Movement roles project/Peer organizations/Models/MSF

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Médecins San Frontières (Doctors Without Borders) is a volunteer-driven membership organization working globally. It is structured as an association of associations:

  • Each constituent part of MSF is a membership organization, governed by its members
  • Individual membership requirements standardizing worldwide: current or past volunteer or staff member
  • Constituent organizations are ordered into 5 operating centers (the original 5 MSF countries: France, Belgium, Spain, Switzerland, and the Netherlands) which each appoint one international board director and two delegates to the International General Assembly; 14 other country organizations (e.g. Germany, USA, UK) which each send two delegates to the general assembly; and 11 other membership organizations that are not yet represented in global governance. The International General Assembly meets annually to appoint seven more board directors and decide whether countries should be admitted (or expelled).
  • Resources are raised almost entirely by the 19 country organizations from the developed world
  • Decision-making is different according to different kinds of decisions, e.g.
    • Chief executives of five operating centers can respond quickly to humanitarian disasters globally
    • International board makes global strategic decisions
    • General assembly admits new member associations
    • Field managers make decisions concerning safety of volunteers in their country

Three reasons why users like this model[edit]

  1. Associative: led by members
  2. Global: it can move resources to disasters from wherever they are
  3. Local: it raises resources in 19 developed countries

Three concerns of users about this model[edit]

  1. Expensive: overhead is needed for all the coordination among different national bodies, and is sometimes duplicated
  2. Hard to make work: the complex sets of bodies can be hard to coordinate – the network has reorganized periodically. Tellingly when MSF recently examined its own design and reorganized it also look to other NGOs for good practice, and studied Wikimedia hard.
  3. Exclusive: Individual membership is only open to people who have worked for MSF (which can be in paid or volunteer capacity); only 19 country organizations participate in global decisions; at least 50% of senior roles must be filled by medics.

Example of Response to a Crisis[edit]

Keeping the MSF movement together has not always been easy. In 1985 it almost fell apart because of a disagreement over priorities: delivering aid vs. speaking out for the suffering in Ethiopia.

"... after a billion people watched Bob Geldof's televised Live Aid concerts for famine relief, MSF watched Ethiopia's Communist dictator, Colonel Mengistu, abuse that aid. With the vehicles, cash and food he received from international donors, Mengistu moved people from the drought ravaged north to the more fertile south. On the surface, the plan seemed logical, but soon it became clear that Mengistu was using the promise of food to uproot people against their will, often with the consent of aid organizations - some were not allowed to distrubute food to hungry children unless their parents agreed to the resettlement plan. But because the organizations wanted to remain in Ethiopia and help where they could, they kept silent – including MSF Belgium. The French section, however publicly denounced the Mengistu regime and was promptly expelled from the country in December 1985. ... relations strained further after the sections disagreed over how to respond in Ethiopia, and the Paris office launched a lawsuit to try to prevent the Belgians from using the MSF name ..."[1]

Similar Models[edit]

A number of other global NGO movements have been integrating step by step in recent years. They have tried to adopt more global designs to have more impact, one voice and better utilization of resources. 'Integrators' such as WorldVision have been able to grow, some by a factor of 3x in a decade, and claim a commensurate or greater increase in impact. This, they would argue, justifies the investment in integration: reorganization, coordination, communication, etc. Accenture Development Partners is a philanthropic arm of Accenture which helps many global NGOs lower costs by consolidating sub-scale national functions into global or regional capabilities.[2].

Save the Children is transforming from a 'movement' to an 'organization'

  • Founded in 1919 in UK and replicated in other developed countries over decades, with each 'replicant' operating in the developing world, often alongside or overlapping other 'replicants'
  • Twenty years ago was more of a 'movement' than an organization, with little ability to coordinate quickly, e.g. responses to global disasters
  • Different constituent parts of Save the Children (developing country NGOs) operating in the same developing country now share a 'unified presence', e.g. shared office space, especially when national organizations are too small to deliver scale in many functions
  • Save the Children has developed an international board with global capabilities to act in the field

Oxfam has become a tighter network around a shared name

  • Founded in 1946 in UK and now replicated in a variety of countries, e.g. Oxfam America
  • Twenty years ago had no regular meeting to make movement-wide decisions
  • Has developed ability to act coherently globally, partly to respond to humanitarian disasters, and partly to be able to advocate clearly and cogently on development issues

Teach for All has tried, from the start, to build in global coherence into what is already a loose, multi-brand network of Teach for America, Teach First, Teach First Deutschland and others, too.

Each of these movements to some degree customizes the role of each national member, giving stronger national members a global lead role on an issue or capability, and ensuring that each national chapter "contributes" more to the movement over the long haul than it "costs" by adjusting roles and responsibilities dynamically. For example, Action Contre La Faim (Action Against Hunger) gave the UK organization global responsibility for evaluation and links to schools of tropical medicine.

Other NGO movements that have actively integrated into global networks include Habitat for Humanity International, Opportunity International, and Greenpeace.


  1. Dan Borlotti, 2006. "Hope in Hell: Inside the World of Doctors Without Borders". Firefly.
  2. M. Ryan and J. Crowley, 2011. "Greater than the "Sum of the Parts"? Getting in Shape? How to make a large international NGO be more than the sum of its parts". ADP.