2025 Annual Report

Edito

The beginning of 2025 saw severe disruption to the humanitarian landscape with the closure of the American international development agency, USAID. The shock decision by the Trump administration had devastating repercussions for the sector, as 75.9 billion dollars of scheduled funding were cancelled. This climate of declining public funding presents profound challenges for
the lives of millions of people and for the capacity to act of organisations that seek to support them.

AN IDEOLOGICAL AND FINANCIAL OFFENSIVE

The reduction in funding is having far-reaching effects for all of us, as armed conflicts continue,
international humanitarian law is violated with impunity, and economic crises and environmental
threats accentuate vulnerability and inequality.

Apart from budget cuts, these changes are evidence of a profound ideological reversal. Western
democracies are now pursuing policies that are openly hostile to human rights, questioning the
principles of solidarity, imposing conditions on aid, restricting access to those in need and delegitimising the activities of independent organisations on the grounds that they no longer promote the “right” values. This drift towards illiberal attitudes represents a direct threat to our mission, our freedom to act and our role as a constructive civil society counterweight.

This new hierarchy of values based on failure to respect rights is illustrated particularly vividly by
the way major conflicts are treated. In the case of Gaza, Sudan and the Democratic Republic of
the Congo (DRC), the international community has displayed a glaring inability to protect civilian
populations and ensure respect for international humanitarian law.

In Europe and France this tendency is seen in the rise of extreme right-wing populism, increased
repression and administrative harassment of organisations, founded on a deliberate tactic of
confusing civil society campaigning with partisan activism. Our chapters find themselves accused
of supporting particular ideologies, encouraging migration or maintaining links with terrorist groups. These repeated and baseless attacks seek to restrict the freedoms of NGOs and delegitimise a discourse that is founded on medical ethics and local expertise developed on the ground.

As around 305 million people are currently in need of urgent humanitarian assistance, the funding
cuts are having direct and dramatic impacts on individuals, primarily women and gender minorities. These impacts include limited access to healthcare, disruptions to the supply of medicines, vaccination campaigns being halted, the closure of essential HIV programmes and gender-based violence services, as well as restrictions on access to sexual and reproductive healthcare.

In the face of ever increasing pressures, Médecins du Monde is fully embracing its role and resisting
these changes by defending a vision of the world based on values of solidarity, freedom and respect for human rights through universal access to healthcare and reducing inequality.

RESISTANCE DESPITE PRESSURE

Internationally, we have continued our work with resolve and determination, remaining realistic
about the constraints we face but always steadfastly focused on the impact of our actions.

In the Middle East, restrictive imperialist and colonial policies are fuelling a crisis of humanity.
Working in Lebanon, Palestine, Syria, Yemen and Iraq, Médecins du Monde reiterates that humanitarian assistance must never be politicised and must be provided unconditionally – the needs of communities must constantly be front and centre.

Our teams have been working tirelessly in Gaza, despite the extreme genocidal violence and a ceasefire that has proved to be a fantasy, with over 500 deaths since it was announced in October
2025. We keep working even amid the monumental destruction and drastic deterioration in access to healthcare. Today they face the very real threat of expulsion, even though the humanitarian needs remain acute, with food insecurity, a health system that has been destroyed, and injured and sick people deprived of appropriate care and any possibility of evacuation.

In Syria the fall of the regime of Bashar al-Assad has enabled our teams to return and gradually
resume their activities in a context that remains fragile but offers glimmers of hope.

We continue to address so-called “forgotten” crises that are still wreaking havoc far from the spotlight. In the DRC, a chronic humanitarian crisis was exacerbated by the capture of the city of Goma in January 2025 and the spread of violence in the east of the country. Médecins du Monde has been in the DRC for a long time and, in a context where over five million people have been displaced, we’ve stepped up our emergency response, focusing particularly on sexual and reproductive health and rights.

We also remain committed to our work in Latin America, especially in Mexico and Colombia and in
connection with the Venezuelan crisis, as well as in Ukraine, where needs are still acute.Everywhere
we work we are alert to attacks on women’s rights, which are aggravated by the reinstatement of
policies such as the Global Gag Rule which prevent access to contraception and abortion.

AN INCREASINGLY HOSTILE CLIMATE

In France, the weakening of international solidarity has been accompanied by concerning developments at the national level. The draft finance bill provides for an €800 million cut to public development aid in 2026. This situation is undermining public health responses and putting effective access to fundamental rights at risk.

The advance of extreme right-wing ideas and the radicalisation of political discourse are a threat to
civil society. Campaigning organisations frequently come under attack, which contributes to a climate of suspicion and greater restrictions being placed on organisations through administrative and security measures.

Despite all this, our work goes on with commitment and determination. We have been active in France for forty years and we are continuing to work with migrants, for example in Calais and Briançon, in situations where access to rights and healthcare is deteriorating. In 2025, which marked the 80th anniversary of the social security system in France, we continued to advocate
for a solidarity model of universal health coverage, for example with the publication of the report by the Observatory on Access to Rights and Health, which contained revealing evidence about
inequalities in access to healthcare.

Our teams were actively engaged in advocacy work during the local elections, in anticipation of
the activities we are preparing for the run-up to the presidential election in 2027.

In 2025, Médecins du Monde was actively involved in tackling environmental inequality, campaigning on the links between health and the environment. France’s Duplomb Law was eventually adopted with amendments in July 2025, despite strong popular opposition in which we were involved. The law illustrates the threats posed to public health and independent scientific expertise. Alongside patients, doctors and researchers, Médecins du Monde continues to call out policy decisions that inhibit the right to live in a healthy environment and which serve private interests at the expense of the interests of the public and downplay public health inequalities.

In a social and political climate that is becoming ever more repressive, we remain fully committed
to solidarity with communities that are particularly stigmatised, such as people who use drugs
and/or are involved in sex work. Ten years after the enactment of the law criminalising users of
paid sexual services, policies that criminalise sex work continue to undermine access to healthcare
and rights.

In April 2025, Médecins du Monde filed two lawsuits challenging the government’s obstruction of the implementation of a harm reduction policy for people who use drugs. We raised awareness of the urgent need to extend and ensure the long-term sustainability of addiction treatment centres which are essential in providing healthcare and access to rights for people who use drugs.

DEVELOPING A STRONG AND COMMITTED ORGANISATION

Médecins du Monde is a campaigning humanitarian medical organisation. Our teams of employees and volunteers work within a democratic, transparent structure that is responsive to the people who constitute it. In a humanitarian sector experiencing significant tensions and a global climate of profound anxiety and concern, we take very seriously the quality of life and working conditions of our teams, because they are the foundations on which the sustainability and future of our work depends.

We have prioritised opportunities for dialogue and appropriate regulation to respond to the realities on the ground. This has also been the guiding principle in the implementation of a new alert management strategy which seeks to improve risk prevention, enhance team safety and provide more structured support with a focus on responsibility and care.

We also continued to work on projects that will shape the future of our organisation. In May 2025
the Board approved a review of our statutes, to be followed by a review of our internal regulations.
The aim is to ensure our governance meets the needs of new operational realities. The implementation of our strategy for France, as well as future developments within the organisation, particularly through consolidation of the regional offices, form part of ongoing efforts to simplify missions, decentralise decision-making and strengthen engagement. Between September 2025 and June 2026, weorganised regional assemblies for regional offices to elect new members to MdM’s regional councils and we call on everyone to get involved in the shared and democratic leadership of our activities.

Finally, Médecins du Monde France is fully integrated into an International Network of 17 organisations based on solidarity and synergy between its members. In the current climate of declining institutional funding, we remain determined to contribute to stronger collective governance and a more balanced development of the Network, in particular through the involvement of new members from the Global South.

As we face attacks on rights, the rise of identity politics and worsening health, social and environmental inequalities, Médecins du Monde will continue to take action, provide care and bear witness. Our commitment remains strong, supported by the energy of our teams of staff and
volunteers, partners, donors and members, as well as everyone who shares our values of solidarity and freedom. Our thanks to all of you.