New Doctors Without Borders Book Reveals Perils of Negotiating Access to Crisis Zones

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“Humanitarian Negotiations Revealed: The MSF Experience” Reflects on Compromises Made in the Name of Humanitarian Action; Aims to Ignite Wider Debate

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Humanitarian negotiations have life-or-death consequences for people in need

In a new book launched in the U.S. today, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) takes readers behind the scenes of humanitarian action, revealing the complicated negotiations and precarious compromises required to negotiate access to populations trapped by armed conflicts and health crises.

Inspired by MSF’s fierce internal debates on the evolution of its independence as a humanitarian organization, "Humanitarian Negotiations Revealed: The MSF Experience" offers a candid, self-critical examination of MSF’s decision-making processes in a dozen countries, including Afghanistan, Myanmar, Somalia, Sri Lanka, and Yemen.

The book, released in conjunction with MSF’s 40th anniversary, reflects on MSF’s medical humanitarian efforts over several decades—some successful, some less so—and aims to ignite wider discussions of humanitarian ambitions and the best ways of fulfilling them.

“Humanitarian negotiations have life-or-death consequences for people in need,” said Sophie Delaunay, executive director of MSF-USA. “As MSF weighs the risks of delivering humanitarian aid in precarious situations, such as Somalia, it seems more important than ever to lift the veil that often obscures the difficult choices our teams confront on a daily basis.”

The book consists of a series of case studies, followed by thematic essays, which examine the delicate balance between upholding MSF’s founding principles of independence, neutrality, impartiality, and speaking out, and the practical realities of delivering humanitarian aid in complex and dangerous political environments.

The authors—MSF veterans with many decades of collective field experience—chronicle MSF’s experience in 12 countries: Afghanistan, Ethiopia, France, the Gaza strip, India, Myanmar, Nigeria, Pakistan, Somalia, South Africa, Sri Lanka, and Yemen. Journalist David Rieff contributes an afterword in the book.

In conjunction with the launch, MSF will present a live, interactive webcast, At Any Price? Negotiating Access to Crisis Zones, free and open to the public, on Tuesday, January 31st, at 8:00pm EST. A panel of experienced MSF aid workers, including Michael Neuman, one of the authors and editors of the book, will discuss their experiences in conducting humanitarian negotiations in the field.

Panel discussions, featuring editors of the book and other guest speakers, will be held at the Boston Public Library on Wednesday, February 1st, at 7:00 pm, and at New School’s Tishman Auditorium in New York City on Thursday, February 9th, at 7:00 pm. Both events are free and open to the public; register online at:

"Humanitarian Negotiations Revealed: The MSF Experience" follows MSF’s 2004 publication, "In the Shadow of Just Wars," and continues the Populations in Danger series produced by MSF’s research center in Paris, CRASH - Centre de Reflexions sur l’Action et les Savoirs Humanitaires (Center for Reflection on Humanitarian Action and Knowledge).

"Humanitarian Negotiations Revealed: The MSF Experience" (ISBN 978-0-231-70315-4) is being published by Columbia University Press. The book can be pre-ordered online from or Columbia University Press, and will available in bookstores by the end of February.


Advance praise for "Humanitarian Negotiations Revealed: The MSF Experience":

“With a refreshing honesty, it explores the thin line that humanitarian agencies tread between saving lives and supporting oppressors. This brave and informative book reconfirms MSF as an organization that thinks as well as acts.” – Mark Duffield, Professor of Development Politics and Director, Global Insecurities Centre, University of Bristol

“This is a very valuable book. It shows one of the world's great humanitarian organizations thinking aloud about the difficult choices it faces as it struggles to save and protect human life.” – Dr. Hugo Slim, Oxford Institute of Ethics, Law and Armed Conflict, University of Oxford

Doctors Without Borders/Médecins Sans Frontières (MSF) is an international independent medical humanitarian organization that delivers emergency aid to people affected by armed conflict, epidemics, natural and man-made disasters, and exclusion from health care in more than 60 countries and was the recipient of the 1999 Nobel Peace Prize. For more information, please visit


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