MSF is a charity who are heavily reliant on fundraising income to support its life saving work. This case describes how MSF more than doubled its annual income over a 10-year period in which charitable giving sharply declined. MSF’s case demonstrates that by taking a long-term approach to short term activation, a virtuous circle has been created between increased fundraising income and growth in media spend, which in turn drives income further. This approach has been powered by audience insight, evidence-based decision-making and close collaboration between client and agency specialists.