How we spend your money

As an MSF donor, you can feel confident that we will use your money in a responsible, effective, and innovative way.

Our work is 100 percent funded by people like you who put their trust in MSF.

So, across more than 70 countries, including conflict zones, epidemics and natural disasters, we work hard to make sure that your donation is spent in an efficient way that ultimately saves lives.

Staff story: Making every penny count in South Sudan

"Every penny you donate helps us provide our life-saving work here – treating communities displaced by floods, people injured by conflict, survivors of sexual and gender-based violence, and children suffering from malnutrition, malaria and other diseases. Without MSF, many communities have no access to medical care.

"My role involves carefully scrutinising the expenditure of our projects and ensuring your money is spent on essential activities that benefit our patients and local communities.

"My team and I carefully analyse and monitor all costs for transparency and accuracy so that we can ensure money is getting to where it’s most needed. As both an MSF staff member and as a national of this country, I would like to extend my personal thanks for your ongoing support to MSF and the people we serve."

Ggale Sharim | Deputy finance coordinator in South Sudan

Caption

Ggale Sharim - MSF deputy finance coordinator in South Sudan

84p

OF EVERY £ DONATED PAYS FOR HEALTHCARE

£6.96

RAISED FOR EVERY £ SPENT ON FUNDRAISING

OF EVERY £ DONATED SPENT ON GENERAL SUPPORT COSTS

Four reasons to trust MSF with your donation

An MSF Land Cruiser passes by a military vehicle during unrest in Bangui, Central African Republic

1 | Your money keeps us independent

MSF UK does not take money from governments. We rely on the support of passionate individuals, as well as the institutions, foundations and companies they make up.

This independent funding means we have the freedom to act fast. We can stay neutral in complex environments and conflict zones, and we can provide impartial care to people regardless of ethnicity, religion or politics.

A young child in the Diffa region of Niger is screened for malnutrition

2 | Support without restrictions

MSF’s emergency teams can only launch a rapid response thanks to ‘unrestricted’ donations – money generously given to our general funds.

This means we don't always need to launch a charity appeal when a humanitarian emergency is in the news or wait for funding to be cleared. Instead, our teams around the world can act fast with valuable flexibility.

In short, our donors trust us to use their donations wherever the need is greatest.

An MSF midwife checks on the labour of a pregnant patient, rushed by boat to a remote hospital in Old Fangak, South Sudan

3 | Direct medical aid

MSF delivers healthcare directly to people in need. We set up and run medical services, build facilities, transport supplies and train staff ourselves.

In many places, we also support existing healthcare staff with professional development and resources – an investment that means life-saving healthcare will continue, even after we leave.

The money you give to MSF is spent by MSF.

MSF project coordination staff working at an office in Kinshasa, DRC

4 | Transparency

Money transferred to an MSF medical programme is carefully managed by expert project teams – including financial staff.

Funds are subject to a rigorous accounting system, with every penny logged and all the information flowing back to headquarters, offices and our donors. We believe transparency and accountability are essential.

We are also transparent about our charity appeals – we will only ever launch a campaign if we are certain that we can spend your money on that specific crisis. There are no hidden disclaimers that will divert your donation to other parts of the organisation.

Essential costs

Money donated to MSF is directed to crises wherever the need is greatest – this is coordinated across 23 offices and our projects in more than 70 countries around the world.

Funds meant for the frontline of a humanitarian emergency are never spent on international admin. However, there are essential running costs for any organisation and a very small percentage is spent in the UK.

For every £1 donated to MSF UK

84p goes directly to medical projects around the world
13p is reinvested in future fundraising – we raise £6.96 for every £1 spent
Just 3p is spent on UK running costs

Each aspect of the way we operate from our London office is designed to keep these essential costs low. We rent an inexpensive basement office, take the lowest fares for travel and stay in budget accommodation when working abroad.

Our finances: In-depth

Senior executive salaries at MSF UK

MSF UK is part of an international movement of entities – please note the figures on this page apply only to staff whose salary is set and paid by MSF UK.

What is the highest salary in MSF UK?

The highest salary in MSF UK is paid to our executive director, Dr Natalie Roberts. Natalie is eligible for an annual salary of £91,044 (as of 31 December 2022). There are no additional bonuses or performance-related additional payments.

This amount excludes pension contributions by MSF, which total 10 percent of the gross salary.

Doesn’t MSF UK have a 3:1 ratio between the highest and lowest salaries?

MSF UK has traditionally paid the most senior member of staff, usually the Executive Director, no more than three times the pay of the lowest-paid UK-based staff member.

However, in 2014 the MSF UK board decided to hold a long-overdue review of pay grades and benefits for all UK-based staff, and as part of that review the board reviewed its policy on setting the Executive Director’s pay.

The board decided in future to treat the 3:1 ratio as a guide rather than a rule in order to avoid a possible tension between either underpaying the Executive Director compared to equivalent roles or being forced to pay more for junior roles than is appropriate.

For the record, the director’s current salary of £91,044 is 3.4 times the lowest current MSF UK salary of £27,134.

How did the board set the Executive Director’s salary?

In considering the Executive Director’s new salary, the Board observed that a gap had opened up between what MSF UK was previously paying and what other parts of the MSF movement and London-based NGOs were paying their Chief Executives.

In setting the Executive Director’s new salary, the Board sought to set the salary at a level that was broadly competitive yet still modest, in keeping with MSF’s focus on maximising the use of funds for frontline work.

Exactly which factors were considered before the pay was set?

Salaries for comparable roles across MSF movement
Salaries of Chief Executives and Directors of similar-sized UK, London-based NGOs (based on voluntary sector salary surveys: XpertHR, Croner Reward)
Pay ratio between the Executive Director and other MSF UK office staff
Annual percentage salary increase given to other MSF UK office staff

When will the director’s salary be reviewed?

The Executive Director’s salary will be reviewed in April 2024 in line with the rest of the UK office.

Although the Board now uses the 3:1 ratio as a guide rather than a rigid limit, they will continue to ensure that the director’s salary remains modest yet sufficient to attract and retain the best candidate, and is published on our website.

What about other senior managers in the UK?

In 2022, three members of the MSF UK Management Team received a salary of between £50,000 and £60,000, six members received salaries of between £60,000 and £70,000, and three received a salary of between £70,000 and £80,000.

How much does MSF pay top executives elsewhere in the world?

We publish the highest and lowest salaries for all MSF offices worldwide as part of our commitment to transparency in financial reporting. The most recent data available (2022) is on page 37 of this document.

Annual accounts

Please find below copies of our annual accounts and activity reports. You can easily download them by right-clicking and choosing 'Save link as ...'.

MSF UK accounts

International MSF accounts

For international MSF accounts and activity reports, visit the activity report website.

Facts and figures

We are an independent, international medical humanitarian organisation. Your support allows us to provide medical aid whenever and wherever it is needed.

Eighty-four pence of every pound you donate is spent on our programmes. We try our utmost to make sure that your donations are spent on saving lives rather than on administration and management costs.

Income	2022		2021
	in million £	in percentage	in million £	in percentage
Private	71.64	93%	63.47	93%
Public institutional	0	0%	0	0%
Other*	5.19	7%	4.55	7%
Total	76.83	100%	68.02	100%

* Includes income from other MSF entities for the recruitment and remuneration of staff working in MSF projects.

How money is spent	2022		2021
	in million £	in percentage	in million £	in percentage
Operations	65.00	84%	61.25	86%
Fundraising	9.59	13%	9.16	12%
General support costs	2.36	3%	1.49	2%
Total	76.95	100%	71.9	100%

Our Investment Policy >