Question 13676 — health

Summary

Mr. Thomas Portes draws the attention of the Minister of Health, Families, Autonomy and People with Disabilities to the announced reorganization of the national public health agency, Santé publique France (SPF), which amounts to a partial dismantling of its missions for the benefit of the Ministry of Health. According to several information made public at the end of January 2026, the Government plans in particular to place under direct authority of the ministry the management of the health reserve and strategic stocks, but also to transfer to the ministry of health and health insurance the management of major national prevention campaigns. Created in 2016, Public Health France was born from the merger of several organizations - including the Institute of Health Surveillance (InVS), the National Institute of Prevention and Education for Health (INPES) and the Establishment of Preparedness and response to health emergencies (EPRUS) - in order to provide France with a public agency capable of bringing together the missions of health surveillance, alert, prevention and health promotion. In less than a decade, the agency has developed recognized expertise in the production of scientific knowledge, prevention and information campaigns based on robust epidemiological data. The campaigns carried out by Public Health France have notably contributed to significant advances in public health, such as the reduction in the number of smokers thanks to the “Month without tobacco” operation, or even preventive actions on nutrition, alcohol, sexual health and screening. However, the announced transfer of national prevention campaigns under the direct authority of the Government arouses great concern and strong opposition among researchers, health professionals and agency agents. More than 300 public health stakeholders - including leading scientists - recently warned in a forum of the risks that this reform would pose to the scientific independence of public health expertise. Several organizations fear in particular that the direct political takeover of prevention campaigns will not weakens the agency's ability to convey messages based on science, particularly when these conflict with the pressures of powerful economic lobbies. These concerns appear all the more legitimate since, in the past, certain prevention campaigns have already been the subject of political interventions. In 2023, two awareness campaigns against the risks linked to alcohol were thus abandoned following interventions by the executive power, illustrating the possible tensions between public health imperatives and the influence of certain economic lobbies. Beyond these national issues, this reform also raises particular concerns in territories marked by strong social and health inequalities, such as Seine-Saint-Denis. In this department, life expectancy is lower than the national average and Populations are more exposed to numerous unfavorable health determinants: social insecurity, poor housing conditions, environmental exposures, more difficult access to care or even high prevalence of certain chronic pathologies. In such a context, prevention policies and public health information campaigns play an essential role in reducing territorial inequalities in health and improve access to information for the entire population. The weakening or fragmentation of Public Health France would thus run the risk of a lasting decline in independent public expertise in matters of prevention and public health, even though health challenges - chronic diseases, cancers, environmental health or the emergence of new health crises - require strong and effective public expertise. credible. In view of these elements, he asks whether the Government intends to reconsider this project to transfer missions from Public Health France to the Ministry of Health and what guarantees it intends to provide to preserve the scientific independence of public health expertise. He also asks what evaluations have been carried out to measure the impact of this reform on prevention policies, particularly in the areas most exposed to health inequalities, such as Seine-Saint-Denis.

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