The Covid-19 pandemic is now behind us, but the scars are still clearly visible for French medical research. Unable to produce a vaccine on time, like the French flagship Sanofi, the sector faltered. To move forward and project itself, it now calls for better support from the State, through an overhaul of funding and the removal of administrative obstacles.
Exclusively for L’Express, the Minister of Health and Prevention, François Braun, and the Minister of Higher Education and Research, Sylvie Retailleau, present their research transformation plan based on four axes: l attractiveness, funding, regulatory framework and promotion of research.
L’Express: Last January, Alain Fischer, the former president of the orientation council for vaccine strategy and current president of the Academy of Sciences, concluded in a report that French medical research was in a worrying state. Do you share his observation?
Sylvie Retailleau: We are the leader in certain sectors such as immunology or oncology for which we are hot on Boston’s heels, but we must continue to progress in others. This is why we are not giving up and why we continue to invest in biomedical research. On the other hand, we have a problem of organization and simplification to save time in research. Today, we are therefore taking action to better support and surround our researchers.
The failure to develop a vaccine against Covid-19 has dealt a serious blow to French research. Are we still able to produce breakthrough medical innovations and champions?
Francois Brown: In France, we have absolutely remarkable biomedical researchers who are the envy of everyone. It’s not just a question of money. Very significant efforts have been made by this government and the previous one. But we can clearly see the phenomenal acceleration of biomedical research. The train has left, or at least it’s leaving, and the challenge is to get on it and get a first seat. We have before us a major challenge: to transform this research into innovations or disruptive products. We have started to do so but we are facing many obstacles, in particular an extremely complex organization.
How do you intend to remove these obstacles?
FB: There must first be a pilot in the plane, to implement the strategy of the State. This role will be devolved to Inserm. And then, we have to simplify financing. There is a lot of money on the table. But very often, scientists spend more time looking for funding than thinking about developing their product, which is not normal. We have very large research institutes. But we have to reach the upper ladder. This transition to industrialization, dubbed “the Valley of Death” by researchers, is currently insufficient.
Concretely, what will be the translation on the ground?
FB: This requires organization into national networks so that patients with rare and serious forms of common diseases can access innovation, and into territorial networks to facilitate clinical research. There too, we have in France an enormous wealth in the field of health. The University coordinates research, it is its role and it is essential. But the hospital practitioner in his service, university or not, can also do research, just like the general practitioner. Everyone should be interested in research. This is how we will progress much faster.
Does this therefore involve horizontality and circulation rather than verticality?
SR: There are many players in France in the various organisations. After having reinvested massively, one of the challenges is to better coordinate everyone’s action. This is the objective of the research reorganization work that we are currently carrying out, to better coordinate research organizations and universities, which are both real strengths. At the health level, Inserm will, for example, better steer and mediate between all health research operators. The second project is to reform financing.
FB: Funding for medical research in hospitals is an aberration that needs to be corrected. University hospitals, centers for the fight against cancer and other hospitals that produce research receive funding that is supposed to compensate for the care activity that is not carried out by doctors while they are doing research! It’s from another age. We must be very clear and reverse the table on this. It is time for academic health institutions to be recognized as full-fledged research operators and to be directly funded for this. We will then promote the attraction of practitioners for research. Currently, there is very clearly a escheat on university hospital positions because research is often the poor relation for which we have not yet clearly identified a line of funding.
Stéphane Bancel in the United States with Moderna, the Nobel Prize in Chemistry Emmanuelle Charpentier at the Max-Planck Institute in Berlin… There is no shortage of examples of successful French researchers exiled abroad. How to retain them?
SR: We won another Nobel Prize in Physics and a Fields Medal this year in France, and our country also attracts international researchers, as recently at the Institut Pasteur. France has real assets, in particular its academic freedom. Of course, we still need to improve working conditions and salary attractiveness. What a researcher hopes to obtain are also equipment, a good hospital environment, technicians, etc.
FB: There is an old sea serpent on hospital-university careers, retirement, which we are in the process of dealing with and which we are going to settle. The objective being that university hospital staff have a retirement that corresponds to their activity. This chorus may seem innocuous, but there were still real blockages.
SR: Our role is also to try to lift the brakes in order to have regulations with strong rules on clinical trials. We also facilitate the production or development of products with the industry. The question is: how to scale up by bringing together the different strike forces? Bioclusters are very good tools. The idea is to bring together the entire academic chain on a geographical site. Not only the medical school, but also data scientists, engineers…
You want to change the regulatory framework in order to simplify and accelerate the clinical development of innovations. Is it not first and foremost at European level that action must be taken?
FB: There is no blockage at European level, in particular on clinical trials. I think that we have a phenomenal resource in terms of clinical research in France, thanks to the mass of health data that we produce. And then you have to rely on this notion of territory. If you do research, the main work leading to therapeutic drugs concerns rare pathologies, even rare complications of frequent pathologies, which should not be neglected. From the moment it is rare, there are few patients, and you have to come together and work in a network.
In this context, is the management and structuring of data a major issue?
FB: We are able to structure the data and share it, with a certain number of constraints that are quite normal. These procedures must be simplified, while respecting patients’ rights, as well as the principles of clinical and medical research. For this, we wish to rely on the National Ethics Advisory Committee.