France’s strategy on health
The acceleration of globalisation has reinforced the far-reaching character of threats to public health and demonstrated the shared benefits of universal access to high-quality healthcare.
When health is seen as a global public good this necessarily calls for global, coordinated mobilisation of all actors in international cooperation. France is at the heart of that mobilisation, notably on the basis of its substantial financial commitments, a health system often seen as an example to be followed, and its expertise, acknowledged and valued by its partners.
France’s strategy with regard to health targets as its priority the realisation of the Millennium Development Goals, and especially those MDGs that relate to maternal and infant health (MDGs 4 and 5) and the fight against HIV/AIDS, malaria, tuberculosis and other diseases (MDG 6). It also aims to intensify efforts against emerging and re-emerging infectious diseases likely to compromise international health security (pandemic influenza, zoonoses, multiresistant infections, and so on). And lastly, it includes non-communicable diseases, these being an increasing drag on the balance of health systems, emphasising the need for multisectoral prevention policies to address common risk factors and social and environmental determinants.
The strategy promotes the strengthening of the most vulnerable health systems (extreme poverty, crisis situations), notably in French-speaking Africa, through the provision of support for sustainable funding of health in a spirit of solidarity, the training of competent, motivated human resources and the development of reliable health information systems. It also encourages cooperation between scientific bodies and universities in all developing countries, but especially in emerging countries where the demand for health partnerships is strong.
- Stronger health systems: access to treatment, health funding, human resources, HIS.
- Women and children’s health: sexual rights and access to family planning, actions in domains where MDGs 4, 5 and 6 overlap, the combat against malnutrition.
- The fight against communicable diseases: HIV/AIDS, malaria, tuberculosis, neglected tropical diseases.
- The fight against (re-)emerging diseases, and the “One Health” approach in the combat against zoonoses.
- The fight against non-communicable diseases (NCDs), essentially cardiovascular diseases, cancer, diabetes and chronic respiratory conditions.
The goals of France’s strategy on health
Looking beyond a vertical approach structured on the basis of medical conditions or population groups, France wishes to strengthen more horizontal approaches in order to address the structural challenges facing health systems and foster universal access to high-quality, safe, effective and affordable treatment. Eight goals have been defined for the strategy on health:
- Continuation of the financial effort on health, standing at an annual €1 billion, notably going to the Global Fund, GAVI and UNITAID. Support for UN organisations (WHO, UNAIDS, UNFPA, Unicef, UN Women) invested in women and children’s health based on projects in which French NGOs are also participating, and making women and children’s health the priority for AFD programmes on health, notably with regard to the family planning aspect.
- More effective combination of bilateral and multilateral aid through the creation of a health division in France Expertise Internationale able to mobilise French-speaking expertise for the support of Global Fund beneficiary countries where the three pandemics are concerned. Driving platforms for each of France’s priorities: health funding, human resources, medical drugs, epidemiological surveillance and non-communicable diseases. Mobilisation of the network of regional health counsellors, which provides an interface between bilateral and multilateral programmes.
- Contributions to synergy on the ground between the various research bodies (universities, the network of Pasteur Institutes, the ANRS (Agence National pour la Recherché sur le Sida / National AIDS research agency), INSERM (Institut National de la Santé et de la Recherche Médicale / National institute for health and medical research), the IRD (Institut de Recherche pour le Développement / Institute for development research) and the CNRS (Centre national de la recherche scientifique / National centre for scientific research), among others).
- Building capacity in beneficiary countries by supporting the training of health personnel and health system management, projects for building staff loyalty and improving working conditions. Support for academic cooperation and training in France based on encouragement of collaboration between universities and university teaching programmes on public health.
- Support for hospital cooperation through hospital partnerships and twinning arrangements via ESTHER, the hospital partnership fund and the Ministry of Health’s hospital cooperation scheme.
- Reinforcement of France’s health diplomacy in dealings with its partners, promoting improved coordination between international health initiatives (IHP+) and greater consideration for the health dimension in the various European aid instruments. Advocacy for new, innovative finance mechanisms, part of which would fund health.
- Ensuring proper account is taken of gender and male-female inequality in health programmes: analysis of gender inequality in the various programmes funded by France, promotion of the male-female equality issue in the different international organisations.
- Improved communication on the various programmes conducted by France, targeting both French and foreign partners.
- Widely recognised medical expertise.
- A deeply embedded, leveraged health cooperation network.
- Pioneering NGOs in humanitarian medicine.
- A historical commitment to the fight against AIDS.
- Promotion of innovative financing for health.
- Human rights:
- Aid effectiveness:
the sharing of medical progress, ensuring the availability of French expertise and improved access to healthcare.
rejection of all forms of discrimination, respect for minorities, promotion of gender equality.
ownership by beneficiary countries, alignment with national strategies and systems, donor coordination, harmonisation of procedures, mutual accountability and development of results-oriented management.