Tribune. The controversy around the cluster [aggregation of cases of disease occurring in a window of time and in a territory given] of babies born with a malformation réductionnelle of the upper limb is unfortunate.

public health authorities of our country are sending the message that, in the absence of assumptions on the factors that are at the origin of these malformations, it is “forced” to stop seeking and to continue the monitoring.” Our position of scientific council of the Remera [Register of malformations in the Rhone-Alps] we obviously leads to support the warning given by its executive director, Emmanuelle Amar, and called for an investigation etiological serious. But it leads us also, beyond this particular situation, to carry out a wider reflection on the small structures of public health in France, whose role is precisely to highlight the scientific issues wider in such a situation.

The small structures have more and more difficult to receive funding, and therefore to exist. Why ? Without a doubt, for two reasons.

current Trend

first Of all, because the priority is given to funding research on large populations, on the diseases that concern most of the world, or the most severe pathologies. We can say simply that what is of interest to health authorities, it is either 10 disease cases are rapidly fatal, the appearance of 100 000 cases of diseases to be less severe. This is understandable at first sight. Then, because the current trend towards concentration of activity areas leads to the small structures to support it with larger structures to work. Thus, they disappear from the landscape to reinvent themselves elsewhere, and this is the market logic of the history of capitalism.

how is it dangerous ? Two reasons again.

on the one hand, the…

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