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.

Between 1988 and 2008, the humanitarian aid budget increased ten-fold to reach 11.2 billion US dollars.

There is, however, a space for negotiation, power games and interest-seeking between aid actors and authorities. MSF’s freedom of action is not rooted in a legal and moral “space of sovereignty” that simply needs to be proclaimed in order to be automatically acknowledged and respected. It is the product of repeated transactions with local and inter

“blurred distinctions between the roles of military and humanitarian organisations; political manipulation of humanitarian assistance [and the] perceived lack of independence of humanitarian actors from donors or from host governments”.

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.

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

independence, neutrality and impartiality—as

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.