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Providing care and bearing witnessDoctors of the World/Médecins du Monde (MdM) provides care to the most vulnerable populations, including victims of armed conflict or natural disasters and those whom the world is gradually forgetting.

As an international humanitarian organisation, MdM’s work depends on the commitment of volunteer logis-ticians, doctors, nurses, midwives...

As an independent organisation, MdM goes further than providing healthcare. We draw attention to human rights violations and fight to improve the situa-tion of populations.

Our identity

A word from our Chair

At the conclusion of the annual general meeting of Doctors of the World, which was held in Paris on 2 June 2012, the organisation elected a new Board of Directors, chaired by Dr Thierry Brigaud. This was the opportunity for him to reaffirm a number of priorities.

The organisation must maintain a strong international presence in order to deliver an appropriate response to emergencies like those in Ivory Coast, in the Sahel region, in Pakistan and in Yemen. In Syria, we condemn the violation of human rights and most particularly those of the injured and of health workers. We are developing new methods of intervention to deal with this, sometimes working remotely in the absence of easy access to affected areas, constantly adapting to evolving situations.

In Europe and France, the internatio-nal network of Doctors of the World is opposed to the narrative of fear. When speaking of the free movement of people, international migration could be seen as an opportunity for Europe rather than a threat. Currently migra-tion journeys often prove disastrous and the human cost, particularly in terms of health, is unacceptable.

At home and abroad, it is important to promote a harm reduction approach in the fight against endemic diseases like Aids and hepatitis B and C. Advocacy for the provision of affordable generic medicines to treat patients with hepati-tis C is part of this struggle. More gene-rally, health promotion is a way to com-bat the social inequalities experienced by excluded populations.

MdM’s associative and activist model allows us to promote an alternative approach that respects the populations we work with and relies on more balanced partnerships with civil society.

Dr Thierry Brigaud Chair, Doctors of the World France

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Our identity

HUMAnreSOUrCeS

 » 2 000volunteers

 » 328 employees

 » 110 international employees, including 45 volunteers

 » 1 290 national employees

MDM frAnCebUDGeT€64M

Key figures

MDM frAnCe finAnCiAL reSOUrCeS

EXPENDITURE

78.5%social programmes15.5%fundraising6%operating costs

INCOME

63% public generosity

29% publicinstitutional grants7% private grants and sponsorship 1% other

At home and abroadDoctors of the World works all over the world: inter-nationally in more than 60 countries, but also in France.

For today and tomorrowAs well as emergency response projects, Doctors of the World runs long-term development programmes. We extend our activities beyond crises to support reconstruction efforts within each country. In the field, training for medical teams and links with local partners guarantee the sustainability of these projects in the long term.

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Collective mobilisation for more freedom and social justiceThe Arab revolutions (in Egypt, Libya, Tunisia as well as Yemen and Syria), the seeds of political change in Burma, social uprisings in Spain and elsewhere serve to remind us of our legitimate aspiration for greater freedoms and to have a say in decisions that affect us all, in the face of growing inequalities.

By endorsing community-based approaches and working with local partners, MdM is drawing up a more balanced delivery model for humanitarian aid.

A radically changing international contextIn 2011, despite the deteriorating political and social context, MdM continued its efforts on behalf of the poorest, working closely with local partners and communities.

The organisation benefits from its roots in civil society for its defence of access to healthcare. With France assuming the pre-sidency of the G20 in 2011, MdM called on the leaders to make a clear commitment to access to healthcare for the most vulne-rable, rolling out a campaign entitled Health is not a luxury!

The impact of the economic crisis As the crisis spreads it affects an increasing number of people, hitting those who were already vulnerable hardest. It is these people we support on a daily basis with our projects.

The best example this year is Doctors of the World’s Greek team, reaching out to an ever-growing number of those living on the margins of society.

In the poorest countries, the reduction in private and public finances places deve-lopment policies and the last decade’s progress, in relation to access to antire-troviral treatment under the auspices of the Global Fund, in serious jeopardy. This has already caused an interruption in treat-ment for some patients, for example in Democratic Republic of Congo, where we continue to work.

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A more dangerous environmentfor aid workers2011 began with the death of two French aid workers, who were killed during a military operation launched against their kidnappers, following their abduction in the heart of Naimey, Niger. The same year ended with the assassination of two collea-gues working for Doctors without Borders in Mogadishu.

These new threats to humanitarian aid have forced us to adapt. For example, our pro-jects in the Sahel region, with the agreement of our African staff, have been regrouped to

focus on the least exposed zones, and our movements are limited.

In Merka, Somalia, as a result of barriers to entering the country and our legitimate concerns about the contribution that huma-nitarian aid makes to the war economy, the work has been suspended. However, we are still present in the country, thanks to a new programme for vulnerable displaced people and the urban population in Bos-saso, Puntland. This programme aims to improve access to sexual and reproduc-tive health services. This area is currently deemed safe to work in.

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41% Africa21% Latin America22% Asia3% Europe10% North Africa and Middle East3% Miscellaneous projects (Adoption, Opéra-

tion Sourire, needs assessments, regionally-managed international programmes and cross-cutting projects)

GeoGraPhical breaKdown oFINTERNATIONAL PROGRAMME EXPENSES

 »  65 programmes

 »  44countries

 »  6800000 target population (people who could have recourse to services delivered by MdM)

 »  1000000medical consultations

beneFiciaries(people who benefited from one or more services provided by MdM)

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Natural disasters, crises and conflicts: more aid workers on the groundOn 14 January 2010, an earthquake devas-tated Port au Prince and the surrounding area. At the end of that same year, cho-lera broke out in the country. Thanks to our long-term presence in Haiti, we were able to respond effectively to both disasters. In 2011, almost 4,000 medical consultations were performed each week across the five intervention zones. Cholera prevention and treatment helped reduce the effects of the epidemic. All funds collected in 2010 and 2011, following the earthquake, were used to carry out projects in the country. In future years MdM will continue its work there, par-ticularly in rural areas.

This year we launched a number of emer-gency responses. Following a period of drought and the major food crisis in the Horn of Africa, MdM worked in Kenya, Ethiopia and Somalia to improve access to healthcare for people living on the outs-kirts of refugee camps. In Cote d’Ivoire, in a bid to lessen the impact of the political crisis on maternal and child mortality, MdM decided to support emergency obstetrics

and sexual and reproductive health in Abidjan and the forgotten regions of San Pedro and Sassandra in the south west of the country. Our teams responded to the devastating tsunami in Japan and, in 2012, will continue to offer psychosocial support to some of families and individuals affec-ted. On the border between Tunisia and Libya, partnerships with local African orga-nisations caring for refugees fleeing the war in Libya confirmed the effectiveness of working with local actors in an emergency context. Unable to bring care to those in need inside Syria, our teams were forced to set up at the borders, in Jordan and Leba-non, to care for those fleeing the country.

We must not forget that the confusion between humanitarian aid and military action remains a problem. The reform of the United Nations humanitarian system continues with European Union involve-ment since the Lisbon Treaty came into force. It calls into question the principle of neutrality inscribed in the “European humanitarian consensus” and, as such, somehow makes the subordination of humanitarian workers to state control more official. Within this context, the

financial independence of the organisation is more important than ever as a means of resisting this influence.

Harm reduction: moving in the right directionAfghanistan, Burma, Georgia, Tanzania, and, soon, Kenya. So many countries, so many projects where Doctors of the World teams have developed and transferred their harm reduction expertise, particu-larly relating to drug use. The fight against HIV and hepatitis B and C transmission in vulnerable groups has helped to improve the health of people, both individually and across vulnerable communities. At the same time, we advocate at local and international levels, sharing the impact of our work with the aim of influencing public policy. Existing policies often favour a repressive approach, to the detriment of those based on public health.

Strengthening sexual and reproductive health activities:evidence-based advocacyThe opening of a programme for pregnant women in Laos, solid advances in our advo-cacy work in favour of safe and legalised

MdM’s international work in 2011 was focussed on four key themes, aimed at strengthening our presence amongst the most vulnerable populations who exist on the fringes of the aid system.

International programmes

Guinea

Liberia

Burkina Faso

Mali

Dem. Rep. of Congo

Madagascar

Tanzania

Somalia

Niger

EgyptMexico

Guatemala

Haiti

Nicaragua

Colombia

Ethiopia

Vietnam

Indonesia

IndiaPakistan

Yemen

Afghanistan

Burma

Nepal

Rwanda

Algeria

Turkey

SyriaPalestinian Territories

Chad

Serbia Romania Bulgaria Moldova

Sudan

Kenya

Côte d'Ivoire

Angola

Zimbabwe

Georgia

Laos

EMERGENCY PROGRAMME

EMERGENCY AND LONG-TERM PROGRAMME

LONG TERM PROGRAMME

Russia

Japan

Uruguay

Tunisia

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abortion in Uru-guay, the continua-tion of projects in the Sahel region, Haiti, Liberia, Guatemala, Mexico and Nepal are several examples of our strong, lasting commit-ment to this issue, in relation to both healthcare delivery and health sys-tem development. Doctors of the World also campaigns for universal access to sexual and reproductive healthcare services in line with international and regional human rights commitments, in particular those relating to women and their right to access good qua-lity sexual and reproductive services.

Bearing witness to the impactof immigration policies on healthThe projects we run in Europe and at its perimeter, in Algeria, Turkey or Mali, allow

us to work closely with migrants. In addi-tion to the medical and psychological care we offer, we bear witness to inhumane European policies that stigmatise and mar-ginalise individuals. Furthermore, MdM is committed to the premise that through dis-cussion on the free movement of people, migration could come to be looked upon as an opportunity rather than a threat for Europe. In order to achieve this, the orga-nisation shares information between pro-grammes, ensuring that local partners are involved throughout the process.

Guinea

Liberia

Burkina Faso

Mali

Dem. Rep. of Congo

Madagascar

Tanzania

Somalia

Niger

EgyptMexico

Guatemala

Haiti

Nicaragua

Colombia

Ethiopia

Vietnam

Indonesia

IndiaPakistan

Yemen

Afghanistan

Burma

Nepal

Rwanda

Algeria

Turkey

SyriaPalestinian Territories

Chad

Serbia Romania Bulgaria Moldova

Sudan

Kenya

Côte d'Ivoire

Angola

Zimbabwe

Georgia

Laos

EMERGENCY PROGRAMME

EMERGENCY AND LONG-TERM PROGRAMME

LONG TERM PROGRAMME

Russia

Japan

Uruguay

Tunisia

PROGRAMME D'URGENCE

PROGRAMME D'URGENCE ET DE LONG TERME

PROGRAMME DE LONG TERME

inTernATiOnAL ADOPTiOnAuthorised since 1988, Doctors of the World is currently France’s largest adoption agency, with over 3,800 adoptions over the last 20 years, in the context of profound changes in international adoptions. As a medical NGO, MdM gives priority to ‘complex’ adoptions: children with medical conditions (heart disease, limb defects, cleft lip and palates...), children aged six and over and siblings. In 2011, 131 children arrived in France and were adopted by 119 families. MdM is committed to reducing the risks associated with international adoption and to developing ethical practices which, first and foremost, respect the interests of the child.

LONG TERM PROGRAMME

EMERGENCY PROGRAMME

EMERGENCY AND LONG-TERM PROGRAMME

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Programmes in FranceCan we still claim that the French health system is the best in the world, given that it increasingly fails to meet the needs of the most vulnerable? Although access to healthcare is recognised as a universal right, not everyone has access in reality, even in France, where the standard of medical care is one of the best in the world.

Problems with access to health-care and to rightsThese days the process of acces-sing treatment and preventive care increasingly resembles an obstacle course for anyone with limited finan-cial means—whether or not they are French! In fact, demand for MdM’s health centres is far from decreasing and our outreach teams are increasin-gly working with people who do not attend health facilities and whose fundamental needs— such as a roof over their heads and access to food and water—are not met. These people have more and more difficulty in acces-sing the healthcare system, or they do not manage to realise their right to health coverage without help. This is despite the fact that anti-exclusion measures are supposed to protect these groups.

As a result, around a quarter of patients attending our Healthcare, Advice and Referral Clinics have delayed seeking medical advice, an increase on pre-vious years (from 11% in 2007 to 24% in 2010). Many children, who account for 12% of consultations in our clinics, still don’t have access to vaccination, nor to health insurance, at a time when potentially lethal epidemics, such as measles and tuberculosis, are retur-ning to mainland France and Europe.

Our solidarity-based health system is under threatThe global economic crisis is certainly contributing to widening health inequa-lities, with the growth in unemployment, insecure employment and heavy debt. Above all, however, it is the threats to

our solidarity-based health system, along with the impact of security poli-cies on health, that are leading to a deterioration in access to healthcare for vulnerable groups.

In fact, we are witnessing falling health insurance reimbursements, an increase in co-payments and, therefore, in patient costs. In addition, six per cent of insurees, equivalent to four million people, have no top-up health insu-rance and we are seeing paradoxical situations where patients find them-selves “too poor” to pay for top-up insurance but “too rich” to be entitled to the complementary universal health insurance (CMU-C).

These elements, among others, explain why, in 2011, 30% of the French popu-lation said that they delayed, or even abandoned, seeking healthcare for financial reasons.

Security responses which harm public healthIn addition, we have to consider the government’s actions, which are often more focused on security than social issues, particularly towards margina-lised populations such as sex workers, people who use drugs, rough sleepers and migrants (irrespective of whether they are European citizens or not).

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bUDDYinGMany children, often from disadvantaged backgrounds, from France and elsewhere in the world, are admitted to hospitals in and around Paris for conditions that cannot be treated closer to home. These children are unlikely to be accompanied by their parents. Since 1988, MdM’s buddying programme volunteers have provided emotional support to over 2,150 children who are separated from their families.

The reintroduction of the offence of passive soliciting, in the 2003 Internal Security Law, has pushed sex workers further into the shadows, leaving them more exposed to violence and high-risk practices. In these conditions, HIV prevention programmes are rendered less effective, a point reiterated by the National Aids Council.

Moreover, there is still no adequate res-ponse to the hepatitis C epidemic which affects around 60% of people who inject drugs, despite a recommendation from the French medical research agency (INSERM) to implement innovative measures, such as supervised injection rooms, which have shown their worth in other countries. Finally, the increase in evictions from homes without any alter-native proposals for re-housing, along with the threats to measures such as State Medical Aid and medical visas for seriously ill migrants, are manifestations of the government’s deliberate desire to dissuade migrants from staying in France. These measures lead to worsening living conditions and deteriorating access to healthcare for patients of foreign origin.

These short-term and medium-term threats to health reflect the tension between a security-driven approach and protecting public health, usually to the detriment of the latter.

serVice Users caMeTo oUr 21CLINICS

29 466  » 2 000 volunteers

 » 90 employees

 » 40 627 medical consultations

 » 70 outreach projects

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/ Argentina / Belgium / Canada / France / Germany/ Greece / Japan/ Netherlands / Portugal / Spain / Sweden / Switzerland /United Kingdom

The international networkIn 2011, the international network, which is made up of 13 organisations, took action in Haiti, Japan and Greece.

The international network management team (DRI in its French acronym) is res-ponsible for its coordination and deve-lopment, with guidance from the two largest organisations in the network, MdM France and MdM Spain, and the network delegates, Dr Françoise Sivi-gnon and Dr Hervé Bertevas.

The DRI supports the development of network members according to their needs and means. In 2011, the work in Haiti continued. When the teams were faced with the cholera epidemic, smooth coordination on the ground

enabled a swift and efficient response.

During the year, two network mem-bers were hugely affected in their own countries:

• MdM Japan responded to the 11 March 2011earthquake, immediately sending teams to the affected areas. The team continues to provide long-term support to the poorest of those affected.

• MdM Greece sees the consequences of the financial crisis in their country

In 2011, Doctors of the World’s international network implemented:

 » 151 international programmes in...

 » 64 countries

 » 190 national projects in...

 » 13 countries

MdM international network budget: €113M

on a daily basis. The number of Greek patients who no longer have access to healthcare continues to rise.

Raising funds remains a constant struggle. To further our reach and to access new international funds, MdM opened an office in New York in January 2012.

» dri@medecinsdumonde.net + 33 1 44 92 14 80 www.mdm-international.org

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rigorous management and financial transparencyMdM is approved by the Comité de la charte (the Charter Committee on Dona-ting with Confidence) and is particularly committed to following the charter’s prin-ciples, including rigorous management and financial transparency.

Controls by external organisationsMdM is subjected to control by the Cour des Comptes (French public finance court) and the organisation’s accounts are certified by the auditor, Deloitte. Detailed audits are carried out by French, European and international institutional donors (such as ECHO, the European Commission’s humanitarian agency) or the United Nations.

The donors’ committeeMdM receives recommendations from an independent donors’ committee, which regularly analyses and examines our work.

financial scopeThe financial results of MdM France include transfers to and from the other organisations in the Doctors of the World network where MdM France has some financial oversight: MdM Germany, MdM Japan, MdM Netherlands, MdM Sweden, MdM United Kingdom and MdM Belgium.

Our detailed financial report is avai-lable from our website: www.medecinsdumonde.org.

Doctors of the World’sfinancial management principles

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Pooling of donations: a fundamental principleMdM has always adhered to the principle that it does not allocate donations to specific projects, unless specifically requested by the donor, but rather pools all donations received.

This policy allows us to intervene accor-ding to real needs on the ground, without being influenced by financial considera-tions or extensive media coverage of indi-vidual emergency situations. we regularly inform or remind our donors, and all those who support our work, that we pool dona-tions in this way.

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The balance sheet shows an overview of our financial position on 31 december 2011. MdM’s balance sheet is healthy and enables us to carry out our humanita-rian work with a view to sustainability and quality. The current assets of €42.5M are considerably larger than the liabilities of €25.8M. The organisation’s reserves and

2011 Balance sheet ASSETS NET 2011 NET 2010

fixed assets

Intangible fixed assets 103 954 76 485

Tangible fixed assets 3 655 663 3 827 511

Financial assets 967 583 893 663

ToTal I 4 727 200 4 797 659

current assets 42 511 437 39 364 685

accruals (Pre-Paid exPenses) 346 320 368 047

ToTal II 42 857 757 39 732 732

TOTAL ASSETS 47 584 956 44 530 391

ANALYSIS OF THE 2011 BALANCE SHEET

the liquid assets available on 31 decem-ber 2011 correspond to three months operating and activity costs. The surplus of €1.3M in 2011, equivalent to 2% of the budget, is partly due to having raised more funds than forecast. The 2012 bud-get is balanced and is based on a volume of activity identical to 2011.

EQUITY & LIABILITIES 2011 2010

equity 17 419 108 15 394 304

SURPLUS (DEFICIT) 1 286 649 2 059 729

ToTal I 18 705 757 17 454 033

PrOVisiOns fOr liaBilities and cHarGes 307 968 323 450

desiGnated funds 2 753 402 5 525 923

deBts 12 024 479 11 037 269

accruals (deFerred inCOMe) 13 793 350 10 189 717

TOTAL EQUITY AND LIABILITIES 47 584 956 44 530 391

The organisation’s general reserve, allocated to all social programmes, remains high and is equivalent to three months operating and acti-vity costs. This enables us to carry out our work with autonomy and financial independence. This level allows us to meet our obligations without excessive hoarding.

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2011 expenditure ratiosThis analysis of our expenditure enables ratios to be calculated. These include hardly any deferred payments and are calculated on the basis of a sub-total of expenditure recorded in the profit and loss account (Total 1) from the annual expenditure account (see table opposite).

Social programmesTThese account for 78.5% of expenditure in 2011 equivalent to €50.3 M. The social programmes budget line encompasses all our programmes in France and overseas. It also includes all Head Office departments linked to programme co-ordi-nation and advocacy, as well as all expenses lin-ked to communication.

Fundraising costsThese costs represent 15.5% of expenditure, equi-valent to €9.9 M. The organisation maintained a substantial level of fundraising costs in order to seek growth in income from the general public, foundations, businesses and public institutions. This investment enables us to maintain our level of financial independence.

Operating costsRepresent 6% of the organisation’s expenditure.

Expenditure

Annual income and expenditure account 2011 ALLOCATION OF FUNDS RAISED *

1 - socIal programmes 50 256 236.59 27 768 208.05

2 - FundraIsIng cosTs 9 902 122.12 9 549 629.23

3 - operaTIng cosTs 3 885 079.75 2 868 723.44

I - ToTal expendITure recorded In The proFIT and loss accounT 64 043 438.46 40 186 560.72

II - charges To proVIsIons 54 518.00

III - ouTsTandIng commITmenTs on allocaTed FundIng 2 041 246.21

IV - surplus 1 286 648.87

ToTal general 67 425 851.54

socIal programmes 6 312 737.70

FundraIsIng cosTs 0

operaTIng cosTs and oTher expenses 0

ToTal (VolunTeer conTrIbuTIons, donaTIons In kInd) 6 312 737.70* collected from the public and used in this financial year

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To fund our work Doctors of the World depends on:

Donations and legaciesIn 2011, donations and legacies represented 63% of MdM’s income. A total of 32.1 million euros were contributed by 338,500 donors. This represents a slight decrease compared to 2010, which was an exceptional year because of the earthquake in Haiti, but is up 10% on 2009. Legacies accounted for €5.9 M in 2011, a significant increase of €1.5M compared to 2010.

Public institutional grants: These represent 29% of income. Around half of this income comes from the European Union, as humanitarian aid through the humanitarian agency ECHO or the development aid agency.

Private grants:These represent 7% of income and come from private foundations or businesses.

Income 2011 FOLLOW UP OF FUNDS RAISED *

Income collecTed From The general publIc

unallocaTed and unused aT The sTarT oF The FInancIal year 10 300 941.70

1- incoMe raised FroM The General PUblic 39 367 345.22 39 367 345.22

2 - oTher PriVaTe incoMe 4 282 871.62

3 - GranTs and oTher PUblic insTiTUTional FUndinG 18 068 783.92

4 - oTher incoMe 823 083.36

I - ToTal Income For The FInancIal year recorded In The proFIT and loss accounT 62 542 084.12

II - reVersals oF proVIsIons 70 000.00

III - carry ForWard oF allocaTed Income noT used

In preVIous years 4 813 767.42

IV - changes In dedIcaTed FundIng raIsed From general publIc (see

dedIcaTed FundIng Table) 10 167.24

ToTal (I+II+III+IV) 67 425 851.54 39 377 512.46

VI - ToTal expendITure FInanced by Funds raIsed From The general publIc 40 186 560.72

balance oF UnallocaTed FUnds raised FroM The General

PUblic and noT Used aT The end oF The Year 9 491 893.44

VolUnTarY worK (on naTional ProGraMMes) 3 820 754.20

serVices in Kind 0.00

GiFTs in Kind 30 908.50

VolUnTarY worK (on inTernaTional ProGraMMes)** 2 461 075.00

TOTAL 6 312 737.70

100% of donations received in 2011 were used during the year.

* from the general public for use in the financial year ** Under French law international volunteers are not paid a salary but do receive an allowance

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Doctors of t h e Wo r l d is a medical huma-nitarian NGO which runs healthcare and advocacy programmes in France and overseas. Depending on the context, particularly in armed conflict situations or during major natural disasters, these programmes require considerable finan-cial resources.

The majority of MdM’s income is raised from the general public, through dona-tions and legacies totalling €39.4M, and in the form of our volunteers’ efforts and gifts in kind valued at €6.3M in 2011.

In order to have a greater impact in our work with vulnerable populations, to ensure long-term sustainability of our work and to be able to carry out a large number of programmes, MdM also seeks grants from institutional or private funders.

Doctors of the World’smacro-economic model

Donations contribute to programme coordination, enabling us to ensure the quality and effectiveness of MdM’s work.

The income and expenditure account shows that, not only do donations from the general public directly finance our operations, they also have a multiplier effect by complementing institutional fun-ding and in this way fund more numerous and larger-scale programmes.

The income and expenditure account highlights the organisation’s macroeconomic model.

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Campaign 2011

Every year, more than 100 million people fall into poverty because of healthcare costs (WHO figures). This is particularly acute in low-income countries. In sub-Saharan Africa less than 10% of the population has health coverage. Universal health coverage is also a challenge in northern countries.

In France, reforms of health insurance undertaken in recent years (e.g. co-pay-ments, removal of some medicines from the list of refundable drugs, attacks on State Medical Aid, the AME, which is no longer free of charge) have only increased the financial difficulties that disadvantaged groups face in trying to access healthcare.

Limousines as ambulancesIn light of worsening health inequali-ties, Doctors of the World launched the Health is not a luxury! campaign in 2011 to reassert that health is not, and must not be, a luxury product. Limousine-ambulances to transport stretchers and doctors, reinforced display cabinets to show medicines, stethoscopes, vac-cines and Gold medical cards, trans-formed into precious protected objects.

All the symbols of luxury and exclusi-vity are used to create this provocative image which nonetheless resembles reality for the poorest populations trying to access healthcare.

Health is not a luxury!Health may be priceless, but it has a cost. This cost is becoming increasingly unaffordable for the most vulnerable in both so-called rich countries and low-income countries. For millions of people across the world, the requirement to pay for healthcare constitutes an insurmountable financial obstacle and is a major cause of impoverishment.

A simple message for the G20 chai-red by France in 2011Arriving in l imousines turned into ambulances, MdM doctors revealed a banner in the Place de la Bourse in Deauville on the opening day of the G8. Our doctors also delivered, letter by letter, a simple message to the G20 leaders during the meeting in Cannes between 3 and 4 November: Health is not a luxury!

Although the promotion of a basic level of universal social protection was on the agenda of the G20 meeting, chai-red by France, it was important for MdM that the issue of access to heal-thcare for all figured in the debate and that firm commitments were made to facilitate access to essential healthcare.

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Gold medical cards, limousine ambulances,

health is not a luxury for the most vulnerable.

MdM wanted to reach G8 leaders with a powerful message.

© Benoit Guénot

© Benoit Guénot

© Benoit Guénot

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Doctors of the World/Médecins du Monde62, rue Marcadet 75 018 Pariswww.medecinsdumonde.org

Tel: +33 1 44 92 15 15 Fax: +33 1 44 92 99 99

we are all docTors oF The world

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