Santé publique France is a national agency with regional offices. The regionalization of the healthcare system should not obscure the fact that an event (a signal, an alert)—even one that is clearly localized and managed at the local level—can nonetheless impact national public health security, and sometimes even international public health security. The flow and sharing of information must therefore be optimized. Furthermore, a regional initiative, led by the regional level, may require national support and response resources.

A key concept for public health action is anticipation: an agency combining surveillance, alert, and response functions must prepare for and thus anticipate an adequate and rapid response, whether for a simple health emergency, an exceptional health situation, or a crisis.

The Alert and Crisis Directorate comprises three main areas of expertise, represented by three units. These units are:

• the Pharmaceutical Establishment;

• the Health Reserve Unit;

• the Coordination, Alert, and Crisis Unit, which also serves as the central hub for the agency’s alerts.

The Alert and Crisis Directorate implements the program dedicated to exceptional health situations. This program has three main objectives:

• to prepare and coordinate the agency’s response to health events;

• to optimize the management and distribution of the government’s strategic stockpile of health products;

• to manage, coordinate, and develop the operational doctrine for the “corps” of health reservists.

In parallel with the process and the programming-based mode of operation, the Alert and Crisis Directorate involves the entire agency in functional organizational structures (anticipation unit, sensitive or complex alert unit, crisis unit, and lessons learned). It is also a key player in the expert assessment process, particularly for complex operations: vaccination campaigns, interventions to restore healthcare services (e.g., in maternal and child health centers in Mayotte, following hurricanes in the Northern Islands (Guadeloupe, etc.)).

Through its missions, this department has numerous key partners: the General Directorate of Health, ministries, national health security agencies, regional health agencies, as well as healthcare facilities and healthcare professionals.