International Activity Report 2025

In moments of crisis and exclusion, Médecins Sans Frontières (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.

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, 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 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While MSF received only 0.96 per cent of our funding from governments in 2025, we worked in places where the effects of withdrawn funding were clear.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’.  

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. 

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.  

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 practicing their shared commitment to humanitarianism. 

We send a heartfelt thank you to every humanitarian who continues to stand in solidarity against inhumanity.