Clémentine Olivier is Humanitarian Affairs Advisor for the Canadian section of Médecins sans Frontières. In the article below, she reviews a recently published OCHA report 'Saving Lives Today and Tomorrow' (March 2014).

In a recent report, OCHA - the United Nations Office for the Co-ordination of Humanitarian Affairs - noted a growing number of humanitarian crises taking place around the world. Given the limited means of the international community to respond to these crises, OCHA recommended that players in the field of humanitarian assistance should anticipate, rather than react to, such emergencies. It also pointed out that governments should be in charge of risk-management policies. This recommendation to anticipate and manage risk is expected to be a major theme of the first-ever World Humanitarian Summit, to be held in Istanbul in 2016, where the overall objectives will be to improve the effectiveness of humanitarian aid and evaluate progress on the UN's Millennial Development Goals.

At first glance, the risk-management approach seems attractive, and can be effective when natural catastrophes occur in relatively stable countries. When responding to these types of emergencies, Médecins sans Frontières/Doctors Without Borders (MSF) cooperates with government-based structures, and recognizes their leading role. In the case of the typhoon that ravaged the Philippines in November 2013, for example, MSF on several occasions recognized the effectiveness of the assistance provided by the local authorities and players and the quality of the cooperation provided. MSF also has a long history of working with governments to prevent infant mortality, malnutrition, and the spread of HIV, as well as providing treatment to patients. MSF does not, therefore, deny the importance of taking a preventive approach to humanitarian action. We are instead expressing our concerns regarding the type of \"one-size-fits-all\" approach that can potentially lead to deterioration in the emergency assistance system by assigning priorities to the system that are not compatible with its purpose.

This is not a wholesale rejection of the idea of co-operation among institutions, whether they be government, UN or non-governmental, to better prepare for catastrophes. But to start off with the assumption that all players share the same goals and strategies, and that uniting their efforts in a single plan can bring peace and improve the well-being of the world, seems to me to be removed from reality. The OCHA report can therefore be criticized on at least three levels.

In the first place, the methodology of the report seems weak. It suggests a normative across-the-board approach - a single solution for the variety of situations encountered by players responding to crises, including situations of conflict. The analysis is based on three cases: Burkina Faso, Central Asia (Kirgizstan and Tajikistan), and Indonesia; without belittling the difficulties that these countries have experienced, it is surprising that OCHA has not instead based its reflection on the major and ongoing crisis situations in South Sudan, Syria or Central African Republic. But even so, there is no evident universal approach that seems capable of providing a response to all the situations that humanitarian players must face.

Second, and contrary to what the report seems to be saying, the idea of a preventive approach contains nothing new. Since the 1960s, improved prevention of potential emergency situations and improvements to the warning systems have always been held out as the panacea for the problems facing the international emergency response system. Seven years ago, in a retrospective analysis of the feeding crisis that hit Niger in 2005, MSF was already critical of the discourse on risk management. The problem encountered by the players responding to that crisis was not that of being unable to anticipate future crises, but of being able to respond to them at all.
The notion that humanitarian assistance can eliminate catastrophes is an illusion. Never before has information been so plentiful or available and accessible; never before has it been possible to foresee certain natural or human catastrophes. As early as the latter part of 2011, MSF alerted the world to what would become a major crisis in Central African Republic, butnone of the key responders, aid agencies, governments or funders mobilized, and the tragedy was not prevented. In April 2014, MSF spoke out about the risk of an unprecedented Ebola epidemic - a position that was then thought to be excessively alarmist by the World Health Organization, which at the time refused to entertain the idea of an \"epidemic.\" The current challenge facing humanitarian organisations is to prioritise all the competing crises, not to predict the risks that a crisis may actually occur.

Finally, and most importantly, the OCHA approach has proven dangerous in the past because it resulted in the erasing of the borders between humanitarian and political objectives. The risk-management system proposed by the United Nations represents a somewhat integrated approach - updated for 2014 - where NGOs place themselves at the service of public policy. Yet the condition for humanitarian intervention in acute crises, especially in times of conflict, is its ability to maintain a distance vis-à-vis the various powers. In those environments where MSF intervenes, the state is more often than not a party to the conflict.
OCHA has also ignored some basic questions: In its risk management strategy, for example, just what is the risk, and who does it affect? The post-9/11 risk remains basically a security one, and the odds are that states will consider as high priority any risks that have the potential to impact their own internal security, regardless of the health situation on the ground. Humanitarian assistance now tends to be used as a political tool designed to stabilize the most fragile or threatened states, and the approach used by OCHA accentuates that tendency.

It is time to re-focus the debate: The challenge today is to analyze the very concrete obstacles that prevent the effectiveness of the humanitarian assistance system. Why is it, for example, there is little or no aid reaching South Sudan? How is it that the Central African tragedy could not be averted or its consequences lessened? There are a number of areas to be explored: the amount of time that elapses (often more than three months, even in emergencies) between the time the alert is sounded and when funding is released; the logistical or security challenges sometimes encountered by humanitarian aid agencies that make access to the victims difficult; and the quality -the material quality - of the help provided, when it comes to such things as water or shelter, for example.
Ahead of the Istanbul Summit, we need to focus on the specific areas in the humanitarian aid system where there are shortcomings, in order to improve the help provided to endangered populations. Beyond emergencies, the OCHA initiative and our intention to improve all the work we do in the field are laudable goals. The question is out there, and the dialogue, like the work to identify these causes and roadblocks, needs to be continued in advance of the World Humanitarian Summit in 2016.

[1] In March 2014, the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) published a report entitled Saving Lives Today and Tomorrow. Managing the Risk of Humanitarian Crisis (full report available only in English). This report echoes the 2014 World Development Report, Managing Risk for Development (fully report available only in English), 

[2] A Not-So Natural Disaster. Niger 2005. Xavier Crombé and Jean Hervé Jezéquel (Ed). HURST & COMPANY, LONDON, 2009.