Médecins du Monde (MdM) operates in 30 cities across France and runs 103 health promotion programs through fixed centers or mobile units, serving vulnerable populations who face difficulties accessing preventive care and medical treatment. To describe the profile of the people served, document barriers to healthcare access, and track changes over time, MdM established a Healthcare Access Observatory in 2000. To this end, the fixed centers use a shared data collection form completed for each person seen. In 2010, the centers served 28,160 people, and data was collected for 21,710 of them. Ninety-two percent were foreign nationals and 12% were minors. Their socioeconomic profile is characterized by a lack of or precarious housing, very limited resources, and an unstable administrative status. Three-quarters may theoretically have health coverage, half of whom are covered by the State Medical Aid (AME) program reserved for undocumented foreigners. Among the main obstacles to accessing care identified are: a lack of awareness of rights, language barriers, administrative difficulties, financial difficulties, and fear of arrest. Analysis of the data highlights the need for medical follow-up, even though these are people without health coverage. Minors and pregnant women are not spared. The complexity of administrative systems limits access to care. Therefore, with the aim of simplification, a merger of the AME and the CMU (Universal Health Coverage) into a single system for all individuals residing in the country and living below the poverty line has been proposed. However, certain security policies and measures to combat illegal immigration, due to the fear of arrest they generate, drive people away from healthcare facilities and hinder efforts in prevention, risk reduction, and access to care. These contradictions should be resolved in the individual interest of the people and the collective interest of public health. (R.A.)