How we spend your money

As an MSF donor, you fuel the delivery of medical aid to the people who need it most, no matter where they are in the world.

Your money pays for millions of consultations, operations, treatments and vaccinations every year. As an organisation, we work to spend your money in the most efficient way and to help those in greatest need. But how do we do it?

At MSF we deliver care directly rather than through local partner organisations. We set up and run medical services, train staff and respond to fast-moving emergencies, as well as longer-term crises. This means the money you trust to MSF is spent by MSF.

Essential costs

When you donate to MSF UK, the money is banked and then directed to the country where the need is greatest. This is coordinated across the 23 MSF offices and our projects in over 70 countries, but none of the funds we send to the frontline is spent on international administration costs.

There are essential costs for any organisation and a small percentage of the money we raise – just two percent – is used for running costs in the UK.

Another 13 percent is reinvested in fundraising to keep the money coming in for our overseas work and for every pound spent we receive £6.60 back. The rest pays for healthcare.

Each aspect of the way we operate from our London office is designed to keep these essential costs low. We rent inexpensive office space, we buy only the lowest fares for travel and stay in budget hotels when travelling abroad.










Money for emergencies

When an emergency breaks – such as an earthquake, an epidemic or a conflict – MSF can respond immediately. This is because we encourage donors to give unrestricted funds, which means we can spend them where the need is greatest.

Thanks to the generosity of our donors, MSF has a significant emergency reserve fund. This means there is no delay in mobilising, no wait for government funds to be released and no lag as donation appeals are launched; we can act immediately and then replenish this fund with new donations.

Once the money reaches the medical programmes it is carefully managed by the project team. It is subject to a rigorous accounting system, with every penny logged and all the information flowing back to the headquarters and our donors – transparency and accountability are essential.

We only launch an emergency appeal if we are certain we can spend the money on that specific crisis; there are no asterisks or hidden disclaimers diverting money to other parts of the organisation.

MSF principles

The way we raise and spend money upholds our core principles – independence, neutrality and impartiality. MSF UK very rarely takes money from the government; 100 percent of our donations come from private donors, like you.

This means they come with no strings attached and allow us to provide medical care where the need is greatest. It is you, our donors, who fuel MSF’s work. Thank you.

Our finances

MSF UK is part of an international movement of entities please note the figures on this page apply only to staff whose salary is set and paid by MSF UK.

What is the highest salary in MSF UK?

The highest salary in MSF UK is paid to our executive director, Vickie Hawkins. Vickie is eligible for an annual salary of £91,023.95 (as of April 2022). There are no additional bonuses or performance-related additional payments.

This amount excludes pension contributions by MSF, which total 10 percent of the gross salary. 

Doesn’t MSF UK have a 3:1 ratio between highest and lowest salaries?

MSF UK has traditionally paid the most senior member of staff, usually the Executive Director, no more than three times the pay of the lowest-paid UK-based staff member.

However, in 2014 the MSF UK board decided to hold a long-overdue review of pay grades and benefits for all UK-based staff, and as part of that review the board reviewed its policy on setting the Executive Director’s pay.

The board decided in future to treat the 3:1 ratio as a guide rather than a rule in order to avoid a possible tension between either underpaying the Executive Director compared to equivalent roles or being forced to pay more for junior roles than is appropriate. 

For the record, the director’s current salary of £91,023.95 is 3.4 [3.354] times the lowest current MSF UK salary of £27,134.48.

How did the board set the Executive Director’s salary?

In considering the Executive Director’s new salary, the Board observed that a gap had opened up between what MSF UK was previously paying and what other parts of the MSF movement and London-based NGOs were paying their Chief Executives.

In setting the Executive Director’s new salary, the Board sought to set the salary at a level that was broadly competitive yet still modest, in keeping with MSF’s focus on maximising the use of funds for frontline work.

Exactly which factors were considered before the pay was set?

  • Salaries for comparable roles across MSF movement
  • Salaries of Chief Executives and Directors of similar-sized UK, London-based NGOs (based on voluntary sector salary surveys: XpertHR, Croner Reward)
  • Pay ratio between the Executive Director and other MSF UK office staff
  • Annual percentage salary increase given to other MSF UK office staff

When will the director’s salary be reviewed?

The Executive Director’s salary will be reviewed in April 2023 in line with the rest of the UK office.

Although the Board now uses the 3:1 ratio as a guide rather than a rigid limit, they will continue to ensure that the director’s salary remains modest yet sufficient to attract and retain the best candidate, and is published on our website.

What about other senior managers in the UK?

In 2021 MSF UK had 10 senior managers in the £60k-70k salary range, depending on their seniority and experience; one senior manager was paid between £70k-80k. 

How much does MSF pay top executives elsewhere in the world?

We publish the highest and lowest salaries for all MSF offices worldwide as part of our commitment to transparency in financial reporting. The most recent data available (2021) is on page 38 (numbered as p. 36) of this document.

We are an independent, international medical humanitarian organisation. Your support allows us to provide medical aid whenever and wherever it is needed.

Eighty-six pence of every pound you donate is spent on our programmes. We try our utmost to make sure that your donations are spent on saving lives rather than on administration and management costs.


Income 2021 2020
  in million £ in percentage in million £ in percentage
Private 63.47 93% 68.2 94%
Public institutional 0 0% 0 0%
Other* 4.55 7% 4.4 6%
Total 68.02 100% 72.6 100%

* Includes income from other MSF entities for the recruitment and remuneration of staff working in MSF projects.

How money is spent 2021 2020
  in million £ in percentage in million £ in percentage
Operations 61.25 85% 60.0 86%
Fundraising 9.16 13% 8.0 12%
General support costs 1.49 2% 1.4 2%
Total 71.9 100% 69.4 100%
Surplus (deficit) for the year (3.87)   3.3  


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