Technical Report > Policy Brief
Smiley S, McIver L, Schwerdtle PN, Lugli M, Claire A, et al.
2021 October 21
This brief details MSF’s experiences providing humanitarian assistance in contexts heavily affected by climate change; adapting our operations to climate-related threats; and working to reduce our environmental impact. Much like the process of ‘greening’ this vast, global movement, this brief is incomplete, imperfect: it tells an infinitely complex story from a limited range of perspectives, and poses more questions than it answers as we grapple with emergent facts. Given the imminent existential threat presented by current levels of environmental degradation, these limitations can probably be forgiven. But as we witness the human toll and deep injustice of the climate crisis, silence is, once again, not an option.
Technical Report > Policy Brief
Baxter LM, Cowan K, Devine C, Guevara M, Kalub D, et al.
2022 October 27
As an independent international medical humanitarian organisation responding to health crises in more than 70 countries, Médecins Sans Frontières/Doctors Without Borders (MSF) is seeing first-hand the suffering caused or exacerbated by climate change and environmental degradation, most often experienced by the most vulnerable people. We are witnessing how climate change directly threatens health – for example, through death and injury due to extreme weather – and how climate change impacts health indirectly, through food insecurity and shifting patterns of climate-sensitive infectious diseases.
Recognising the role of the climate crisis in amplifying humanitarian needs, MSF is adapting its operations to be more responsive to the populations it serves while also facing up to the challenges of measuring and reducing its own environmental footprint.
Recognising the role of the climate crisis in amplifying humanitarian needs, MSF is adapting its operations to be more responsive to the populations it serves while also facing up to the challenges of measuring and reducing its own environmental footprint.
Conference Material > Slide Presentation
Smiley S, Devine C
MSF Scientific Days International 2021: Innovation. 2021 May 20
Conference Material > Video
Smiley S
MSF Scientific Days International 2021: Innovation. 2021 May 20
Technical Report > Policy Brief
Blume C, Dallatomasinas S, Devine C, Goikolea I, Guevara M, et al.
2023 November 15
Most of the over 70 countries Médecins Sans Frontières /Doctors Without Borders (MSF) works in are in lower-income regions. They are facing not only humanitarian crises but also the most severe impacts of the climate emergency. In 2023, MSF continued to witness and respond to the consequences of extreme weather events around the world, including unprecedented flooding in South Sudan, severe cyclones in Myanmar and Madagascar, and the relentless heat and extended droughts that have driven millions to the edge of starvation throughout the Horn of Africa. This year, the organisation has also responded to epidemics of climate-sensitive diseases, including multiple concurrent cholera outbreaks and the rise of dengue and malaria in several areas, including in conflict-affected settings.
In a time of polycrisis, a simultaneous occurrence of multiple catastrophic events, MSF and other aid organisations are already struggling to meet the rising health and humanitarian needs. If human activities contributing to climate change and environmental degradation go unabated and unaddressed, including the continued dependence on fossil fuels, these needs will only escalate. With each fraction of a degree of global temperature rise, there will be further limitations on adaptation, and reckless losses and damages to lives, livelihoods, and general well-being.
Drawing on evidence from indicators in the 2023 Report of the Lancet Countdown on Health and Climate Change, MSF builds on previous experiences and messages with a focus on three key areas: MSF’s ongoing efforts to reduce its environmental impact; the challenges of adapting emergency humanitarian operations in a rapidly warming world; and the consequences of climate change when the capacities of communities to adapt are surpassed
In a time of polycrisis, a simultaneous occurrence of multiple catastrophic events, MSF and other aid organisations are already struggling to meet the rising health and humanitarian needs. If human activities contributing to climate change and environmental degradation go unabated and unaddressed, including the continued dependence on fossil fuels, these needs will only escalate. With each fraction of a degree of global temperature rise, there will be further limitations on adaptation, and reckless losses and damages to lives, livelihoods, and general well-being.
Drawing on evidence from indicators in the 2023 Report of the Lancet Countdown on Health and Climate Change, MSF builds on previous experiences and messages with a focus on three key areas: MSF’s ongoing efforts to reduce its environmental impact; the challenges of adapting emergency humanitarian operations in a rapidly warming world; and the consequences of climate change when the capacities of communities to adapt are surpassed
Conference Material > Abstract
Devine C, Smiley S, Willett B, Blundell A, Christie WT, et al.
MSF Scientific Days International 2021: Innovation. 2021 May 20
WHAT CHALLENGE OR OPPORTUNITY DID YOU TRY TO ADDRESS? WERE EXISTING SOLUTIONS NOT AVAILABLE OR NOT GOOD ENOUGH?
The environmental impacts of MSF operations risk unintentionally undermining the organisation’s social mission. Although MSF has taken measures to reduce its environmental footprint, these have been largely ad hoc. To systematise these efforts, MSF developed the Environmental Impact (EI) Toolkit, which expanded into a wider ‘Climate Smart MSF’ initiative.
WHY DOES THIS CHALLENGE OR OPPORTUNITY MATTER – WHY SHOULD MSF ADDRESS IT?
The negative health consequences of environmental degradation and climate change are acute. Recognising this, MSF has committed to mitigating its environmental impacts. Futureproofing the organisation requires adoption of more environmentally responsible practices.
DESCRIBE YOUR INNOVATION AND WHAT MAKES IT INNOVATIVE
The EI Toolkit, a first-of-its-kind initiative within MSF, allows offices and projects to assess their carbon emissions and waste production and decide on mitigation measures. We reviewed existing tools and explored ways in which they may be customised to measure MSF’s common carbon emissions such as freight, passenger flights, fuel use by generators and vehicles, electricity purchased from public utilities, and commuting. The resulting tool categorises emission sources into three scopes including direct emissions from sources owned and controlled by MSF (scope 1 and 2) and in-direct emissions resulting from the production of purchased materials (scope 3). Scope 3 is the most challenging to evaluate due to the complexity of mapping emissions from the life-cycle of supply chains, and includes business travel and the movement of freight. The tool is intended to be agile and flexible and is in excel sheet format with an embedded data visualisation chart.
WHO WILL BENEFIT (WHOSE LIFE / WORK WILL IT IMPROVE?) AND WERE THEY INVOLVED IN THE DESIGN?
Beneficiary communities and MSF staff will directly benefit from the EI Toolkit through improved environmental conditions and health, while MSF offices and projects will benefit from reduced spending and inefficiencies. It will also facilitate the mitigation of global climate change through reduced greenhouse gas emissions.
WHAT OBJECTIVES DID YOU SET FOR THE PROJECT – WHAT DID YOU WANT TO ACHIEVE AND HOW DID YOU DEFINE AND MEASURE SUCCESS (IMPROVED SERVICE, LOWER COST, BETTER EFFICIENCY, BETTER USER EXPERIENCE, ETC.)?
The objectives of the EI Toolkit were to provide MSF teams with a method of assessing the environmental impact of their offices and projects, and to establish a baseline to enable teams to measure mitigation and monitor improvements.
WHAT DATA DID YOU COLLECT TO MEASURE THE INNOVATION AGAINST THESE INDICATORS AND HOW DID YOU COLLECT IT? INCLUDE IF YOU DECIDED TO CHANGE THE INDICATORS AND WHY.
In 2019, the EI Toolkit was developed and piloted in five countries. It was later rolled out in MSF offices in USA, Germany, and Sweden, and the MSF International office. It was also launched in projects in Bangladesh, Pakistan, Papua New Guinea, Cambodia, and Indonesia. By the end of 2020, 14 MSF sites had used the EI Toolkit, and its use is planned by over 40 more in 2021. Data on emission-producing activities and user feedback were collected. A tool to assist household/office and project waste reduction was added in 2020.
HOW DID YOU ANALYSE THIS DATA TO UNDERSTAND TO WHAT EXTENT THE INNOVATION ACHIEVED ITS OBJECTIVES? DID THIS INCLUDE A COMPARISON TO THE STATUS QUO OR AN EXISTING SOLUTION?
The EI Toolkit quantified carbon emissions for 14 projects and offices and provided guidance on mitigation. Emissions and their sources, and mitigation measures, were compared across MSF sites.
WERE THERE ANY LIMITATIONS TO THE DATA YOU COLLECTED, HOW YOU COLLECTED IT OR HOW YOU ANALYSED IT, OR WERE THERE ANY UNFORESEEN FACTORS THAT MAY HAVE INTERFERED WITH YOUR RESULTS?
In cases where exact emission measures were not available, data on emissions-producing activities (e.g. monthly fuel use, electricity use, and transportation) were collected, and emissions were estimated using conversion factors.
WHAT RESULTS DID YOU GET?
Sources of emissions and emission levels varied significantly across the 14 sites. Air freight and air travel (business flights) were identified as major sources of emissions. Commonalities in mitigation opportunities were identified, including limiting non-essential travel, finding substitutes to air freight and diesel use, and scaling up solar energy. Our findings suggest the need for rationalisation of emergency shipment use across the organisation. There is considerable scope to make MSF more efficient and environmentally responsible by reducing its carbon footprint.
COMPARING THE RESULTS FROM YOUR DATA ANALYSIS TO YOUR OBJECTIVES, EXPLAIN WHY YOU CONSIDER YOUR INNOVATION A SUCCESS OR FAILURE?
The EI Toolkit has provided projects and offices with quantitative insight into their environmental footprint. The steady adoption of the Toolkit and positive user feedback suggests that this innovation is a success. It provides a supportive framework through which MSF teams can take positive action for beneficiaries and the environment.
TO WHAT EXTENT DID THE INNOVATION BENEFIT PEOPLE’S LIVES / WORK?
Users report that the tool has aided in both identifying sources of highest carbon emissions and prompting discussions on policy changes required to improve low-carbon and sustainable working. The Bangladesh project, for example, identified that electricity consumption was a more significant source of emissions than international shipping. As a result of Toolkit use, the MSF hospital was connected to the electricity grid, monitoring of electricity use was enhanced to inform action, and reducing air freight in favour of sea freight became a central focus.
IS THERE ANYTHING THAT YOU WOULD DO DIFFERENTLY IF YOU WERE TO DO THE WORK AGAIN?
We would begin outreach earlier to improve acceptance and uptake across the organisation.
WHAT ARE THE NEXT STEPS FOR THE INNOVATION ITSELF (SCALE UP, IMPLEMENTATION, FURTHER DEVELOPMENT, DISCONTINUED)?
The scale-up of Toolkit use should continue at an accelerated pace. Courageous leadership and behavioural change will be important to making environmentally responsible practices “business as usual”.
IS THE INNOVATION TRANSFERABLE OR ADAPTABLE TO OTHER SETTINGS OR DOMAINS?
The EI Toolkit can be used by all MSF offices and projects.
WHAT BROADER IMPLICATIONS ARE THERE FROM THE INNOVATION FOR MSF AND / OR OTHERS (CHANGE IN PRACTICE, CHANGE IN POLICY, CHANGE IN GUIDELINES, PARADIGM SHIFT)?
What one measures, one can mitigate. Providing projects and offices with their baseline environmental impact can drive decision-making and adoption of more environmentally responsible practices. The enormous health and humanitarian implications of climate change and environmental degradation are well reported; environmental considerations must be mainstreamed into all aspects of MSF’s action.
WHAT OTHER LEARNINGS FROM YOUR WORK ARE IMPORTANT TO SHARE?
We recognise the importance of early buy-in for behavioural change interventions. By reducing its environmental impact, MSF has an opportunity to positively contribute to planetary and human health.
ETHICS
This innovation project did not involve human participants or their data; the MSF Ethics Framework for Innovation was used to help identify and mitigate potential harms.
The environmental impacts of MSF operations risk unintentionally undermining the organisation’s social mission. Although MSF has taken measures to reduce its environmental footprint, these have been largely ad hoc. To systematise these efforts, MSF developed the Environmental Impact (EI) Toolkit, which expanded into a wider ‘Climate Smart MSF’ initiative.
WHY DOES THIS CHALLENGE OR OPPORTUNITY MATTER – WHY SHOULD MSF ADDRESS IT?
The negative health consequences of environmental degradation and climate change are acute. Recognising this, MSF has committed to mitigating its environmental impacts. Futureproofing the organisation requires adoption of more environmentally responsible practices.
DESCRIBE YOUR INNOVATION AND WHAT MAKES IT INNOVATIVE
The EI Toolkit, a first-of-its-kind initiative within MSF, allows offices and projects to assess their carbon emissions and waste production and decide on mitigation measures. We reviewed existing tools and explored ways in which they may be customised to measure MSF’s common carbon emissions such as freight, passenger flights, fuel use by generators and vehicles, electricity purchased from public utilities, and commuting. The resulting tool categorises emission sources into three scopes including direct emissions from sources owned and controlled by MSF (scope 1 and 2) and in-direct emissions resulting from the production of purchased materials (scope 3). Scope 3 is the most challenging to evaluate due to the complexity of mapping emissions from the life-cycle of supply chains, and includes business travel and the movement of freight. The tool is intended to be agile and flexible and is in excel sheet format with an embedded data visualisation chart.
WHO WILL BENEFIT (WHOSE LIFE / WORK WILL IT IMPROVE?) AND WERE THEY INVOLVED IN THE DESIGN?
Beneficiary communities and MSF staff will directly benefit from the EI Toolkit through improved environmental conditions and health, while MSF offices and projects will benefit from reduced spending and inefficiencies. It will also facilitate the mitigation of global climate change through reduced greenhouse gas emissions.
WHAT OBJECTIVES DID YOU SET FOR THE PROJECT – WHAT DID YOU WANT TO ACHIEVE AND HOW DID YOU DEFINE AND MEASURE SUCCESS (IMPROVED SERVICE, LOWER COST, BETTER EFFICIENCY, BETTER USER EXPERIENCE, ETC.)?
The objectives of the EI Toolkit were to provide MSF teams with a method of assessing the environmental impact of their offices and projects, and to establish a baseline to enable teams to measure mitigation and monitor improvements.
WHAT DATA DID YOU COLLECT TO MEASURE THE INNOVATION AGAINST THESE INDICATORS AND HOW DID YOU COLLECT IT? INCLUDE IF YOU DECIDED TO CHANGE THE INDICATORS AND WHY.
In 2019, the EI Toolkit was developed and piloted in five countries. It was later rolled out in MSF offices in USA, Germany, and Sweden, and the MSF International office. It was also launched in projects in Bangladesh, Pakistan, Papua New Guinea, Cambodia, and Indonesia. By the end of 2020, 14 MSF sites had used the EI Toolkit, and its use is planned by over 40 more in 2021. Data on emission-producing activities and user feedback were collected. A tool to assist household/office and project waste reduction was added in 2020.
HOW DID YOU ANALYSE THIS DATA TO UNDERSTAND TO WHAT EXTENT THE INNOVATION ACHIEVED ITS OBJECTIVES? DID THIS INCLUDE A COMPARISON TO THE STATUS QUO OR AN EXISTING SOLUTION?
The EI Toolkit quantified carbon emissions for 14 projects and offices and provided guidance on mitigation. Emissions and their sources, and mitigation measures, were compared across MSF sites.
WERE THERE ANY LIMITATIONS TO THE DATA YOU COLLECTED, HOW YOU COLLECTED IT OR HOW YOU ANALYSED IT, OR WERE THERE ANY UNFORESEEN FACTORS THAT MAY HAVE INTERFERED WITH YOUR RESULTS?
In cases where exact emission measures were not available, data on emissions-producing activities (e.g. monthly fuel use, electricity use, and transportation) were collected, and emissions were estimated using conversion factors.
WHAT RESULTS DID YOU GET?
Sources of emissions and emission levels varied significantly across the 14 sites. Air freight and air travel (business flights) were identified as major sources of emissions. Commonalities in mitigation opportunities were identified, including limiting non-essential travel, finding substitutes to air freight and diesel use, and scaling up solar energy. Our findings suggest the need for rationalisation of emergency shipment use across the organisation. There is considerable scope to make MSF more efficient and environmentally responsible by reducing its carbon footprint.
COMPARING THE RESULTS FROM YOUR DATA ANALYSIS TO YOUR OBJECTIVES, EXPLAIN WHY YOU CONSIDER YOUR INNOVATION A SUCCESS OR FAILURE?
The EI Toolkit has provided projects and offices with quantitative insight into their environmental footprint. The steady adoption of the Toolkit and positive user feedback suggests that this innovation is a success. It provides a supportive framework through which MSF teams can take positive action for beneficiaries and the environment.
TO WHAT EXTENT DID THE INNOVATION BENEFIT PEOPLE’S LIVES / WORK?
Users report that the tool has aided in both identifying sources of highest carbon emissions and prompting discussions on policy changes required to improve low-carbon and sustainable working. The Bangladesh project, for example, identified that electricity consumption was a more significant source of emissions than international shipping. As a result of Toolkit use, the MSF hospital was connected to the electricity grid, monitoring of electricity use was enhanced to inform action, and reducing air freight in favour of sea freight became a central focus.
IS THERE ANYTHING THAT YOU WOULD DO DIFFERENTLY IF YOU WERE TO DO THE WORK AGAIN?
We would begin outreach earlier to improve acceptance and uptake across the organisation.
WHAT ARE THE NEXT STEPS FOR THE INNOVATION ITSELF (SCALE UP, IMPLEMENTATION, FURTHER DEVELOPMENT, DISCONTINUED)?
The scale-up of Toolkit use should continue at an accelerated pace. Courageous leadership and behavioural change will be important to making environmentally responsible practices “business as usual”.
IS THE INNOVATION TRANSFERABLE OR ADAPTABLE TO OTHER SETTINGS OR DOMAINS?
The EI Toolkit can be used by all MSF offices and projects.
WHAT BROADER IMPLICATIONS ARE THERE FROM THE INNOVATION FOR MSF AND / OR OTHERS (CHANGE IN PRACTICE, CHANGE IN POLICY, CHANGE IN GUIDELINES, PARADIGM SHIFT)?
What one measures, one can mitigate. Providing projects and offices with their baseline environmental impact can drive decision-making and adoption of more environmentally responsible practices. The enormous health and humanitarian implications of climate change and environmental degradation are well reported; environmental considerations must be mainstreamed into all aspects of MSF’s action.
WHAT OTHER LEARNINGS FROM YOUR WORK ARE IMPORTANT TO SHARE?
We recognise the importance of early buy-in for behavioural change interventions. By reducing its environmental impact, MSF has an opportunity to positively contribute to planetary and human health.
ETHICS
This innovation project did not involve human participants or their data; the MSF Ethics Framework for Innovation was used to help identify and mitigate potential harms.
Journal Article > CommentaryFull Text
Lancet. 2022 November 5; Volume 400 (Issue 10363); 1561-1563.; DOI:10.1016/S0140-6736(22)01991-2
Baxter LM, McGowan CR, Smiley S, Palacios L, Devine C, et al.
Lancet. 2022 November 5; Volume 400 (Issue 10363); 1561-1563.; DOI:10.1016/S0140-6736(22)01991-2
The climate emergency is a humanitarian and health crisis. Extreme weather events, heat stress, declining air quality, changes in water quality and quantity, declining food security and safety, and changes in vector distribution and ecology threaten all of us. As the planet heats, climate risks are increasingly complex, frequent, and unpredictable, compounding existing vulnerabilities and inequities within populations and causing emergencies that cascade across different systems and sectors. Humanitarian agencies are now seeing how these problems are putting millions of people across the world at immediate risk of famine and death.