if we consider that humanitarian aid is not an exact science but an art, then the essence of this art is to create and maintain the conditions of its existence—to generate interest, make itself useful, identify conjunctures that could be propitious for change—and to be capable at all times of modifying the balance of power, creating a hiatus,

All societies inevitably generate their quota of victims—their excluded populations—groups with no share in society, who are doomed to a violent death or to be deprived of things that are essential to their survival (water, food, shelter and medical care).

If, by its actions in a given context, MSF cannot hope “to reduce the number of deaths, the suffering and the frequency of incapacitating handicaps within groups of people who are usually poorly served by public health systems”,13 then the compromises it agrees to are neither justifiable nor acceptable.

“that blurry, but very real, line beyond which assistance for victims imperceptibly turns into support for their tormenters”.

But by treating people without challenging the political and social origins of their exclusion, is MSF not confining itself to the role expected of it by the authorities?

Negotiation frameworks do not include universal markers indicating the line that must not be crossed; and MSF must therefore pay attention to the developing dynamic of each situation and to its own ability to revoke compromises that were only acceptable because they were temporary.

As the interview with Benoît Leduc on MSF’s project in Somalia demonstrates, “everything is open to negotiation”. No parameter is fixed from the outset: the safety of personnel, the presence of expatriates, MSF’s intervention priorities, the quality of the assistance provided, control over resources, etc.

independence, neutrality and impartiality—as

Because acknowledging that humanitarian aid is only possible when it coincides with the interests of the “powers that be” does not have to mean giving way to political forces.