What is at stake: Letter to the IB

February 2013

Dear International Board Member

Re: Identity Ramifications Regarding Proposed Changes to Remuneration for Expats (IRP-2)

In light of the recent debates in MSF about the role of our staff in the new humanitarian reality, we believe that a deeper reflection is needed on the part of the IB and the International Association (IGA) before validating the principles of IRP-2. We cannot artificially separate remuneration from a re-think on how we deploy and compensate both national and international staff and from its far-reaching implications on our identity. We strongly urge the IB to explicitly acknowledge that IRP-2 touches on our identity as an international organization and therefore needs to be considered by the IGA.

If we are considering changes in remuneration in order to be a more effective organization and to augment our ability to save lives and address the unmet needs of populations in danger; and if we want to differentiate this international movement from others, we need our changes in remuneration to be considered in the larger context of a changing humanitarian environment.

Central to our identity is MSF’s most valuable resource: those who make personal sacrifices and commit individual acts of humanitarianism. Unfortunately the IRP 2 asserts that the international humanitarian actors that MSF sends to the field are mainly compensated based on their country of residence rather than their humanitarian work and values.

We are increasingly needing mixed profile teams in complex environments and we need a policy that makes that happen so that we can actually better respond to our operational and security demands and ultimately our social mission.  At a time when our coordination teams are increasingly comprised of people from developing countries isn’t it time to create real equality of staff while striving to reduce the distinctions between those that are hired locally, those that are hired internationally from stable high-income countries and those that are hired internationally from low income countries? MSF needs skilled humanitarian aid workers that are treated equally for what they contribute to our core mission.  In a world were socio-economic inequalities fuel the diseases we treat and where wealth determines health, MSF has a more complex challenge than just dishing out pills and needs a more complex response than merely reinforcing existing inequality.

As we continue to struggle with the dichotomy of “opposition controlled territory” as opposed to “liberated zones” we do not understand, it is important that MSF continues to remain relevant by being organized to ensure that through individual acts of humanitarianism MSF is able to access any context of vulnerability and have the legitimacy to intervene and save lives!

We believe that we need a radically different compensation system that addresses that fact that today MSF international recruits come from our countries of activity as well as from wealthy countries. We have to be wary of linking individual’s humanitarianism with nationality.

We find indemnity on an already low base salary as punitive. In addition, this will severely hamper recruitment base for the years to come, and will be a barrier to entry for many national staff becoming international staff; and creates an unintentional inequality  since lower salaries are not offered for people taking first assignments in HQ.

We do take note of terminology used and wonder if this actually reflects the underlining intent of the IRP in creating different ranks of humanitarian workers within the organisation.  We ask the IB to review the terminology as an alert of the wider issues within the IRP2. Surely it is time to eliminate the regressive concept and consequences of Third Country Nationals. And we certainly can’t guild two-third of the world population under one category (TCN) which has huge inconsistencies and dissimilarities in cost of living and come-up with a superficial system of bias.

We strongly believe that international staff should be compensated according to their contribution not according to their country of origin. Quality of assistance depends on quality of staff their capability, knowledge, volunteerism and engagement —not country of origin. We want a policy that reflects this principle. This principle is counter to that in the proposed IRP2. 

We made a choice to diversify the markets we raise funds from, we recruit from, we enter a humanitarian discourse with, a strategic choice many years ago—yet to day this regressive step from that strategic orientation is puzzling. We really do have ask a tough question of how much are we willing to accept that we will be perceived as differing pay according to country of residence.

In addition, we also believe that the Medical act—should be considered anyone with a patient practitioner relationship and we should value patient management not just for doctors. We ask that you must consider that it could go against our own advocacy when we are advocating for other cadres in the health system who don’t have professional qualifications e.g. adherence councellors. So we need to recognize the medical act is really much broader than a traditional notion of a doctor.

Thus, while appreciating the importance of advancing the discussion about management of human resources in MSF, understanding the willingness of the MSF Executive to address a long overdue reform expeditiously --the new associative entities are calling on IB to stimulate a rethink on renumeration and compensation as the far reaching implications of this policy will be hard to reverse. We accept that some issues are for executive decision and that this policy change has the support from the ExCom however we strongly believe that we cannot in 2013 make a decision without recognizing its effect on our social mission and our identity – and believe this is a critical issue for the associative before it is approved/endorsed. We call on the IB to hold consultation with associations prior to the IGA with a view to the IGA taking a decision at its next Assembly in June 2013.


From the Presidents of

MSF Brazil

MSF East Africa

MSF Latin America

MSF South Africa


By: Association Intern