In late August 2018 the Zionist Advocacy Center (TZAC), which is spearheading legal tactics aimed at NPOs working in Palestine, announced via facebook that the Internal Revenue Service (IRS) rejected its effort to revoke the charitable, tax-exempt status of Doctors Without Borders’ (MSF – Medecins Sans Frontiers). The IRS does not publish its decisions in such cases, but TZAC’s complaintminus the appendices, is available in a 2016 news story from War News Information Press. It argues that by working with the Ministry of Health in Gaza to provide hospital services MSF provided material support to Hamas, because the Ministry of Health is part of the Hamas-ruled local government in Gaza. A source at MSF said it had no information about the complaint.

The complaint alleges that MSF “admits to collaboration with the Palestinian Ministry of Health” in Gaza, providing intensive care training for medical and paramedical staff at Nassar Hospital and training to al-Shifa Hospital, both in Gaza.  It concludes that these services amount to support of Hamas, which the U.S. has listed as a terrorist organization. It notes that MSF has acknowledged that Hamas rule in Gaza creates potential conflict with laws prohibiting support for terrorism. TZAC argues that providing training in hospitals that treat civilians in Gaza constitutes material support under the Supreme Court’s 2010 ruling in Holder v Humanitarian Law Project. However, that case did not address the question of how the material support prohibition applies to medical services for civilians in areas controlled by listed groups where such services enjoy protections under international humanitarian law. Instead, it focused on training in conflict resolutions skills and human rights advocacy. The complaint also notes that there is no material support exemption for medical services. (It incorrectly states that the only medicine and food are exempt. However, food is not exempt, but religious materials are.)

The complaint against MSF follows accusations by NGO Monitor that accuse MSF of taking sides in the Israel/Palestine conflict, contrary to the humanitarian principle of neutrality, because it has publicly shared information about the impact of the conflict on Palestinians as part of its “bearing witness” function. MSF describes this,noting that:

“Our actions are guided by medical ethics and the principles of impartiality, independence and neutrality…Neutrality is not synonymous with silence. Our proximity to people in distress implies a duty to raise awareness on their plight to ultimately help improve their situation. We may seek to bring attention to extreme need and suffering, when access to lifesaving medical care is hindered, when our teams witness extreme acts of violence, when crises are neglected, or when the provision of aid is abused.”

TZAC’s complaint was filed using an IRS whilstleblower process. This process asks the IRS to investigate whether an organization’s tax-exempt status should revoked.  In cases where revocation results the complainant can file for a monetary award (IRS Form 212). Rules protecting the privacy of taxpayers and exempt organizations prohibit the IRS from releasing information on these investigations.