The French network for health
France has numerous possibilities for action on the ground in the health cooperation sphere, which helps ensure a highly diversified French presence in the field. Those possibilities are based around the Ministry of Foreign Affairs and its responsibility for French strategy in the areas of international cooperation and health development, in conjunction with the Ministry of Social Affairs and Health, the Ministry of Finance and the Ministry for National Education, which helps finance research bodies.
A number of public-sector operators are active in the health sector, particularly the following:
The AFD, working under the terms of government directives and frame agreements signed with its supervisory authorities, implements cooperation and development assistance in the health sphere at the bilateral level. Using a wide range of financial instruments it has been able to develop and expand, the AFD supports official authorities, the private sector and local networks of non-profit associations to implement highly diverse economic and social projects. Its activities are conducted on five continents and in French overseas territories.
The AFD’s programmes to assist economic growth and protection of the environment are directly linked to the Millennium Development Goals (MDGs). The latter priority development targets were defined in 2000 by the United Nations and are aimed at reducing global poverty by half by 2015. More recently, France gave a commitment to increase its financial effort in the area of maternal and infant health by €100 million a year between 2011 and 2015 (cf. G8 Muskoka summit), of which €48m in grants were allocated to the AFD for projects in the 14 poor countries with priority. The AFD also builds financial and intellectual partnerships with other donors and endeavours to defend French influence in the development sphere. It applies policy focuses defined under the auspices of the interministerial committee for international cooperation and development (Comité Interministériel de la Coopération Internationale et du Développement – CICID), a body chaired by the Prime Minister. In 2004, CICID laid down the priorities for action and broadened the role of the AFD, which now has a mandate to fund the whole range of French bilateral programmes in the health domain.
There are three clear focuses for action over the period 2012-2014 in response to the major health issues and international concern regarding MDG achievement: (i) Improvement of maternal and infant health and support for population policies; (ii) Strengthening health and social welfare systems, especially in response to non-communicable diseases (NCDs) and population ageing; (iii) Action on the environmental determinants of health and the fight against epidemics.
The AFD sits on the 5% Initiative Steering Committee.
Find out more at www.afd.fr
The FEI is classed as an industrial/commercial public-sector body operating under the oversight of the French Ministry of Foreign Affairs. It works as an operator implementing all types of cooperation projects linked to Millennium Development Goals, governance and human rights and safety & security.
In the health sphere, FEI implements 5% Initiative programmes, acting on behalf of a number of donors (European Union, AFD, UNITAID, among others) to mobilise health expertise from France and the French-speaking world and to drive large-scale projects.
Find out more at www.fei.gouv.fr
ESTHER is a public interest grouping operating under dual oversight by the Ministry of Foreign Affairs and the Ministry of Social Affairs and Health. It has developed hospital partnerships in 18 countries. Its activity covers over 170 locations where care is provided to those living with HIV and fifty or so French hospitals are twinned with 78 hospitals of reference and 100 decentralised care facilities, the aim being to improve practice in the healthcare provided for HIV, tuberculosis, opportunistic infections and hospital hygiene.
Find out more at www.esther.fr
Non-governmental organisations (NGOs) are key actors in development and French cooperation.
There are numerous French NGOs working in the health domain and they are not only at the cutting edge of advocacy and mobilisation programmes, but they also support and build capacity for countries of the South, especially in the fight against the pandemics.
French NGOs have two seats on the 5% Initiative Steering Committee. These are occupied by AIDES and Solthis (with Sidaction and Solidarité Sida acting as their deputies). The French Red Cross also sits on the Steering Committee.
Find out more at http://www.coordinationsud.org/plaidoyer/sante
Local government authorities
French local government authorities are in the front line where cooperation is concerned and are particularly active in cooperation on health.
Local authority programmes are conducted with a focus on sustainable partnerships between territories in the North and in the South. Reciprocity and co-development are core principles for decentralised cooperation projects. Skills are transferred between the partners in order to strengthen local public services and provide long-term support. Support for local public services helps involve the actors and the assimilation of projects not only by the local authority but also by the local population.
The projects conducted usually entail participation by specialists from both geographical areas. These may be health professionals or public servants specialising in the medical sphere.
There are currently 270 decentralised cooperation health projects conducted by local government.
Find out more at www.cncd.fr
Research and training organisations
These partnerships between volunteering hospitals in the North and the South involve numerous operators: teaching and general hospitals, regional government authorities, the AFD, which manages the Hospital Partnership Fund with the French Hospital Federation, and the Ministry for Social Affairs and Health.
Looking beyond traditional cooperation between hospitals and universities, France supports the development of pairing arrangements between hospital teams in the field based around hospital twinning programmes in ESTHER, the Network of Hospitals of Africa, Indian Ocean and the Caribbean (RESHAOC) and the training of public health decision-makers and managers at EHESP, the school of advanced studies in public health.
French strategy in developing and emerging countries is focused on responding to growing demand for partnerships between scientific bodies and universities. The aim is also to share more widely the French model, which is notably based on the financing of disease risk on the basis of solidarity, and on excellent health personnel, fair access to healthcare and the right to health.
A range of actors are involved in this form of cooperation: hospitals, universities and research facilities.
The principal public and private research centres that prioritise scientific and academic cooperation are: the Pasteur Institutes, INSERM (Institut National de la Santé et de la Recherche Médicale / National institute for health and medical research) and the IRD (Institut de Recherche et de Développement / Institute for Research and Development).
The Pasteur Institute is a private non-profit body dedicated to preventing and treating disease, infectious disease first and foremost, by means of research, teaching and public health programmes.
Find out more at www.pasteur.fr
INSERM is the only French public-sector research organisation entirely dedicated to human health and in 2008 it was given responsibility for strategic, scientific and operational coordination of biomedical research. INSERM plays a leading role in the construction of the European Research Space and consolidates its international positioning through close collaborative partnerships (teams abroad and associated international laboratories).
Find out more at www.inserm.fr
IRD is a French research organisation that is exceptional, indeed unique, in the context of European development research. It favours interdisciplinary approaches and has focused its research for over 65 years on the relationship between human beings and their environment in Africa, the Mediterranean, Latin America, Asia and French overseas territories in the tropics. The goal of its research, training and innovation activities is to contribute to the social, economic and cultural development of the countries of the South.
Find out more at www.ird.fr
France favours long-term training programmes that are an integral part of agreements involving a number of partners, hospitals, universities and political bodies bound by reciprocal commitments.
Those partnerships include the acceptance of students for training courses of varying durations in French partner organisations. Other types of training in the field are covered by more broadly-based programmes.
Since 1992, 8 ANRS sites of research were constituted between the French teams and countries of the South and their National Aids or Viral hepatitis Control Programme. The ANRS dedicates a quarter of its budget to the countries of the South and represents the second institution of research on HIV/AIDS in the world. About twenty projects are financed every year, on clinical research in social sciences and health economics and on operational research.