As one of the key architects of this initiative, what was your vision for the creation of this new agency?

The creation of Santé publique France was a unique period of development, dialogue, and action. Our goal was to establish an independent scientific agency with a five-year plan and strategic directions through 2022, ensuring the stability and time needed to carry out ambitious projects. This collective effort has enabled significant advancements such as:

• The development of social marketing in prevention. This approach is based on scientific studies. The goal is to support behavioral change by influencing environments, influencers, and decision-makers to strengthen citizens’ ability to take action for their own health.

• Strengthening our presence across the country. The CIREs, the agency’s regional offices, provide expert support to the ARSs in defining their public policies and structure the national surveillance system. They now issue regional public health bulletins in a coordinated manner at the national level, enabling comparisons with other regions and with national data.

• Better access to knowledge to facilitate the implementation of preventive measures. The Géodes mapping observatory, which we created, provides access to 300 health indicators across 40 themes, allows for comparisons between regional and national indicators, and enables users to download data and maps. https://geodes.santepubliquefrance.fr/#c=home

What do you consider to be the key developments of the past three years?

The National Health Strategy has been renamed Prevention Priorities. We supported this shift by strengthening our resources in prevention. These investments have borne fruit.

• Vaccination: Through the organization of public consultations, we contributed to the implementation of the current vaccination policy, and the initial results in terms of vaccination coverage are tangible. The creation of the vaccination-info-service reference website has allowed us to meet the public’s high demand for information.

• Tobacco, with an unprecedented decline in the number of smokers: 1.6 million fewer smokers in two years, a result of the public policy in which the agency participated by developing a strategy spanning surveillance to action—a social marketing strategy whose major event is “Smoke-Free Month” in November.

• Alcohol, where everything had to be built from scratch and which required significant mediation work before launching a campaign: we had to define new benchmarks for consumption—in close collaboration with the INCA—understand French people’s perceptions of and consumption of alcohol, measure the impact of this consumption in terms of morbidity and mortality, and then develop information campaigns aimed at healthcare professionals and the general public, targeting regular drinkers, young people, and pregnant women.

What are the major challenges for the future?

• Taking action at age 40 rather than at the end of life: this requires shifting the focus of preventive measures by targeting actions at 40- to 50-year-olds, with the goal of improving later aging. In midlife, intervention is needed regarding tobacco, alcohol, diet, and physical activity, as well as diabetes, hypertension, and dyslipidemia, which are major risk factors. In these areas, indicators for identification, screening, and management still need improvement.

• Better account for the impact of the work environment on health: The proportion of morbidity and mortality attributable to the environment is likely underestimated. Issues related to contaminated sites and soil, as well as exposure to pesticides and endocrine disruptors, are already significant. They will require long-term investment to establish critical sample sizes and robust hypotheses.

• Incorporate health economics. In the future, it will be necessary to integrate the economic dimension—and particularly the concept of return on investment—into the agency’s work. This must be taken into account when setting priorities, following the example of Public Health England.