As part of its health activities and political commitments, Médecins du Monde’s mission is to ensure universal and sustainable access to quality healthcare for all, without discrimination or judgment. This mission is based on an essential approach: providing healthcare, bearing witness, advocating and supporting people in their desire for social change.
Thus, the healthcare services provided or supported by MdM must meet requirements that pertain not only to the quality of medical and pharmaceutical practices but also to the overall quality of all health project activities. In its projects, the organization is committed to providing a welcoming environment that supports the mental health of the people it serves. It also incorporates a positive approach to gender in its health activities, while encouraging active participation to strengthen individuals’ empowerment.
Furthermore, some of MdM’s battles are accompanied by the organization’s positions, notably aimed at decriminalizing certain practices. It is essential that every actor of MdM actively supports these efforts.
SEXUAL AND REPRODUCTIVE HEALTH AND RIGHTS (SRHR)
Freely enjoying one’s sexuality—safely and without violence, without fearing unintended pregnancy or infection—is a key health issue. However, accessing reliable, non-judgmental information and prevention and care services to understand and embrace one’s sexuality remains a major challenge in all the countries where we operate.
In crisis contexts, the risks of maternal mortality and sexual violence are heightened. Vulnerable populations are disproportionately exposed to the risks of infectious diseases, unintended pregnancies, genital cancers, and sexual, physical, and psychological violence.
This is why Médecins du Monde advocates for universal access to sexual and reproductive health and rights (SRHR).
SRHR ensure that every individual can:
Exercise their sexual and reproductive rights, including the right to bodily autonomy, to choose when to have a child, to decide whether to have sex, to marry, and with whom. When these human rights are denied, sexual and reproductive health is impeded.
Access sexual and reproductive health services to support their choices and meet their needs. These essential services are varied and not limited to controlling Sexually Transmitted Infections (STIs) and issues related to pregnancy, childbirth and postnatal care. They also include prevention and management of genital cancers, comprehensive sexuality education, access to contraception or abortion, and management of fertility disorders.
Given these many issues, Médecins du Monde focuses on three aspects of the sexual and reproductive health care continuum that are too often neglected:
Prevention and management of unintended pregnancy
Prevention and management of cervical cancer
Access to SRHR in crisis situations, with a particular focus on preventing and responding to sexual, physical and psychological violence
Access to Safe Abortion
Médecins du Monde advocates for the decriminalization of abortion. Médecins du Monde defends the recognition of every individual’s right to have children or not, to choose the number of children, and to decide on the spacing between births. Therefore, every woman must have the option to use contraception to avoid unwanted pregnancies and, if necessary, access safe and legal abortion. MdM adopts a pro-choice approach.
MIGRATION, EXILE, RIGHTS & HEALTH (MERH)
Migrants, including unaccompanied minors, encountered in the areas where we operate, are victims of repressive and abusive policies, both in their migration journeys and in the so-called host countries, which have a negative impact on their health and access to rights.
MdM advocates for:
Access to rights and healthcare throughout the migration journey
Dignified and unconditional reception that ensures access to fundamental rights, including the right to safety, health, housing, and children’s rights
Access to appropriate protection and care for unaccompanied minors in France
The elimination of all forms of violence during migration journeys or in host countries
Protection against cruel treatment
In France and internationally, we provide medical care to people excluded from healthcare services due to their administrative status, and support them in accessing mainstream rights.
Whenever attacks are made in France against the rights of foreign individuals, and consequently against their right to health, we engage in advocacy to counter these attacks.
Everywhere, we advocate for appropriate services and recognition of access challenges, particularly sociocultural or linguistic barriers (such as access to translation and peer education). We also fight against discrimination, stigmatization, and exclusion.
In France, we advocate to ensure that children and adolescents are cared for by child protection services.
HARM REDUCTION (HR)
Harm reduction is a pragmatic approach aimed at minimizing risks associated with the use of psychoactive substances and/or sex work. These risks primarily concern health, including exposure to HIV, hepatitis, sexually transmitted infections (STIs), and violence.
Harm reduction has a political dimension because it generally involves populations that are discriminated against and stigmatized due to their practices. It is also connected to issues shaped by ideologies and/or societal perceptions.
This approach, grounded in public health and human rights, is based on the principle that the individuals concerned may not want to, or may not always be able to, change their way of life. It asserts that no preconditions should be imposed on the exercise of their citizenship or their access to healthcare and rights.
Despite strong moral opposition in certain contexts, harm reduction, initially illegal, has emerged as an effective public health response. Today, this approach is recognized by the international community and recommended as the most effective method to ensure meaningful access to comprehensive healthcare for people who use drugs, sex workers, and LGBTQI+ people.
MdM advocates for:
The elimination of repressive policies that drive individuals into hiding, force them to conceal their practices, and push them away from prevention and healthcare services
A legal framework and public policies that enable the establishment of sustainable harm reduction programs, effective access to these services, and the recognition and funding of community-based organizations
The removal of all criminal and administrative sanctions related to drug use for minor, non-violent offenses
A legal framework for regulating the production, sale, and use of drugs
The decriminalization of sex work
Sex Work
Due to the harmful effects of laws that criminalize sex workers, restrict their capacity to act, hinder their emancipation, and contribute to their social stigmatization, Médecins du Monde-France advocates for the decriminalization of sex work. The organization also calls for the effective and sustainable implementation of international and national legal frameworks that protect individuals facing exploitation and vulnerability. Médecins du Monde firmly rejects any homogeneous or compartmentalized portrayal of sex work. Public policies on the protection and health of sex workers must take into account the diversity of their circumstances and respond in a tailored manner to the variety of individual situations. This includes addressing factors such as age, sexual orientation, and gender identity.
The environment in which people live and work has a positive or negative impact on their health. A degraded environment is detrimental to health: lung diseases, untreated wounds, difficulties in follow-up and access to treatment, disrupted continuity of care, and unrecognized occupational diseases, and therefore difficult to manage for those who suffer from them.
Médecins du Monde works with people facing degraded living and/or working conditions to address the root causes, propose solutions, and improve access to healthcare.
The challenge also lies in recognizing the impact of all these factors on people’s overall health and the importance of addressing them, particularly in public health policies. Furthermore, exposure to health risks associated with unhealthy or informal housing and precarious or informal work is compounded by systematic rejection, expressed on a daily basis, by residents, elected officials, and the media. This rejection disproportionately affects marginalized populations who face discrimination and are in vulnerable situations.
MdM advocates for:
Access to healthcare, health promotion, clean water, sanitation, garbage collection services, and hygiene services regardless of people’s leaving conditions
The effective clearance of slums and informal settings in France, regardless of the origin of the people living there, through comprehensive policies that ensure the participation of people concerned in developing alternative solutions
Combating all factors degrading the health of workers in precarious conditions, particularly the harmful use of pesticides
Implementing risk reduction measures to address the mental and physical health of people affected by poor living and working conditions
Integrating the specific needs of people facing degraded living or working environments into health policies
(Currently, this battle is being waged only in France)
Considering health as a fundamental and inalienable human right, MdM advocates for a healthcare and prevention system guaranteed by public authorities, ensuring equal access to health and rights for all, based on the principles of equity, solidarity, and user involvement. We are mobilizing for a system of protection and universal health coverage. We are fighting for health insurance, as well as prevention and care structures, that meet the healthcare needs of everyone across the entire territory, both in mainland France and in the overseas territories.
3 sub-themes:
Access to Health Rights
Access to Care and Prevention Services and Facilities
Effective Access to Quality Medicines and Health Technologies
MdM-F operates in numerous crisis contexts. We are witnessing an intensification of crises: conflicts, food insecurity, the impacts of climate change, gender inequalities, and the paralysis of the multilateral political system are overlapping to create increasingly complex and long- lasting crises.
Crises impact people’s health and lead to:
Violation of the right to health and disruption of access to healthcare
Increased vulnerability of individuals
Weakening of states and healthcare systems
Creation of specific health needs
In these various crisis contexts, MdM has observed:
Non-compliance with international law and humanitarian principles
A significant reduction in humanitarian space, limiting our ability to act
International humanitarian law (IHL) states that even wars have rules and aims to protect civilian populations during conflict, but it is not respected. It is the role of MdM, alongside other actors, to remind all parties involved in a conflict (both states and armed groups) of the existence of these laws and to call for their compliance. Furthermore, third-party states have a legal obligation to ensure that IHL is respected.
MdM also emphasizes that humanitarian actors operate according to the principles of humanity, impartiality, neutrality, and independence, and calls on all state and non-state actors to respect these principles.
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