The risk does not restore the argument of authority

eulogy or opprobrium. The campaign against influenza A (H1N1) applies or the excess of praise that the Government expects indeed more, or the flow of criticism spilled by the opposition in the early days of the year. For the protection of civilian populations, precaution is not that a principle of action dictated by an ethical duty, it has become a political liability in the judicial sense of the term. And this, since, in the case of blood contaminated, judicial and administrative judges have enacted a duty to act to a presumption of risk.

Although it has developed after the first battle - a second viral wave is expected-, this controversy has perhaps not been useless.

Of course, it focused on three major strategic choices that have been less radical that is has been said. The first was "massive" so-called vaccination, which would have been a French specificity. In reality, the France is mostly complied with little about the vaccine strategy established on 7 July by the who, which recommended vaccinations in order of priority: agents of health care, pregnant women, infants of more than six months and entourage of less than six months, subject to risk factors...

The second choice was to practise a double injection, atypical choice in influenza coverage, where injection is usually sufficient but linked to the "length" of the epidemic. On 7 September, the High Council of public health has validated this option. Is that on 28 October and, especially, on 3 December following an opinion of the European Medicines Agency, vaccine dosages have been updated for each category of population, the more generally to a single administration. This point of view, health authorities therefore did not evidence of an excess of particular zeal.

The third option, the most criticized perhaps, was the use of a "field hospital" type organization Specialist socialist MP for health issues, Jean-Marie Le Guen speaks of a "prefectural management". lI is true that, at the outset, the Ministry of the Interior took a prominent place in the management of the crisis. But, far however, almost military logistics which had been planned, five years ago to avian influenza, the H5N1 virus, much more lethal. Still startable, it reads, in part to vaccinate people based on their importance in society. This is not the schema was adopted.

The real lessons of the "case" of influenza A (H1N1) are elsewhere. Misunderstanding a clear opinion on the manner in which has been implemented, this time, the precautionary principle reveals a flaw in the methodology. It was not sufficiently explained or no doubt quite formalized. The precautionary principle must be enabled after a solid scientific assessment, with a weighting of the means implemented and in the confrontation of points of view.

"The principle of assessment above the duty of precaution," said Didier Tabuteau, State Councillor and former Director and founder of the drug, in a recent article, very documented Agency, published in the "Risk & quality" (2009, vol. VI, no. 4). To pandemic influenza A (H1N1), the risk analysis was, first, essentially based on the opinion of who, whose alarmist communication contributed to create a global panic. Until the summer, the political power, in France, was also under the pressure of premature assessments expressed in the press by virologists deemed, fueling fears materialize this first great contemporary pandemic so often announced, never materialize. At a minimum, the seizin of the HCSP, or of a formed body of independent scientists, could intervene at an early stage of detection of the risk.

The proportionality of the devices implemented, also should be consubstantial with the precautionary principle, which still says Didier Tabuteau, "not necessary to mobilize all possible means to cope with risk". Today, at the Ministry of health, it concedes that, in such a situation, the decision would no longer spend a firm command of 94 million doses, but first firm order for the half and an option on the second. If it did had not been excluded this time due to multidose, mobilization of first city physicians participate response weighted to the threat.

The public confrontation of medical advice and political points of view becomes a condition of membership of the populations health instructions. "To join, people need to see that there is plurality of opinions;" "the truth ex cathedra, this does not work", rightly explains Jean-Marie Le Guen. The confrontation scientific and poli-tick "is a condition of confidence", also observed Didier Tabuteau. The risk does not restore the argument of authority. The imperative of safety is more categorical: there is no exception to the Act of defiance of the society for political speech.