MSF’s role is more critical than ever

Our new director on coming back to MSF, and looking ahead

It is a great privilege to be joining Médecins Sans Frontières Australia and Médecins Sans Frontières New Zealand as executive director.

While this role is new for me, MSF is not. I have spent many years working with the organisation in different parts of the world and across a range of roles. Those experiences shaped not only my professional and personal life, but specifically my commitment to ensuring humanitarian responses – even in the most dangerous and challenging circumstances. Returning to MSF now, and doing so from Australia and New Zealand, feels both deeply familiar and newly challenging.  

Having worked with MSF in South Sudan and Pakistan and supported operations in many other contexts, I have witnessed first-hand the plight of populations caught up in violent conflict and constant displacement. That connection stays with you. When I meet South Sudanese people now living in Australia, for example, it’s a chance to hear about what they’ve been through to get here. It’s a reminder of the part we have to play in bringing a bit of humanity to people caught in crisis. As a member of MSF’s national association, I’ve also kept informed about what’s happening on the ground in the places we work.

We are living through a period of extraordinary challenge for MSF and the humanitarian sector.

Across the globe, conflicts are becoming longer and more complex, with civilians bearing the brunt of violence and instability. Protracted crises are now the norm rather than the exception. Targeting of humanitarian workers and health infrastructures has become all too common. Forced population movements combined with malnutrition and food insecurity further challenge resources in affected countries and create the conditions for epidemics. At the same time, neglected diseases continue to cause unnecessary suffering and death, an issue I am passionate to take on.  

Access to essential medicines is profoundly unequal. Unaddressed medical needs led to the launch of the MSF Access Campaign in 1999 to overcome the problems that stood in the way of better treatment for our patients. I served for three years as deputy director of Access, and I’ve seen how despite progress, the Ebola outbreak and the COVID pandemic laid bare the need not just for improved emergency response, but also for access to new treatments and vaccines. Climate change is amplifying all these pressures, increasing the frequency and severity of disasters and placing additional strain on already fragile health systems.  

As humanitarian needs grow, funding for aid has been dramatically cut and respect for humanitarian space and action is being challenged, forcing difficult decisions, including the closure of vital programs, most recently in Gaza and Sudan.

It is against this backdrop that MSF’s role is more critical than ever. Since MSF started working in humanitarian emergencies more than 50 years ago, the aid system has changed dramatically: reforms, resolutions, new coordination mechanisms, and increasing politicisation of aid. We have also seen growing dangers for humanitarian staff, particularly for national colleagues working in their own communities.

Throughout all of this, MSF has remained independently funded and guided by clear principles – neutrality, impartiality, independence and medical ethics. These are not abstract values. They are practical tools that allow us to reach people others cannot, and to stay when others are forced to leave.

Here in Australia and New Zealand, our most recent funding results show continued donor commitment, even in a difficult global environment. That trust is something we must earn every day – through impact, transparency and integrity.

On a personal level, my confidence in MSF comes from experience.

I’ve seen what MSF can do in very different contexts – in China, in South Sudan, in Pakistan. I’ve seen what it takes to negotiate humanitarian access in highly sensitive environments, and what it means when access is achieved: lives saved, dignity preserved, suffering reduced.

I’ve seen teams adapt quickly, innovate under pressure, and deliver care in places where there were few other options. Those experiences showed me not only what is possible, but what is necessary. 

Looking ahead, the challenges before us are stark.

The human consequences of conflict in places like Gaza, Sudan and Ukraine demand sustained attention and action. At the same time, there are many other emergencies – forgotten, neglected, underreported – where people continue to suffer largely out of view, such as in the Central African Republic, in Haiti, and in the Rohingya refugee camps of Bangladesh.

Closer to home, the Pacific Islands face growing humanitarian and health challenges linked to climate change, geographic isolation and a non-communicable disease crisis. Infectious diseases and access to essential medicines remain critical issues, as does the inclusion of people with disabilities in humanitarian response – an area where we still have much to learn and improve. 

MSF also has an important role and ethical responsibility to tell what we are seeing and doing on the ground, and to speak out with a sense of urgency to prevent greater harms. We must continue to bear witness – to practise témoignage.  

Speaking out about what we see is not optional; it is central to our mission. This issue of The Pulse testifies to how much we in Australia and New Zealand value this aspect of our work – and how our international colleagues honour this responsibility.

We must continue to earn the trust and support of the public here at home. We must draw on the extraordinary professional talent in this region and inspire a new generation to serve with MSF projects around the world. And we must be a strong, credible voice for those who are marginalised, vulnerable and too often unheard.

Above all, we must continue to respond – quickly, effectively and with humanity – when crisis strikes.

I am grateful for the opportunity to do this work alongside all of you, and I look forward to what we  
can achieve together. 

Tom Roth

Executive Director, MSF Australia and MSF New Zealand