Even the internal acknowledgement of poor humanitarian leadership, non-existent responsiveness, and the urgent need to vastly improve performance, has not led to visible changes in UN processes and activities. Rather, there have been very time-consuming discussions over the design of a humanitarian emergency programme (100 Day Plan), which would only start on 1 January 2014, leaving the exhausted and traumatized CAR population without assistance for the foreseeable future. Full implementation of the plan would require weeks or even months.

To compound an already dismal situation, there appear to be serious perception gaps over (in)security, both among the various UN agencies and between MSF field workers and UN officials, the latter unwilling to share the rationale behind their extremely risk-averse analyses. The distorted view of the threats faced by aid agencies in the CAR, demonstrated, for example, by UN officials wearing military helmets and flak jackets in an environment that does not require such protective gear, cannot be accepted if it represents a restriction on assisting people in an extreme state of need. While not playing down residual risks, MSF considers current UN security concerns disproportionate to field realities. Yet those concerns remain the main stumbling block and a constant excuse for UN agencies to postpone required timely scale-up of resources. Overall, such a complete disconnect from their surroundings only serves to discredit and delegitimise UN agencies and their implementing partners, jeopardising future activities and negatively impacting the protection and assistance effort to the CAR as a whole.

Apart from recalling the urgent need to scale up the humanitarian intervention without delay, in order to alleviate the suffering of the local population, and insisting on redeployment beyond Bangui, MSF deplores the appalling performance of UN humanitarian agencies and reminds them of their responsibility to mobilise and coordinate effective and principled humanitarian action, advocate for the rights of people in need, and facilitate sustainable solutions to the current crisis. An internal and independent UN investigation should also be considered by senior UN leadership to better understand such failures and ensure lessons are learned for the future.

Humanitarian emergency responses entail risk, but MSF has shown over the last year that an upgrade in capacity through international staff deployment is feasible. Despite several incidents, not only has MSF never fully evacuated its projects, but it has indeed expanded its presence in six of the most vulnerable areas of the country affected by violence, through new emergency interventions leading to targeted medical aid response activities. However, notwithstanding its own important efforts, MSF and the handful of other competent NGOs in CAR cannot cover all the needs. United Nations agencies need to reinforce their capacity at ground level since many aid agencies rely on them to provide the umbrella under which they can operate.

CC: Anthony Lake, Executive Director UNICEF

Ertharin Cousin, Executive Director WFP

Dr. Margaret Chan, Director-General WHO

Antonio Guterres, High-Commissioner UNHCR

Kevin Kennedy, Under-Secretary-General for Safety and Security UNDSS

On behalf of MSF

Dr Joanne Liu

International President

Médecins Sans Frontières