrant workers’ mental health crisis in Lebanon

July 2020

Access to healthcare by migrant workers is very restricted in Lebanon, due to the nature of the employment model to which they are tied – known as the Kafala system – which makes them dependent on a sponsor. The mental health of migrant workers – many of whom are young women – reflects the hardships they have endured while living and working in Lebanon.  

Migrant workers are often subjected to long working hours, low wages, and restrictions on their movements and on their communication with the outside world, poor living conditions and a lack of privacy. Many are also survivors of physical and sexual abuse.

The onset of the COVID-19 lockdown – which came on top of the ongoing economic crisis in Lebanon – saw a dramatic decline in migrant workers’ conditions and is having a dire impact on their physical and mental health.

MSF has released a report describing the critical mental health needs of migrant workers living in Lebanon. Migrant workers, including those without legal status in the country, should have access to comprehensive health services – including mental healthcare. In the current context of economic collapse and COVID-19, the provision of these services is urgently needed.

Reality check: Afghanistan's neglected healthcare crisis

March 2020

Over 40 years of conflict and instability have left Afghanistan’s economy and infrastructure in ruins and millions dependent on humanitarian assistance.

The international medical humanitarian organisation Médecins Sans Frontières (MSF) finds that Afghans today still struggle to get access to healthcare due to pervasive violence, widespread poverty, and a weak public health system. Morbidity and mortality rates remain high.

This briefing paper features the stories of patients, their caretakers, and our staff in Herat and Helmand provinces to illustrate the many obstacles people face in their efforts to get medical care.

No way out - The humanitarian crisis for Central American migrants and asylum seekers

February 2020

Since 2012, Médecins Sans Frontières (MSF) has been providing medical and mental healthcare to tens of thousands of displaced people along the migration route through Mexico. MSF teams have personally witnessed the human costs of increasingly brutal migration policies in the region.

MSF has released a report, No way out: The humanitarian crisis for migrants and asylum seekers trapped between the United States, Mexico and the Northern Triangle of Central America, which looks to expose the devastating effects that the criminalisation of migration is having on people fleeing violence.

With this report, MSF seeks to expose the devastating effects that the criminalisation of migration is having on people fleeing violence and poverty in the NTCA. Seeking safety is not a crime. Over the course of seven years providing medical aid to people along the migration route, we have witnessed terrible suffering as well as extraordinary resilience among our patients.

2019 reports

MSF report "No time to lose" examines the fight against AIDS in 15 countries

November 2019

"No time to lose", a report published by Médecins Sans Frontières (MSF), reveals that hundreds of thousands of people are still dying of AIDS because countries are not sufficiently equipped to prevent, detect and treat it.

Governments have been slow to adopt WHO guidelines recommending easy-to-use rapid tests to assess the status of people's immune systems and to diagnose the most common and deadly opportunist infections such as tuberculosis and cryptococcal meningitis.

The report covers 15 countries in Africa and Asia and presents a dashboard of where countries are in terms of policies, implementation and funding to address advanced HIV, which killed 770,000 people worldwide in 2018.

Burden sharing or burden shifting? How the HIV/TB response is being derailed

October 2019

MSF provides treatment for HIV and tuberculosis (TB) in more than 20 countries around the world. 

The report Burden sharing or burden shifting? How the HIV/TB response is being derailed examines the situation in nine countries where MSF runs programmes: Central African Republic, Democratic Republic of Congo, Eswatini, Guinea, Kenya, Malawi, Mozambique, Myanmar and Zimbabwe. With a focus on the financial resources available, this report highlights the current risks and gaps in HIV and TB service delivery in these countries.

Given the findings of gaps in diagnosis, prevention and care services and dwindling resources, MSF calls for a robust assessment of the needs and the resource capacity of each affected country, and calls on international donors to ensure that the financial burden is shared, rather than shifted onto those countries worst affected by the diseases

Displacement and humanitarian response in Ethiopia: challenges and dilemmas in complex crises

October 2019

Since the end of 2017, the number of people internally displaced by violence in Ethiopia has risen significantly. As a result, the humanitarian community – including MSF – has suddenly found itself needing to adapt and scale up its response to meet the acute needs in conflict-driven crises.

Our report, Displacement and humanitarian response in Ethiopia: challenges and dilemmas in complex crises, examines the humanitarian response to two conflict-related displacement crises in 2018: large-scale displacement in Gedeo and West Guji Zones, and displacement along the border between Benishangul Gumuz and Oromia Regions.

Based on research and interviews with over 50 humanitarian workers and decision-makers, it analyses how humanitarian needs on the ground were assessed and met and examines some of the key constraints to an effective response.

Breaking the cycle: Paediatric DR-TB detection, care and treatment in Tajikistan

May 2019 

The Tajik Ministry of Health and Médecins Sans Frontières (MSF) began a comprehensive paediatric tuberculosis (TB) care programme in 2011.

The paediatric TB project in Dushanbe aims to decrease the TB morbidity and mortality rates among children and their family members. In 2013, MSF documented this, producing a report about improving paediatric TB care.

Following the progress made in treating paediatric TB in Tajikistan, MSF produced a follow-up report titled Breaking the cycle: Paediatric DR-TB detection, care and treatment in Tajikistan. This new report documents the progress made during the last five years, and reflects on the sustainability of the programme and the challenges and opportunities that lie ahead.

Complicated delivery: The Yemeni mothers and children dying without medical care

April 2019

After four years of conflict, the medical and humanitarian situation in Yemen continues to deteriorate due to violent clashes, continuous airstrikes, political interference in aid operations by warring parties, and an economic maelstrom in what was already the poorest country in the Middle East.

For Yemenis living through this protracted crisis, getting hold of the essentials of daily life is a constant struggle.

This is especially true of medical care, as Yemen’s public health system is far from meeting the needs of the country’s 28 million people.

Complicated delivery: The Yemeni mothers and children dying without medical care takes a look at two facilities where MSF is providing free healthcare – the MSF-run Taiz Houban mother and child hospital and the MSF-supported hospital in Abs – and offers an insight into some of the challenges facing mothers and children in Yemen.

Unprotected: Summary of internal review on the October 31st events in Batangafo, Central African Republic 

February 2019

For six years the people of Central African Republic (CAR) have had little respite from conflict. The horrific consequences of the ongoing violence have been witnessed by teams from Médecins Sans Frontières (MSF). In recent months, armed groups have deliberately targeted civilians in towns such as Batangafo, Alindao and Ippy, where MSF has assisted the victims of the violence.

MSF has published the results of our investigation into the attacks against civilians that took place in November 2018 in the town of Batangafo, northern CAR, where we have run a hospital for the past 12 years. Fifteen people died and 29 were injured in the attack; houses were set on fire and destroyed.

More than 20,000 people were displaced from camps for displaced people. Some of MSF’s hospital services were disrupted after more than 10,000 people sought refuge inside the hospital compound.

Our report, Unprotected: Summary of internal review on the events of 31 October in Batangafo, Central African Republic, describes the events of November 2018, the consequences of the events, and the lack of protection afforded to civilians.

It highlights the violence perpetrated by armed groups targeting civilians and the ineffectiveness of the UN’s peacekeeping mission in CAR, known as MINUSCA. The UN peacekeepers deployed to Batangafo were unable to prevent the attacks, resulting in death and displacement. “MINUSCA was responsible for protecting civilians,” says MSF head of mission Omar Ahmed Abenza. “However, they were unable to do this.”  

2018 reports

"No one was left": Death and violence against the Rohingya in Rakhine State, Myanmar

March 2018
MSF estimates that at least 9,400 people lost their lives in Myanmar between 25 August and 24 September, of whom at least 6,700 died due to violence. At least 730 children under the age of five are estimated to have been killed.

While the speed and scale of displacement alerted the international community to the severity of events, MSF mortality data indicates that violence reached an unprecedented level in the month following 25 August 2017.

This contrasts sharply with official statements from the Myanmar authorities denying any wrongdoing in Rakhine State, and underestimating casualties caused by the so-called clearance operations.

2017 reports

Forced to flee Central America's Northern Triangle: A neglected humanitarian crisis

May 2017

An estimated 500,000 people cross into Mexico every year. The majority making up this massive forced migration flow originate from El Salvador, Honduras, and Guatemala, known as the Northern Triangle of Central America (NTCA) - one of the most violent regions on Earth

This report compiles two years of data from our teams in Mexico, highlighting huge levels of violence experienced by migrants in transit through the country - and the systemic failings of the governments meant to protect them.

Our teams have witnessed and documented a pattern of violent displacement, persecution, sexual violence, and forced repatriation akin to the conditions found in the deadliest armed conflicts in the world today.

Yemen: Healthcare under siege in Taiz

January 2017

 

After almost two years of continuous fighting, the medical-humanitarian situation in Taiz, Yemen’s third most populous city, is extremely dire and only seems likely to further deteriorate.

Shelling, airstrikes, crossfire, landmines and snipers are consistently injuring, maiming and killing local residents, while access to lifesaving healthcare has become increasingly limited.

This report focuses on the direct impact of the war on the population of Taiz, the collapse of the health services in the divided city and the human suffering of the war on the population as observed by MSF teams in Taiz.

2016 reports

Insufficient humanitarian response to crisis in Diffa

December 2016

Despite having saved thousands of lives, the humanitarian system’s internal dynamics and security restrictions have undermined the deployment of a timely, flexible and sufficient response for the hundreds of thousands of people affected by the conflict in Diffa.

Greece in 2016: Vulnerable People Left Behind

October 2016

Seven months after the signature of the EU-Turkey deal and despite the huge amount of funds pledged by the EU, more than 50,000 migrants and refugees still live in substandard conditions in Greece and lack proper access to healthcare. MSF is especially concerned for the most vulnerable, including victims of violence, those with chronic diseases and psychiatric disorders, people with mobility limitations, unaccompanied minors, pregnant women and newborn babies, whose specific needs are not cared for and whose health is particularly at risk. MSF urges the Greek authorities to live up to their responsibilities in terms of assistance to a population in danger in its own territory and provide, with the support of EU member states, an adequate response based on  individual needs and not just the nationalities of the people.

Reality Check: UN High-Level Meeting on Refugees and Migrants

September 2016

On 19 September, leaders from all over the world will meet to adopt  the New York Declaration, coming together to work on a more “coordinated and humane approach to address large movements of refugees and migrants”.

Ahead of the Summit, MSF has released a short report, titled Reality Check, on the current situation in nine pressing emergencies affecting refugees and migrants. The report is not designed to be an exhaustive look at displacement or migration but instead aims to show the reality as seen from MSF projects assisting some of the 65 million forcibly displaced and the 244 million migrants around the world.

Neglected Trauma

July 2016

A high number of migrants and asylum seekers are suffering from mental health disorders following experiences in their home countries, the trauma of the journey to Europe and due to the inadequate reception conditions in Italy, warned Médecins sans Frontieres (MSF) in a published report. 

Emergency now: a call for action beyond summits

MSF’s reflections on the World Humanitarian Summit

May 2016

In early May 2016, MSF announced its decision to pull out of the World Humanitarian Summit (WHS). The statement published expressed MSF’s lack of hope that the WHS will address the weaknesses in humanitarian action and emergency response, particularly in conflict areas or epidemic situations.

Instead, the WHS’s focus would seem to be an incorporation of humanitarian assistance into a broader development and resilience agenda. Further, the summit neglects to reinforce the obligations of states to uphold and implement the humanitarian and refugee laws which they have signed up to.

MSF has been significantly engaged in the WHS process over the past 18 months, and this report summarises our reflections on some of the key themes in the ‘Agenda for Humanity’ put out by the UN Secretary General.

An Unprecedented Year: Médecins Sans Frontières’ response to the largest ever Ebola outbreak

March 2016

The severity of the West Africa Ebola epidemic saw MSF launch one of the largest emergency operations in its 44-year history.

Through this short report, MSF would like to provide transparency about its expenditure linked to the worst Ebola outbreak in history.

DR-TB drugs under the microscope: Sources and prices for drug-resistant tuberculosis medicines

March 2016

MSF published the fourth edition of DR-TB Drugs Under the Microscope, a report analysing the barriers and factors affecting access to treatment regimens for drug-resistant tuberculosis. The report finds that current preferred DR-TB treatment regimens are priced between US$1,800 to $4,600 per person per treatment course, not including the new TB drugs or repurposed companion drugs that can dramatically increase efficacy.  This represents an important price decrease from the first such report in 2011, when the same regimens cost $4,400 to $9,000 per person.  However, adding the new and repurposed TB drugs that could make treatment much more tolerable and improve success rates for people could unfortunately drive prices back up. 

Return to abuser

March 2016

'Return to Abuser' uncovers the gaps in services and systems in Papua New Guinea, trapping women and children in cycles of severe family and sexual violence.

The report details how a dire lack of protection mechanisms, a weak justice system and a culture of impunity endanger the health and lives of patients in Papua New Guinea even if they manage to reach medical care.

Syria 2015: Documenting war‐wounded and war‐dead in MSF‐supported medical facilities in Syria

February 2016

As the conflict in Syria approaches its 6th year, the humanitarian and medical toll of the violence remains appalling. Millions of people have been internally displaced, or have sought refuge abroad. Millions more are trapped in communities that are under siege or hemmed in by the closed borders of neighbouring countries. These countries, already overwhelmed by the numbers of Syrians seeking protection, have increasingly introduced restrictions on entry for new arrivals.

This report aims to present a documented analysis of the medical and humanitarian consequences of the intensification of the military campaign in 2015, based on medical reports and data from 70 clinics and hospitals in Syria supported by Médecins Sans Frontières/Doctors Without Borders (MSF).

2015 reports

HIV: Antiretroviral drugs fail to consistently reach patients in countries most affected by HIV/AIDS

November 2015

MSF today warned that life-saving antiretroviral medicines (ARVs) are routinely not making their way to patients in sub-Saharan Africa - most often despite sufficient stocks already being present in countries - and called for urgent improvements in ARV supply chains in the region.

Epidemics: Neglected emergencies?

October 2015

The Ebola outbreak that hit West Africa in 2014 dominated the headlines for months, eclipsing coverage of other medical emergencies.

It was an enormously important crisis, with many lessons learned during the response phase and with much work remaining to be done. But if we focus too intently on any single disease, we risk overlooking less spectacular but far more common outbreaks of measles, malaria, cholera, and meningitis that take place every year, with profound consequences and loss of life.  

An unprecedented year: MSF's response to the largest ever Ebola outbreak

June 2015

On 22 March 2014, an Ebola epidemic was officially declared in Guinea. Over the course of the next year, the virus would infect more than 25,000 people in nine countries and claim more than 10,000 lives, dwarfing all previous Ebola outbreaks. For comparison, the biggest previous outbreak had a total of 425 cases.

This is our accountability report.

Ebola: Pushed to the limit and beyond

March 2015

A year into the outbreak, many questions abound. How did the epidemic spiral so spectacularly out of control? Why was the world so slow to wake up to its severity and respond? Was it due to fear, lack of political will, lack of expertise, or a perfect storm of all three?

Did MSF make the right choices? How could MSF have done more and saved more lives? What have we learned from this outbreak and what must be done differently in future? There are many questions and few simple answers.

Aleppo’s reality - Daily life under barrel bombs

March 2015

“You could be sleeping. You could be walking to the shop. At any time a bomb can happen,” says an MSF health worker in one of the hospitals the organisation runs in northern Syria. This reports aims at depicting the dreadful humanitarian situation in Aleppo city and surrounding areas especially since mid-December 2013, when the Syrian forces started a campaign of aerial bombardments and dropping of barrel bombs in this strategic area of the country.

2014 reports

Pushing the envelope

August 2014

The Global Fund is by far the biggest contributor to the fight against the three largest killer diseases: HIV, TB and malaria. It gets its funding by donor countries who pool their resources into the Global Fund. It has introduced recently a new model to fund those diseases which is having very concrete impact on the ground, which is what this brief examines.

Considering the Global Fund has a budget of 16 billion dollars in the next four years its new funding model has a direct impact on the 12 million people currently on HIV treatment (it directly finances care for half of the total, six million people), and to the 16 million people who are HIV positive and don’t have access to treatment yet. 

Where is everyone? Responding to emergencies in the most difficult places

July 2014

Working at the frontline of delivering humanitarian aid, we at MSF are acutely aware of the limitations and deficiencies of the international aid response to crises. Some good work is taking place, and lives are being saved, but much more can, and should be done, to reach those people most in need.

In 2016 the World Humanitarian Summit brought together global experts in aid to consider the structure and funding of humanitarian work in the future. In parallel to this important meeting, MSF is publishing Where is everyone?, a report which diagnoses some of the key issues inherent in the international response to humanitarian crises.

Vaccinating Children beyond the 'Cold Chain'

April 2014

More than 22 million children worldwide did not complete basic childhood vaccinations in 2012 and an estimated 1.5 million children aged under five die every year from vaccine-preventable diseases.

Shipping and storing vaccines in a ‘cold chain’ in the tropical heat of many resource-limited countries – whereby the vaccine is kept at temperatures between 2°C to 8°C from the point of manufacture until reaching the recipient – is a tremendous challenge and a major cause of poor immunisation coverage rates. Ministries of Health and organisations such as Médecins Sans Frontières (MSF), which carry out vaccination in developing countries, struggle with the immense task of keeping vaccines within the recommended temperatures in contexts where infrastructure is weak and electricity supply and refrigeration unstable.

Between rhetoric and reality: the ongoing struggle to access healthcare in Afghanistan

February 2014

2014 is another crucial year for Afghanistan: after 12 years the US-led NATO military intervention in the country has entered its final phase, and presidential and provincial elections are scheduled for April. As the bulk of international troops withdraw before the end of the year, the world's attention is rapidly turning elsewhere.

What interest remains in Afghanistan is firmly fixed on military drawdown, security transition and pre-electoral wrangling. Conspicuously lacking is a focus on the daily reality for Afghans, trapped in an escalating conflict - indeed 2013 was reportedly the second most violent year for civilians since 2001.

2013 reports

Improving paediatric TB care in Tajikistan

November 2013

Children are, globally, the most vulnerable patient group in tuberculosis treatment and have been neglected for too long.

Estimates for paediatric TB indicate that it accounts for 10-15 percent of all tuberculosis cases in the 22 highest-burden countries and worldwide kills at least 130,000 children each year.

Central African Republic: Abandoned to its fate?

July 2013

Three months after Seleka forces seized power in Central African Republic, the country is in the grip of a humanitarian emergency while the international community looks on with indifference, warned the international medical organisation Médecins Sans Frontières (MSF) today.

Central African Republic was plunged into chaos by the coup, and the country remains politically unstable. Citing lack of security, UN agencies and many non-governmental organisations have withdrawn to the capital, leaving the majority of the country without aid. According to a report by MSF, the people of the country have effectively been abandoned just when they most need help.

Violence, vulnerability and migration: trapped at the gates of Europe

March 2013

Over the last ten years, as the European Union (EU) has tightened its border controls and increasingly externalised its migration policies, Morocco has changed from being just a transit country for migrants en route to Europe to being both a transit and destination country by default. MSF’s experience demonstrates that the longer sub-Saharan migrants stay in Morocco the more vulnerable they become.

Syria two years on: the failure of international aid so far

March 2013

After two years of an extremely violent conflict which has resulted in more than 70,000 dead according to the UN, the Syrian people are faced with a humanitarian catastrophe. Despite repeated requests, MSF has not received permission from the government to work in the country, but has been able to open three hospitals in the opposition-held areas in the north where assistance remains well below the level of the needs.

Hear my voice: Somalis on living in a humanitarian crisis

February 2013

Violence, displacement and food shortages are salient features of Somalia’s humanitarian landscape. The report draws on the testimonies of more than 800 Somali patients attending MSF medical facilities in Somalia and in Ethiopian refugee camps.

2012 reports

DR-TB drugs under the microscope

November 2012

Tuberculosis (TB) is a curable disease that continues to kill nearly 1.4 million people across the globe each year, and is the main cause of death in people living with HIV/AIDS.

Yet the response to the epidemic remains inadequate. With 94 percent of patients at risk of MDR-TB (those previously treated) not having access to tests capable of diagnosing MDR-TB, and only 19 percent of people with MDR-TB having been enrolled on treatment in 2011, the full extent of the burden is unknown and undertreated.

Progress under threat

July 2012

While significant gains made in the fight against HIV/AIDS in the past decade are encouraging, countries most affected by the pandemic continue to struggle to place enough people on treatment and to implement the best science and strategies to fight the disease. The current situation in these five affected countries reminds us that the HIV epidemic is still an emergency in many African countries.

Dadaab: shadows of lives

June 2012

Dadaab: Shadows of Lives describes the plight of half a million refugees living in increasingly insecure conditions with nowhere else to go, and argues that there is an urgent need to explore alternatives.

Fighting neglect

May 2012

Charting MSF's 25 years of experience in diagnosing and treating Chagas disease, sleeping sickness, and kala azar in Latin America, Sub-Saharan Africa, South Asia and the Caucasus, the report examines past, present, and future management of the diseases and discusses the access to quality life-saving treatment.

Somebody help

May 2012

The forgotten population of Jebel Si in North Darfur is left without healthcare as MSF struggles to continue its medical activities in the region.

The right shot: extending the reach of affordable and adapted vaccines

May 2012

Lack of information on both the price and the different product characteristics of vaccines has been limiting countries’ ability to operate affordable and effective immunisation programmes.

This publication serves as a resource for immunisation stakeholders, such as donors, implementing partners, and developing countries, which are ultimately responsible for their national immunisation programmes.

From the ground up: building a drug-resistant TB programme in Uganda

March 2012

In this report, MSF calls on all key stakeholders to assure quality rapid TB diagnosis, treatment and care, and argues that a scale-up of the decentralised and community-based approach, including access to second-line TB drugs at district level, is the most feasible method of averting Uganada's impending TB crisis.

Maternal death: the avoidable crisis

March 2012

Around the world women continue to die needless deaths due to medical complications that are preventable or treatable.

This report highlights how limited access to skilled staff, drugs and medical equipment means that a thousand women a day are denied the chance to become mothers.

Lives in the balance: the urgent need for HIV and TB treatment in Myanmar

February 2012

Urgent funding and assistance must be made available by the international donor community to help Myanmar close the devastating gap between people’s need and people’s access to treatment for HIV and TB.

2011 reports

Treating drug-resistant TB: what does it take?

October 2011

Tuberculosis (TB) is a curable disease that kills nearly 1.45 million people across the globe each year and is the main cause of death for people living with HIV/AIDs. Of the 8.8 million new tuberculosis cases each year, 440,000 are forms of the disease that are multidrug-resistant, meaning they cannot be treated with the two primary antibiotics used to treat TB.

Haiti one year after

January 2011

Haitians faced the adversities of life on a daily basis even before a devastating earthquake struck on January 12, 2010. As a major medical and humanitarian organization that’s been present in Haiti since 1991, MSF saw firsthand how Haiti’s people are exposed to life-threatening suffering and neglect.

This report intends to share with the general public, the people of Haiti, and our supporters a detailed breakdown of how the funds donated to MSF for the earthquake emergency relief effort have been used to meet the needs of the Haitian people in the year since the earthquake hit. It attempts to outline the choices made by MSF in deploying its operations, the challenges we faced, the lessons we learned, and our plans and perspectives for the future.

2010 reports

Giving developing countries the best shot: an overview of vaccine access and R&D

April, 2010

MSF and Oxfam show how access to newer vaccines and the development of products for developing countries is faltering and failing to provide life-saving vaccines to children in developing countries.

Sexual violence and migration

March, 2010

This briefing paper highlights the problem of sexual violence against Sub-Saharan migrant women, who arrive in Morocco on their way to Europe. Through the data and testimonies gathered in its medical-humanitarian projects, Médecins Sans Frontières hopes to contribute to finding a comprehensive answer to this problem, which increasingly affects more, and younger, women.

2009 reports

The underfunding of TB research across Europe

October 2009

EU member states are not contributing their fair share to research and development for tuberculosis (TB). Médecins Sans Frontières (MSF) set out to analyse selected countries in greater detail and the results of funds spent in 2007 are summarised here. MSF sees research and development of new tools for neglected diseases such as TB as a major priority. This is because its field teams are losing too many battles in the fight for the lives of their patients due to the lack of adequate medical tools. Therefore, MSF is calling for a significant scale-up of research and development for TB and increased commitment by European governments.

HIV/Aids treatment in developing countries: the battle for long-term survival has just begun

July, 2009

Over three million people living with HIV/AIDS in the developing world receive antiretroviral treatment. However, the medicines and diagnostic tools available are inadequate to respond fully to their needs. It is now time to invest in improving the public health approach.

No refuge, access denied: medical and humanitarian needs of Zimbabweans in South Africa

June, 2009

This report highlights the plight of Zimbabweans seeking refuge in South Africa, the appalling conditions in which they live and their ongoing lack of adequate protection, shelter and basic services, particularly healthcare, in South Africa.

Hidden behind barbed wire: plight of Hmong refugees held in detention camp in northern Thailand ignored amid ongoing deportations to Laos

May, 2009

Over the past four months, the Thai military has used heightened restrictions and coercive tactics to pressure some 4,700 ethnic Lao Hmong refugees to renounce their claims for protection and accept a forced return to Laos.

Beyond cholera: Zimbabwe’s worsening crisis

February, 2009

This report discusses the worsening health crisis emerging in Zimbabwe in the wake of the country's political and economic breakdown.

2008 reports

Cough up for TB! The Underfunding of Research for Tuberculosis and Other Neglected Diseases by the European Commission

November 2008

Médecins Sans Frontières (MSF) teams are faced every day with the lack of adequate or effective tools needed to treat, detect or prevent disease. This situation is particularly dramatic for those diseases that predominantly occur in poor countries. All too often, effective medicines, vaccines or easy-to-use tests simply do not exist.

A major reason for this is the insufficient research devoted to developing new health tools for neglected diseases.

Full prescription: better malaria treatment for more people, MSF’s experience

September, 2008

In a new report launched today, MSF said many more lives can be saved if newer effective strategies to tackle malaria are more widely implemented. The report describes the organisation’s work in Sierra Leone, Chad and Mali, and shows that unnecessary deaths can be avoided with simple, affordable treatment and diagnostic tools available today.