Emergency Response to a Long-Term Crisis? Medecins sans Frontieres and HIV/AIDS in Ethiopia

Medecins sans Frontieres (MSF, Doctors without Borders) is an organization that responds to humanitarian crises throughout the world with medical staff and supplies. The organization also acts as an advocate for those it serves, providing "testimony" (temoignage) about the plight of those caught up in humanitarian crises. In the late 1990s MSF began caring for people with HIV/AIDS and in 2000 began the first efforts to provide anti-retroviral (ARV) drugs to HIV-infected people in developing countries. The case describes these efforts, and, in particular, an initiative in Ethiopia by MSF Holland. The discussion of the situation in Holland focuses on the reasons why MSF began an ARV program in Ethiopia and what its future was likely to be. The case highlights the problems facing a highly decentralized organization oriented towards emergency response, which is, nevertheless, engaged in a long-term intervention. As such, it raises questions about the alignment between the organization's mission, structure, and the requirements of a particular program. It also highlights questions about organizational decision making both in terms of entry into a new initiative and exit from it. Finally, it provides an example of organizational effectiveness as advocacy - how proving the impossible is possible moves policy makers to act. The case is appropriate for classes on strategic management and operations management. HKS Case Number 1851.0

• Healthcare benefits
• Economic growth
• Strategic planning
• Project evaluation
• Public health services
• Health and behavioral science
• Decision making
• Crisis management
• Nonprofit organizations
• Nongovernmental organizations