In 2022, Doctors Without Borders/ Médecins Sans Frontières (MSF) teams responded to complex and interconnected emergencies in 78 countries as war, climate-related disasters and forced displacement drove humanitarian needs. Core to our work remained the act of bearing witness – amplifying the voices

of those we assisted and speaking out about what we saw and heard while delivering medical care. In doing so, we aimed to draw the world’s attention to crises and stand in solidarity with people experiencing emergencies firsthand. Thank you for being part of our work.

Once again, we assisted people affected by extreme weather events such as floods in South Sudan and South Africa, drought in Somalia and cyclones in Madagascar and the Philippines. In January, our teams provided treatment to children with malnutrition on the outskirts of N’Djamena, Chad, in what was the driest and shortest rainy season many people could remember. Several months later, our teams assisted communities in the same area, as thousands of people were displaced by flooding due to abnormally high seasonal rains.

In June, Pakistan was swept by severe floods, putting one-third of the country underwater. Some areas were still flooded more than three months later. The devastation displaced over 30 million people and left thousands dead and injured. MSF teams provided medical and nutritional care as well as water and sanitation support for people across Sindh and Balochistan provinces.

We swiftly increased our humanitarian response in Ukraine following the dramatic escalation of violence when Russian forces conducted large-scale attacks across the country. MSF provided staff and materials, as well as training to Ukrainian surgeons and other healthcare workers to help them cope with large influxes of wounded patients.

The escalation of war in Ukraine posed several challenges for MSF teams and we had to adapt new ways of reaching people amid fast-moving frontlines. This included using specially designed medical trains to transport patients away from danger zones and running mobile clinics in shelters for people who had been displaced. At the same time, we opened hotlines to provide tele-healthcare support for people with chronic conditions.

Consequences of the war in Ukraine were felt well-beyond Europe, worsening other less reported emergencies. Compounded by wide-spread global economic decline, a lack of food and a surge of diseases including measles left millions of children at risk of malnutrition. MSF teams responded to alarming rates of malnutrition in Nigeria, Ethiopia, Kenya, Afghanistan, Chad and Yemen during the year.

Climate change, water scarcity and conflict also contributed to a resurgence in cholera globally, with more than 30 countries recording cases or outbreaks last year. MSF responded to this highly contagious disease in at least 10 countries, including Cameroon, Democratic Republic of Congo, Kenya, Niger and Syria.

The UN estimated that nearly 100 million people were forcibly displaced around the world last year. Some were caught at Belarusian, Latvian, Lithuanian or Polish borders, where they were met with frequent and often violent pushbacks. From the beginning of the year, hostile policies restricted our access to people in need of medical assistance. The war in Ukraine revealed a stark double standard in European migration policies: entry to EU countries was swiftly facilitated for millions of Ukrainians fleeing violence, while others seeking asylum in Europe were harshly denied entry.

In spite of widespread humanitarian needs, rhetoric against nongovernmental organizations (NGOs) continued in some parts of the world. In December, edicts were issued banning female NGO workers in Afghanistan, with an informal exemption for those working in healthcare. While MSF can retain women on our teams – for now – we are deeply worried about the longer-term and what impact this will have on the health and well-being of women and girls in the country.

We also witnessed the criminalization of humanitarian assistance in some places, including Mali and Niger. This has made it extremely difficult to reach people caught in a decade-long conflict along the Sahel border region of Niger, Mali and Burkina Faso that saw rocketing insecurity and displacement levels last year.

Despite challenges, our teams continued to deliver emergency care to millions of people, many of whom had no other access to healthcare. This work was made possible thanks to nearly seven million donors, who together raised $3.08 billion – more than 97 per cent of our funding last year. This independent funding enables our rapid impartial response to communites around the world and inspires us to speak out about what they experience.

We are deeply grateful for your support. Thank you.