Disaster and the Reinvention of Public Health in France

描述(由申请人提供)： 这项提议的目的是资助编写一本书的手稿，该手稿将详细重建导致社会进程的过程，从法国血液供应受到艾滋病毒污染的经历所代表的“灾难”，到公共卫生从一个相对被忽视的死水转变为法国政府的核心关切和创新和社会变革的主要目标。在大多数发达国家，一次输血--更不用说血友病患者需要反复注射血液制品--可能会传播艾滋病的发现，被视为一种公共卫生危机。然而，只有在法国，它被解释为一场全国性的灾难，随后公共卫生及其社会和政治组织的含义发生了重大变化，这些变化并未停止发挥作用。这本书的作者康斯坦斯·A·内桑森和亨利·贝热隆将对这一事件及其后果进行详细的重建，因为他们在1990年至2005年的15年间展开了这一事件(主要关注1991年至1994年)。他们将利用的数据包括法国政府的主要文件、媒体和对主要参与者的口述历史采访，以及关于法国对最近几个被认为是医疗保健和公共卫生方面的“危机”的反应的大型二手来源文献的补充。这些材料将使他们能够描述和解释多重变化，这些变化包括：公共卫生从疾病预防和促进健康问题转变为国家安全问题；通过和实施了与公共卫生机构和公共卫生监管有关的大量新法律；创建了新的公共卫生机构；公共卫生领域出现了新的公共卫生行为者和新的职业机会；病人协会成为一支新的政治力量。不仅在法国，而且在其他发达国家，公共卫生的声望和影响力在20世纪都有所下降。这本书将解决这个问题，在什么情况下，公共健康会成为国家的严重利益？我们将把完成的手稿提交给牛津大学出版社，牛津大学出版社已经通知我们，它对考虑出版它有强烈的兴趣。

DESCRIPTION (provided by applicant): The aim of this proposal is to fund the preparation of a book manuscript that will reconstruct in detail the social processes that led from the "disaster" represented by France's experience of HIV-contamination of the blood supply to the transformation of public health from a relatively neglected backwater to a central concern of the French state and a primary target for innovation and social change. The discovery that a single blood transfusion-not to speak of the repeated injections of blood products required by hemophiliacs-could transmit AIDS was regarded in most developed countries as a public health crisis. Only in France, however, was it construed as a national disaster and followed by significant changes in the meaning of public health and in its social and political organization, changes that have not ceased to play themselves out. The book's authors, Constance A. Nathanson and Henri Bergeron, will undertake a detailed reconstruction of this event and its consequences as they have unfolded over the decade and a half from 1990-2005 (focusing most heavily on the period, 1991-94). The data on which they will draw include primary French government documents, the media, and oral history interviews with key actors, complemented by a large secondary source literature on France's response to several perceived recent "crises" in health care and public health. These materials will allow them to describe and interpret multiple changes that include: the reframing of public health from a matter of disease prevention and health promotion to one of national security; the passage and implementation of a vast new body of laws relative to public health institutions and the regulation of public health; the creation of new public health agencies; the emergence of new public health actors and new career opportunities in public health; and the emergence of patient associations as a new political force. Not only in France but in other developed countries as well, the prestige and influence of public health declined over the twentieth century. This book will address the question, under what circumstances does public health become a serious interest of state? We will be submitting the completed manuscript to Oxford University Press, which has notified us of its "strong interest" in considering it for publication.