2019 Financial report by Médecins du Monde

MÉDECINS DU MONDE

FINANCIAL REPORT 2019 EDITION

Médecins du Monde 2019 Financial Report

A WORD FROM OUR TREASURERS

It could be said that 2019 belongs to a different world, the world before COVID. Nonetheless, our 2019 financial report provides us with a valuable overview of our organisation’s health that we can use to plan for a future full of uncertainty, but also of opportunities for promoting more social justice and solidarity. In 2019, MdM’s activity topped €103 million. With a surplus of €1.5 million and a growth rate of 4.3%, the momentum gained over recent years was maintained. Yet 2019 was a singular year for our international operations. Against a backdrop of numerous persistent crises - none of which deemed sufficiently calamitous by governments or international bodies to motivate the kind of funding required to meet the resulting needs -, Doctors of the World/Médecins du Monde (MdM)-France entered a period of adjustment. Thanks to sound management, MdM was able to deal effectively with the consequences of this adjustment period. But it meant making choices. Thus, in order to continue pursuing the goals set forth in our mission statement, we developed strategies and implemented policy decisions that are already bearing fruit, as will be seen in this report. Our social programmes reached a high level of activity in 2019 - and are still growing. As an international aid and development organisation, MdM runs programmes in 34 different countries, including France, which - as shown in our Income and Expenditure Statement - accounted for 83,5% of the year’s expenditure. The distribution between France and abroad remained much the same as in 2018, with a slight increase in activity in France in a context marked by social violence, dwindling access to rights and refusal to accept migrants. On our international programmes, activity grew thanks to the support of our partners and network colleagues who helped us maintain a presence in areas that are increasingly hard to access and where the needs are considerable, such as Syria, for example. Our financial links with MdM’s international network members are essential and reciprocal. Thanks to the network, we attained €24 million in resources in 2019. MdM’s political independence is guaranteed by its balanced funding model in which the general public is our main funding source. In 2019, public giving exceeded €45 million. This public generosity illustrates the commitment of the civil society towards our organisation, alongside the dedication of our staff and voluntary workers. We must cultivate this engagement. Indeed, in 2019, the level of public giving in France was up slightly despite a particularly unfavourable context, and we are grateful for the unfailing trust shown to us at a time when donor militancy is on the wane. Ensuring the diversification of public and private funding sources is a constant challenge, as is the financing and control of running costs. 2019 saw the creation of both an audit committee, made up of four voluntary workers, and an internal auditing unit. These two entities are complementary to the organisation’s existing financial steering tools, which have been strengthened over recent years. Looking to the future… 1

Médecins du Monde 2019 Financial Report

The 2020 budget estimate presented in this report was drawn up before the appearance of COVID and focuses on the development of our programmes. This budget will be revised, as it is every year, but considering the pandemic we will have to make more allowances for contingencies than is usually the case. We are already anticipating the consequences of the pandemic on MdM's financial and political management. The next few months will test our ability to calibrate them. Indeed, this pandemic will challenge not only our management capabilities, but also our flexibility, responsiveness and solidity. However, the priorities identified prior to COVID still apply, and include:     

Developing our international programmes; Increasing the diversity of our institutional donors and securing better coverage of our fixed costs by these same donors; Consolidating and developing public giving Developing management tools that are better adapted to our organisation and its operational volume Prioritising and arbitrating, forgoing when necessary, but always remaining ready to take action when needed.

MdM’s financial management - which has been both stringent and flexible for several years – will be a valuable asset to our organisation in the times ahead. The figures in this report illustrate our strengths and weaknesses. They are also proof of the commitment of all our stakeholders - users, volunteers, donors, partners, network members, and employees - to refusing the fatality of injustice. We are ready to move our action forward!

Florence Rigal Sophie Alary

Médecins du Monde 2019 Financial Report

CONTENTS

Part 1: The Statutory Auditor’s Report Médecins du Monde’s Annual Accounts for the financial year ended on the 31st of December 2019     

The Statutory Auditor’s Report 2019 Balance Sheet 2019 Income statement 2019 Notes to the annual accounts 2019 Annual Income and Expenditure Statement: funds raised from the general public

Part 2: Analysis of the 2019 Accounts

Part 3: Special Report on Regulated Agreements Part 4: 2020 Budget

Médecins du Monde 2019 Financial Report

Part 1 The Statutory Auditor’s Report on Médecins du Monde’s Annual Accounts for the financial year ended on the 31st of December 2019

Médecins du Monde 2019 Financial Report

2019 BALANCE SHEET (in Euros) ASSETS

DEPREC + AMORT

GROSS

FIXED ASSETS Intangibles Licenses, patents etc. Advances and downpayments

NET 2019

Net 2018

1 199 216 40 051

1 061 906

1 206 101 7 628 444 5 518 355

1 206 101 5 983 975 1 644 468 4 838 506 679 849 0

20 962

868 628 736 441

TOTAL I 17 218 198

11 884 387 5 333 811

280 881

Other receivables

41 281 556

5 743 41 275 813

Securities Cash

0 33 873 982

Tangible assets Land Buildings Other fixed assets Fixed assets in progress Investments Other long-term securities Loans Other investments

CURRENT ASSETS Stocks of medicines & med.

137 311 40 051

ADJUSTMENT ACCOUNTS Prepaid charges

14 161 462

TOTAL II 89 597 881

5 743 89 592 138

LIABILITIES

EQUITY Statutory funds 130 986 Gratuities/Bequests 0 General intervention reserve

TOTAL III

TOTAL IV 0 TOTAL ASSETS 106 816 079

0 0 11 890 130 94 925 949

- Received commitments, net bequests to be processed : 6 490 304 €

15 245

17 706 312

17 667 953

765 914

432 615

24 745

18 512 216 1 508 697,72

18 140 558 371 658

20 020 913

18 512 216

2 654 188

2 989 354

139 546

119 780

203 333

85 717

3 520 587

3 631 749

5 207 694 53 328

4 953 770 57 342

19 079 548

10 050 077

TOTAL II

44 046 811 72 111 302

53 789 738 72 568 393

Translation adjustments TOTAL III 0 94 189 743 TOTAL LIABILITIES

0 94 925 949

0 94 189 743

Associative project reserve 1 206 101 Accumulated profit 1 749 002 Balance brought forward 693 238 Capital grant 0 Surplus allocated to investments Sous total 20 962 (-) DEFICIT or (+) SURPLUS 800 460 TOTAL I 790 303 PROV. for liabilities and Charges 5 391 052 Dedicated Funds CURRENT LIABILITIES 305 221 Bank borrowings (1) 55 550 490 Supplier accounts payable & rel. Acnts 0 Tax and social liabilities 27 872 210 Fixed asset liabilities & related acnts Others liabilities 5 070 770 ADJUSTMENT ACCOUNTS 88 798 691 Deferred income 0

(1) Including overdraft : 203 333 €

2018

15 245

Deferred charges Translation adjustments

2019

Médecins du Monde 2019 Financial Report

2019 INCOME STATEMENT (in Euros) On 31/12/19

Operating Income Institutional grants Private grants Office grants (from private fundraising) Office grants (none private fundraising) Donations in kind

On 31/12/18

52 859 722 3 716 302 1 488 898 44 673

46 103 663 3 096 584 2 472 302

39 274 708

38 810 049

3 843 924

5 244 240

Corporate fundraising Subscriptions Children sponsorship

0 41 159 18 285

0 41 910 9 625

Events income

15 037

4 840

452 451 1 326 129 103 081 287

307 600 1 603 852 97 694 664

on 31/12/19 7 723 268 24 465 28 163 600 3 203 587 32 724 039 8 298 932

on 31/12/18 9 385 809 29 602 29 900 337 3 090 820 34 348 754 8 972 756

515 179

614 228

1 627 317 19 617 092 387 496

1 477 257 8 665 024 603 950

TOTAL II : Operating expenses

102 284 974

97 088 535

1- Operating Income/Loss (TOTAL I) - (TOTAL II)

796 313

606 130

Bequests

Other revenue Transfer of operating costs TOTAL I Operating income Operating expenses Purchase of raw materials and other supplies Movement in stock of medicines & med. Supplies Other purchases and external charges Taxes, duties & related Salaries & payroll Payroll taxes Depreciation and amortization On fixed assets On deferred charges Provisions and other allow ances/current assets Grants accorded by the Association Other expenses

Financial Income

on 31/12/19

Income from other investments and loans Other interest and similar income Foreign exchange gains Net income on disposal of investments and loans Reversal of provisions TOTAL III : Financial Income

Au 31/12/19

Extraordinary Income

on 31/12/18

41 547 904 556

0 32 068 1 025 818

795 562 1 741 665

348 972 1 406 858

Financial expenses Amortization and depreciation Interest and similar expenses Foreign exchange losses Net expenses on disposal of securities investment TOTAL IV : Financial expenses

on 31/12/19 156 403

on 31/12/18 795 562

2 - Financial income/loss (TOTAL III) - (TOTAL IV)

595

651

800 601

1 195 346

957 600

1 991 559

784 065

-584 701

On management operations On capital transactions Reversals of provisions TOTAL V : Extraordinary income Extraordinary expenses

5 474

5 133

5 474

5 133

au 31/12/19

On management operations On capital transactions Amortization and depreciation

Au 31/12/18

au 31/12/18

37 496 7 958

37 374 1 373 0

TOTAL VI : Extraordinary expenses

45 454

38 747

3 - Extraordinary items (TOTAL V) - (TOTAL VI)

-39 980

-33 614

TOTAL VII : Corporate income tax

11 934

10 807

TOTAL VIII : Balance carried forward from previous year

119 780

486 544

TOTAL IX : Commitments of expenditures to be relised on earmarked funds

139 546

91 893

TOTAL INCOME (I + III + V + VIII)

104 948 206

99 593 199

TOTAL DES EXPENSES (II + IV + VI + VII + IX)

103 439 508

99 221 541

(-) DEFICIT or (+) SURPLUS

1 508 698

371 658

5 503 081

6 744 156

Benefits in kind

Médecins du Monde 2019 Financial Report

1. 2. 3. 4.

6. 7. 8. 9. 10.

11. 12. 13. 14. 15. 16. 17. 18. 19.

20. 21. 22.

KEY EVENTS IN THE FINANCIAL YEAR CHANGES IN PRESENTATION, VALUATION OR ACCOUNTING METHODS ASSOCIATIVE PROJECTS ACCOUNTING RULES AND METHODS 4.1 Basic accounting principles 4.2 Fixed assets and depreciations 4.3 Stock and stock depreciation 4.4 Claims 4.5 Debts 4.6 Cash investments 4.7 Bank accounts and cash funds in foreign currencies 4.8 Grant funding – International programmes 4.9 Subsides and investments grants – French programmes 4.10 Earmarked funds from grants, donations and legacies 4.11 Funding obtained on behalf of the network 4.12 Associative projects 4.13 Provision for liabilities and charges 4.14 Legacies and other donations 4.15 Benefits in kind 4.16 Other information TANGIBLE AND INTANGIBLE FIXED ASSETS 5.1 Fixed assets movements table 5.2 Depreciation table 5.3 Net book values table FINANCIAL FIXED ASSETS STOCK STATEMENT OF END-OF-YEAR CLAIMS ACCRUED INCOME LIQUID ASSETS 10.1 Marketable values 10.2 Banks and cash funds PREPAID COSTS ORGANISATION’S OWN FUNDS TABLE OF PROVISIONS EARMARKED FUNDS STATEMENT OF END-OF-YEAR DEBTS TABLE OF LEGACIES AND DONATIONS IN PROGRESS ACCRUED LIABILITIES DEFERRED INCOME OFF-BALANCE-SHEET COMMITMENTS 19.1 Commitments received 19.2 Given commitments EMPLOYEE STATISTICS OPERATING EXPENSES: DETAILS INCOME AND EXPENDITURE STATEMENT 22.1 Expenditure 22.2 Income 22.3 Fixed assets funded by funds raised from the public 22.4 Allocation of funds raised from the public 22.5 Benefits in kind

These Annual Accounts were approved by the Board of Directors at their meeting on May 20th, 2020

Médecins du Monde 2019 Financial Report

KEY EVENTS OF THE 2019 FINANCIAL YEAR

2019 saw a 4.3% increase in activity and a year-end surplus of €1.5 million. Indeed, at the end of the financial year operating income stood at €0.8 million, an improvement of €0.19 million on last year, and financial income at €0.78 million, against €-0.58 million in 2018. MdM France’s fundraising in support of the international network continued to grow. MdM’s international network is now composed of 16 members across Europe, America and Asia. For several years, the network has largely contributed to the financing of MdM France’s projects (€24.3 million in income in 2019), and since 2018, MdM France has been transferringgrants to some of its members to help fund their operations. These donor grants rose sharply in 2019 (+€11 million) and were allocated to MdM Turkey for operations in Turkey and Syria and MdM Belgium for operations in DRC. This inter-network funding has had a significant impact on both our balance sheet (increase in other receivables and prepaid charges) and income statement (increase in donor grants, as income, and grants allocated, as expenses). Actions implemented directly by MdM France in France and abroad decreased in 2019. Three points should be mentioned here: - The year was marked by a reflection on operations in France, resulting in the drafting of a national strategy, and abroad, with the development of the medium-term operational trajectory. The clarifications achieved will enable us to develop new programmes as from 2020. MdM-France also pursued its strategy of reducing the number of intervention zones in 2019 in order to strengthen our activities in a smaller number of countries and thus increase their impact. Wherever possible, activities in the intervention zones concerned were transferred to other members of the network. - The organisation had to adapt to developments in the Syrian context: transfer of its activities in Northwest Syria to MdM Turkey, difficult access in southern Syria and closure of the unit in Amman. - The Adoption mission was closed in 2019 after nearly 30 years of existence and more than 4,000 adoptions. All open cases were taken over by other authorised adoption bodies. Financial income rose sharply in 2019 due to more favourable exchange rates and lower foreign exchange exposure than in previous years (several multi-year donor contracts in foreign currencies came to an end at the end of 2019). MdM France also continued to implement the transformation plan launched in 2017, which resulted in the adoption of the new Articles of Association by the General Assembly in May 2019 and their publication in the Official Journal in December 2019, as well as the creation of an Audit Committee, made up of members of the Board and two qualified external experts, and an Internal Auditing Unit. Lastly, Dr Florence Rigal and Sophie Alary were appointed as MdM France’s Treasurer and Deputy Treasurer respectively. Modification of the scope of missions in 2019:  Opening or reorientation of countries or programmes: • • •

France: PASS project in Marseille Africa:DRC - Tanganyika Middle East: Syria, Turkey

 Closure or transfer of countries or programmes: • • • • • •

France: CASO Besançon, Sex workers in Poitiers, slum mediation in Nantes Africa: Somalia Europe: Serbia, Migrants project in Bulgaria Middle East: Turkey, Northwest Syria Latin America: Haiti, Venezuela Asia: Vietnam

Médecins du Monde 2019 Financial Report

CHANGES IN PRESENTATION, VALUATION OR ACCOUNTING METHODS

N/A

ASSOCIATIVE PROJECTS

MdM France’s 2016, 2018 and 2019 General Assemblies voted in favour of constituting two reserves for specific associative projects: -

The adaptation of premises used in France (this reserve was used up at the end of 2016, but as it concerns investments, depreciation runs until 2026) The financing of investments related to MdM-France's transformation plan (particularly those related to the transformation of our information system).

In conformity with the French General Chart of Accounts for Associations, the appropriation to reserves of expenditures for associative projects must be approved by the General Assembly. The expenses recorded in 2019 against the associative project “Adaptation of premises”, which are included in the € 1 508 698 surplus, amounted to €11,936 overall. If the 2020 General Assembly approves these expenses and their appropriation to the "Adaptation of premises” reserves, the surplus for the financial year for distribution, after being restated with the cost of these expenses, will be €1,520,634 instead of €1,508,698 (+€11,936). NB. The General Assembly having decided that only expenditure related to financing investments should be appropriated to the reserve for the transformation plan, and no investments being recorded in 2019, no expense was allocated to this reserve for the 2019 financial year.

ACCOUNTING RULES AND METHODS

The financial year extended over 12 months, from the 1st January to the 31 December 2019 The accounts are drawn up in euros. On the 31 December 2019, the Balance Sheet showed a total of €94.925.949, while the Income Statement, presented in the form of a table, showed a surplus of €1.508.698 (before cost allocation on the reserve account for associative projects). 4.1. BASIC ACCOUNTING PRINCIPLES The accounts have been drawn up: -

In accordance with basic accounting conventions, and the following principles in particular: - The principle of prudence; - Consistency of accounting methodology from one financial year to the next; - Continuity of operations; - Non-compensation; - Independent financial years.

In compliance with the general rules for the drawing up and presentation of annual accounts applicable in France, and in compliance with the following regulations in particular: - CRC 99-01 regarding the rules and regulations for the drawing up and presentation of annual accounts for French associations, foundations and endowment funds; - ANC 2014-03 of 05 June 2014 regarding the general chart of accounts, modified by regulation ANC 2015-06 on the 23rd of November 2015; - CRC 2008-12 regarding the drawing up of the Annual Income and Expenditure Statement for French associations and foundations.

Médecins du Monde 2019 Financial Report

4.2. FIXED ASSETS AND DEPRECIATIONS The Association’s fixed assets are entered in the accounts at their acquisition cost (purchase price plus incidental costs). They are recorded and valued in accordance with the standards laid down by the regulation regarding assets. Fixed assets which can be broken down: The only fixed asset found which could be broken down was the Association’s Head Office in Paris. It was broken down as follows: Net Value (€) on 31 December 2019 1 206 101

Depreciation period

Building

1 352 670

20 years

Total

2 558 771

Land

Fixed assets in progress: None.

Depreciation: Fixed assets are depreciated using the straight-line method over their useful life. This remained unchanged in relation to the previous financial year, as set out below. The allowance for depreciation for the financial year is entered in the accounts under the heading ‘Allowances for depreciation: fixed assets’. The following methods have been used to calculate depreciation over the financial year: Software

Straight-line, 1 - 3 years

Software developed by subcontractors

Straight-line, 3 years

Building

Straight-line, 20 years

Fixtures & fittings

Straight-line, 6 years and 10 years

Transportation equipment (Headquarters)

Straight-line, 3 years and 4 years

Transportation equipment (Programmes)

Straight-line, 2 years and 3 years

IT equipment

Straight-line, 3 years

IT equipment (International Programmes)

Straight-line, 2 years

Office equipment and furniture

Straight-line, 6 years

Medical equipment

Straight-line, 6 years

Communication equipment

Straight-line, 6 years

Amortisation of the Association's Headquarters The basis for an asset’s depreciation is its gross value minus its residual value, which is taken to be the sum (minus anticipated disposal costs) which the Association would obtain if it disposed of the asset on the market at the end of its service life. The residual value is considered whenever the service life of an asset is noticeably shorter than its anticipated physical life.

Médecins du Monde 2019 Financial Report

The Association’s Head Office is a fixed asset which can be broken down. Its service life has been set at 20 years, but its physical life will no doubt be much longer. On 31/12/2019, the net book value of our Marcadet building was €1,35M for the building itself, and €1,21M for the land, which is not depreciable. Since then, within the context of a potential move of our headquarters, several purchase offers have valued the building at an amount well above €20M (the last proposal dates from 2020). Since the net book value is clearly lower than its residual value, no allowance for depreciation charge has been entered in the accounts since 31/12/2004. Financial fixed assets: Long-term securities: these are investments securities held for more than 1 year. On 31/12/2019, these amounted to €0,02M. Loans: Médecins du Monde frees itself from the obligation to take part in any building effort by paying its contribution to accredited collecting bodies in the form of interest-free loans, repayable over 20 years. On 31/12/2019, these totalled à €0,87M. Other financial fixed assets: this heading corresponds to advances, deposits and guarantees paid to third parties in France and abroad. On 31/12/2019, these came to €0,74M. Provision for depreciation on fixed assets: No provision for depreciation on fixed assets was recorded on the 31/12/2019. 4.3. STOCK AND STOCK DEPRECIATION Stock consists mainly of medical and surgical equipment, medicines, emergency kits, vehicles and communications equipment. Stock is entered in the accounts at its acquisition cost, and valued using the ‘first in, first out’ (FIFO) costing method. Depreciation is recorded if the actual value is lower than the entry value at the close of the financial year. 4.4. CLAIMS These are valued at their nominal value. Depreciation is recorded whenever their balance-sheet value is lower than their nominal value. Claims in foreign currency are accounted using the InforEuro exchange rate on the month concerned by the claim. The InforEuro exchanges rate is set by the European Commission. Any unrealised losses on the 31st of December, resulting from the difference between the InforEuro exchange rate and the closure rate on the 31/12/2019, trigger the creation of a provision for foreign exchange losses. 4.5. DEBTS These are valued at their nominal value. Supplier’s debts in foreign currency are converted using the InforEuro exchange rate on the month concerned by the debt. The InforEuro exchange rate is set by the European Commission.

Médecins du Monde 2019 Financial Report

Any unrealised losses on the 31st of December, resulting from the difference between the InforEuro exchange rate and the closure rate on the 31/12/2019, trigger the creation of a provision for foreign exchange losses.

4.6. CASH INVESTMENTS Marketable securities are entered in the accounts at their acquisition cost and valued using the FIFO method. Depreciation is recorded whenever the balance-sheet value is lower than the acquisition cost. Investments earning interest (term deposits and passbook accounts) are entered in the accounts at their nominal value. Any accrued interest is entered in the accounts.

4.7. BANK ACCOUNTS AND CASH FUNDS IN FOREIGN CURRENCIES Bank accounts and cash funds in foreign currencies are converted into euros at the rate for the 31 December of each year.

4.8. GRANT FUNDING – INTERNATIONAL PROGRAMMES a. Once an agreement has been signed with a funding agency (public-sector or private), the total amount of the contractual grant is entered against the account of the third-party funding agency, under the balance-sheet heading ‘Other receivables’. b. At the close of the financial year, the Association decides how far the financed project has progressed (by comparing actual expenditure to the expenditure forecast in the funding agreement) and how much of the grant should therefore be recognised in the accounts for that financial year. Any administrative costs covered by the contract are also taken into account. c. The difference between the total grant funding awarded and the portion recorded as income is shown under deferred income. This represents the share of the grant linked to future financial years. d. Any agreements signed after the close of the financial year, but used to fund eligible expenditure for that year, are recorded as accrued grants.

4.9. SUBSIDIES AND INVESTMENT GRANTS – FRENCH PROGRAMMES Operating subsidies are included under operating income for the financial year during which the Association is notified of the decision authorising the subsidy. If the subsidies apply in whole or in part to a period prior to the close of the financial year, a pro rata calculation is made, so that the income in question can be allocated to the relevant financial year, and, where necessary, deferred income can be entered in the accounts. Investment grants allocated to property which can be replaced by the Association are kept with liabilities under the heading ‘Non-recoverable Association funds’. Investment grants allocated to property which cannot be replaced by the Association are allocated to non-replaceable property and recorded in the investment grants account, then reclaimed on the Income Statement, as the item of property gradually depreciates.

4.10. EARMARKED FUNDS FROM GRANTS, DONATIONS AND LEGACIES Whenever income raised from French donors, general public and testators and allocated by them to a dedicated purpose and has not been used for that particular purpose by the end of the financial year, the restricted funds are entered in the accounts under balance-sheet liabilities. They represent the unused part of any restricted grants, donations and legacies, and are allocated via a specific expenditure account entitled ‘Outstanding commitments from earmarked funds’. 17

Médecins du Monde 2019 Financial Report

Whenever these donations and legacies are used during subsequent financial years, the earmarked funds are recovered using a specific income account entitled ‘Unused, earmarked funds brought forward from previous financial years’.

4.11. FUNDING SECURED ON BEHALF OF THE NETWORK MdM-France may receive donor grants for transferal, in whole or in part, to whichever members of the network will be implementing the activities financed by this donor. These grants are recorded as outlined in paragraph 4.8. When the contract is signed, their amount is recorded simultaneously under "Receivables" on the assets side of the balance sheet and "Deferred income" on the liabilities side. At the same time, MdM-France signs a contract with the network members covering the activity financed by the donor that the members will be implementing. This contract is recorded on the liabilities side of the balance sheet under "Other liabilities", and under "Prepaid charges” on the assets side. The network member will report to MdM-France on the progress of the action and the corresponding entries will be made in the income statement as follows: the donor grant will be recorded as income and the amount used by the network member will recorded as an expense under "Grants awarded by the Association". Prepaid charges and deferred income will be decremented accordingly. Third-party accounts on the assets and liabilities side of the balance sheet will be gradually cleared by the different cash movements recorded (receipt of donor payment, disbursement to the network member concerned).

4.12. ASSOCIATIVE PROJECTS The General Assembly can decide to use its reserves to carry out a specific project, called "associative project" and therefore constitute "reserves for associative projects". The reserve for the associative project is established and used as follows: Associative projects must be compliant to the associative object; Expenditures are clearly identified and not assimilated to usual expenditure. The allocation for an associative project and the expenditure commitments affectation concerning this project must be voted during the General Assembly, as well as the affectation to the general reserve of the unused funds. As indicated in paragraph 3, there are currently two reserves for associative projects in the accounts of Médecins du Monde.

RESERVES FOR ASSOCIATIVE PROJECTS

Equity Grant of Year of Equity the reserve fund Grant by the GA by the GA

Adaptation of premises MdM-France transformation plan

2016 2018 + 2019 Total

Consumption*

Balance sheet amount on 31/12/2019 before approval for use by the GA

119 359 671 951

119 359 0

93 962 671 951

791 311

119 359

765 913

Amount in the balance sheet at the end of 2019 if use approved by the GA

Use 2019*

11 936,00 0

82 026 671 951

11 936

753 977

* when the expenditure relates to an investment, the total amount of the investment appears in the "consumption" item and in the "use" item the part corresponding to the annual amortization of the investment

4.13. PROVISION FOR LIABILITIES AND CHARGES Provisions for liabilities and charges are set up based on events which have already occurred or are ongoing at the close of the financial year and render any such liabilities probable.

Médecins du Monde 2019 Financial Report

On 31/12/2019, this heading included: -

provisions for litigation and for risks (on legacies, agreements with donors, on our missions), provisions for expenses (closing costs), the provision for retirement benefits, the provision for unrealized exchange loss (difference between the exchange rate used when accounting for the receivable or debt and the exchange rate on 31/12, when the latter adversely affects the receivable or debt).

Provision for retirement benefits: The value of retirement benefits for Médecins du Monde’s total workforce (excluding local staff in countries other than France) was calculated. When calculating total retirement commitments (including social security contributions), the following were considered: -

retirement age: 65 years turnover rate averaged out for the last 4 years (2016 to 2019) pay increases of 1.1% per annum annual discount rate: 0,77% 2018 life table

4.14. LEGACIES AND OTHER DONATIONS Moveable and immoveable property originating from legacies or donations and destined to be sold by the Association is recorded in the following way: On the date a legacy is accepted by the Board of Directors or, in the case of legacies prior to 2006, on the date of their administrative authorisation, the items of property in question are recorded (off balance sheet) at their estimated value, and net of any charges they may have incurred in connection with the estate or its realisation, under ‘Commitments received’. As money is either received or paid out in connection with the sale of these items of property, the sums in question are either credited to (receipts) or debited from (withdrawals) the balance sheet account ‘Legacies and donations in progress’. The amount of the corresponding off-balance-sheet commitment is altered to reflect the movements are recorded. Once the realisation of any moveable and immoveable items of property has been finalised and has taken effect, the income account ‘Legacies and other gratuities’ is credited with the final, exact sale amount, net of any acquisition costs incurred by the property during its transfer, and the account ‘Legacies and donations in progress’ is then adjusted with respect to that legacy or donation. On 31 December 2019, legacies in progress totalled €4.076.930 and legacies receivable came to €6.490.304 (off balance sheet). Temporary, usufructuary donations are recorded as off-balance-sheet commitments to the value of the usufruct and its associated fruits, which are recorded as income for the financial year based on the sums received.

4.15. BENEFITS IN KIND The receipts and expenditure relating to Médecins du Monde’s activities over the course of the financial year can be clearly identified thanks to our accounting records and financial statements. However, our accounts only provide a partial picture of the way we operate. The fact is that as an Association we receive numerous voluntary contributions which are never entered in the accounts.

Médecins du Monde 2019 Financial Report

These voluntary contributions are made of the commitment of hundreds of unpaid men and women, without them we would not be able to run our programs, but they are also made of goods, services put to our disposal freely by companies, associations, foundations or donors For example, Médecins du Monde benefits from gifts of equipment, goods or medicines, as well as free communications materials and media. This kind of non-financial giving appears at the foot of the Income Statement and of the Income and Expenditure Statement, and it is thanks to contributions of this kind that the Association can save money and expand its operations still further. 4.15.1.

Donations in kind:

The valuation of goods and services in kind is based on official documents, supplied by the donors, certifying the financial value of the goods or services being given to Médecins du Monde. This financial value reflects the cost price of the goods or services in question. The valuation of services in kind for the year 2019 is stable compared to 2018: €1,04M in 2019 compared to €1,02M in 2018. 4.15.2.

Voluntary work in France:

A volunteer is a physical person who works for a not-for-profit organisation without receiving anything whatsoever in return. Since 2014, the work carried out by French volunteers has been centrally recorded using a data-processing tool. Thanks to the information gathered, we now know the identity of each of our volunteers, the kind of work he/she does, and the number of hours worked. Assessing the value of voluntary work involves calculating how much those hours would have cost if they had been worked as paid employment. The reference grid used to calculate their value in monetary terms is Médecins du Monde’s pay scale. The cost of employer contributions is included in this calculation. During the financial year 2019, the volunteers entered on the system worked 153.905 hours and would have cost us approximately €4.4M (€5.6M in 2018) so 84.56 FTE. This valuation is not an accurate reflection of all the work done by volunteers during an entire year, since it is based on individual volunteers’ declarations of the hours they have spent working for the Association. Inevitably, this method of record-keeping fails to pick up every detail and therefore ends up underestimating the true picture. In addition, this year the data are certainly undervalued due to the time taken by all the players to adapt to the new software.

4.15.3.

international voluntary work:

An international voluntary worker is a physical person over the age of eighteen who fulfils the following 3 conditions: 1) Signs a voluntary service contract with a French voluntary organisation promoting international solidarity and recognised by the French Ministry of Foreign Affairs or Ministry for Overseas Development. 2) Under this remit, takes part in an operation promoting international solidarity. 3) Completes one or more missions of general public interest in a country not on a list determined by French government decree (Decree of 02 May 1995). Under the terms of a voluntary work contract, a voluntary worker must receive training; a regular subsistence allowance and benefits in kind; payment of travel expenses and repatriation; medical and civil liability insurance; Social Security cover; and technical support. Welfare protection is also guaranteed under the provisions regarding voluntary insurance for French expatriates (the Fund for French nationals abroad [CFE]). The value of the contribution made by international voluntary workers is assessed using the following method: 20

Médecins du Monde 2019 Financial Report

Médecins du Monde knows the exact number of voluntary workers engaged in one or more programmes over the course of a financial year. This number of variable-length programmes equates to a certain number of days, and that number of days can be expressed in terms of their full-time equivalence per month/per person. Each volunteer’s working profile is matched to a similar function already carried out within Médecins du Monde, allowing the theoretical cost to payroll to be calculated using Médecins du Monde’s internal pay scale. Any allowances and benefits in kind which have actually been paid to these voluntary workers are deducted from this total. On 31 December 2019, international voluntary worker contributions totalled €0.1M. 4.16. OTHER INFORMATION Statutory Auditor’s Fees The Statutory Auditor’s fees shown in the Income Statement for the financial year ended on the 31/12/2019 amounted to €84.642,40 Administrators’ expenses During the financial year 2019, the Association’s administrators incurred travel and programme expenses of €74.007, a decrease of €26.933 compared to 2018, notably due to the reduction of travels. Remuneration of the Association’s Chair In compliance with the statutory provisions and with Article 261-7-1-d and Article 242 C of Appendix II of France’s General Tax Code, Médecins du Monde remunerates the position of Chair of the Board of Directors. The upper limit for this remuneration is set at 1.3 times the ceiling set by French Social Security or by whichever body is used as a reference instead. This remuneration, which is intended to be a gross amount, may not be paid for more than 3 terms of one year each, whether or not they are consecutive. The remuneration paid for 2019 came to €52.681. Remuneration of the Association’s three most senior executives, whether volunteers or paid employees (Article 20 of Act 2006-586 of 23 May 2006): The Association’s three most senior executives, whether volunteers or paid employees, are the Chair, the Treasurer and the General Secretary. Only the Chair is remunerated, as indicated in the previous paragraph, i.e. €52.681 in 2019. Events occurring after the close of the financial year The Covid-19 pandemic affected France and several of our intervention areas from the first quarter of 2020. The financial impact of this unprecedented health crisis is still difficult to estimate in its globality. For the time being, the donors are following Médecins du Monde in its efforts to redirect the activities planned in France and abroad towards actions to prevent Covid-19 from reaching the most vulnerable. The fact remains that the significant and rapid deterioration of the economic situation can significantly affect the resources of the association from the end of 2020. The consequences of this pandemic on MdM-France will therefore be measured in the medium term. The COVID crisis has already forced us to postpone the holding of the 2020 General Assembly until the end of September 2020, initially scheduled for May 16. 21

Médecins du Monde 2019 Financial Report

TANGIBLE AND INTANGIBLE FIXED ASSETS 5.1.

FIXED ASSETS MOVEMENTS TABLE

INTANGIBLES (€)

Acquisitions

01/01/2019

Subcontracted software

749 542

Licences (software)

Fxd asset alloc. In prog. &

Disposals

70 956

31/12/2019 820 498

379 980

2 500

3 761

378 718

Subtotal

1 129 521 -

73 456 40 051

3 761 -

1 199 216 40 051

TOTAL INTANGIBLES

1 129 521

113 507

3 761

1 239 267

IFA Advances

TANGIBLE ASSETS (€) LAND Land Marcadet land Subtotal BUILDINGS Buildings

Acquisitions

01/01/2019

31/12/2019

1 754

1 204 347

1 206 101

2 761 874

4 853 100

83 083

7 628 444

Marcadet building

2 761 874

Fixtures/fittings & improvements Marcadet

4 853 100

Fixtures/fittings & improvements Int. Prog.

Fxd asset alloc. In prog.

Disposals

96 552

83 083

13 469

Subtotal OTHER TANGIBLE ASSETS Fixtures and fittings

7 711 527 1 055 544

89 475

Transportation equipment

5 207 111

91 376

4 138 176

1 160 311

IT equipment

1 994 923

131 895

424 095

1 702 723

Office equipment

601 698

13 852

13 388

Office furniture

520 012

4 031

2 054

75 547

6 465

Medical equipment Communication equipment Audiovisual equipment

437 819

1 145 019

602 161 521 988

1 226

80 786

192 735

245 085

60 054

988

761

60 281

Subtotal Tangible assets in progress

9 952 707 -

338 082

4 772 435

5 518 356 -

TOTAL TANGIBLE ASSETS

18 870 335

338 082

4 855 518

14 352 900

TOTAL

19 999 857

451 589

4 859 279

15 592 167

Médecins du Monde 2019 Financial Report

5.2.

DEPRECIATION TABLE

INTANGIBLES (€)

01/01/2019

Amort.

Recovery

31/12/2019

Subcontracted software

674 015

44 011

Licenses (software)

324 520

23 120

3 761

343 879

998 535

67 131

3 761

1 061 905

Total INTANGIBLES TANGIBLE ASSETS

01/01/2019

Deprec.

718 026

Recovery

31/12/2019

Buildings Building

1 409 204

Fixtures & fittings (Bdg)

4 553 320

99 023

77 572

4 574 771

5 962 524

99 023

77 572

5 983 975

Subtotal Other Tangible Assets Fixtures & fittings

1 409 204

794 168

75 533

Transportation equipment

5 012 748

124 456

4 138 197

869 702 999 007

IT equipment

1 807 425

126 976

423 648

1 510 753

Office equipment

572 120

14 391

11 921

574 591

Office furniture

513 845

3 199

2 054

514 990

71 672

1 790

1 226

72 237

429 730

1 751

192 204

239 277

57 759

1 032

841

57 950

Medical equipment Communication equipment Audiovisual equipment Subtotal

9 259 468

349 131

4 770 092

4 838 507

Total Tangible Assets

15 221 992

448 154

4 847 664

10 822 482

Total

16 220 527

515 285

4 851 425

11 884 387

Médecins du Monde 2019 Financial Report

5.3.

NET BOOK VALUES TABLE

GROSS AMOUNTS ON 31/12/19

INTANGIBLE ASSETS (€)

TOTAL AMORTISATION ON 31/12/19

NET BOOK VALUE ON 31/12/19

Subcontracted software

820 498

718 027

102 471

Licences (software)

378 718

343 879

34 839

Advanced on intangibles assets

40 051

Total Intangibles

1 239 267

GROSS AMOUNTS ON 31/12/19

TANGIBLE ASSETS (€)

40 051

LAND Land Marcadet Land Subtotal

1 061 906 TOTAL AMORTISATION ON 31/12/19

177 361

NET BOOK VALUE ON 31/12/19

1 754

1 204 347

1 206 101

BUILDINGS - Building - Marcadet building

2 761 874

1 409 204

1 352 670

- Fixtures/fitting & improvements Marcadet

4 853 100

4 574 771

278 329

- Fixtures/fitting & improvements Int. Prog.

13 469

Subtotal

13 469

7 628 444

5 983 975

1 644 469

OTHER TANGIBLE ASSETS Fixtures & fittings

1 145 019

869 702

275 317

Transportation equipment

1 160 311

999 007

161 304

IT equipment

1 702 723

1 510 753

191 970

Office equipment

602 161

574 591

27 571

Office furniture

521 988

514 990

6 998

80 786

72 237

8 550

245 085

239 277

5 808

Medical equipment & supplies Communication equipment Audiovisual equipment

60 281

57 950

2 331

Subtotal

5 518 356

4 838 506

679 850

Total Tangibles

14 352 900

10 822 481

3 530 419

Total

15 592 167

11 884 387

3 707 780

Tangible assets in progress

FINANCIAL FIXED ASSETS

FINANCIAL FIXED ASSETS (€)

31/12/2019

Other long-term securities Housing construction loans (tax on French employers) Deposit & guarantees

20 962 868 628 736 441 Total

1 626 031 24

Médecins du Monde 2019 Financial Report

STOCKS

STOCKS (€)

31/12/2019

End of year amount of stock Depreciation of vehicle stock

280 881

Net stock amount

280 881

STATEMENT OF END-OF-YEAR CLAIMS

CLAIMS STATEMENT (€)

Gross amount

Relating to fixed assets : Loans (deposits and guarantees) Other financial fixed assets Total 1

Over 1 year

868 628 736 441

47 962 47 972

820 666 688 469

1 605 069

95 934

1 509 135

Relating to current assets : Account receivables

34 831

40 511 050 22 156 146 978 294 746 81 902 189 893

22 164 671 22 156 146 978 0 294 746 81 902 47 342

18 346 379 0 0 0 0 0 142 551

41 281 556

22 792 626

18 488 930

14 161 462

12 460 643

1 700 819

Total 3

14 161 462

12 460 643

1 700 819

GRAND TOTAL (1 + 2 + 3)

57 048 087

35 349 203

21 698 884

Funding bodies Personnel and related accounts Social security bodies State Various debtors Accrued income Legacies in progress Total 2 Prepaid costs

Amount of :

1 year maximum

- Loans granted during financial year - Loan repayments over financial year

Médecins du Monde 2019 Financial Report

ACCRUED INCOME

OTHER RECEIVABLES (€)

On 31/12/2019

- Discounts, reductions & rebates obtainable and credits receivable

12 463

- Social security bodies – accrued income

146 978

- State – accrued income

- Accrued income

81 902

* Grants income

1 611

* other accrued income

80 292

Total

241 343

10. LIQUID ASSETS 10.1.

MARKETABLE VALUES

INVESTIMENTS (€)

Share price on 31/12/2019

Purchase value

SICAV or FCP

0 0

Shares Term deposit account

Latent revaluation gains

Latent revaluation losses 0

19 438 145

Term deposit account interests

TOTAL

19 438 145

10.2.

BANKS AND CASH FUNDS

GROSS VALUE (€)

On 31/12/2019

Values for collection

4 843 884 28 663 075

Bank balances Cash in hand

367 023

Total

33 873 982

The values for collection represent the donations sent by donors until the December 31st and collected by us in the first days of January.

Médecins du Monde 2019 Financial Report

11. PREPAID COSTS

PREPAID COSTS (€)

On 31/12/2019

Suppliers’ charges billed in advance

1 550 996

International Network members for which MdMFrance has obtained funding

12 610 466

Total

14 161 462

12. ORGANISATION’S OWN FUNDS

OWN FUNDS (€)

Increase

01/01/2019

Statutory Reserve

Reduction

31/12/2019

15 245

Gratuities / Legacies

General Reserve : Operations Reserve: Associative project

17 667 954

38 359

432 615

345 234

17 706 312 11 936

765 914

Balance brought forward

Emergency Reserve

Operating Reserve

Investments grants/renewable assets

24 745

Investments grants

Surplus allocated to investments

0 Total

2018 Surplus

18 140 559

0 383 594

371 658

2019 Surplus

11 936

18 512 216

371 658

1 508 698

Total

18 512 216

1 508 698

1 892 291

383 594

Allocations for the year

Provision write-off

20 020 913

13. TABLE OF PROVISIONS

PROVISIONS (€)

01/01/19

31/12/19

Provisions for possible losses Litigation provisions Other Contingents Provisions Contingents Provisions related to retirement benefits Provisions for foreign exchange losses Subtotal 1

407 500

12 000

150 000

269 500

1 278 930

1 137 426

810 963

1 605 393

507 362

622 891

507 362

622 891

795 562

156 403

795 562

156 403

2 989 354

1 928 721

2 263 887

2 654 188

Provisions for impairment On Financial Asset

Other provisions for possible losses

5 742

Subtotal 2

5 742

Total (1+2)

2 995 096

1 928 721

2 263 887

2 659 930

Médecins du Monde 2019 Financial Report

14. EARNMARKED FUNDS

EARNMARKED FUNDS (€)

Provisions for outstanding commitments (+)

EFs at start of financial year

From grants

40 887

Write-backs of EFs (-) 0

EFs at the end of financial year (=)

40 887

Africa Asia

Europe France Middle East et North Africa From donations

40 887

78 894

139 546

78 894

139 546

78 894

139 546

78 894

139 546

119 781

139 546

119 781

139 546

40 887

78 894

139 546

78 894

139 546

119 781

139 546

119 781

139 546

Africa Asia Europe France Middle East et North Africa From legacies France

TOTAL Africa Asia Europe France Middle East et North Africa

TOTAL

15. STATEMENT OF END-OF-YEAR DEBTS DEBTS STATEMENT (€) Borrowings and similar debts Accounts payable and related accounts Personnel and related accounts Social security bodies State taxes Fixed asset debts and related accounts Other debts Total Debts Deferred Income

Grand Total

Gross amount as at 31/12/19

1 year maximum

Over 1 year to 5 years maximum

203 333 3 520 587 1 606 189 2 754 246 847 260 53 328 19 079 548 28 064 491 44 046 811

203 333 3 520 587 1 606 189 2 754 246 847 260 53 328 14 705 250 23 690 193 35 607 098

4 374 298 4 374 298 8 439 713

72 111 302

59 297 291

12 814 011

Borrowings repaid during financial year

Médecins du Monde 2019 Financial Report

16. TABLE OF LEGACIES AND DONATIONS IN PROGRESS

LEGACIES AND DONATIONS (€)

Total

Ongoing legacies and donations on 31/12/2018

Ongoing legacies and donations on 31/12/2019

2 982 515

4 076 930

17. ACCRUED LIABILITIES

ACCRUED LIABILITIES (€)

On 31/12/19

Borrowings and debts with credit institutions : * Accrued interest, not yet matured Accounts payable and related account * Invoice not yet received Tax and social security debts * Accrued paid leave debts * Other personnel costs payable * Social security bodies – accrued contributions * Accrued State taxes Other debts * Miscellaneous expenses accrued

1 092 897 1 092 897 3 453 021 1 565 402 719 792 820 054 347 773 315 138 315 138

TOTAL

4 861 056

18. DEFERRED INCOME

DEFERRED INCOME (€)

On 31/12/19

Foreign Grants

33 599 264

Africa

11 171 489

Latin America and Caribbean

509 863

Asia

4 562 289

Europe

331 425

Middle-East and North Africa

11 118 720

Cross countries

5 905 477

Grants linked to network financing

10 017 901

France Grants

429 647

TOTAL

44 046 811

Médecins du Monde 2019 Financial Report

19. OFF-BALANCE-SHEET COMMITMENTS 19.1.

COMMITMENTS RECEIVED

COMMITMENTS RECEIVED (€)

Legacies

Donations

On 31/12/19

119

Number of testamentary accepted by the board and not received

Valuation of the amount to be received (€) 19.2.

6 490 304

GIVEN COMMITMENTS

Leasing Commitments

Entry Costs Financial Year

(€)

Cumulated

Rolling stock

Total

OTHER COMMITMENTS

Depreciation Charges Over 1 1 Year year to 5 Total to Maximum years pay maximum 0

Net value

Total on 31/12/19

Security, guarantee, bond

none

Security in rem

none

20. EMPLOYEE STATISTICS Workforce as at 31 December 2019 : 1.540 international programs staff    

1.366 national employees 3 international solidarity volunteers 103 expatriate employees 68 head office IOD employees

1.672 French sector staff :  1.533 volunteers (including the 257 voluntary association managers below)  123 employees in the field and in regional delegations  16 employees of the French Operations Department (FOD) at head office 429 operational support staff:  257 voluntary association managers (directors, regional members, group leaders, heads of projects)  172 head office employees For a total of 3.384 staff. Pay: Average of the 3 highest gross annual salaries: €83.629 Average of the 3 lowest gross annual salaries: €25.821 Average gross annual salary: €39.192 Ratio 3 highest gross annual salaries/3 lowest gross annual salaries: 3,24 The lowest gross annual salary is higher than French minimum wage of 30,57% (excluding 13th-month pay). The figures above do not include seniority bonuses. 30

Médecins du Monde 2019 Financial Report

21. OPERATING EXPENSES : DETAILS OPERATING EXPENSES (€)

2019

Stock variation Sanitation equipment Housing equipment Logistics equipment Vehicles Miscellaneous equipment Non-storable supplies Medicines and medical equipment Cleaning and maintenance supplies International personnel equipment Expendable equipment Mailing supplies Food aid / foodstuffs Event merchandise Purchases Subcontracting Leasing charges Rental and rental charges Maintenance and repairs Insurance premiums Studies and research Miscellaneous

24 465 715 631 58 056 157 339 148 386 25 309 910 862 4 048 968 721 123 124 966 182 481 18 900 580 395 30 853 7 747 733 7 883 254

Other management costs Allowance for depreciation

4 589 018 1 243 191 319 896 98 412 243 744 14 377 514 207 102 1 225 348 2 384 663 2 176 883 668 323 4 680 123 2 070 135 266 595 106 914 13 786 086 3 203 587 32 723 474 8 299 497 41 022 972 387 496 19 617 092 20 004 588 2 142 495

TOTAL

102 284 974

Outside services Outside staff Local staff Fees Advertising and publications Transportation Trips / Receptions Postage and Telecommunications Bank charges Miscellaneous Other outside servcies Taxes and similar payments Salaries and pay French NI contributions Personnel costs Miscellaneous management costs Grants paid by the association

2018 29 602 1 128 699 87 770 189 485 105 639 24 586 902 255 5 063 733 929 481 142 485 197 331 15 172 548 304 50 869 9 415 410 8 158 457 -2 374 5 082 317 1 171 726 340 670 56 994 225 743 15 033 534 128 374 1 527 450 2 506 638 2 343 319 372 933 5 015 336 2 464 059 368 092 140 602 14 866 803 3 090 820 34 348 754 8 972 756 43 321 510 603 950 8 665 024 9 268 974 2 091 484 97 088 534

2019/2018 -17% -37% -34% -17% 40% 3% 1% -20% -22% -12% -8% 25% 6% -39% -18% -3% -100% -10% 6% -6% 73% 8% -4% 61% -20% -5% -7% 79% -7% -16% -28% -24% -7% 4% -5% -8% -5% -36% 126% 116% 2% 5%

Médecins du Monde 2019 Financial Report

22. INCOME AND EXPENDITURE STATEMENT

The Annual Income and Expenditure Statement (IES) was drawn up in compliance with the provisions of Regulation No. 2008-12 of the Accounting Regulatory Committee and according to the allocation of resources approved by the Board of Directors of MdM-France in 2019, already used during the 2018 decree. The IES explains how the Association’s overall resources were used, i.e. how they were divided up between social programmes, fundraising costs and running costs. The totals in columns 1 and 2 match the total expenditure and income in the Income Statement. The IES also gives a separate breakdown of the way in which funds raised through public giving have been used. Columns 3 and 4 enable the monitoring of all such funds, whether they have been raised in the same financial year or brought forward from previous years’ unused funds. The total shown on the Income and Expenditure Statement is always identical to the totals on the Balance Sheet and on the Income Statement 22.1. 22.1.1.

EXPENDITURE

Social Programmes :

Médecins du Monde’s vocation is to treat the most vulnerable people groups in crisis situations or situations of exclusion, both here in France and Worldwide, highlighting the harm caused by crises and by threats to people’s health and dignity. Its aim is to help prevent such harm and, through its witness-bearing initiatives, to denounce human rights violations, in particular the obstacles preventing access to treatment. Until the end of 2019, the Association also aims to promote adoption, as an organisation authorised and empowered by the competent authorities, in order to help those children who have been put up for adoption legally by the authorities in their country of origin, and who cannot be kept safe in any other way. Social programmes therefore include the following: operations carried out in France, arranged by type of activity (centres, outreach, harm reduction, regional delegations, exploratory programmes, witness-bearing programmes, and associated coordination, management and monitoring costs – that they are carried out on the ground or at headquarters); operations carried out abroad, arranged by continent, and including adoption (direct costs of programmes, of exploratory programmes and of witness-bearing programmes, and associated coordination, management and monitoring costs-whether they are carried out on the ground or at headquarters). Information and communications costs are shown under social programmes, since the Board of Directors has decided that these activities constitute an integral part of the Association’s social purpose. The distribution of these costs is made according to the public to which the advocacy, information or communication action is addressed (actions intended for the French public are charged to Actions carried out in France, etc.). Social programmes in France and abroad are now broken down into “Actions undertaken directly” and “Payments to other organisations”. The Board of Directors took the following stances: -

“Actions undertaken directly” include support provided to our implementation partners. There are indeed two possible cases:

Médecins du Monde 2019 Financial Report

o In accordance with our mission statement, the purpose of such support is to reinforce the partner’s intervention capacity, so that it is ultimately able to take over our activities. We then support it financially but, more importantly, operationally, in terms of processes, tools, procedures, etc. o Amidst, MdM must go through local actors even in cases when action is sponsored directly by the organisation. -

“Payments to other organisations”, include grants paid by MdM-France outside the framework of a field programme, designed, implemented and supervised directly by the organisation (e.g., unrestricted grants paid to members of the network, financial support to organisations in France, repayments of funding obtained on behalf of the international network, etc.).

Guidelines for the allocation of expenses to social programmes Expenditure on social programmes is the sum of the costs incurred by the Association in pursuit of its operations. Expenditure on social programmes therefore includes direct costs (charged as soon as transactions are entered in the accounts) and costs that cannot be directly assigned and are therefore shared out using allocative keys. Only an expense which has actually been incurred is assigned to a specific social programme. Provisions are recorded under the headings ‘Charges to Provisions’ or ‘Write-back of Provisions’ in the Annual Income and Expenditure Statement, depending on whether they are being created or recovered. Allowances for depreciation can be classed as operational expenses if the above definition applies. Only financial costs linked directly to social programmes (and which would disappear if the social programme in question came to an end) should be recorded under social programmes.

22.1.2.

Fundraising Costs :

Costs of appeals for public giving This heading includes the costs of appealing for donations (marketing, direct mail advertising, newspaper inserts, etc.) and the costs of processing donations, issuing tax receipts, and finding and managing legacies, as well as donations linked to life insurance, managing special events, dedicated personnel costs, and the costs of fundraising from other network members. Some of the costs for the donors’ newsletter are charged to this heading (cf. allocative keys below). Costs of finding other sources of private funding This heading includes the costs of the Corporate Sponsorship & Partnerships Department; Costs of obtaining grants and other public-sector participation This heading includes the costs of the department dedicated to public-sector and institutional funding [DDI].

22.1.3.

Running Costs

Running Costs include the costs of the following services : -

Statutory costs (to be distinguished from the costs of animation of the volunteers who appear in social operations) Administrative and legal (not counting missions) Financial Directorate (strictly speaking) and Accounting Department at headquarters Information technology (excluding the share of amortisation broken down based on the principle stated below) General Services Department and headquarters amortisation (share determined based on the principle stated below) Headquarters management controls Human Resources Directorate (strictly speaking) and HR Administration Department (strictly speaking) Service in charge of the organisation’s plan for evolution (H25) Legal department (not counting programmes) Financing costs (not counting costs directly attributable to one mission) 33

Médecins du Monde 2019 Financial Report

22.1.4.

Allocative Keys Used

Allocation of indirect costs depending on their financial weighting: Common costs for social programmes in France and abroad : prorated to the direct costs of missions and the financial weight of volunteers. Common costs for fundraising: prorated to resources raised (e.g., fundraising department, strictly speaking) Directorate General and documentation costs: prorated to direct costs of uses and the financial weight of volunteers Allocation based on time spent : Intervention costs: supervision of volunteers is included in social programmes, with statutory projects being recognised under running costs. Health and Advocacy Directorate: breakdown between social programmes in France and abroad Purchasing Logistics Department: breakdown between social programmes, fundraising costs, and running costs General Services Department (excluding costs linked to the headquarters building): breakdown in Programmes in France (General Services Department handles logistics issues for them) and running costs. Breakdown based on staff concerned : -

Career, hiring and training HR Department: prorated to the number of persons managed Headquarters building costs (including human resources): prorated to the number of headquarters employees working for social programmes, fundraising or operations.

Other keys : -

Journal of donors: costs split between social programmes and fundraising costs based on the number of pages of communication or advocacy and the number of pages of appeals for donations. Web: costs broken down by number of clicks (those generating fundraising are attributed to fundraising costs) Grants paid to the international network and not restricted to a specific purpose: broken down into thirds for social programmes, fundraising costs and operations.

22.2. 22.2.1.

INCOME

Funds from public giving

Funds from public giving are: donations from private individuals and businesses (excluding corporate sponsorship, salespercentage and partnership agreements); legacies; donations linked to life insurance; income from special events; and funds raised from other network members. Financial income from our investments is also included in “Other income from public donations”. To make things simpler, we have considered that invested funds are from our reserves and collection of donations and other funds. Note that financial income investments came to €0.03m. Such investment income was previously recognised under “Other income”. Financial income from currency gains: Given the complexity of tracing the origins of currency gains, we have applied the percentage of funding of field operations that is not from our funding bodies to the total amount of currency gains, in order to determine those that are from public donations

22.2.2. Other private funds Other private funds include : -

Funds received from businesses in the form of corporate sponsorships, sales percentages or partnerships; Grants received from private, not-for-profit organisations. 34

Médecins du Monde 2019 Financial Report

22.2.3. Grants & other public-sector participation: This heading includes grants from the European Union, the French State, local authorities, public-sector institutions, UN agencies as well as foreign governmental organizations.

22.2.4. Other income : Other income includes : - Miscellaneous operating income - subscriptions - contribution to the ‘Adoption’ service. 22.3.

FIXED ASSETS FUNDED BY FUNDS RAISED FROM THE PUBLIC

The portion of fixed assets financed by public donations must appear specifically in the Income and Expenditure Statement. Since 2018, we now consider that investments that are not from a specific funding source (grants by a public or private funding body, or an earmarked donation or bequest) shall be funded by the balance of Other Income or Public Donations, which is still available after funding other use categories. 22.4.

ALLOCATION OF INCOME FROM PUBLIC GIVING

The order of allocation of resources to uses is as follows: Resources earmarked by the funding body or donor are used, first of all, for the purpose stated by the funding body or donor. Earmarked grants Other earmarked private funds Earmarked public donations

Costs released from the use of volunteers are assigned to funding the department in which they work. Member dues are given priority use in funding statutory obligations. Currency gains fund social programmes as a priority. Resources not earmarked to a specific purpose are then used as follows: -

Other non-earmarked public or private funds and other income: o Unrestricted resources (excluding those from public donations, administrative costs on grants and currency gains) fund, by order of priority, fundraising costs for the activity concerned, thenrunning costs, and then other fundraising costs (excluding general public) and then the missions. o The percentages of administrative costs assigned to public-sector grants fund, by order of priority, the cost of obtaining public-sector grants, then grants paid to the international network, then running costs of the organisation, and then the social programmes. o The percentages of administrative costs granted to private-sector grants fund, by order of priority, the costs of obtaining private-sector grants, then grants paid to the international network, then the organisation’s running costs, and then social programmes. o Other income funds, by order of priority, running costs, then investments.

Non-earmarked public donations: o Funds paid by the international network: fundraising costs tied to the international network, then grants paid to the international network, then the social programmes o French public donations: social programmes until the amount to be financed is exhausted, then fundraising costs from public donations, then running costs, then investments.

Médecins du Monde 2019 Financial Report

Changes to Earmarked funds from public giving: These changes show either that the funds allocated by a donor have been used, or, when it has not been possible to use a donation as requested by the donor, the continued existence of earmarked funds.

22.5.

INCOME IN KIND

Inventory of French volunteer workforce : 1 533 French volunteers intervened in 2019 - the Full Time Equivalent of 84.56 people. Nature and quantity of income in kind : See comments on this subject under Point 4.15 of Accounting Rules and Methods above. The information presented here has been drawn up based on our accounting records.

Médecins du Monde 2019 Financial Report

INCOME AND EXPENDITURE STATEMENT 2019 (€) Allocation (according to use) of funds raised 2019 Expenditure from the general public for use during the financial year

EXPENDITURE

Monitoring of funds raised from the Funds raised in 2019 general public for use during the financial year

INCOME

Brought forward funds raised from the general public, unrestricted and unused at the start of the financial year 1 - SOCIAL PROGRAMMES

84 772 106,14

29 891 918,91

1.1 Activities carried out in France 1.1.1 Activities directly carried out 1.1.2 Payments to other institutions

15 428 530,65 15 375 721,65 52 809,00

11 272 523,85

1.2 Activities carried out abroad 1.2.1 Activities directly carried out 1.2.2 Payments to other institutions

69 343 575,50 56 488 079,69 12 855 495,81

18 619 395,06

2 - FUNDRAISING COSTS

12 837 878,32

11 629 781,27

2.1 Costs of appeals to public generosity

11 631 781,27

11 629 781,27

2.2 Costs of fundraising from other private sources

874 056,48

2.3 Costs related to applications for grants and other public sector funding

332 040,57

3 - RUNNING COSTS

3 906 257,36

2 121 500,83

TOTAL 101 516 241,82 I - TOTAL EXPENDITURE FOR THE FINANCIAL YEAR RECORDED IN THE INCOME STATEMENT 101 516 241,82 1 783 720,74 II - CHARGES TO PROVISIONS

43 643 201,01

III - OUTSTANDING COMMITMENTS FROM EARMARKED FUNDS

1-FUNDS RAISED FROM THE GENERAL PUBLIC

44 737 838,72

1.1 Donations and legacies received

43 118 631,54

- Unrestricted donations by hand - Earmarked donations by hand - Unrestricted legacies and other gratuities - Earmarked legacies and other gratuities

39 087 468,13 187 239,46 3 843 923,95 -

1.2 other revenue from appeals to public generosity

1 619 207,18

2 - OTHER PRIVATE FUNDS 3 - GRANTS AND OTHER PUBLIC SECTOR FUNDING 4 - OTHER REVENUE

3 734 586,81 52 904 395,18 1 332 718,14

I - TOTAL FUNDS FOR THE FINANCIAL YEAR RECORDED IN THE INCOME STATEMENT II - WRITE-BACKS OF PROVISIONS

102 709 538,85 2 118 887,31

III - UNUSED, EARMARKED FUNDS BROUGHT FORWARD FROM PREVIOUS FINANCIAL YEARS

139 546,00

6 361 341,52

119 780,12

IV - CHANGE IN EARMARKED FUNDS RAISED FROM THE GENERAL PUBLIC (cf table of earmarked funds) 1 508 697,72

IV - SURPLUS FUNDS FOR THE FINANCIAL YEAR

V - GRAND TOTAL VI - Proportion of grossfixed asset acquisitions in the financial year finances since the regulation first came into force by funds raised from the general public VII - Offsetting of depreciation allowances on fixed assets financed since the regulation first came into force by funds raised from the general public

104 948 206,28

44 798 491,28

173 732,78

43 881 006,80

5 367 737,09 135 343,43 TOTAL

VI - GRAND TOTAL 411 538,57

VIII - Total expenditure financed by funds raised from the general public

Social programmes Fundraising costs Operating costs and other expenses

60 652,56

V - FUNDING DEFICIT FOR THE FINANCIAL YEAR

VI - Total expenditure financed by the funds raised from the general public Balance of funds raised from the general public which are unrestricted and unused at the end of the financial year

43 881 006,80

7 278 826,00

Volontary work (France)

4 463 249,96

Donations in kind

1 039 830,56

5 503 080,52

TOTAL

5 503 080,52

Médecins du Monde 2019 Financial Report

Part 2 Analysis of the 2019 Accounts

Médecins du Monde 2019 Financial Report

INCOME STATEMENT

In thousands €

2016

2017

2018

2019

Income

97 024

100 104

99 593

104 948

Expenses

95 861

99 111

99 223

103 439

1 163

993

371

1 509

Surplus/Deficit

An increase in activity In 2019, MdM France’s global activity increased by 4.3% compared to 2018. A financial year ending with surplus MdM France ended the year with a total surplus of €1.5 million, up €1.1 million on the previous financial year. This increase can be explained by the amount of surplus, which, after several years of net expenses, became markedly positive again, reaching €0.8 million in 2019, i.e. up €1.4 million on 2018, and, to a lesser extent, by the €0.2 million increase in net operating income. These two factors more than offset the fact that fewer dedicated funds were brought forward in 2019 than in 2018 (+€0.4M in 2018 and break-even in 2019).

1.1 1.1.1

NET OPERATING INCOME Operating income

Operating income reached €103.1 million, up €5.4 million on 2018 (+5.5%). Moreover, a significant proportion of these grants (€13.1 million) concerned financing transferred to the international network for its operations in Turkey, Syria and DRC. Private-sector funding was composed of funds raised from the general public1 (€44.6 million against €46.5 million in 2018), private-sector grants (€3.8 million against €31 million in 2018) and other revenue (€0.5 million against €0.4 million in 2018). MdM’s financing model therefore remained globally balanced (52% public-sector funds and 48% private-sector funds, excluding write-backs of provisions). If we exclude funding obtained on behalf of the network, the percentage breakdown is 45% of public-sector funding and 55% of private-sector funding (excluding write-backs of provisions). This breakdown gives us the financial independence we need to develop programmes that don’t correspond to a donor’s call for projects, to start projects without having to wait for external funding and to launch exploratory missions. Public-sector grants increased overall (+€6.8M, up 14.7% on 2018), in line with growth on the programmes, both French and international -the growth in public-sector grants for international programmes being driven by the increase in funding obtained on behalf of the network.

Operating income from public giving is made up of donations, bequests and donations from the network. 39

Médecins du Monde 2019 Financial Report

Private-sector grants rose again (+€0.6 million), after a particularly difficult year in 2018. Funding raised from the general public in France and in the international network was down by €1.9 million compared to last year. Fundraising from the French public reached €39.27 million, up €0.46 million on 2018. This is a very satisfactory performance in an unfavourable context (tax deductions at source, year-end strikes, etc.). Direct debits represented more than 70% of fundraising, i.e. up 2 points as a result of the introduction of a new fundraising method combining the web and telemarketing). On the other hand, there was a decrease in the number of one-off donations. The change of focus to online one-off donations continued in 2019, with a growing proportion of internet donations. This is encouraging progress in finding new fundraising levers. Funds raised by the international network reached €1.5M, a sharp decrease compared to 2018 (-40%, or -€0.98M). Agreements with the network were renegotiated in 2019. Most of the donations were from MdM Germany and MdM Japan. Income from bequests and other similar donations came to €3.84 million, down by €1.4 million or 27% in comparison with 2018. Income from bequests only includes bequest files that have been fully concluded and so does not include those – sometimes very big files – in which there is an outstanding asset to settle, however small it may be. Several large and complex bequests could not be finalised by the end of the financial year. However, the global bequest portfolio was very large overall compared with previous years. Write-backs of provisions for €1.33M came from the resolution of a number of liabilities or litigations during the financial year for which prior provisions had been made. They break down as follows: Write-backs of provisions offset by the recognition of an expense in 2019 for the amount of €0.8M. These writebacks, notably of provisions for the costs of closing countries (Somalia, Haiti, etc.) and the settlement of litigation, had no effect on the final accounting result. The provision for retirement benefits is written back and re-provisioned every year. The amount of the write-back of this provision in 2019 was €0.5M. This provision is listed in the expenses below.

1.1.2

Operating expenses

Operating expenses increased by 5.35% in 2019 to reach €5.19 million. There was a reduction in our direct costs, but an increase in grants awarded. This increase was due to the amount of institutional funding secured by MdM France for onward payment to members of the international network. There were contrasting trends in operating expenses, depending on their nature. The most notable differences between 2018 and 2019 were as follows: -

Purchases (€7.72 million), down by 18% (-€1.66 million) compared to 2018. There was notably a reduction in purchases of pharmaceutical products and medical equipment (-€1 million) and construction materials (-€0.5 million), due mainly to the transfer of activities in Turkey and Northwest Syria to MdMTurkey.

Salaries and payroll costs (€41.02 million in total) also decreased by €2.3 million, or 5.3%. This reduction applied to both French contracts (-€1 million) and staff recruited locally on international programmes (-€1.3 million, or -8%) and reflects the transfer of activities in Turkey and Northwest Syria to MdM Turkey and the closure of our missions in Haiti, Somalia and Venezuela.

On the other hand, grants awarded by MdM France (€19.62 million) increased by €10.95 million, or 126% in 2019.

Médecins du Monde 2019 Financial Report

These grants are awarded as follows:



To members of the international network: o Either in the form of a funding contracts obtained on their behalf (MdM-Turkey and MdM-Belgium in 2019) by MdM France. As indicated above, activities previously implemented by MdM-France in Turkey and North-West Syria were transferred to MdM-Turkey in early 2019. This transfer included the transfer of funding contracts already obtained by MdM-France or which MdM-France was able to obtain during the year on behalf of MdM-Turkey.The expenses relating to the share of donor contracts used by MdM Turkey were recorded in our accounts under Grants awarded by the Association. The same applied to the contract obtained on behalf of MdM Belgium for the Democratic Republic of Congo. The amount awarded in 2019 came to €12.83 million, against €0.79 million in 2018) o Or to help them develop or increase their fundraising.



To local institutional or civil society organisations (in France or abroad) who take over our direct operations in the field, in line with our mission statement. The amount of these operations in 2019 was €4.8 million, down €0.3 million on 2018.

Provisions (€1.3M), up by €0.15M The main provisions made in 2019 were for liabilities related to our international operations and the annual adjustment to the provision for retirement benefits. 1.2

FINANCIAL INCOME

Financial income produced a surplus of €0.78 million in 2019 due to foreign exchange variations. There are three components to financial income: - Excluding foreign exchange: Financial expenses and financial income related to our investments Recognition of realised foreign exchange gains and losses - Variation in provisions for foreign exchange losses As a result of more favourable exchange rate movements than in 2018, the exchange variations actually recorded on our international operations generated a net gain of €0.15M, compared to a net loss of €0.2M last year. Provisions for currency losses, resulting from a comparison between the book value of our payables and receivables in foreign currencies and their theoretical value based on exchange rates as of 31 December, were down considerably on last year (-€0.6 million), with positive consequences for financial income. Our foreign exchange exposure was lower than in 2018 as certain multi-year contracts came to an end in 2019. Income from financial investments remained marginal (€0.04 million), although slightly up compared to 2018 (+€0.01 million). Our investment policy focused on cash-type investments (term or passbook deposits or accounts, SICAV/FCP) as they are among the most secure assets on the market.

1.3

EXTRAORDINARY INCOME, CORPORATE TAX AND DEDICATED FUNDS

There are no particular remarks on our extraordinary income (-€0.04 million) in 2019. Corporate income tax concerns income from some of our investments and rental income from bequests, taxable at a reduced rate. The change in dedicated funds (unused earmarked funds brought forward and outstanding commitments) in 2019 was due to an additional provision for Yemen (+€0.04M), against a net reversal of dedicated funds (€0.4M) in 2018.

Médecins du Monde 2019 Financial Report

BALANCE SHEET

In thousand € ASSETS

2019

2018

LIABILITIES

Fixed assets Stocks Claims Cash Prepaid charges Total

5 334 281 41 276 33 874 14 161 94 926

5 391 305 55 550 27 872 5 071 94 189

Equity Provisions for liabilities and charges Dedicated funds Debts Deferred income

2019

2018

20 021 2 654 140 28 064 44 047 94 926

18 512 2 989 120 18 778 53 790 94 189

There was little difference in the balance sheet total for 2019 (€94.93 million) as compared to 2018 (+€0.74 million), but despite overall stability, there were significant item-to-item variations.

Balance sheet assets There are no particular remarks to be made on fixed assets (€5.3 million). No significant investments were made in 2019. The main acquisitions concern the renewal of vehicles for the field and computer equipment. There was a decrease in donor receivables (-€13.22 million on the assets side) and deferred income related to grants (-€9.74 million on the liabilities side). NB. Agreements with institutional donors are recorded as receivables from the moment the agreement is signed, regardless of the period covered; and deferred income represents the share of grants pertaining to future financial years. There are two main reasons for the decrease in donor receivables in 2019. Firstly, we had fewer multi-year contracts underway than in previous years; and secondly, several large donor contracts were completed during year. This phenomenon also largely explains the decrease in deferred income: as the contracts covered a shorter period, the share of grants relating to future financial years was lower. Cash increased by €6 million to reach €33.9 million. This increase was mainly due to our secure passbook investments (+€4.9M).

Balance sheet liabilities Own funds grew by the amount of the surplus recorded over the financial year. Their level at 31/12/2019, i.e. €20.02 million, is the equivalent of 2.35 months of operation. While this ratio was up slightly on last year (2.29 months of operations), it remains below the 3-month target set by the Board. Own funds (MdM’s reserves) enable us to finance our fixed assets, ensure the continuation of our operations in the event of difficulties and guarantee our autonomy of action. Provisions for liabilities and charges were down by €0.34 million in 2019, settling at €2.65 million, notably due to the writeback of provisions on unrealised foreign exchange losses. “Other liabilities” rose by €9 million to €19 million. This increase is mainly the result of donor grants contracted by MdM-France on behalf of the network (a total of €8.78m for DRC to be paid to MdM-Belgium and for Syria/Turkey to be paid to MdM-Turkey). The portion of the grants not yet used by the members of the network appears as prepaid charges (+€9.1M) in our balance sheet and explains the increase in this item on the assets side of the balance sheet. The "Other liabilities" item also includes receipts from current outstanding bequests, up by +€1.08 million. The amount for consortia decreased by €1.57million.These are funds transferred to partners within the framework of programmes conducted by MdM-France jointly with other NGOs.

Médecins du Monde 2019 Financial Report

INCOME AND EXPENDITURE STATEMENT

The calculation of ratios is based on the Annual Income and Expenditure Statement, excluding changes to provisions (provisions and write-backs) and dedicated funds (outstanding commitments and unused earmarked funds brought forward from previous financial years), i.e. from the ‘Total 1’ line of the Income and Expenditure Statement (lines headed “Total expenditure for the financial year recorded in the Income Statement” and “Total funds for the financial year recorded in the Income Statement”.

3.1.

EXPENDITURE

2018 Expenditure 3,5%

Social Programmes

14,7%

Fundraising Costs Operating costs 81,9%

2019 Expenditure 3,8%

Social Programmes

12,6%

Fundraising Costs Operating costs

83,5%

Médecins du Monde 2019 Financial Report

The share of social programmes increased by 1.6% overall. This increase was driven by actions carried out both at home (+0.2% in France) and abroad (+1.5% internationally), and especially by the network's actions financed by grants secured by MdM-France (13% of expenditure). While the proportion of social programmes expenditure increased, that of fundraising costs decreased (-2.1%). Running costs rose slightly (+0.4%).

3.1.1

Social programmes

FRENCH AND INTERNATIONAL PROGRAMMES The same breakdown between French and international programmes as in 2018. Missions abroad and in France increased in the same way in 2019, and their distribution was strictly equivalent to that of 2018.

DISTRIBUTION OF SOCIAL PROGRAMMES IN 2018 18%

82%

DISTRIBUTION OF SOCIAL PROGRAMMES IN 2019

Social programmes France Social programmes International

18%

82%

Social programmes France Social programmes International

Médecins du Monde 2019 Financial Report

PROGRAMMES IN FRANCE

French programmes

2018

2019

in thousands of € Healthcare, advice and referral clinics

3 801

4 057

Other programmes in France

4 015

4 044

Witness-bearing actions

1 921

2 255

524

702

4 266

4 318

14 567

15 428

Grants awarded to other institutions Advocacy and quality of practices Coordination and management of programmes in France

Total

Variations between 2018 and 2019 Operations in France (Reception centres and other missions) Operations in France grew by €0.03 million (see below: Key events 2019) Witness-bearing actions A slight increase (+€0.3 million) Operational support (advocacy, quality of practices, coordination and management A slight increase (+€0.2 million)

Key events in 2019 2019 saw a further deterioration in the systems and measures in place in France for the reception of migrants, as well as an increase in the number of evacuations from migrant camps in Paris and other French cities. In response, in order to be in close proximity, bear witness and denounce living conditions, MdM strengthened its actions in the different regions of the country and drew up a more participatory national strategy. In 2018, a programme was launched on the transalpine border in collaboration with local stakeholders to support existing care and reception facilities. This programme, providing a health check-up, first aid and referrals (if necessary), active listening and partner assistance services, was strengthened in 2019 to include a mobile shelter unit for migrants that assesses their health condition and provides them with shelter and (non-invasive) healthcare, or refers them or requests emergency assistance. Finally, a "care pathway – pathway in exile" component was developed in 2019 and is to be implemented in Gap in early 2020. In Paris, MdM strengthened its health monitoring in 2019, setting up a psychosocial and legal counselling centre specifically for migrants living in camps and coordinating the lobbying of the authorities by different field operators. Symbolic actions, such as the charity workers’ "strike" on 9 April, were carried out regularly to support a very active local and national advocacy campaign involving numerous associations. In the Littoral des Hauts de France, MdM continued its efforts to promote access to healthcare and rights for migrants through activities on the ground, advocacy and legal action. An evaluation was also carried out in the coal-mining district, with a view to setting up a prevention, health mediation and community health project in 2020. The main aim is to co-construct an innovative, user-friendly and generous approach with the people concerned (users, inhabitants, local actors, professionals and institutions), putting the inhabitants and local actors at the heart of the system.

Médecins du Monde 2019 Financial Report

Transferal of programmes and launch of new programmes One of our primary objectives is to ensure that the innovative approaches that we develop, once they have demonstrated their effectiveness, are adopted by common law stakeholders or other associations. Thus, in 2019, MdM’s programme with sex workers in Poitiers was taken over by other associations that share MdM’s philosophy about empowerment and respect of individual choices, and will continue the fight for access to rights and healthcare for sex workers. Similarly, the Besançon Healthcare, Advice and Referral Clinic closed in 2019, when our lobbying for its take-over by a “common law” organisation finally met with success. In Nantes, MdM’s slum mediation programme was transferred to the associations Les Forges Médiation and PASS mobile. At the same time, an evaluation was carried out with a view to setting up a new programme with a community health approach and a research component in mid-2020 in areas with substandard, unhealthy, informal and unstable housing. In the same spirit, Médecins du Monde organised the transfer of the Sponsorship of Children in Hospital programme, a historic mission for MdM, to the Chain of Hope in the first quarter of 2019. MdM continued to develop innovative programmes in 2019. After a successful pilot phase, the PASS (Permanence d’Accès aux Soins de Santé) de Ville project was launched in Marseille. This project works with people without effective social security coverage, in collaboration with its partner, an urban health care centre. Its objectives are to improve access to primary care in the city for low-income people, promote actions combining medical care and social support, fight against the refusal of healthcare, and reduce the need to go to an emergency department for outpatient care. A similar system has been put in place in Cayenne. Finally, 2019 saw the definition -, and validation by the ministries and all the partners concerned - of MdM’s AILSI programme [Alternative to Incarceration through Housing and Intensive Follow-up, for homeless people living with severe psychiatric disorders], scheduled for implementation in Marseille in 2020. This programme aims to scientifically evaluate the effectiveness of alternatives to incarceration based on judicial, health and socio-economic indicators, while respecting the interests of offenders, society and the rights of victims.

2019 - volume of expenditure by regional delegation (K€) 2 500 000,00 2 000 000,00 1 500 000,00 1 000 000,00 500 000,00 -

Médecins du Monde 2019 Financial Report

INTERNATIONAL PROGRAMMES

Social programmes In thousands of € Africa

2018

2019

14 894

17 129

Latin America

3 241

3 333

Asia

6 534

5 375

Europe Middle East/Maghreb

2 394

1 770

23 409

16 242

Regionally-Managed international programmes

Exploratory Programmes

Cross-sector programmes

453

713

Operation Smile

424

386

Adoption

364

191

Expansion of International Network

681

595

Witness-bearing Programmes

Advocacy and quality of practices

1 175

1 166

Amman regional operational unit

1 467

889

Programme Coordination and Management Funding obtained on behalf of the international network

8 703

8 153

790

13 238

64 724

69 344

Main variations between 2018 and 2019 International operations (5 regions, exploratory missions, cross-sector missions, Opération Sourire and adoption. The global volume of direct activities in the field went down from €51.8 million in 2018 to €45.2 million in 2019 (see below for variations per continent). International network There was an overall reduction in support to the network in 2019. Moreover, unrestricted grants were distributed differently between the three expenditure categories. As for funding secured on behalf of the network, this increased significantly (from €0.8 million in 2018 to €13.2 million in 2019).

Key events in 2019 2019 was a year of transition for MdM France’s international operations. Indeed, the decision to focus on fewer countries and to increase the volume of operations in these countries resulted in closures, transfers and the opening of new operational bases in countries where MdM-France was already present. Closures: In 2019, MdM France closed its missions in Haiti, Somalia, Vietnam and Venezuela. Transfers: As mentioned earlier, MdM France transferred its activities in Syria and Turkey to MdM Turkey, which became a member of the international network at the end of 2018. These activities represented a very significant volume, which explains the

Médecins du Monde 2019 Financial Report

reduction in operating volume in the Middle East and North Africa Unit (-31%). This transfer also led to the closure of the operational unit in Amman in the summer of 2019. Reorientations: The reduction in MdM-France's direct activities in the Middle East was only partially offset by the increase in operations in other countries (Nigeria, Yemen, Uganda, DRC, etc.).

Distribution of operations by continent*: Excluding exploratory missions and funding secured on behalf of the network

25 000 20 000 15 000 10 000 5 000 0 Africa

Latin America and Caribbean

Asia 2018

2019

Europe

Middle East/Maghreb

Médecins du Monde 2019 Financial Report

FOCUS ON AFRICA Expenditure in 2018 Expenditure in 2019:

€15.7 million €17.1 million

The key events in 2019 were as follows: • Somalia: End of community health project in Puntland and closure of operations in the country • Uganda: Extension of the project in the Bidi Bidi refugee camp following the resumption of activities at Bolomoni hospital • Ethiopia: Launch of an emergency project in collaboration with MdM Germany to improve access to healthcare in the Somali region • Burkina Faso: End of Sexual and Reproductive Health/Unwanted Pregnancies project in the Djibo region and launch of cervical cancer project in Ouagadougou • Madagascar: End of the HIV Observatory project in the Antanarivo region • Tanzania: Transfer of Drop-In Centre activities to the local partner, Mukikuté • CAR: Continuation of activities in Bangui and postponement of the opening of the Bouca project to 2020 • DRC: Opening of the emergency project in Tanganyika • Nigeria: Upscaling of activities in Damboa

Financial volume of operations in € 2 500 000 2 000 000 1 500 000 1 000 000 500 000 0

2018

2019

2018

Burkina Faso

2019

Ivory Coast

2018

2019

Ethiopia

2018

2019

Kenya Somalia

2018

2019

Madagascar

4 000 000 3 500 000 3 000 000 2 500 000 2 000 000 1 500 000 1 000 000 500 000 0

2018

2019

Niger

Nigeria Emergencies

2018

2019

Uganda

2018

2019

DRC Emergencies

2018

2019

Tanzania

2018

2019

Chad

CAR Emergencies

Médecins du Monde 2019 Financial Report

FOCUS ON ASIA Expenditure in 2018: Expenditure in 2019:

€6.5 million €5.4 million

The key events in 2019 were as follows: • Sri Lanka: Transferral of Sexual and Reproductive Health programme to MdM Japan • Nepal: Postponement to 2020 of the next phase in the project to 2020 • Vietnam: End of the programme at the start of 2019 and closure of operations in the country

Financial volume of operations in €

3 000 000

2 500 000

2 000 000

1 500 000

1 000 000

500 000

2018

2019

Sri Lanka

2018

2019

Nepal

2018

2019

2018

Pakistan

2019

Philippines

2018

2019

Myanmar (Burma)

2018

2019

Vietnam

2018

2019

Bangladesh

Médecins du Monde 2019 Financial Report

FOCUS ON EUROPE Expenditure in 2018: Expenditure in 2019:

€2.4 million €1.8 million

The key events in 2019 were as follows: • Migration, Exile, Rights & Health (MERH): Closure of the Serbia mission; end of project in Bulgaria; • Italy: Activities adapted to funding secured/not secured • Bulgaria: Recruitment difficulties and postponement of activities • Caucasus regional project: Postponement of the launch of activities in Armenia

Financial volume of operations in €

700 000

600 000

500 000

400 000

300 000

200 000

100 000

2018

2019

Bulgaria

2018

2019

Caucasus

2018

2019

Russia

2018

2019

Serbia

2018 Greece

2018

2019

Italy

2018

2019

Med Migrants

Médecins du Monde 2019 Financial Report

FOCUS ON LATIN AMERICA AND THE CARRIBEAN Expenditure in 2018: Expenditure in 2019:

€3.2 million €3.3 million

The key events in 2019 were as follows: • Colombia: Development of activities in response to the crisis in Venezuela • Haiti: End of project and closure of operations in the country • Venezuela: Transfer of the mission to MdM Spain

Financial volume of operations in €

2 000 000

1 500 000

1 000 000

500 000

0 2018

2019

Colombie

2018

2019

2018

Haiti

2019

Meso America

2018

2019

Venezuela

Médecins du Monde 2019 Financial Report

FOCUS ON MIDDLE EAST AND NORTH AFRICA Expenditure in 2018: Expenditure in 2019:

€23.4 million (excl. Operational Unit in Amman) €16.2 million (excl. Operational Unit in Amman and programmes run directly by the network)

The key events in 2019 were as follows: • Amman: Closure of the Operational Unit • Syria: Transfer of activities in the Northwest to MdM Turkey and resumption of MdM France’s activities in the South • Algeria: Difficulties implementing activities because of the political situation in the country • Yemen: Increase in activities due to the new operational base in Aden

Financial volume of operations in €

16 000 000 14 000 000 12 000 000 10 000 000 8 000 000 6 000 000 4 000 000 2 000 000 0 2018 2019 2018 2019 2018 2019 2018 2019 2018 2019 2018 2019 Algeria

Egypt

Palestine

Yemen Emergencies

Iraq

Syrian crisis

Médecins du Monde 2019 Financial Report

3.1.2

Fundraising costs

In thousands of € Fundraising costs

2018

2019

14 214

12 838

Fundraising costs were lower than in 2018. Considerable efforts were made to optimize spending in 2019. Support for MdM Germany to develop its fundraising was reduced.

3.1.3

Running costs

In thousands of € Running costs

2018

2019

3 351

3 906

On a like-for-like basis between 2018 and 2019, the percentage of running costs increased slightly to 3.8% of expenditure against 3.4% in 2018 (€0.6 million) NB: MdM France set up an Internal Auditing Unit in 2019.

Médecins du Monde 2019 Financial Report

3.2.

FUNDING SOURCES

2018 Funding Sources Funds raised from the public Other private funds 47%

Other income

48%

Public-sector grants

2019 Funding Sources Funds raised from the public Other private funds 44%

Other income

52%

Public-sector grants

Our funding sources were analysed earlier on in this report. However, it is worth highlighting that public-sector funding represented 52% of our total revenue in 2019, whereas in 2018 it was below 50%. This was mainly due to the amount of funding secured on behalf of the network.

3.3 INVESTMENTS ACQUIRED THROUGH PUBLIC GIVING In application of the new rules governing the allocation of resources, public giving to the tune of €411,539 was used to finance investments in 2019. The amortisation corresponding to these investments and those made in 2018 came to €173,733 in 2019.

Médecins du Monde 2019 Financial Report

Part 3: Special Report on Regulated Agreements

Médecins du Monde 2019 Financial Report

Part 4: 2020 Budget

Médecins du Monde 2019 Financial Report

Expenditure (in thousands of euros)

2020 Budget

Social Programmes Activities carried out in France Activities carried out abroad Fundraising costs Costs of appeals to public generosity Costs of fundraising from other private sources Costs related to applications for grants and other public sector funding Running costs

Total

Income (in thousands of euros)

2020 Budget

Funds raised from the general public 17 897 Donations

99 733

47 493 40 120

81 835 Legacies, other gratuities Other revenue from appeals to public 14 366 generosity 13 062 Other private funds Grants and other public sector 987 funding

5 723 1 650 2 211 68 090

317 Other revenue

3 809 Deficit for the financial year

117 908 Total

117 908

Comments on the 2020 budget The 2020 budget was approved by MdM France’s Board on 14 December 2019. This budget was drawn up before the start of the COVID-19 pandemic and so does not factor in the potential financial impact of this health crisis on our actions in France and abroad. It is presented in the form of an Income and Expenditure Statement, with the activities of our organisation under “Expenditure” and the funds used to finance these activities under “Income”. Provisions for contingencies concerning grants not secured are recorded as a deduction in income. A structured and participatory process was used in its construction, drawing on the 2020-2022 strategic framework document, the work of budgetary commissions, the results of arbitrations, etc. It covers three years: 2020, 2021 and 2022. Only the budget for 2020 will be put to the vote at the 2020 General Assembly meeting; the other two years will be reviewed and updated on a rolling basis. The Board has decided to ask the General Assembly to approve a budget with a very slight deficit. This deficit is for an amount of -€0.06 million (-€0.4 million after taking into the account the reserves created for associative projects by previous General Assemblies). The 2020 budget covers the priorities identified by the Board: -

Pursuance of the MdM Community development project Implementation of the human project Decentralisation/regionalisation of the management of our field actions, both in France and abroad. Maintaining of our operational momentum Continuation of the international network’s road map Strengthening of the organisation’s efficiency and implementation of the Information System Master Plan

It further reflects: -

The implementation of the operational trajectory developed for our international programmes MdM France’s stated ambition to reinvest in specific areas of international work, especially major crises where it is not currently present. Continued efforts to secure fundraising for members of the network

Médecins du Monde 2019 Financial Report

The strengthening of our funders diversification policy (a funder shouldn’t finance more than 10% of our activities overall). The redefinition of financial processes, with the objective of implementing a new management software package (ERP) in 2021 The desire to obtain better coverage of headquarters costs by institutional donors, wherever possible negotiating the inclusion of the coordination and headquarters costs directly attributable to the project in each project submission. Control of HR spending, particularly at headquarters.

2020 budget expenditure The comparisons below are between realised 2019 expenditure and the budget estimated for 2020. The 2020 budget provides for growth of more than 16% (€16 million) between the realised 2019 budget (€102 million) and the budget estimated for 2020 (€118 million). It foresees growth in actions in France and abroad (either direct actions or via members of the international network for which MdM France has secured funding).

Social Programmes : The volume of social programmes in the 2020 budget is €99.7 million, representing growth of €15 million compared to the €84.4 million realised in 2019. The social programmes/total expenditure ratio for 2020 is thus 84.6%, against 83.5% in 2019. Growth in social programmes in France is estimated to represent a financial volume of €17.9 million in 2020 against €15.4 million in 2019 (+16%). Projected expenditure on international programmes for 2020 is significantly higher than realised expenditure in 2019 (+18%), based on an increase in activities run directly by MdM France and a levelling-out of the financing secured for use by the international network.

Fundraising costs : Projected fundraising costs increase from €12.8M in 2019 to €14.4M in the 2020 budget. A mixture of investments has been validated for 2020, with the introduction of innovative fundraising levers.

Running costs : Projected running costs remain stable at 3.8M€ in the 2020 budget (-0.1M€). However, their weighting decreases from 3.8% of expenditure in 2019 to 3.2% in the 2020 budget estimate.

2020 budget income Projected revenue from public giving increases by 16% (€47.5M) in the 2020 budget compared to €44.7M in the 2019 budget and realised income for 2019). This increase is expected to come from bequests, which performed very poorly in 2019. There is a sharp increase in public-sector grants between the income realised in 2019 and the 2020 budget estimate (€68.1 million in the 2020 budget compared to €52.9 million in 2019 realised income), i.e. +28% (as compared to +33% between realised income in 2018 and the 2019 budget). This increase has been calculated in line with estimated growth in operations. 62

Médecins du Monde 2019 Financial Report

Conclusion on the 2020 budget MdM France’s 2020 budget - after taking into account the reserves for associative projects constituted during the 2016, 2018 and 2019 General Assemblies - more or less breaks even. It reflects the strategy and objectives that the organisation has chosen to pursue: -

Strengthening French operations Implementing the operational trajectory developed for international programmes in order to achieve significant growth Diversifying funding sources to ensure our financial independence Preserving the level of MdM France’s own funds to consolidate its financial solidity given the scale of its overall growth Continuing to strengthen the international network.

ALSO CARES FOR INJUSTICE

DOCTORS OF THE WORLD FRANCE

62, rue Marcadet 75018 Paris Tel. 01 44 92 15 15 Fax. 01 44 92 99 99 medecinsdumonde.org