“Monitoring the health of the French population: let’s not break the thermometer!”

For several months, certain functions of the French public health agency Santé publique France have been under threat, which worries us, as public health professionals. The General Inspectorate of Social Affairs is currently conducting an inventory of the agency's missions, with the aim of producing reorganization scenarios that raise fears of a weakening of its role . In the face of current health and environmental changes, it is essential to remember that monitoring the health of populations is not a luxury, but an essential function in order to be able to prevent, alert, and act.

Monitoring the health of populations means observing, measuring, and understanding diseases, their causes, and their consequences: infectious diseases, cancers, chronic diseases, risky behaviors, the effects of pollution, climate change, social inequalities in health, and population aging. It also means alerting and intervening, as close as possible to the field, when an epidemic occurs, an unusual number of clusters of cases, or a previously unknown emerging signal.

The production of scientific data on the health status of populations and risky exposures (heat, noise, alcohol, tobacco, chemicals, dietary imbalances and contaminants, sedentary lifestyles, etc.) fuels the work of researchers who identify the determinants of diseases and model their development. In return, health monitoring and expertise professionals adapt surveillance systems and monitor exposures and diseases and propose health prevention interventions. It is this chain—research, monitoring, decision, action—that structures all public health policy. Breaking this link risks disconnecting health action from the reality of needs.

Eliminating or weakening the health surveillance function would be tantamount to breaking the thermometer: we won't lower the fever by removing what measures it. Without reliable and continuous data, we can neither prevent crises and determine their causes, nor respond appropriately, nor ensure that the actions taken are effective. Scenarios proposing to remove Santé publique France from its primary prevention communication functions (nutritional recommendations, Nutri-Score, tobacco, alcohol, etc.) are also worrying, in a context where these campaigns should instead be reinforced by increased resources allocated to the agency.

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