Unsafe abortion is a leading cause of maternal death, and the only one that is completely preventable. Yet over 30 million unsafe abortions occur each year, leading to at least 28,000 deaths and millions of serious complications—nearly all in low- and middle-income countries. MSF teams see these tragic consequences first-hand, treating thousands of patients every year with severe, potentially life-threatening effects from unsafe abortion. So in 2016 we launched a program to systematically implement safe abortion care (SAC), starting with ten pilot sites and then applying the lessons learned to scale up at projects across the globe. This Collection presents highlights of these efforts. Since our first publication on the need to provide SAC as a way of reducing maternal death and injury, several studies assessed the role of unsafe abortion in driving this suffering in specific contexts. Others described internal obstacles to providing SAC, operational solutions developed, and outcomes achieved. And we advocated for shifting towards community-led and self-managed SAC, particularly given new obstacles that emerged during the Covid-19 pandemic.

The climate crisis is also a health and humanitarian crisis, disproportionately impacting people in the world’s most climate-sensitive regions—mainly low- and low-middle income countries with the least capacity to respond. MSF and other humanitarian organizations witness the consequences daily. More frequent, intense weather events and a warming planet contribute to food and water scarcity, more severe and widespread disease outbreaks, and more injuries and preventable deaths. They also drive massive population displacement, with over 32 million people fleeing their homes in 2022 alone due to floods, drought, storms and fire—nearly triple the number displaced by violence and conflict. As global leaders convene in Dubai for the UN climate conference (COP28, 30 Nov-12 Dec 2023) we present this cross-section of work by MSF and collaborators, drawing from first-hand experience at our medical projects. Emphasizing the urgency of adapting humanitarian operations to the climate crisis, the collection also explores loss and damage through a health lens, proposes policies and practices for creating climate-resilient health organizations, and advocates for embedding fair, just ethics perspectives into humanitarian action and research on climate.