Every year, Doctors Without Borders / Médecins Sans Frontières (MSF) turns away money.
Not by accident, and not because the money isn’t needed. Quite the opposite. MSF operates in some of the most expensive, hardest-to-fund environments on earth. But roughly 98 percent of its global income comes from private donors, not governments, and that’s not a fundraising quirk. It’s a governance decision, made and re-made at the highest level of the organization, that the mission is worth more than the revenue certain money would bring with it.
That’s the real subject of this post. Not thank-you notes. Custody. And, as it turns out, custody is also the actual mechanism behind something nonprofits talk about constantly and rarely define: a culture of philanthropy. Not a training session. Not a slogan on a strategic plan. This.
Stewardship Is Custody, Not Courtesy
Ask most nonprofit staff what “donor stewardship” means, and you’ll hear about acknowledgement letters, impact reports, maybe a handwritten note. Ask most boards what “mission stewardship” means, and you’ll often get a blank look, because most boards have never been asked the question at all.
The word “steward” comes from an old idea: someone entrusted with property that isn’t theirs, accountable for how it’s used and in what condition it’s handed to the next person. A board doesn’t own the mission. It holds it in trust. Every governance decision (what to fund, what to refuse, when to hold the line) is either a faithful act of custody or a quiet erosion of it.
MSF is one of the clearest working examples of custody in the entire nonprofit sector, and it’s worth walking through in some detail, because the discipline shows up at every level of the organization, not just at the top.
The Board-Level Decision: Refusing Money to Keep Mission Intact
Since 2016, MSF has refused funding from the European Union, its member states, and Norway, specifically in protest of those governments’ deterrence policies toward migrants. This wasn’t a symbolic gesture; it meant walking away from a major, reliable source of funding. MSF USA goes further still and accepts no government funding at all, of any kind, from any administration.
This is what stewardship looks like as governance rather than communications. Someone had to decide, explicitly, that money attached to policies MSF’s own field teams were witnessing the harm of was money the organization could not take without compromising the thing it exists to do. That’s a board-level custody decision, not a donor-relations tactic.
And it isn’t only about refusing bad money. MSF has also, at times, asked donors to stop giving. After the 2004 Indian Ocean tsunami, MSF found itself with more funding than its medical programs in the region actually needed, and rather than sit on the surplus or find a way to spend it, the organization publicly asked donors to redirect or “derestrict” their gifts so the money could go to neglected crises elsewhere. Try naming another sector where “please don’t give us more money” is standard institutional behavior. It only makes sense to start from custody rather than courtesy: the mission defines what the organization needs, not the other way around.
How That Discipline Cascades
Mission fidelity doesn’t stay at the board table. It cascades, whether anyone intends it or not. MSF makes the mechanism visible at every level.
Staff: Field teams operate under a doctrine of independence, neutrality, and impartiality, laid out in MSF’s own Charter, that holds together only because leadership has already refused to compromise it upstream for funding. A field doctor can credibly tell a community, a militia, or a government official that MSF isn’t there on anyone’s behalf but the patient’s, because the organization has already turned down money that would have made that claim false. Staff doesn’t have to defend a principle that leadership only pays lip service to.
Volunteers and new hires: MSF’s principle of témoignage (bearing witness, speaking publicly about what its teams see, even when it’s politically uncomfortable) is treated as core doctrine in onboarding, not a footnote. People joining the organization learn why it turns down money and why it sometimes criticizes the very governments operating in the countries where it works. That’s the difference between a rule and a value. A rule gets followed until it’s inconvenient. A value is defended because people understand what it protects.
Donors: This is the part that inverts the usual stewardship model entirely. MSF’s version of donor stewardship isn’t primarily a thank-you letter; it’s radical transparency about where money comes from, what it isn’t allowed to buy, and sometimes an explicit request to give somewhere else. MSF publishes detailed annual financial reports so that donors, staff, and the public can hold the organization to its own stated standards. The stewardship is the disclosure. Donors are trusted with the truth about tradeoffs, not just thanked for their generosity.
Community: By the time this reaches the people MSF serves, it isn’t an abstraction; it’s the reason communities in conflict zones can credibly believe MSF isn’t an extension of any government’s agenda. That trust is the whole reason access is possible in places other organizations can’t reach. It was purchased upstream, at the board level, by refusing money.
Notice what didn’t have to change through any of this: the thank-you notes still go out looking ordinary. What changed is that they’re backed by an organization that has refused money to stay true to itself, which is the only thing that makes a thank-you note honest rather than decorative.
Where the Substitution Happens
The shift from stewardship-as-custody to stewardship-as-courtesy often occurs for an understandable reason: courtesy is measurable, whereas custody isn’t. You can count thank-you notes sent, gala tables sold, and newsletters opened. You can’t easily put a number on “mission fidelity maintained under financial pressure.” There’s no dashboard for the funding MSF walked away from in 2016, or the surplus it asked donors to redirect after the tsunami.
Boards, being made up of busy, well-meaning people who want to see progress, gravitate toward what’s countable. Development staff, evaluated on retention and renewal rates, do the same. Neither is doing anything wrong. But over time, the measurable proxy quietly replaces the thing it was supposed to represent. The thank-you note becomes evidence of stewardship instead of one small artifact of it.
This Is How a Culture of Philanthropy Actually Gets Built
“Culture of philanthropy” shows up in nearly every strategic plan and gets defined almost nowhere. Usually, it means something like: everyone in the organization, not just development staff, understands their role in fundraising and treats donors as partners rather than ATMs.
That culture doesn’t get built by a training session or a memo. MSF shows what builds it: a board willing to refuse money, staff who understand why, and donors who are told the truth instead of just thanked for their generosity. A field worker who understands why MSF turned down EU funding will describe the organization’s independence to a journalist very differently from one who’s only ever been handed a talking point. A donor who reads MSF’s own financial transparency reports and sees the organization asking for less money in an overfunded crisis trusts it in a way no thank-you letter could manufacture.
You don’t get a culture of philanthropy by asking staff and volunteers to care more. You get it by giving them something true to care about. And stewardship, practiced as custody rather than courtesy, is what makes it true.
Skip the stewardship, and you can still build a fundraising operation. You just won’t get a culture of philanthropy. You’ll get a well-run ask machine that also sends nice notes.
The Thank-You Note Still Matters
None of this is an argument against gratitude or against doing donor communications well. A sincere, specific, well-timed thank-you note is a genuine act of stewardship of the relationship. It just isn’t the whole job. MSF proves the point from the other direction: you can build world-class donor trust without leading with charm, because the trust was earned upstream, at the level of what the organization was willing to refuse.
Stewardship is the discipline of asking, at every level of the organization, “Are we still who we said we’d be?” and being willing to hear the answer, even when the honest answer costs you a major funder.
The thank-you note is what you send once you already know it’s true.
