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Direct Relief: 2023 Impact Report

Multiple emergency responses and ongoing support on safety-net health facilities added up to more than $1.7 billion in medical assistance in the first 11 months of 2023.



A midwife at a hospital run by Syria Relief and Development in Jindires, Syria, uses a midwife kit provided by Direct Relief in September 2023. (Photo courtesy of Boraq Albsha for Syria Relief and Development)

Doctors and community health workers around the world rely on Direct Relief to equip them with the medical resources they need to care for any patient, without regard to politics, religion, or ability to pay.

In 2023, Direct Relief once again demonstrated the effectiveness of its flexible approach across all of its programmatic priorities. The organization sustained and expanded existing programs while also responding to humanitarian emergencies globally. The organization’s continuing response to the war in Ukraine – now exceeding $1 billion in humanitarian assistance – remains the largest mobilization of medical resources in Direct Relief’s history.

Direct Relief’s longstanding approach of supporting locally run facilities providing essential health services to underserved communities has enabled the organization to distribute more medicine and supplies, and strengthen fragile health systems in more places than ever before in its 75-year history. This report provides an overview of how Direct Relief has leveraged contributions from generous individuals, companies, and foundations to improve the health and lives of people affected by poverty and emergencies in 2023.

Unaudited totals through November 1, 2023

  • $1,779,114,181 in medical assistance
  • $51,300,000 in financial assistance
  • 458,049,778 Defined Daily Doses of medicine
  • 5,537,556 pounds of medicine and supplies
  • 17,975 deliveries
  • 2,371 healthcare providers supported
  • 87 countries

Thank you for being part of Direct Relief


First responders walk through a common migrant crossing path near the Mexico-U.S. border in Piedras Negras, bringing along Direct Relief’s field medic packs. (Photo by Paul Barcena for Direct Relief)

Responding to humanitarian crises requires rapid mobilization of the right kind of assistance to the right partners at the right time. Direct Relief responds to emergencies using state-of-the-art data tools and guidance from its extensive global network of vetted partners. The result is swift and always tailored to specific requests from local front-line health workers. Coordination with other organizations and public agencies ensures the most efficient and precise use of resources.

The Right Products: Turkey/Syria Earthquake

Medical support for the Turkey-Syria earthquake response departs from Los Angeles to Turkey. (Photo courtesy of FedEx).

A 7.8-magnitude earthquake in Turkey and Syria left 100,000 people injured and destroyed hospitals and health clinics. Within 48 hours, Direct Relief began shipping requested supplies to help establish temporary medical facilities.

In its continuing response to the disaster, Direct Relief has delivered $92 million (wholesale) in material assistance, including:

  • 63 million defined daily doses of vital medications
  • 945 Direct Relief Emergency Medical Backpacks to equip first responders
  • 3,680 Direct Relief Hygiene Kits for 18,400 displaced persons
  • Prefabricated temporary housing for medical workers

Medicine and Money to Maui

Healthy Mothers Health Babies Coalition of Hawai’i visits the Royal Lahaina Hotel, one of many sites used as temporary housing for displaced residents after the Maui wildfires. (Brea Burkholz/Direct Relief)

The West Maui Wildfire destroyed the town of Lahaina, disproportionately affecting residents who are low-income, elderly or very young, pregnant, or who have chronic medical conditions. People with chronic conditions may face acute medical crises if they evacuate without their medications. Wildfires generate airborne particulates that can worsen respiratory and cardiovascular disease.

Direct Relief responded within 24 hours with a commitment of $500,000 in cash assistance to maintain health services. The first emergency shipments of requested medical essentials, including asthma inhalers, diabetes medicines, antibiotics, pain relief, wound care products, and cardiovascular medications, followed within days.

Data and Emergency Preparedness

When responding to natural disasters, displacements, and disease outbreaks, time is of the essence. Early detection and early response lead to better outcomes. Direct Relief can quickly provide the right assistance to the right places at the right times by linking real-time disaster data with information about community-level vulnerability, hazards, and losses.

Each year, Direct Relief leverages data analysis to pre-position materials needed to rapidly respond to hurricanes and efficiently mobilize in response to wildfires. Direct Relief monitors population movement, tracks disaster effects, and remains responsive to evolving circumstances in the affected areas.


Direct Relief works to improve the health of people living in high-need areas by strengthening fragile health systems and increasing access to quality health care. The organization’s medical assistance programs equip health professionals who serve vulnerable populations, and increase access to medicine for patients who would otherwise go without.

Broadening Access to Cold Chain Medicines

Temperature-sensitive medications bound for India are packed into cold shippers in one of Direct Relief’s cold rooms at the organization’s distribution facility in Santa Barbara, California. (Lara Cooper/Direct Relief)

Increasingly, new vaccines and medications for cancer, genetic diseases, diabetes, and other medical conditions require consistent cold temperatures (cold chain medicines) from the point of manufacture until dispensed to a patient. Communities that lack the infrastructure, power, and systems required to handle such medications properly, often go without these therapies.

Direct Relief improves cold chain infrastructure by providing cash grants, donations of refrigeration equipment, and expertise. In 2023, the organization delivered pharmaceutical-grade cold storage equipment to 113 healthcare facilities in low-resource communities.

With this support, health workers can store and administer important temperature-sensitive medicines for a range of conditions.

In 2023, Direct Relief delivered:

  • 67 shipments of cancer treatments to 35 healthcare facilities in 24 countries
  • Insulin to manage diabetes for 40,332 children with Type 1 diabetes in 32 countries
  • Critical rare disease therapies to treat more than 600 patients in 17 countries

Increasing Access to Resilient Power

The Direct Relief-funded battery and solar power system at Family Health Center in Arroyo, Puerto Rico. (Courtesy photo)

Modern healthcare relies on continuous power. Increasingly, record-setting emergencies result in extended power shut-offs. With healthcare systems’ growing dependence on power to provide treatment and maintain patient records, thousands of patients go without care when the power goes out.

Direct Relief’s Power for Health initiative promotes health equity by providing site-specific, reliable power to nonprofit community clinics and health centers serving the most vulnerable communities throughout the U.S. The initiative has already launched projects to provide energy solutions for 41 healthcare facilities in California, Florida, Louisiana, and North Carolina, benefitting 1.3 million low-income patients. These projects have created an estimated $4.3 million in annual cost savings for the participating health facilities.


Cancer, cardiovascular disease, and diabetes have become responsible for the highest shares of death and disability globally. Cancer alone has become the leading cause of death worldwide, and approximately 70 percent of cancer deaths occur in low- and middle-income countries. Direct Relief has responded by increasing its delivery of medical products and financial assistance to bolster the treatment of these conditions.

Delivering Lifesaving Medications to Children with Cancer

A young patient receives oncology care at Muhimbili National Hospital in Dar es Salaam, Tanzania. (Photo by Daniel Msirikale for Direct Relief)

Direct Relief is the principal logistics provider for Global HOPE, a collaborative initiative to improve the survival rates of children with cancer and blood disorders in Sub-Saharan Africa to bring them in line with those of wealthy countries. Currently, only 10 to 20 percent of these children survive the disease.

Since 2019, Global HOPE has treated 13,000 children and trained more than 5,600 healthcare professionals in cancer care protocols.

Expanding Access to Cancer Care for Children in Mexico

A young oncology patient at CDLA. (William Vazquez for Baxter International Foundation)

In Mexico, specialized pediatric cancer care is available only in large cities. For low-income families who live in remote rural areas, the cost of transportation puts cancer care out of reach. Direct Relief and Casa de la Amistad, or CDLA, ensure that hundreds of children from the country’s most resource-poor areas have access to cancer treatment in urban centers. In 2023, Direct Relief and CDLA facilitated cancer treatment of 650 children.

Improving Care for Mothers and Babies

Hiba, who asked that her last name not be used, is a midwife at a hospital run by Syria Relief and Development in Jindires, NW Syria. The hospital recently received an infusion of midwife kits from Direct Relief. (Photo by Boraq Albsha for Syria Relief and Development)

Complications arising from pregnancy are significant causes of death and disability among mothers and babies in low-resource communities. Access to a trained, equipped midwife is one of the most effective ways to ensure healthy pregnancies and safe births.

This year, Direct Relief extended the range of resources available to midwives and health workers to provide care for mothers and babies in medically vulnerable communities. The organization began distribution of its newly-developed Perinatal Health Kit, designed to treat the most common causes of death and disability during and after pregnancy. In 2023, Direct Relief’s Perinatal Health Kits were delivered to maternal healthcare facilities in Bangladesh, Malawi, and Somaliland to support care for 3,750 mothers and babies.

Up to 25% of pregnant women and newborns at partner facilities are estimated to experience the conditions addressed by the Perinatal Health Kit. The amount of supplies provided in 2023 sufficiently equipped midwives and health workers to address all identified cases.

Giving is Good Medicine

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