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

80p

OF EVERY £ DONATED PAYS FOR MEDICAL OPERATIONS

£6.53

RAISED FOR EVERY £ SPENT ON FUNDRAISING

OF EVERY £ DONATED SPENT ON SUPPORT AND OVERHEAD 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 crisis appeals – we will only ever launch a campaign if we are confident that we can spend your money on that specific emergency. 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 26 offices and our projects in more than 75 countries around the world.

We aim to maximise the funds spent on medical operations and humanitarian emergencies. However, there are essential running costs for any organisation and a small percentage is spent in the UK.

For every £1 donated to MSF UK

80p goes directly to medical operations around the world
12p is reinvested in future fundraising – we raise £6.53 for every £1 spent
Just 8p is spent on support and overhead costs

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 £96,586 (as of 31 December 2023). 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.

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

In 2023 the MSF UK board decided to hold a long-overdue review of pay grades for all UK-based staff, and as part of that review the board reviewed its policy on setting the Executive Director’s pay. 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.

The Board reaffirmed its 2014 decision to treat the historic 3:1 ratio between highest and lowest salaries as a guide, rather than 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.

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 2025 in line with the rest of the UK office.

What about other senior staff in the UK?

In 2023, 16 members of MSF UK staff received a salary of between £60,000 and £70,000, 10 staff received salaries of between £70,000 and £80,000, three received a salary of between £80,000 and £90,000, and two received a salary of between £90,000 and £100,000.

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

Income	2023		2022
	in million £	in percentage	in million £	in percentage
Private	79.53	93%	71.64	93%
Public institutional	0	0%	0	0%
Other*	5.73	7%	5.19	7%
Total	85.26	100%	76.83	100%

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

How money is spent	2023		2022
	in million £	in percentage	in million £	in percentage
Operations	67.54	80%	62.93	82%
Fundraising	10.16	12%	8.72	11%
General support costs	6.34	8%	5.31	7%
Total	84.04	100%	71.9	100%

Our Investment Policy >