MSI Reproductive Choices (Marie Stopes International)

MSI is a leading abortion provider worldwide. Between 2015 and 2020, the group performed over 90 million abortions.³

MSI-US, the group’s United States affiliate, acts as a financial pass-through to direct donations from left-of-center foundations such as the Susan Thompson Buffett Foundation and Hewlett Foundation to MSI Reproductive Choices, the London-based parent organization. Those funds are then distributed internationally to support abortion and birth control.³

Marie Stopes

Marie Stopes International was named for, but not founded by, the 20th century British abortion and birth control activist Marie Stopes (1880-1958). Stopes was born to a wealthy family and received her university education and doctorate in paleobotany, later teaching at the University of Manchester.⁴

Birth Control Advocacy

Stopes founded the first free birth control clinic in the United Kingdom (and the entire British Empire) in 1921 and edited the local newsletter Birth Control News. ⁵ She is also credited with influencing the Church of England’s slow relaxation of its stance against contraception. Stopes publicly opposed abortion, which was illegal in Britain until 1967, preferring instead to prevent pregnancies thereby avoiding medical risks to mothers.⁴ A 1933 biography of Stopes notes: ⁶

Another matter that she has refused to deal with is the question of abortion. Heartbreaking as have been many of the appeals addressed to her and to her clinic by women in whose cases an abortion seemed a lesser evil for the individual and for society than the birth of the child would be, Dr. Stopes has stood resolutely aside. She is aware of the very great prevalence of the practice of abortion both among the married and the unmarried, and she makes her contribution towards checking that evil by making knowledge of cheap, easy, and safe methods of prevention readily accessible to those who need that knowledge.

Support for Eugenics

Stopes was a prominent leader in the U.K.’s eugenics movement. “Eugenics” refers to the pseudoscience of “beautifying” and “improving” society through selective breeding of human populations. Marie Stopes International admits to its namesake’s support for eugenics, “opinions” which the organization claims “are in stark contrast to our values and principles.”⁷

In 1920, Stopes authored Radiant Motherhood: A Book for Those Who are Creating the Future. In the book she praised parenthood, writing that “every lover desires a child. Those who imagine the contrary, and maintain that love is purely selfish, know only of the lesser types of love.” Stopes added: ⁸

The century long working of economic laws based on physical force . . . has resulted in man generally having the selective power and tending to choose for his wife the most beautiful or charming woman that his means allow; hence hitherto on the whole, the race has been bred from the better and more beautiful women. This has undoubtedly tended to keep the standard of physical form from sinking to the utter degradation which we see in the worse of the slums, and in institutions where live the feeble-minded offspring of inferior mothers who have wantonly borne children of fathers devoid of any realization of what they were doing.

Another entry read, “The power of parenthood ought no longer to be exercised by all,” she wrote, “however inferior, as an ‘individual right.’ It is profoundly a duty and a privilege, and it is essentially the concern of the whole community.” ⁹

Stopes allegedly criticized “wanton” parenthood as she believed it brought forth people facing “the burden of taxation which they have not the resources to meet” while “provid[ing] for children also.” Stopes believed that a massive national financial burden had been caused by “the too numerous children of those who do not contribute to the public funds by taxation, yet who recklessly bring forth from an inferior stock individuals who are not self-supporting.” She claimed that this was damaging to the middle- and upper-classes, which were forced to work to pay for the public upkeep of “inferior” individuals. She continued:⁹

While on the other hand, society allows the diseased, the racially negligent, the thriftless, the careless, the feeble- minded, the very lowest and worst members of the community, to produce innumerable tens of thousands of stunted, warped, and inferior infants. If they live, a large proportion of these are doomed from their very physical inheritance to be at the best but partly self-supporting, and thus to drain the resources of those classes above them which have a sense of responsibility. The better classes, freed from the cost of the institutions, hospitals, prisons and so on, principally filled by the inferior stock, would be able to afford to enlarge their own families, and at the same time not only to save misery but to multiply a hundredfold the contribution in human life-value to the riches of the State.

Stopes added: ⁸

It should be the policy of the community to encourage in every way the parenthood of those whose circumstances and conditions are such that there is a reasonable anticipation that they will give rise to healthy, well-endowed future citizens. It should be the policy of the community to dis- courage from parenthood all whose circumstances are such as would make probable the introduction of weakened, diseased or debased future citizens. It is the urgent duty of the community to make parenthood impossible for those whose mental and physical conditions are such that there is well-nigh a certainty that their offspring must be physically and mentally tainted, if not utterly permeated by disease.

[. . .]

So long as parenthood is kept outside the realm of rational thought and reasoned action, so long will we as a race slide at an ever-increasing speed towards the utter deterioration of our stock through the reckless increase of the debased.

History and Founding

Background

The modern organization MSI Reproductive Choices was founded in 1976 by two men, Tim Black (1937-2014) and Phil Harvey (1938-2021). Black and Harvey were abortion activists who met in the late 1960s while pursuing master’s degrees in Population Dynamics at the University of North Carolina. Their studies were funded by fellowships from the Population Council, a major advocate for global forced sterilization and population control policies, and the Ford Foundation, one of the largest foundations in the world and a leading funder of left-of-center causes.¹⁰

Harvey and Black reportedly shared the same vision of “preventing unwanted pregnancy” and together came up with the idea of marketing condoms through the mail, an approach to “family planning that did not rely on medical infrastructure” and so could be targeted at poor countries with large rural populations and few medical or abortion facilities, such as India and Nepal. (Mailing birth control products was illegal in the United States at the time.) ¹⁰

Their idea led the men to found Population Services International (PSI) after graduating in 1970, today a leading provider of abortions, birth control, and education designed to discourage reproduction in poor countries.¹¹ PSI was founded with a grant from the U.S. Agency for International Development and “revenue from a condom catalog [sic] they started,” allowing them “to create their first social marketing campaign in Kenya.”¹²

Adam & Eve and DKT International

Also see DKT International (nonprofit)

Black and Harvey also co-founded Adam & Eve in 1971 in North Carolina, an “adult pleasure company” whose profits funded the pair’s abortion and family planning nonprofits. In 1989, Harvey founded DKT International, a nonprofit which promotes abortion sells inexpensive condoms to people in developing countries. ¹² As of 2020, Adam & Eve reported that it had given away 25 percent of its profits to DKT International. ¹³

In 2017, DKT acquired global distribution rights for a manual vacuum aspiration (MVA) technology to perform “uterine evacuations” from Ipas, an abortion advocacy group. The abortion technology uses suction to pull out fetuses and embryos through the cervix.¹⁴ DKT markets and distributes the product in over 100 countries. ¹⁵

Harvey has been called “one of the most influential figures in the American sex industry today” and has reportedly donated roughly $10 million (£7.5 million) to MSI as of 2020. ^{16 17}

Formation of MSI

After Stopes’s death in 1958, the birth control clinic she founded in central London continued to operate under the aegis of the Marie Stopes Memorial Foundation until it declared bankruptcy in 1975. In 1976, the clinic was taken over by Tim Black, his wife Jean Black, and Phil Harvey, who re-founded it as Marie Stopes International, its name until 2020. ¹⁸ Black worked as MSI’s chief executive officer in London from its founding until 2006, when he retired.¹⁹

In June 2021, MSI permanently closed its original birth control clinic founded by Stopes in 1925 in London. The clinic performed 4,235 abortions between 2018 and 2019.¹⁵

Activities

MSI has called abortion “lifesaving, essential healthcare” and has called itself “one of the world’s leading providers of comprehensive abortion care,” stating that it is “unapologetic in our defence of the right to choose.” ²⁰

As of 2026, the group was providing abortions and birth control services in the 36 countries where it had active affiliates. These were overwhelmingly located in Africa and Asia. ²¹

The group provides abortions and birth control services in the 37 countries where it has active affiliates. These are overwhelmingly located in Africa and Asia; in 2020, MSI reported that less than one percent of its services targeted Europe, Australia, and Latin America, whereas 43 percent of its services were in the regions of South and West Asia, 36 percent in Africa, and 13 percent in the Pacific and East Asia.³ In 2019, the group provided 19.5 million abortions. ²²

In 2020, MSI performed approximately 19 million abortions worldwide. It also provided 32.6 million people with contraception. Between 2015 and 2020 MSI reported to have performed over 90 million abortions. ³

Criticism of Pro-Life Activists and Christians

MSI refers to pro-life and anti-abortion activists as leading a “global assault on choice” using “sophisticated tactics” targeting “young people” of “all ages, economic status[es] and religious affiliation[s].” In its opinion, pro-life activists have “co-opted spaces traditionally used to advance human rights such as the United Nations and the World Health Organization” and have used “demonstrations and rallies to gather support”: ²³

The Pro-Life Activist’s Encyclopedia trains followers in debate tactics and instructs them on the right language to persuade others to join them.  Starting with the ingenuous moniker “pro-life,” the opposition uses vocabulary that refers to pro-choice as the “anti-life” movement. They declare supporters of choice “anti-family.” Stories built on concepts of “the natural family” and “natural sovereignty” also undermine pro-choice values. ²³

MSI is critical of anti-abortion organizations such as the Spain-based Citizen Go, which “mobilizes in East Africa to condemn a range of LGBTQI+ issues.” The U.S.-based group Heartland International, MSI writes, “target[s] vulnerable young pregnant women” in Uganda “seeking abortion with misleading promises of help.”²³

According to MSI, “Right-wing Christian organizations” supposedly provide “$280 million each year” promoting unspecified conservative causes, while MSI estimates that “anti-gender equality groups” based in the United States and backed by “oligarchs from the Russian Federation” raised $702 million in funds between 2009 and 2018. (MSI-US, just one branch of Marie Stopes International, raised $473 million in that period.) ²³

Of religious conservatives, MSI has written: ²⁴

We believe that no one should be judged for having an abortion, though we understand that there may still be some stigma attached to abortion within religious communities, or from peers who have religious views.

The group promotes affiliation with left-of-center religious, or nominally religious, groups that are pro-abortion, such as Catholics for Choice, Muslims for Choice, and the Religious Coalition for Reproductive Choice. ²⁴

In December 2025, MSI published a report detailing pro-life sentiment around the world. MSI claimed that pro-life activists were “spreading disinformation online. Starting lawsuits to try to intimidate and censor us. Instigating police raids of clinics. Attempting to block policies that would support reproductive choice, like having sex education in schools.” MSI reported that, “In Addis Ababa, a vehicle has stationed itself outside MSI’s clinic with the words ‘Pray to end abortion in Ethiopia’ printed on it for all to see as they attend appointments.” The group claimed that attacks and intimidation of clinics and staff are on the rise. MSI also characterized peaceful protesting outside abortion clinics as “harassment” and warned about the spread of pro-life protesting tactics from the United States such as 40 Days for Life, which is an annual around-the-clock protest of abortion clinics for 40 days. MSI bragged about its success in convincing the U.K. government to pass a law instituting a 150-meter buffer zone around abortion clinics in 2024. ²⁵

Criticism of Trump Administrations

Mexico City Policy

MSI-US is highly critical of the “Mexico City Policy” (formally “Mexico City Policy and Assistance for Voluntary Population Planning”), a federal policy issued first in 1985 by President Ronald Reagan that banned non-governmental organizations (NGOs) from using federal funds provided by the U.S. Agency for International Development (USAID) “to pay for the performance of abortions as a method of family planning, or to motivate or coerce any person to practice abortions.” The policy has been continued by Republican presidential administrations and rescinded by Democratic administrations in the intervening years.²⁶

In January 2017, then-President Donald Trump reinstated the Mexico City Policy upon taking office. ²⁷ On January 28, 2021, then-President Joe Biden rescinded the policy. ²⁸ The second Trump administration reinstated the Mexico City Policy upon taking office, later expanding it to additionally cover diversity, equity, and inclusion policies and promotion of transgenderism. ²⁹

The Mexico City Policy has been criticized by some pro-abortion advocacy groups, calling it the “Global Gag Rule.” MSI-US complained that during the first Trump administration the Mexico City Policy cost the group “30 million in annual USAID funding,” or $120 million “over Trump’s full term,” funds that it would have used to provide an estimated 7.8 million abortions. MSI-US is a 501(c)(3) public charity with strict lobbying limits. However, the group has endorsed passage of the Global Health, Empowerment and Rights Act (“Global HER Act,” H.R.556, 2021), a Democratic-backed bill which would codify federal funding of abortions overseas, effectively blocking future presidents from reinstating the Mexico City Policy, demanding that the policy be “permanently repealed.” ^{30 31 32}

MSI-US denies that funds distributed to pro-abortion groups by USAID during periods when the Mexico City Policy is not in effect are taxpayer funds. The group previously released a statement claiming, “American citizens are told that the GGR [“Global Gag Rule”] prevents their taxes from being spent on abortion, however this is already prohibited under the 1973 Helms Amendment.” ³³

MSI-US claimed that the Mexico City Policy “was a decision that undid years of progress on global reproductive rights and caused untold pain to millions of women, limiting their opportunities for the future.”³⁴ The group has written: ³⁵

President Trump re-instated the Global Gag Rule in 2017, cutting off US Government funding for organizations that provide or even talk about abortion. MSI could never accept its conditions, and as a result faced a $120 million funding gap over four years.

Second Trump Administration

In December 2025, Beth Schlachter, the senior director of U.S. external relations at MSI Reproductive Choices spoke at the International Conference on Family Planning (ICFP) in Bogotá, Colombia on the closing of USAID, where she reportedly said, “Consider the first nine months [of the second Trump administration] as round one…[n]ow they’ve taken down the system of US foreign assistance, the [government] is rebuilding it.”³⁶ According to The Guardian, Schlachter also claimed that ongoing bilateral aid agreements between the U.S and other governments will “make it harder for organisations to provide family planning services.” ³⁶ She called the U.S’ funding through bilaterial aid agreements a “complete Trojan horse moment” and further alleged “the US is highly transactional, [and] we don’t know the full extent of what the Trump administration will ask as payback for the investment.” ³⁶

In July 2025, MSI Reproductive Choices criticized the Trump administration’s plans to destroy contraceptives warehoused in Belgium that were intended to be distributed by USAID. The group called it a part of the Trump administration’s “war on women.” At the time, MSI’s director of advocacy Sarah Shaw said: “To me that sends a really clear signal that this is an ideological position… This is just another front on the war on women that we’re currently seeing coming out of the U.S., both domestically and internationally.” The group was told by an intermediary that MSI Reproductive Choices could buy the contraceptives from the U.S. government at full market price. However, the group said that it could not afford them. The U.S. State Department claimed that the contraceptives did not include condoms or HIV medication but instead comprised of products that could be used as a abortifacients. ³⁷

In January 2026, MSI Reproductive Choices released a report detailing what it claimed were the effects of the Trump administration’s closing of USAID. The report stated in part: ³⁸

Supply chain distribution networks are collapsing. People are being turned away from the care they need. Many of our partner organisations have been forced to close. With 50% of our income being self-generated, and having moved away from a heavy dependence on USAID, MSI has been in a strong position to plug gaps, continue providing services and supporting governments to do the same. But the shockwaves have been felt around the world.

The group went on to claim that USAID provided 35 percent of the contraceptives in the world before it was closed. The report also claimed that African governments were forced to increase their health-care spending, specifically on reproductive health care, to offset the cuts in USAID spending. ³⁹

In February 2026, MSI Reproductive Choices opposed the Trump administration’s expansion of the Mexico City Policy to ban foreign aid for “groups that promote “gender ideology” and diversity, equity and inclusion.” Senior director of MSI Reproductive Choices Beth Schlachter said: “It’s a little mind-boggling to imagine how you would attach language on race to programs that are meant primarily for Black people in Africa.” ⁴⁰

Controversies

Eugenics Associations and Name Change

In November 2020, Marie Stopes International announced it was changing its name to “MSI Reproductive Choices” to “intentionally break [. . .] with its connection to Marie Stopes the woman.” The group’s chief executive, Simon Cooke, said, “We’re absolutely not trying to erase her [Stopes] from history, or what she did . . . but we really need to look forward and not back.” Cooke continued: ⁴¹

Marie Stopes was a pioneer of family planning; however, she was also a supporter of the eugenics movement and expressed many opinions which are in stark contrast to MSI’s core values and principles. The name of the organisation has been a topic of discussion for many years and the events of 2020 have reaffirmed that changing our name now is the right decision. As we look to the future with our new 10-year strategy, we are reflecting our fundamental focus in our new name, MSI Reproductive Choices. [emphasis added]

Cooke told The Guardian that “the events of 2020 have reaffirmed that changing our name now is the right decision,” indicating the Black Lives Matter demonstrations which occurred across the United States and parts of Britain following the police-involved death of George Floyd in Minneapolis, Minnesota that year. ⁴²

Taxpayer Funding for Abortions

In 2019, it was revealed that the British government was the single largest donor to the UK-based MSI Reproductive Choices. Taxpayer funds accounted for roughly £308 million ($407 million USD) in government grants to the abortion provider between 2009 and 2019. In 2019, the U.K. government was responsible for 15 percent of MSI’s income that year, a massive increase from the one percent it provided the group in 2009. ⁴³

Abortion Persuasion Incentives

The U.K.’s Care Quality Commission (CQC), a government watchdog agency which monitors national health services, accused Marie Stopes International of paying staff bonuses “for encouraging women to go through with a termination” in 2017, including girls as young as 16 years old. ⁴⁴

The CQC reported that MSI’s staff had privately criticized the organization for having a “cattle market culture” and “very target-driven culture,” with MSI employees reportedly being “encouraged” to recommend patients to undergo abortions because it was “linked to their performance bonuses.” Government inspectors discovered minutes of one meeting where MSI staffers discussed an aggressive “company-wide focus on DNPs,” or patients who “Did Not Proceed” with abortions, with instructions to call them and attempt to schedule another appointment. ⁴⁴

The report also found that parents, partners, or friends of pregnant women who might persuade them to think again about the termination were “seen as an inconvenience” and that “their presence was strongly discouraged.” ⁴⁵

MSI called the allegations “categorically untrue.” The group’s managing director, Richard Bentley, told reporters: “It’s true that our team members are measured against key performance indicators (KPIs) that relate to quality and client care. However, none of these KPIs relate to client numbers, and it is untrue that any member of our staff receives a performance related bonus for the number of clients they treat.” ⁴⁴

Safety Violations

A 2016 government inquiry by the Care Quality Commission, which monitors public health services in the United Kingdom, found that MSI clinics in Britain had committed over 2,600 “serious incidents” by failing to follow “basic safety procedures,” leading to a temporary halt in performing abortions.⁴⁶

The report found that MSI doctors were “bulk signing” and “pre-signing” consent forms for female patients undergoing abortions. At one clinic, doctors were leaving nurses unequipped and untrained for emergencies to tend to sedated women while they went home. One woman with learning disabilities was reportedly “allowed to have an abortion without fully understanding the procedure or consequences.” The Daily Mail reported:⁴⁶

She arrived alone at the clinic in Sandwell, West Midlands, and became distressed just before the procedure. Doctors went ahead anyway – despite not clearly explaining the procedure – and spoke to her ‘insensitively’.

The report further found that almost half of nurses had not been trained to do resuscitation; some women did not understand the full consequences of what they were about to do; safety incidents including medical blunders and equipment failures had increased by one third in a year; doctors were signing off up to 60 consent forms at a time when they were meant to be making a thorough assessment, including one incident where a doctor filled in up to 26 forms in two minutes; and fetal remains were dumped in ordinary medical waste bins rather than sealed for cremation. ⁴⁶

Botched Abortions

A 2017 inquiry by the U.K. government’s Care Quality Commission discovered there had been 373 “botched abortions” carried out by MSI clinics in a period of two months. The report was the third to find serious failings in the organization’s operations. ⁴⁷

Illegal Abortions in Kenya

In October 2020 it was reported that the decomposing corpses of ten babies, all illegally aborted by MSI, had been found discarded in a dumpster outside an MSI abortion clinic in Nairobi, Kenya. Police also reported discovering medical equipment and drugs commonly used for conducting abortions at an MSI-run health clinic.⁴⁸ Kenyan national police arrested two unregistered medical practitioners “on suspicion that they were conducting abortion[s] in the said facility where 10 decomposing fetuses and other appliances suspected [of having] been used for conducting abortion[s] were recovered.” ⁴⁹

In 2018, the Kenyan government banned Marie Stopes International from offering abortion services.⁵⁰ Kenyan law holds that abortion is illegal except in the case of rape, and the national constitution stipulates that “the life of a person begins at conception.”⁵¹ As such, the Marie Stopes clinic was shuttered in 2020.⁴⁸

Abortions for Homeless Women

In October 2025, the Big Issue news outlet profiled an employee of MSI Reproductive Services, Ailish McEntee, who was trying to provide abortions to homeless women in the United Kingdom. “One of the main things is frequent relocation between temporary accommodations or during sofa surfing. It happens with very little notice and that can disrupt care. It can cause issues with registering with a GP. There’s limited access to information via the internet,” McEntee complained. ⁵²

The group also announced that it would be “contributing or participating” in that year’s “women’s rough sleeping census” in London. The group stated: “We’ll be supporting and working with Solace in that, and we hope that we’ll be able to support with that data and help services build an accurate picture of what’s going on.” ⁵²

At-Home Abortions

In April 2025, Right to Life UK called for an end to the practice of mailing abortion drugs to patients to administer abortions at home. This came after MSI Reproductive Choices mailed abortion drugs to a woman who used them to terminate her pregnancy; she had been pregnant for 26 weeks. The group also called for an investigation of MSI Reproductive Choices. ⁵³

This incident highlighted MSI Reproductive Choices’ at-home abortion scheme under which it sends out abortion pills without an in-person consultation with a medical professional. Before the introduction of the at-home abortion scheme, women were required to have an in-person consultation with a medical professional to take mifepristone, the first abortion pill used for a medical abortion, under medical supervision in the clinic. During an in-person medical visit, the unborn baby’s accurate age could be determined via examination through ultrasound or a physical examination by a doctor. If an in-person appointment takes place, the gestational age of the baby can be accurately identified. Right to Life UK said abortion pills cannot be sent out if the baby is beyond the nine weeks and six days limit for at-home abortions. ⁵⁴

In addition, Right To Life UK pointed to examples where abortion drugs were procured through MSI Reproductive Choices and other abortion providers to coerce women to have an abortion against their will. The group pointed out that in debates in Parliament before the abortion at home scheme was legalized, there were warnings that the drugs could be procured by abusive partners to coerce women to have an abortion against their will and even without their knowledge. In-person appointments allow signs of coercion or abuse to be more easily assessed. It was approved permanently in 2022.  ⁵⁴

Complaints of Censorship

In December 2025, MSI Reproductive Choices accused Meta of censoring its social media profiles on Facebook and WhatsApp. The WhatsApp account of Fundacion MSI, which is part of MSI Reproductive Choices and the largest abortion provider in Mexico, had reportedly been suspended. WhatsApp is the leading channel for people seeking to have an abortion and the suspension of the account led to a drop in the number of people seeking to have an appointment by 80 percent. The account was given a number of warnings before it is suspended, according to Meta. ⁵⁵

Global Declaration on Abortion

Marie Stopes International was one of roughly 350 pro-abortion activist and research groups which formed the Global Declaration on Abortion in November 2019, following the Nairobi Summit of the United Nations International Conference on Population and Development. The declaration urged all governments worldwide to: ⁵⁶

• Make abortion . . . safe, legal, available, accessible and affordable by eliminating all laws and policies that restrict or criminalize access.
• Ensure that universal health coverage integrates . . . comprehensive sexual and reproductive health information and services, including abortion, post-abortion and contraception, into national strategies, budgets, and programs.
• Provide children and young people . . . with comprehensive sexuality education that supports their right to . . . contraception and abortion, and connects them with sexual and reproductive health services that are free, accessible, age-responsive . .. .
• Increase access to early, quality medical abortion to make abortions safer . . . .
• Meet the sexual and reproductive needs of . . . young women, indigenous women, women with disabilities, unmarried women and girls, and trans men . . . and help to improve equity and ensure their access to contraception and abortion.
• Promote gender equality and women’s and girls’ autonomy by implementing interventions at all levels to change harmful social and gender norms and stereotypes around sexuality, pregnancy and abortion; and by engaging partners, relatives and community members as supportive advocates for sexual and reproductive rights and abortion.

Other listed signatories included the Center for Reproductive Rights, DKT International, EngenderHealth, Ipas, Pathfinder International, Population Services International, Population Connection Action Fund, and Planned Parenthood.⁵⁶

Leadership

As of 2026, Simon Cooke was the CEO of MSI Reproductive Choices. He had worked as the CEO of the group since 2013. He previously spent 15 years with Procter & Gamble and eight years with Reckitt Benckiser, where he was based in Dubai as general manager for Middle East and North Africa until 2012. He was CEO of an Indian-owned, private equity-backed industrial company, Super-Max, also based in Dubai. In addition to working in Dubai, he has worked in Latin America, Eastern Europe, Asia, the Middle East, and Africa. ⁵⁷

As of 2026, Hayley Savage was the chief financial officer of MSI Reproductive Choices. She has worked for the group since 2024. Previously, she spent over two decades in health and social care. Over the past six years before joining the group, she held senior leadership roles as executive director of finance and technology, and interim CEO. She was also the CFO for labs and physician services at HCA Healthcare UK. ⁵⁸

As of 2026, Amanda Seller was serving as the president of MSI-US and the vice president of its global partnerships & philanthropy division. She has worked for the group since 2022. Before joining, she worked with the United Nations and other groups on a variety of issues. Among the issues she has worked on is homelessness, addiction, domestic violence, refugees and displacement, and reproductive health. Among the groups Seller has worked for include the pro-migration International Rescue Committee. ⁵⁹

As of 2026, Nicole Raatgever was the director for Asia for MSI Reproductive Choices. She has worked for the group since 2011. She has worked in West Africa, South Asia, Southeast Asia, the Middle East, and the Pacific. In particular, she has worked in Nepal, Madagascar, and Ghana, serving as the country director in each of the countries. She became the Asia director in 2022. ⁶⁰

As of 2026, Megan Elliott was the vice and president and chief operating officer of MSI Reproductive Choices. Before becoming COO, she was responsible for driving MSI’s strategic direction, as well as advancing its strategic engagement with key partners and donors, and securing new financing across the global partnership. Before that, she spent 20 years designing and implementing complex service delivery and social marketing programs in Africa and Asia across a wide variety of health areas including abortion and contraception, HIV prevention and treatment, tuberculosis, malaria, and child survival. ⁶¹

As of 2026, Frank Braeken was the chair of the board of MSI Reproductive Choices. He was also chairman of Baobab + and NED of Agra, AECF, Buhler and Tiger Brands. He was based in Dubai at the time. Until May 2013, he was a regional president for Unilever in Africa and the Middle East. Previously, he worked for the company as regional president of the China Region, managing director of Unilever Foods France, and chairman of the Andina Region. ⁶²

Funding

Financial Overview

MSI is composed of a United Kingdom-based parent charity, MSI Reproductive Choices, and a United States-based 501(c)(3) affiliate, MSI-US. It is listed as a “supporting organization” to MSI Reproductive Choices on its nonprofit tax returns. ⁶³

According to MSI Reproductive Choices’ 2024 Annual Report, the group reported a total income of £309 million (approximately $412 million) for that year, which was down from its 2023 total income of £414 million (approximately $552 million). The group increased its unrestricted reserves further to £211 million (approximately $282 million), noting in its accounts that “with geopolitical uncertainty and institutional donors making tough decisions about their own funding priorities, a strong reserves position is essential.” The group’s grant income was down from 2023 to 2024 by over a quarter, with the organization citing “timing differences, foreign exchange volatility and difficulties in operational areas such as Yemen.” The group reported spending 92.9 percent of its 2024 total expenditure on charitable activities, versus 94.1 percent in 2023, and 5.6 percent on support costs, versus 5.3 percent in 2023. The group reported that it paid its CEO Simon Cooke a £249,000 salary (approximately $332,000) and a bonus of £246,000 (approximately $328,000) in 2024. ⁶⁴

According to MSI-US’s 2024 tax returns, the group had $59,763,738 in revenue, $59,762,187 in expenses, and $861,912 in net assets with nearly all revenue transferred to MSI Reproductive Choices. ⁶⁵

Donors to MSI-US

Most of MSI-US’s annual funding has been from grants provided by left-of-center foundations. The Susan Thompson Buffett Foundation, which is funded by billionaire Warren Buffett, gifted at least $508 million to MSI between 2009 and 2020, accounting for approximately 88 percent of the group’s total revenues in that period. ⁶⁶ In 2020 alone, the Buffett Foundation gifted MSI $38.8 million, or 74.7 percent of the group’s income that year. ⁶⁷

Other major donors to MSI-US have included the William and Flora Hewlett Foundation, which has gifted the group at least $23.5 million from 2010 to 2020; Fidelity Investments Charitable Gift Fund (a donor-advised fund provider used by anonymous funders), which had channeled at least $27 million to the group from 2016 to 2020; the David and Lucile Packard Foundation, which had gifted it at least $3.5 million from 2011 to 2020; Wellspring Philanthropic Fund, which had given it at least $1.7 million as of 2020; and the Gates Foundation, which had gifted the group at least $3.5 million from 2014 to 2020. ⁶⁶

The following are identified grants to MSI-US: ⁶⁶

Donors to MSI Reproductive Choices

MSI Reproductive Choices, the London-based parent charity of MSI-US, received grants in 2020 from the Gates Foundation ($4.1 million), Hewlett Foundation ($1.2 million), International Planned Parenthood Federation ($8.6 million), United Nations ($5.4 million), and the British Foreign, Commonwealth and Development Office ($48.4 million).³

In 2018, the Canadian government announced an $8 million grant to MSI during an International Conference on Family Planning.⁶⁸

U.S. Government Grants to MSI

MSI and a handful of international affiliates based in Africa received nearly $187 million in U.S. federal grants between 2014 and 2019. All of the grants came from the U.S. Agency for International Development (USAID), which was previously responsible for distributing U.S. foreign aid funds before it was shut down in 2025.⁶⁹

Grants from Marie Stopes International

Between 2002 and 2020, MSI-US paid out approximately $655 million in grants, all of which went to its U.K. parent, Marie Stopes International, for international distribution. ⁷⁰ As such, MSI-US acts as a pass-through funder to the UK-based parent organization.

In 2020, MSI Reproductive Choices reported roughly $212 million (£160.4 million) in grant income; cash transfers from MSI-US accounted for 23.3 percent of its global income. ³

International Affiliates

MSI has affiliates in 37 countries, many of which operate as for-profit entities whose shares are 99 or 100 percent controlled by the parent organization based in London (an * indicates 99-100 percent share control by MSI Reproductive Choices): ³

• United Kingdom* (parent organization)
• United States
• Australia*
• Austria*
• Bangladesh
• China*
• India*
• Kenya*
• Madagascar
• Malawi
• Mexico
• Mongolia*
• Nepal*
• Nigeria
• Pakistan
• Papua New Guinea
• Romania
• Sierra Leone
• South Africa
• Sri Lanka
• Tanzania
• Vietnam
• Yemen
• Zambia
• Zimbabwe

In 2020, MSI-US, the group’s American affiliate, posted revenues of $39.2 million, according to the U.K. arm’s annual report; the second-highest earner for the network was Options Consultancy Services, its main U.K. services subsidiary, which brought in $19.7 million in 2020.³ The reason for the disparity with MSI-US’s revenues posted in its 2020 IRS Form 990 ($52 million) is unclear.