Archive: GA 2019 (Stockholm)

Final Agenda

MEDICAL DEBATE: Medical Cosequenses of Climate Change

HUMANITARIAN DEBATE: Criminalization of Humanitarian Assistance

Termination of Pregnancy

Access Campaign

MSF’s Work with Victims of Snakebite - PASSED MSF NORWAY & SWEDEN

Elderly as a Vulnerable Group - PASSED MSF NORWAY & SWEDEN

Legally Empower OC Boards to keep them more Accountable - PASSED MSF NORWAY

Urgent Reform of MSF's Abortion Policy - DID NOT PASS

Election Results MSF Norway

The following were elected to the Board of Directors of MSF Sweden: 

Karin Fischer-Liddle, Regular Member (2019-2022)

Katrin Kisswani, Regular Member (2019-2022)

Katrine Konar, Regular Member (2019-2022)

Erling Larsson, Alternate Member (2019-2021)


The Swedish association approved the 2018 Annual Report (Svenska, English) voted to approve the proposed statutes change (Memo, svenska, English) opening up for remote electronic voting, approved the Election Committee Guidelines including the election of IGA representative, elected a new Election Committee, and appointed Motion Committee members (and was presented the new Motions Committee Terms of Reference). The Board reported back on passed MSF Sweden Motions

Day 1

Day 2

Debate: Medical Consequences of Climate Change, pleaes note that the first couple of minutes are lacking sound

Debate: Criminalization of Humanitarian Assistance

Update: Access Campaign

Update: Termination of Pregnancy 

Motion 1: MSF’s Work with Victims of Snakebite 

Motion 2: Elderly as a Vulnerable Group 

Motion 3: Legally Empower OC Boards to keep them more Accountable 

Motion 4: Urgent Reform of MSF's Abortion Policy 

2019 Joint MSF Norway and MSF Sweden General Assembly


MEDICAL DEBATE: Medical Consequences of Climate Change

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The health risks related to climate change are on the rise worldwide and is expected to exacerbate health problems that already pose a major burden to vulnerable populations. In fact, many of the crises where MSF is working today are intensified by climate change, and we know that the effects will continue to drive migration, worsen conflicts in failed states, and change the patters of disease propagation to name a few. In addition, climate change is a general detriment to health – with diminishing clean air, safe drinking water, sufficient food and secure shelter.

Even though MSF is on the front lines of the humanitarian consequences of climate change, we have had little focus on understanding what will be required of MSF in terms of responding to its effects. And what kind of response would be needed to help prevent some of the worst impacts of climate change on health.

The purpose of this debate is to have an open discussion between external experts and MSF, and to inform the membership of new medical humanitarian challenges which will surely have an impact on operations, but also on advocacy, human resources and even on how we raise funds.

Questions for debate:

  • Wherein lies MSF’s responsibility in relations to climate change?
  • Do we have a responsibility to speak out on climate change issues we are observing in our missions? Or does our responsibility end when we treat the patients (treat the illness not the cause)?
  • As a medical humanitarian organization, should we be collecting evidence of climate change and use it in our témoignage? If so, do we have the right people to collect and extrapolate data pertaining to climate change?
  • Climate change will undoubtedly change the way we work, how can we prepare to face coming challenges?


Erlend Gronningen, Medical Doctor Department of Global Public Health and Primary Care Bergen University


Adil Najam, Frederick S. Pardee School of Global Studies, Boston University

Hanna Majanen, Field Worker Nurse

Lachlan McIver, AMR and Emerging Infectious Diseases Advisor for the Access Campaign

Sebastian Spencer, Medical Director OCB

Background materials: 

The video of the introduction by Dr. James Orbinski

The Thematic Flash Climate & health series

The Thematic “Flash” Climate, Environment and Health Series includes short articles and case studies by authors working across Médecins Sans Frontières and external contributors to share information and encourage dialogue and collaboration on humanitarian action including through a climate change and health lens.

Lancet countdown: The 2018 report of the Lancet Countdown on health and climate change: shaping the health of nations for centuries to come

The Lancet Countdown tracks 41 indicators across five domains: climate change impacts, exposures, and vulnerability; adaptation, planning, and resilience for health; mitigation actions and health co-benefits; finance and economics; and public and political engagement. The report draws on world-class expertise from climate scientists, ecologists, mathematicians, geographers, engineers, energy, food, livestock, and transport experts, economists, social and political scientists, public health professionals, and doctors. This work builds on decades of research in this field, and was first proposed in the 2015 Lancet Commission on health and climate change, which documented the human impacts of climate change and provided ten global recommendations to respond to this public health emergency and secure the public health benefits available.

Lancet countdown: Climate Change and Health: an urgent new frontier for humanitarianism

As part of the Lancet Countdown project, policy briefs are produced to highlight emerging issues of relevance to global and national discussions. Current and forecast climate-related impacts on human health and the operations of humanitarian actors, such as Médecins Sans Frontières/Doctors Without Borders (MSF), necessitate an updated analysis of the intersection of climate change and global health. This brief seeks to integrate the findings of the 2018 Lancet Countdown on Climate Change’s International Report with MSF’s on-the-ground experience in treating some of the world’s most vulnerable populations, with a view to highlighting the dramatic health consequences already unfolding, as well the dangerous levels of humanitarian need likely if greenhouse gas emissions are not urgently brought in line with levels consistent with the Paris Agreement on climate change. The brief identifies major areas at the nexus of climate change and global health where new policies and approaches are needed and further research is required.

HUMANITARIAN DEBATE: Criminalization of Humanitarian Assistance

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We are witnessing a global trend of criminalization of both those we seek to assist and acts of assistance and solidarity. This is not only a reality for cross border activities in countries such as Syria but is also prevalent in many countries around the world where individuals, groups or organizations are assisting people on the move. To give one recent example, MSF’s Search and Rescue activities in the Mediterranean Sea have recently been under interrogation and both the organization and our staff have been accused of committing criminal acts by the Italian government.

Interlinked with criminalization of humanitarian assistance, and something MSF has been dealing with in the field, is are counterterrorism policies and practices that were enacted after the tragic events of 9/11 2001. For humanitarian organizations like MSF, the emergence of counterterrorism laws has impacted our operational space in several ways. MSF operates in contexts where terrorist labelled groups are active, which impact our security not only through hostilities directed at humanitarian agencies by these groups, but also by counterterrorism policies and measurements. The impact comes both from domestic governments combatting terror-listed groups as well as international mechanisms aimed at criminalizing support to these groups.

The act of criminalization is not new, the treatment of refugees fleeing Nazi-occupied Europe during World War II, and those fleeing civil wars in Central America in the 1980s are historic examples. What is new is the criminalization of compassions itself. Criminalizing basic acts of providing humanitarian support (provisions like food, water, or medical aid) to those who have fled violence, persecution, or famine in their home countries and compassionate assistance for imperiled people in all settings is a right that must be protected – not persecuted. Therefore, how to resist the emerging repression of solidarity is a key strategic point for MSF.

In this session we will tackle the concept of criminalization of humanitarian assistance. Where does it occur and what are the consequences for our operations, or staff, our patients, and the communities in which we work? Looing back, have we encountered similar barriers in the past? How did we deal with them? We will not only talk about which measures we can put in place to mitigate legal trouble in the countries we work, but also what we as an organization can – and should – do to fight the attempts to criminalize humanitarian assistance. What can be do to ensure that we can reach those most in need of assistance, regardless of where they are?


Anna Sjöblom, Medical Humanitarian Advisor MSF Sweden


Emma O’Leary, Humanitarian Policy Advisor at the Norwegian Refugee Council (NRC) Geneva

Benoit de Gryse, Operations Manager OCA

Background Materials:

This report is the result of an intersectional workshop conveyed by MSF Italy to reflect upon the issue of “criminalization of solidarity”. The workshop’s main objectives were to agree on a definition of the concept of “criminalization” and to define a way forward for MSF positioning on this issue. Further to this, it aimed at defining a number of advocacy, communication and operational objectives and activities. The report includes also experiences of criminalization of solidarity in three European countries: Greece, Serbia and Italy, with an additional focus on the criminalization of Non-Governmental Organizations (NGOs) operating in the Mediterranean Sea – aka the SAR controversy. This enhances a bottom-up approach: as criminalization translates in different forms across countries, it is necessary to begin from practical examples in order to come to a comprehensive definition of it. The situation in France, Sweden and Turkey is also discussed.

In 2015, the UN Special Rapporteur on the human rights of migrants warned that war, violence and persecution were leading to ‘an age of unprecedented mass displacement’ and it was time for the world to prepare. That humanity is under an obligation to intervene in the face of suffering, is a principle embodied in religious teaching, as well as humanist and secular thought. In the wake of the first and second world wars, humanitarian principles were codified in the Geneva Conventions on the laws of war and on refugees, the Universal Declaration of Human Rights and the European Convention on Human Rights (ECHR). Codes of conduct of international aid organizations stress that humanitarian assistance must be impartial, not based on nationality, race, religion or political point of view, but solely on need. But whether today’s Europe respects and upholds that humanitarian tradition on land and sea is now in question.

Distrust and suspicion that public health programmes are being used to advance foreign interests have contributed to the increase in murders and violent attacks on vaccination workers. There have been setbacks to polio eradication efforts and other public health objectives. Counterterrorism policies and practices can have unintended health impacts, especially where health programmes are co-opted or undermined, in countries where health systems are strained and population-health indicators are poor. 

As states continue to adopt measures aimed at combating terrorist activity, humanitarian organisations remain concerned about the impact these measures have on their ability to deliver aid to populations in areas under the control of designated terrorist groups (DTGs). A new report by the Norwegian Refugee Council (NRC) examines the impact of counterterrorism measures, and the impact of the emerging area of Preventing/Countering Violent Extremism (P/CVE) on principled humanitarian action. The report shows that counterterrorism measures limit organisations’ ability to deliver humanitarian aid according to needs alone, and oblige them to avoid certain groups and areas.

The United Nations Security Council adopted Resolution 2462 in an effort to counter the financing of terrorism while avoiding unintended consequences for humanitarian activities in areas under the control of terrorist groups. Reaffirming that acts of terrorism are a threat to international peace and security, the Security Council made a legally binding decision requiring all States to criminalize financial transactions carried out with the intention or knowledge that they are to be used for the benefit of terrorist organizations or individuals. This resolution reinforces a long sequence of UN Security Council resolutions to combat terrorism and its financing.

Italian authorities have accused Miguel Roldán of aiding human traffickers after he helped save thousands of people from drowning in the Mediterranean. “It’s unbelievable. We respect the rules so much that we’ve watched people die because of bureaucracy. The accusation is a huge slap in the face,” says Roldán. According to the International Organization for Migration (OIM), 3,116 people died trying to cross the Mediterranean in 2017, with the majority – 2,832 people – drowning on the central Mediterranean route where Roldán was working as a volunteer.


Termination of Pregnancy Update

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MSF responds to the life-preserving needs of people. As a medical-humanitarian organization working in contexts where the population is threatened, deprived of healthcare and where mortality is high, MSF can make access to safe abortion care available – a measure that can dramatically reduce maternal mortality. Our own field experience is at the origin of this commitment. Every day we see women dying from consequences of unsafe abortion, knowing that these deaths could have been prevented.

MSF’s International Council (IC) passed a resolution to this effect in 2004, as a formal step in recognizing the needs, and establishing a framework to support staff and patients. “The availability of safe abortion should be integrated as a part of reproductive health care in all contexts where it is relevant … MSF’s role in termination of pregnancy must be based on the medical and human needs of our patients.” Despite established policies and protocols, guidance to the field and staff training, and making the appropriate equipment available, implementation of safe termination has lagged in MSF’s projects.

Concerned by the limited scope of action, in 2012 the International Board (IB) stated that “unsafe abortion and unwanted pregnancy contribute significantly to the burden of ill health, suffering and maternal mortality in contexts where we work.” Not responding to requests for termination of pregnancy means recognizing that women and girls may have to opt for a potentially unsafe alternative to address their need – this is unacceptable for a medical organization.

At the International General Assembly in Johannesburg a motion passed with overwhelming majority once again emphasizing the need to enact the MSF Resolution on Safe Abortion.

In this session we will talk about a MSF’s policy on Sexual and Reproductive Health, on the greatest challenges in providing termination of pregnancy in the field, and what lessons we have learned.


Séverine Caulwaerts, Medical Department, Women’s and Adolescent Health, OCB

Sophie Graner, Board Member MSF Sweden

Background Material:

We Can do More from Rebecca Cederholm on Vimeo.

Taboo Breakers from Rebecca Cederholm on Vimeo.

Access Campaign

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In 1999, MSF launched the Access Campaign out of medical necessity and frustration. MSF staff in the field were facing multiple challenges – unable to provide adequate treatment to people dying from HIV/AIDS, tuberculosis, malaria, and neglected tropical diseases because new or existing drugs were priced out of reach; were ineffective, toxic, or ill-adapted for use in the places we work; or simply did not exist at all.

These deficiencies were not due to scientific or technical limitations. They were the result of conscious political choices about how medical innovation and access to health tools are organised and financed globally. Rooted in an economic and political system put forth by wealthy governments, the multinational pharmaceutical industry has wielded unchecked pricing power through patents and other monopolies, imposed globally through trade laws that prioritise profits over people’s health. “Medicines Shouldn’t Be a Luxury” has been, and remains, the Campaign’s most poignant rallying cry.

But where do we stand today, 20 years on? Unfortunately, despite winning some battles, the access-to-medicines challenges are larger than ever, with many new drugs, diagnostics and vaccines marketed at increasingly high prices, monopolies more entrenched, and pharmaceutical corporate powers more globalised. At the same time, we are missing the tools we need to control rising antimicrobial resistance and outbreaks of epidemic diseases such as Ebola. But herein lies an opportunity. The crisis of access to medicines and innovation is no longer one of only ‘poor people’ in developing countries, but a truly global one. Our slogan “Medicines Shouldn’t Be a Luxury” is valid for people all over the world, and finding solutions is a topic of public and political debate in wealthy and developing countries alike.

Marking the 20th anniversary of the Access Campaign provides an opportunity to look back on what we’ve learned, reflect on this new reality, and carve out new ways for MSF to engage in transforming the medical innovation and access ecosystem to better address the health needs of people in our care.


Lachlan McIver, AMR and Emerging Infectious Diseases Advisor for the Access Campaign

Pehr-Olov Pehrsson, Former President MSF Sweden, and the first Access Campaign responsible in the Swedish office

Background material:



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Alongside working on access to affordable and effective antivenom, MSF should actively promote snakebite prevention programs where the emphasis is on education and information.  


An estimated 2.7 million people are bitten by venomous snakes worldwide every year, resulting in death for more than 100,000 people and life-long disfigurement and disability for 400,000 more (  Treatment with antivenom can cost 100USD for one victim and is out of reach for many.

Snakebite is on the WHO list of neglected tropical diseases, and MSF is working for access to affordable and effective antivenom.  Antivenom production and availability is of course necessary, but prevention could save both lives and money.

The focus in many texts from MSF is currently on treatment, and in some of the texts killing the snake is depicted as a success. But trying to kill a snake is a good way to get bitten.

Snakes are, as all other species, part of the ecosystem and highly important as such. Snakes keep the rodent population to a minimum, and thereby decrease the disease burden. Snakes are also beneficial for fertility in agriculture.

Programs for snakebite prevention have been launched with good results for example in India, by the Madras Crocodile Bank Trust and Center for Herpetology and Global Snake Bite Initiative. In those programs emphasis is on education and information, for example using mosquito nets while sleeping, using a torch while walking in the dark, and keeping walking paths free from dry leaves. Those are simple ways to avoid snakebite.

Education and information on how to handle a snake inside or near a building is also spread by the same organization, and the techniques are well explained and useful.

As the majority of victims get bitten while working in the fields during darkness distribution of rubber boots and head lamps could be beneficial. That could save both lives and money.

Hella Hultin, MSF member

Patric Falck, Advisor, Member of Stockholms Herpetologiska förening


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To assure that this population has access to relevant healthcare, and insure inclusion, MSF should recognize the elderly as a distinctly vulnerable population; seek to understand their special medical and social vulnerabilities in the context of humanitarian crises.

Background: According to data from  UN population division, the number of older persons — those aged 60 years or over — is expected to more than double by 2050 and to more than triple by 2100, rising from 962 million globally in 2017 to 2.1 billion in 2050 and 3.1 billion in 2100. Globally, population aged 60 or over is growing faster than all younger age groups.

With an aging global population, more elderly are impacted by conflict. MSF has recognized the special vulnerabilities of women and children when health care is disrupted during conflict. The elderly with parallel risks albeit different needs are less visible and thereby receive less attention and relatively fewer appropriate services.

Increased age is often associated with increased frailty, morbidity, disability and decreased resiliency. They are both less able to flee and seek safety, and less visible to those who might help them. Isolated and unable to access medical humanitarian aid directed at the general population and the aid so conceived doesn’t necessarily address their needs. Thus they are marginalized and excluded.

Rebecca Cederholm and the OCG FAD in the Ukraine

MOTION 3: Legally Empower OC Boards to keep them more Accountable - MOTION PASSED BY MSF NORWAY

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MSF operational centers, starting with Operational Center Brussels (OCB), should go as far as is feasible towards becoming separate legal entities from their host sections, with separate and legally responsible boards, so they can be more accountable to patients, members and donors.


Similar proposals have also been discussed elsewhere in Médecins Sans Frontières. MSF Japan has for instance suggested: “The Operational Directorates should become legal entities, which governance should be separated from partner/host section. This will establish true equality in the associative ownership of the social mission.”[1] Within the Operational Center Brussels (OCB) a legal split from MSF Belgium was at the very least a topic for serious debate around 2002-2005. While many definitions exist, accountability is here understood as: “The fact of being responsible for what you do and able to give a satisfactory reason for it, or the degree to which this happens.”[2]


The operational centers are different, but OCB can perhaps be a model for the others with regards to board accountability. If the OCB Gathering approves this motion, the OCB Board could explore if and how establishing OCB as a separate legal entity could be done legally, practically and financially feasible. OCB and MSF Belgium’s legal governance structure could also be audited and potential risks related to their relationship assessed. In parallel, a version of this motion could be raised at the International General Assembly.

The current situation for OCB and MSF Belgium (MSF-B) is described by a footnote in the OCB Board’s regulations: “The partnership of the OCB is based on a gentleman’s agreement. Due to legal matters, the MSF-B Board is legally responsible, but the OCB Board is functionally accountable for OCB actions.[3] This motion is humble about the historical and legal reasons for why OCB is organized the way it is, but maybe it can be improved. It is perhaps understandable that in its early days, a small organization may have relied on a gentlemen’s agreement as a sufficient legal foundation — at least temporarily. However, OCB’s total expenses have more than doubled from about €179 million in 2010[4] to roughly €468 million in 2017[5]. It has probably also grown in complexity. With great power comes great responsibility.

While not referring to the OCB Board, and likely not intended as a sweeping generalization, a review of OCB concluded: “Interviewees and evaluators noted that MSF does not possess a culture of accountability.”[6] To be fair, OCB has recently made efforts to improve and has for instance launched a Resource Accountability Program. It states: “The first objective is to bring behavioural change within MSF enabling its employees to be (more) accountable for resources (‘’be accountable, spend wisely’’).”[7] By example, the OCB Board can perhaps contribute even more to a culture of accountability within OCB.

The OCB Gathering and board member elections are ways to hold the OCB Board to account, but it is only once a year and not enough. As association members, we should be able to rest assured that the OCB Board members we elect are legally empowered to decisively steer the General Director — and that the OCB Board can ultimately be held legally to account for their decisions. While we should have very modest hopes, particularly in the short term, approving this motion may perhaps strengthen the board a little in its relationship with the executive and improve governance ever so slightly. Our patients and donors have few means to influence MSF, yet we can assume they would appreciate more accountability. This is an expectation we likely can live up to.

Essentially the MSF Belgium Board operates as a shadow board — rubberstamping the decisions of the OCB Board. When decision makers are not legally responsible for their actions it may add unnecessary risk — and sometimes create a situation of moral hazard. This may work out fine most of the time, particularly when there is consensus between the boards of MSF Belgium and OCB. Yet, it can also be wholly inadequate in times of crisis or when difficult decisions need to be made. It will potentially only solve a few of the many issues related to accountability. However, having the boards of the operational centers — if feasible — become separate legal entities might be a small but critical step in the right direction.

Jakob Aure

[1] MSF Japan 2019 ”MSF Japan’s Board proposal for RSA4 – March 2019” Page 1.

[2] Cambridge Dictionary “Accountability” 

[3] OCB Gathering 2012 “Regulations for the Board of MSF Operational Centre of Brussels. Updated and Approved June 2012.” Page 2.

[4] MSF(OC)B Annual General Meeting/Gathering 2011 “Financial Report”  Page 3.

[5] OCB 2018 “Financial Report” Page 47.

[6] Stockholm Evaluation Unit 2017 “MSF OCB Bureaucratisation Review”. Page 15.

[7] OCB Finance 2019 “Q&A on Resource Accountability”

MOTION 4: Urgent Reform of MSF's Abortion Policy - MOTION REJECTED

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We PROPOSE that the highest decision-making body of MSF take the following steps:

  1. Issue an immediate stop to the manipulative value-tweeking of our staff on the abortion-issue, ending all ongoing abortion-promoting media & communication efforts and the EVA project,
  2. That a 5-7 person TASK FORCE be created, with a mandate to
    1. expand MSF´s understanding of and approach to abortion, in order to bring it in full harmony with the light of the Charter,
    2. submit a proposal for a Road Map, containing 
      1. the outline of the reformed policy within a framework of “Protection of Vulnerable Human Life” following the Guiding Principles stated in this motion (see page 5) ,
      2. a SWOT analysis,
      3. description of R&D needs,
      4. the outline of perceived needs for educational resources,
      5. suggestion on and availability of necessary strategic alliances
      6. analysis of economic consequences,
      7. deliberations on implementation
  3. That the TASK FORCE be given a time frame of 8 months to prepare the Proposal and be allocated a budget capped at 150.000 Euros, financed by funds re-directed from abolished abortion-promotion efforts.
  4. That a Directive be issued, for all central departments and national members to prioritize cooperation with the TASK FORCE.

Based on the 15 observations given in the background statement, we give the following GUIDING PRINCIPLES for the formulation of the new abortion policy (A-E):

A. Acknowledgment of the BIOLOGICALLY unequivocal fact that the human embryo is an unmistakable human body in fast development, starting at the moment of conception´s confluence of the two proto-nuclei in the zygote, and followed by subsequent, irreversible and incontestably human, epigenetic/genetic events.

B. Acknowledgment of the PHILOSOPHICAL and MORAL implications of the biological facts: a human being is created, brought into existence, woven into it´s distinctly human state at the moment of conception´s confluence of the two proto-nuclei in the zygote, with no ontological or teleological limbo/gap. Every human being is a unique person with inviolable dignity and rights, unless we deny the principle of equal value.

C. Acknowledgment of the full SOCIAL, SOCIETAL, justly JURIDICAL, CULTURAL, and HISTORICAL context into which each newly conceived  human person, justly and morally, need to be welcomed and tenderly cared for, due attention to be given to resources and capabilities, threats and vulnerabilities of family and close community.

D. Acknowledgment of MSF´s competence in MAPPING UNMET NEEDS and consequently rolling out adapted, but flexible, INTERVENTIONS based both on local and exterior sources.

For instance, in the context of this motion it could amount to

  1. a) establishing what is at stake for the abortion seeking individual(s) , then
  2. ascertaining what it would take to make necessary improvements to the underlying premises, for the mother/couple to abandon the decision to seek to end her/their child´s early life,
  3. making an inventory of the options at hand to meet the disclosed needs in order to deflect the threat to the life of the unborn child and at the same time to strengthen the capacity of the mother/father/family to grow in their role as loving & wise guardians,
  4. assisting the parent(s) and relatives as necessary, in making their choices among the new options,
  5. securing available resources, including those of MSF and relevant partners, 
  6. establishing an action plan, and
  7. following up and reviewing the scope of resources, after repeated mapping of needs & vulnerabilities.

E. Affirmation of the centrality of our Charter as our inspirational beacon, underscoring our privilege and duty to re-align our own use of LANGUAGE and CONCEPTS, to ring in harmony with the full reality of any abortion-seeking person.                      


This motion has grown out of reflections on the current abortion policy, and the consequent alarm, evoked by insights into

  1. a) the policy´s evident ontological threat to the Charter and Her vital centrality
  2. b) the ongoing push to weaken, what is viewed by the abortion enthusiasts as, ”internal resistance” against the political vision of ubiquitous services of abortion-on-demand, to be offered in all MSF missions, a push carried out centrifugally by means of a bundle of value-manipulating techniques rolled out on media-platforms, internal linguistic “rulings” and the team-based EVA project.   

We are compelled raise alarm against the intellectually, morally and socially subversive influence of relativistic situational ethics, underpinning the current abortion policy – undermining the immutable principles of the universal human rights, and of the concepts of individual and common good. Therefor, their application in MSF is eroding the very foundation of our luminous Charter – the beacon of inspiration for all MSF endeavors.

“Study the Charter, and prosper  -  desert It, and stumble”

Therefore, any fruitful reform of the current abortion policy calls for an  acknowledgment of the need for sincerely addressing the comprehensive context in which abortion services claim their devastating costs, putting to shame the facade of compassionate offering of effective preventive medicine and fulfillment of basic human rights.

To this end, it will be useful to take the following 15 observations into account:

  1. The major genetic/epigenetic event in mammalian life, EGA (embryonic genetic activation), starts in the human zygote shortly after the magnificent confluence of the two protonuclei, when a singular number of genes are activated, an event never again to be matched. This sets in motion all the precisely directed processes that constitute the epic creation of the exquisitely well-defined body of the human being.
  2. With the application of current technology, we are able to accurately ascertain the presence of a living human being, as early as in its zygote stage of development, its longevity notwithstanding.
  3. Claims, positing that a human being in its early intra-uterine life, constitutes ”a part” of the mother´s body, on par with her other limbs and organs, and as such remains under the mother´s exclusive disposition, is invalid for a number of reasons. One biological reason is the observation that the mother´s immune system undergoes a profound adjustment in order to avoid rejection of the child, due to his/her alien antigenicity. Another is the fact that the growing child in the mother´s womb does not serve any purpose in upholding any specific functions of the mother´s body, as do all constituents of her own body. Rather, the science of human biology shows us to what extent, the mother´s body and mind is tuned in to providing the growing child with all means necessary for him/her to thrive and grow, in preparation for autonomous life.
  4. The philosophical implications of human biology don´t leave room for ontological nor teleological limbo in the development of human beings or persons. Furthermore, the undeniable witness of science underscores the fetus´/child´s status of individual, set apart from his/her mother.
  5. It is a self-contradiction to claim respect for universal human rights, but deny the right not to be arbitrarily killed by others, as the sine qua non, first right in the respect for, and dignity of Man as well as the inviolability of the individual, a right without which all other human rights stand easy pray to instrumentalization, seconding changing needs of the powerful. 
  6. 'Considering the above observations (1-5), it is equally self-contradictory to defend universal human rights, but deny the right to life, to protection and provision of basic needs to human beings at some arbitrarily chosen stage of development
  7. Systematic juridical discrimination is exposed when, within the context of a given jurisdiction, disputes are resolved using principles that tend to disregard the rights of one party. Elevating such unjust practice into promulgated law, leaves the law void of moral imperative and calls for expedient amendment. Thus, following the observations in points 1-6, laws allowing for “abortion-on-demand”, where license is given to services offering the ending of life of persons in their fetal stage of development, without any qualification other than an arbitrarily set fetal age, are intrinsically unjust
  8. A rule of law that freely adopts and enforces unjust laws (as seen in point 7), offends against its role of custodian and promoter of both the individual and the common good. It undermines the respect among its citizen for everyone´s equality before the law, and paves the way for a more brutal societal climate. The idea of the rule of the strongest tends to be promoted, and thus contributes to the ruling class´ expectation that laws be at their service. The roads to tyranny and the totalitarian state are added lanes... Let´s refuse to carry stones for any such road.
  9. What has been observed concerning the compellingly constant ontological and teleological unity of the life of a person/human being, from the moment of conception to natural death, as well as concerning the unity of justice in rule of law with both equality and the individual/common good, must also be held concerning value in metaphysical virtue. For instance, this holds true for Compassion, often voiced as central to the endeavors of abortion activists around the globe, including those in our own ranks. Sadly weaponized to serve the aims of activists, compassion need to be brought back into full metaphysical union with it´s sisters in virtue: Justice, Truth and Charity to carry good fruits. The light, emanating from this most fruitful of metaphysical unions, concerning a reformed MSF´s abortion policy, to the greater benefit of abortion-seeking persons, shows us that the pleas for “status quo” of life voiced by many a abortion-seeking mother, might find its fortunate replacement through efforts that simultaneously aim at saving the child´s life and spare no efforts facilitating a solution to the underlying, at times critical, predicament of the mother, father and/or family.  What is at stake, adding to the concrete challenges articulated by the unhappy mother, is her own and her family´s invaluable loving contribution to the full life (also standing on it´s own merits) of the unsuspecting person in the womb. Many more lives, their experience and contribution are often at stake, since the threatened fetus/child risks being denied the opportunity to bring into life his/her own family in due time, with its lineage of generations to follow with their potential extensions over the world to come. The combined losses of wide-spread abortion practice inflicted on humankind is incalculable. On the other hand, efforts made to honor sacrificial love in truth and justice, is what carries many through and beyond pain, setbacks and suffering. Such actions become way-signs of hope for others, with fruits likewise inestimable. Be that, rather, our legacy. 
  10. Individuals and organizations that hold on to, or chooses systematically to avoid taking action on the self-contradictions of points 5-7, and refuses to explore the broader perspectives of points 8-9, undermine their own intellectual and moral integrity and credibility. Sadly, they are also opting out on contributing with their competence, vitality and good hearts to the forging of true, profoundly satisfactory solutions to the injustices they are trying to stamp out. Rather, let's join forces.
  11. People in other cultures have long voiced concerns for being made to pay the price of own cultural and societal decay by forced adoption of alien, unwanted life-styles and norms, as prerequisite for economic development. What decay are they trying to avoid? What components of a Western/American lifestyle had they rather opted out of, if given a choice? Those are questions that we have to answer in MSF, if we are to successfully avoid ”spreading the bug” ourselves. In the quest for providing global access to abortion–on-demand, are not the activists - and now MSF - expecting other peoples and societies to accept, on a mass-scale, toxic subversion and weakening of+ the high esteem and prime protection, enjoyed through all ages, of the first of all natural relationships: that of the mother, father and their children?  As carriers of ideological luggage of the primacy of personal choice, do we in MSF (maybe unwittingly?) endeavor, by the push for “abortion-on-demand”, to introduce a relativization and trivialization of the inspirational funding value and unique experience of self-giving, unifying, transforming parental and cross-generational agape, and of the family as the first society and school of filial love and charity – transcending cultures and ages? We´d better pray not... To what extent are we willing to respect and support other peoples right to honor the legacy of their predecessors, and the right to pass on true wisdom from generation to generation, even if we ourselves – pray not - might have been deprived the sense of it?  What if that wisdom teaches tenderness toward the most dependent of all human life, carried and protected in the mother´s womb, asking a free gift of sacrifice? Let´s find the courage to allow our own deep wounds and frustrated longings be soothed in gratitude before any example of the liberating and fulfilling beauty and privilege of Man´s abandonment to the higher good.
  12. The fear of offending the charisma of our organization and prompting a decay of MSF´s credibility, following betrayal of our own predecessors´ funding principles of justice, dignity, compassion, responsibility and self-giving charity, enshrined in our Charter, may provide a supplementary motive to any reform of the current abortion policy.
  13. Accepting the truth and wisdom in the reasoning and observations presented in the previous points 1-12, we need to direct our efforts, when approached by abortion-seeking women and couples, in such a way, that we might bring a humble, thoughtful, contribution to every persons´ opportunity for giving his/her unique gift to the society into with the person has come.
  14. The primary responsibility for securing good conditions for a new member of humankind lies with the parents, family and the surrounding community. This means also that MSF personnel, in their contact with abortion-seeking persons, needs to be well aware of the potential impact of the organization´s presence, and direct it in such a way, as to facilitate, reinforce and complement, when needed, the capacity of the mother, father, family and local community to protect the unborn person, while preparing for an optimal reception after birth.
  15. The tuning of the quality and extent of a specific MSF mission´s participation in supporting family- and community-based measures, say by networking and building alliances, need to be decided upon in the light of the specific mission´s mandate, context and available resources.

Paul Amberg


By: Rebecca Cederholm