DOCTORS WITHOUT BORDERS USA INC

Doctors Without Borders would like to acknowledge and address your concern regarding our recent rating change on Charity Navigator. Charity Navigator 2.0, the updated system by which the site assess charitable groups' accountability and financial position, assigns significant value to year over year increases in programmatic spending. Charity Navigator asks that the nonprofits they evaluate grow at a certain rate each year in order to be considered healthy financially. Doctors Without Borders, however, is an emergency response organization and our program commitments can shift from year to year. In 2009, the year considered for our current 3 Star rating, Doctors Without Borders made an internal decision to cap our program expense growth over the prior year. We did this to ensure that after a 26% growth in 2008 that we could continue to maintain the high quality of our projects while growing prudently. We made this conscious decision to make sure our patients were receiving the high quality care they needed, in addition to continuing to expand our reach at a reasonable rate. In this regard, the Charity Navigator ratings system, while positive in its intent, does not consider this piece of information which we feel is a responsible way in which we manage our donor dollars as well as our growth. If you would like a further explanation on the matter please contact our Donor Services group at donations@doctorswithoutborders.org

I'm confused. You are saying that you dropped to three stars due to lack of revenue growth. However, you are classified as Development and Relief Services. Charity Navigator's explanation of their Primary Revenue weighting seems to be saying that, if you have growth of over 5% in that catgegory, you get the top score. Your growth is shown as 5.8%. Am I misunderstanding something? Also, you didn't address the low Accountability & Transparency rating.

Hi Robert. Jennifer Tierney here, Development Director for doctors Without Borders (MSF) USA. Just want to help clarify the situation. MSF was told that the star was dropped because of a slower than Charity Navigator desired growth in program expenditure. Not in revenue. From 2007-2008 our program expense grew at 23.6% but from 2008- 2009 our growth was purposefully slowed to 6.8% which significantly affected our score. Charity Navigator encourages consistent steady growth, but MSF had made a conscious decision in 2009 not to grow at the same rate year over year for fear of outstripping our human resources capacity and damaging the quality of our programs. We continue to stand behind that decision. Please feel free to email me at jennifer.tierney@newyork.msf.org or call 212-655-3767 if you want to chat further. (I can always check the site too, but the alternative may get a quicker response!) You can feel free to post responses I send back as well, of course.

I agree. I wish the rating was higher. I just started to send them a monthly payment because it seemed the staff on the ground did such great work. I will keep giving but check later to see if they listen to our concern about the rating. If it doesn't improve I might stop giving.

Thank you for writing this review and posting the subsequent comment. I am wrestling with this decision right now. I'm thinking of donating instead to International Medical Corp. Any thoughts? Have you heard of that one? It seems like it has a similar mission but without the high admin costs. Thanks in advance for any insight you might have.

Doctors Without Borders would like to acknowledge and address your concern regarding our recent rating change on Charity Navigator. Charity Navigator 2.0, the updated system by which the site assess charitable groups' accountability and financial position, assigns significant value to year over year increases in programmatic spending. Charity Navigator asks that the nonprofits they evaluate grow at a certain rate each year in order to be considered healthy financially. Doctors Without Borders, however, is an emergency response organization and our program commitments can shift from year to year. In 2009, the year considered for our current 3 Star rating, Doctors Without Borders made an internal decision to cap our program expense growth over the prior year. We did this to ensure that after a 26% growth in 2008 that we could continue to maintain the high quality of our projects while growing prudently. We made this conscious decision to make sure our patients were receiving the high quality care they needed, in addition to continuing to expand our reach at a reasonable rate. In this regard, the Charity Navigator ratings system, while positive in its intent, does not consider this piece of information which we feel is a responsible way in which we manage our donor dollars as well as our growth. If you would like a further explanation on the matter please contact our Donor Services group at donations@doctorswithoutborders.org

Thank you for your past support and for sharing your concerns about Doctors Without Borders' cost of fundraising. We value your feedback and want to address your concerns specifically and directly. Doctors Without Borders' executive staff and board of directors is highly conscious of its cost of fundraising and strategize as best they can to keep that cost low. At $.13 to raise a dollar our cost of fundraising exceeds nonprofit industry standards, and is comparable to that of other humanitarian aid organizations you will find on Charity Navigator. That said, the figures that you are looking at are from 2009 audited financials. That year, as the economy dipped, our fundraising team had make significant efforts to raise the revenue that needed to support our programs, as donor response dipped from the prior years. With those additional efforts our cost of fundraising slightly increased. In our 2010 financials, you will see that our cost to raise a dollar has decreased to less than $.10, dipping because of the significant amounts of support we received in response to the earthquake in Haiti. As you can see, external factors can influence our cost to raise a dollar from year to year. In order to help bring down the cost of fundraising the best thing that donors can do is to become a monthly donor. You will receive less mailings, which means less cost, and you provide a dependable stream of revenue for our projects. We appreciate your concern and hope this sheds a bit more light on the question of our cost of fundraising. If you would like to discuss this further please contact our Donor Services department at Donations@newyork.msf.org.