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Doctors Without Borders

Note: the review below was completed in 2009. Our current review of Doctors Without Borders is available here.
Doctors Without Borders does not currently qualify for our highest ratings. More information:

Published: July 2009

Doctors Without Borders (MSF) implements a diverse set of activities aimed at helping people living in conflict zones or regions affected by natural disasters.1

Reason for MSF's notable rating

We have marked MSF as "notable" because it has publicly published a negative review of a program it implemented.2 The summary states:
"MSF started the Nujiang TB assistance program in March 1999, after signing a Memorandum of understanding with the Nujiang Prefecture Health Bureau and the Public Health Bureau's in Fugong and Gongshan Counties. The Directly Observed Treatment Short-course (DOTS) WHO TB control guidelines were followed. After the initial set-up phase of nine months, enrollment of patients started in January 2000. In April 2000 low cure rates (< 60%) were registered which led to a mid-term evaluation of the program under supervision of Professor Zhao Fengzeng in August 2000. Professor Zhao and his team recommended increasing the patient detection rate, to strengthen DOTS and the laboratory work, to consolidate the training and (implicitly) to cooperate well with county governors and PHB directors. MSF wrote a response document to the evaluation report, revised the TB control guidelines, organized refresher training together with PHB and implemented new working methods from February 2001 onwards. In June 2001 the MSF-H Health Advisor visited the project and came to the conclusion that these changes had had little impact on the treatment outcomes. In August the TB advisor of MSF-H performed a technical evaluation and recommended to stop enrolment of patients."
In our experience, charities are very rarely willing to share evidence of disappointing impact. We believe that any charity that does so is being unusually honest about the challenges of international aid, and unusually accountable to donors. We expect that charities capable of spotting, documenting and sharing disappointing results are better positioned to improve over time.

Sources

  • 1. MSF provides aid in nearly 60 countries to people whose survival is threatened by violence, neglect, or catastrophe, primarily due to armed conflict, epidemics, malnutrition, exclusion from health care, or natural disasters. Doctors Without Borders, “About Us.”
  • 2. Doctors Without Borders, "China Tuberculosis Assistance Project: End of Evaluation Report (2002)," Pg 2.