Is @MSF harming the global #poor with its #EU-centric thinking? No it isn't! #BetteridgesLaw

Summary in three bullet points:

• World renowned health charity Medecins Sans Frontieres (aka Doctors without Borders) has announced that it will reject EU funding over the EU's treatment of migrants/asylum seekers/refugees from Turkey.
• This essentially transfers money from MSF to the EU, around half of whose budget is spent on the Common Agricultural Policy; some argue this would have negative consequences for third world farmers. Combined with the reduction in MSF medical work, this is arguably a bad thing, and arguably even outweighs the good that would be done by making a political statement in support of refugees and asylum seekers.
• However this line of reasoning is wrong, because providing extra funding to the EU would almost certainly not increase funding to the CAP.

MSF's action is intended to be symbolic
Within the context of the EU budget, and even within the context of MSF's budget, the €60 million rejected is not a large number. Hence the act's intended significance is the message it sends about MSF's stance on EU policy.

The impact of this symbolism is hard to quantify and highly uncertain. If you believed the act diverts funds away from MSF's good work and towards the EU's CAP, and if you believed that the CAP is clearly damaging, then it would be reasonable to object to MSF's act, on the grounds that it trades a definite negative (less funding for MSF is negative, and more funding for the CAP is negative) for an uncertain (and perhaps low probability) positive.

This may result in around 1 million fewer MSF medical consultations
- By rejecting EU funding, MSF will miss out on €60 million [1] of extra funding. This would be sufficient to fund around 2000 more staff members [2] which could result in around 1 million extra medical consultations [3]
- Note that this analysis is based on data from the SoGive database, which provides conversions between money invested and impact for several charities
- MSF has stated that none of its patients would be affected by its decision on funding [4]. This is valid in the short term, as it has something like €800 million of reserves [5].
- However in the long term, it is counter-intuitive to suggest that an organisation can refuse funding without there being any effect. In MSF's case, this can be reasonably approximated as a reduction in medical activity anywhere in the world - likely somewhere in the developing world [6]

MSF's action results in €60 million of extra funding being available to the EU. Opponents of the CAP may think this a bad thing...
- The EU budget includes a significant amount of money spent on the Common Agricultural Policy (or CAP). This percentage has been as high as 70% in the past, and is now closer to 40%.
- This policy has been widely criticised [7]; criticisms include the claim that the subsidies to EU farm produce result in third world countries being flooded with subsidised goods, making it impossible for local farmers to trade profitably
- if you agree with the criticism, you may conclude that more money going to the EU is a bad thing, and that MSF would do better to accept the funds to stop them being used so poorly

Betteridge's law of headlines strikes again!
Betteridge's law of headlines states that any headline that ends in a question mark can be answered with the word "no". This article is no exception; read on to see why.

We should look at the marginal extra euro, which would probably be spent well
- The mechanisms behind the CAP are largely formulaic, and an extra €60 million being available to the EU is unlikely to influence the amount spent on the CAP, especially since this is a very small number for the EU
- indeed the trend in funding for the CAP has been down for some time, largely reflecting criticism of it, so extra funding being available is unlikely on its own to lead to an increase in funding for the CAP
- it may, however, end up being spent in some of the areas where the EU has more discretion around spending. This includes, for example, research and innovation (or indeed funding other charities to do other good work), which many would agree is a positive use of EU funds.

So MSF are doing the right thing after all
The incorrect logic says that implications of MSF's actions are as follows:
Less funding for MSF medical activity: definitely bad
More funding for EU (which goes to CAP): definitely bad
Possible improvement in the lives of refugees: possibly good

The correct logic is as follows:
Less funding for MSF medical activity: probably bad
More funding for EU (which goes to CAP): probably good
Possible improvement in the lives of refugees: possibly good

So MSF are doing the right thing after all

Note:
This article is based on the assumption that MSF's position about the treatment of migrants and asylum seekers in the EU is the correct opinion. This article does not have the space to investigate this topic, which is discussed in length elsewhere.

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Notes and references
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[1] €60 million figure mentioned in Guardian article: https://www.theguardian.com/world/2016/jun/17/refugee-crisis-medecins-sans-frontieres-rejects-eu-funding-protest
[2] cost per staff member based on averages across the organisation - p4 of 2014 report says that they deployed 7,000 international staff members and 31,000 locally hired staff members; total spend came to c €1 bn (p6 of 2014 report) 2014 report can be found here: http://www.msf.org.uk/sites/uk/files/msf_financial_report2014_final.pdf
[3] MSF's outputs are measured here in terms of consultations - this is a simplification, since they do a number of specialist consultations that are glossed over here - if anything, this way of looking at things is likely to understate the extent of MSF's impact. If we look at the ratio of the number of consultations in country X to the cost of operations in country X, we see numbers around $30-$100 ($76 in Bulgaria, $32 in Bangladesh, $81 in Afghanistan) so based on figures in this region, it seems reasonable to conclude that 1 million consultations is the correct number, correct to 1 significant figure.
[4] http://news.bbc.co.uk/1/hi/world/europe/8036096.stm
[5] Amount of reserves stated in note 2.14 of the 2014 accounts (page 20)  http://www.msf.org.uk/sites/uk/files/msf_financial_report2014_final.pdf
Amount of reserves not stated in € amounts, so I had to calculate it as 9.8 months of reserves / 12 * annual spend of €1 billion.
According to reserves policy (page 6) this is towards the upper end of what MSF considers a reasonable level of reserves, but not yet what they would consider to be too much
[6]  In MSF's case, the effect of refusing funding is that reserves will be lower, meaning that in future there will be less funds to deploy in case of a crisis, or if the reserves are depleted for other reasons, MSF will ultimately be more at risk of having to close down.
- The net effect of this over time is unclear, however to a rough order of magnitude, it is reasonable to estimate that the "missing" €60 million may result in a larger programme not happening. However this is uncertain, so the weighted or "expected" impact (taking into account the uncertainty) may well average out again to the 1 million consultations mentioned earlier.
- Note that while the "missing" €60 million is likely to result in less medical work occurring, this is not certain, and it is not clear where this would happen. However MSF's work is biased towards work in the developing world (for good reasons). Hence any reduction in MSF activity is more likely to hit people in the developing world.
[7] CAP criticism: https://www.theguardian.com/world/2003/jun/26/eu.politics1 https://en.wikipedia.org/wiki/Common_Agricultural_Policy#Criticism http://www.bbc.co.uk/news/world-europe-11216061

other relevant links:
http://news.bbc.co.uk/1/hi/world/europe/8036096.stm