Why did Libya order Doctors Without Borders (MSF) to leave?

A decision shrouded in silence threatens to deepen a humanitarian crisis for migrants and vulnerable Libyans alike.

In a terse letter from Libya’s Ministry of Foreign Affairs, the clock started ticking. The international medical charity Médecins Sans Frontières (Doctors Without Borders, or MSF) was ordered to pack up its life-saving operations and leave the country by November 9. No explanation was given; no justification offered. For the thousands who depend on its care, the directive felt less like a bureaucratic missive and more like a death sentence.

The expulsion order, confirmed by MSF on Wednesday, marks a drastic escalation in a months-long crackdown on humanitarian groups in Libya and threatens to eviscerate an already fragile healthcare system for the nation’s most vulnerable: refugees, migrants, and Libyans trapped in the crossfire of a fractured state.

“No reason has been given to justify our expulsion and the process remains unclear,” said Steve Purbrick, the head of MSF’s programmes in Libya, in a statement that echoed the confusion and concern rippling through the aid community. “We believe that MSF still has an important role to play in Libya.”

That role has been substantial. The Nobel Peace Prize-winning organization, founded in 1971 and now operating in over 70 countries, is not a minor player. In Libya last year alone, MSF reported conducting more than 15,000 medical consultations, often in collaboration with Libyan health authorities. Its work has been a critical bulwark against the collapse of public health, focusing on treating tuberculosis, supporting maternal and pediatric care, and offering a lifeline to those “excluded from care and subject to arbitrary detention and serious violence.”

The Slow Squeeze on Humanitarian Space

Doctors Without Borders (MSF) have been ordered to leave by November 9th.

This formal expulsion did not happen in a vacuum. It is the culmination of a pressure campaign that began in March, when Libyan authorities, specifically the Internal Security Agency, shuttered MSF’s premises and subjected several of its staff members to intense interrogations. At the time, this was part of a broader “wave of repression” that, according to MSF, targeted at least nine other humanitarian organisations operating in western Libya.

Since the NATO-backed uprising that toppled and killed longtime leader Muammar Gaddafi in 2011, Libya has been fractured between rival administrations in Tripoli, in the west, and Benghazi, in the east. The UN-recognised Government of National Unity (GNU), led by Prime Minister Abdul Hamid Dbeibah in Tripoli, is the body that officially registered MSF to work in the country. Purbrick was careful to note that this registration remains technically valid, expressing a faint hope for a “positive solution.” The GNU, however, has maintained a stony public silence on the matter, leaving observers to decipher the motives behind the move.

The timing is particularly cruel. The order comes just over a year after catastrophic flash floods devastated the city of Derna in eastern Libya, killing thousands. MSF was among the first international responders on the ground, deploying emergency teams to treat the wounded and prevent the spread of disease. The memory of that emergency response highlights the stark contradiction of their expulsion: a group lauded for its crisis intervention one year is being shown the door the next.

A Void in Care Amid European Border Politics

So, why now? While the official reason remains a mystery, the context points to a politically charged landscape where humanitarian aid has become collateral in a wider geopolitical game.

The crackdown on NGOs coincides closely with deeper European cooperation with Libyan authorities on one specific issue: border control. The European Union, desperate to stem the flow of migrants crossing the Mediterranean, has poured funding and support into the Libyan Coast Guard and detention systems. This has empowered Libyan forces to intercept and return tens of thousands of people to shore, where they are often funneled into a network of overcrowded, unsanitary, and abusive detention centers.

MSF has been one of the few consistent, independent medical actors able to access these facilities and provide care for the consequences of this system—treating wounds from violence, malnutrition, and diseases like tuberculosis that thrive in cramped, unsanitary conditions. Their vocal reports on the dire conditions and human rights abuses have often been an inconvenient truth for both Libyan and European officials.

“In a context of increasing obstruction of NGO intervention… there are now no international NGOs providing medical care to refugees and migrants in western Libya,” MSF stated bluntly.

This is the core of the crisis. The expulsion of MSF is not just about one organization leaving. It is about the deliberate creation of a void. With over 67,000 staff worldwide, MSF represents a scale and expertise that cannot be easily replaced. Their departure signals the near-total closure of humanitarian space in western Libya for migrants and refugees, leaving them with nowhere to turn for medical care.

The question “why?” hangs heavy in the air. Is it a desire to silence witnesses to the treatment of migrants? Is it an assertion of sovereignty by a government keen to project control? Or is it part of internal political manoeuvring, using a renowned aid group as a pawn?

For now, there are only questions. But as the November 9 deadline looms, the consequences are terrifyingly clear. For the vulnerable populations MSF serves, the departure of these doctors doesn’t just mean the loss of a service. It signals the loss of a lifeline, leaving them alone in the shadows, with their suffering unseen and their cries unheard.