France is the 4th-largest public funder of global health R&D; it has strong national research institutions
In 2015, France provided US$88 million for research and development (R&D) on poverty-related and neglected diseases (PRNDs), referred to as ‘global health R&D’ in this profile. It is the fourth-largest public funder of R&D for PRNDs in 2015, both in volume and in relation to the size of its economy. These figures are based on the G-FINDER survey conducted by Policy Cures Research. Funding level has remained stable between 2014 and 2015, after a peak in 2013. In 2015, funding focused on HIV/AIDS (US$18 million; 20% of France’s total global health R&D), diarrhoeal diseases (US$15 million; 17%), bacterial pneumonia and meningitis (US$11 million; 13%), and malaria (US$9 million; 10%). France is also an important funder of research on African viral haemorrhagic fever, which includes Ebola: with US$9 million in 2015, it is the fifth-largest focus of French R&D funding in terms of disease. At the Summit on International Sanitary Security in Lyon in March 2016, former President Hollande stressed the importance of R&D in the response to epidemics and infectious diseases, and announced that the French government would allocate €8 million to the REACTing consortium to fund research on the Ebola and Zika viruses (see box below).
The Ministry for National Education, Higher Education and Research (Ministry of Education) is the main public funder for France’s global health R&D. The Ministry of Foreign Affairs (MAE)’s contribution to global health R&D is limited to funding provided to the Drugs for Neglected Disease Initiative (DNDi; US$1 million in 2015) through the French Development Agency (AFD).
According to G-FINDER data, three institutions channel virtually all of France’s global health R&D funding (99% in 2015): the French National Institute of Health and Medical Research (INSERM; 70% or US$62 million), the Institut Pasteur (25% or US$22 million), and the French National Research Agency (ANR, 4% or US$3 million).
- The INSERM is a public institution, of which the French National Agency for Research on AIDS and Viral Hepatitis (ANRS) is an autonomous agency. Research mainly focuses on HIV/AIDS, diarrheal diseases, and bacterial pneumonia and meningitis. The INSERM draws most of its resources from the Ministry of Education (67% of its budget, or €609 million in 2016).
- The Institut Pasteur is a private nonprofit foundation that seeks to contribute to the prevention and treatment of diseases through research, education and public-health activities. Its sources of funding are diverse. It benefits from grants by the Ministry of Education (around 20% or €55 million of its budget in 2016). It generates almost half of its revenues (49%) through research contracts and services, and around 30% comes from donations, bequests or endowments. Within global health R&D, the Institute spent US$22 million in 2015, mostly allocated to malaria, diarrhoeal diseases and tuberculosis. The Institut Pasteur is one of the founding members of the DNDi.
- ANR coordinates and allocates public funding for R&D under the direction of the Ministry of Education. However, it does not carry out any research itself. According to G-FINDER data, its global health R&D funding amounted to US$3 million in 2015, a third of which was allocated to the INSERM and the Institut Pasteur. Other recipients include universities and national research centers, such as the French National Center for Scientific research. Calls for tenders are published every year to determine which projects will be funded.
Decision-making is fragmented but efforts have been made to increase coordination
France’s decision-making landscape for global health R&D is fragmented: The different institutes involved in global health R&D mostly set their own focus areas and research agendas, while government’s priorities are demonstrated through funding decisions or high-level political declarations. However, in recent years, France’s public research institutions have started setting up coordination structures, in order to increase coherence around the provision of global health R&D.
In 2009, eight institutes (including the INSERM, the Institute for Research on Development (IRD) and the Institut Pasteur) set up the French National Alliance for Life Sciences and Health (Aviesan) to coordinate general medical research. As part of the Aviesan, the Multi-Organization Thematic Institute ‘Immunology, Inflammation, Infectious diseases and Microbiology’ (ITMO I3M) was set up in 2015 to coordinate programming of global health R&D amongst France’s different research institutes (including INSERM, IRD, and Institut Pasteur). It also aims to strengthen the international presence of French research institutes and collaboration with institutions abroad. In April 2016, Aviesan launched the first francophone network on neglected tropical diseases.
REACTing, tackling infectious diseases emergencies through R&D programs
REACTing is an interdisciplinary consortium set up within Aviesan, established in 2013 by several research institutes under the leadership of the INSERM. Members include INSERM, Institut Pasteur, Institut Mérieux. It aims to contribute to the response to epidemics and infectious diseases, through two types of action:
- During ‘peacetime’, improvement of in-country preparedness to set up R&D projects
- When an epidemic breaks out, mobilize a rapid intervention force to respond quickly and set up emergency research programs