Gaining health : analysis of policy development in European ...

Box 2. Communication and health education
France has a long and considerable tradition in health education, as exemplified by the foundation of the International
Union for Health Promotion and Education (IUHPE) on a French initiative in 1951. Jacques Parisot and Lucien Viborel,
French researchers in health education, were the main founders of IUHPE, which received strong commitment from
French political leaders (12). As the paradigm of health education was called increasingly into question, France shifted
its approach to health promotion. Nevertheless, health education is still an incontestably dominant and determining
concept. It is also reflected in the name of INPES, which was created in 2002 as a result of the Act relating to patients’
rights and improving the quality of the health care system. According to this decision, the status of the former CFES was
changed from a nongovernmental to a governmental body and renamed INPES. The regional offices of CFES remained
nongovernmental, however, and therefore a new umbrella organization had to be found to coordinate the work of the
(currently 110) regional and departmental associations. The new organization is called the National Federation of Health
Education and cooperates closely with INPES.
In addition, communication is an important aspect of INPES activities. Intensive use of communication channels is seen
as key to changing norms, beliefs and attitudes. Even if some criticize the expensive and only moderately effective use
of the mass media in health communication, INPES spends a considerable part of its €100 million budget on influencing
public thinking. It is argued that this is one of the most important and effective ways of counteracting the massive influence
of companies promoting unhealthy products and lifestyles.
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for either quantitative or qualitative research exists and thus
only a few examples of good practices have been developed.
The interpretation of research is not strong enough,
although some improvement has been observed (the nutrition
and diabetes programmes are based on solid scientific
evidence). Nevertheless, the coordination of scientific
research in NCD prevention should be more extensive and
interrelated at various levels (13).
2.7.1. Cancer
Cancer research and prevention have enjoyed a high priority
in the French health policy since the beginning of the last
century. The first association in the field of cancer prevention,
the National League Against Cancer, was founded in
1918 and was among the first such association in Europe.
From its outset, diversified international collaboration was
developed and the League paved the way for establishing
the International Union Against Cancer in 1921. At national
level, the activities of the League have greatly influenced
public thinking and have always been a driving force for
health policy in France. After the Second World War,
Charles de Gaulle made strong commitments for strengthening
national programmes against cancer and funded the
Centre for the Fight Against Cancer in the mid 1950s. In a
short time, the Centre developed a powerful network and
significant level of advocacy. In 1964, the Centre changed its
name and became the National Federation of Cancer Centres,
a non-profit-making umbrella organization that unites a
number of hospitals and regional centres. Both the League
and the National Federation are among the largest public
health organizations in the country.
As a result of the presidential initiative in 2003, an interministerial
committee was established to create a national
cancer strategy. The Cancer Plan 2003–2006 aims to
reduce cancer mortality by 20% by 2007 through improving
Case studies: policy development in countries for tackling noncommunicable diseases