Exclusion persists in one of the most wealthiest country in the world

Coordination SUD
Secours Catholique / Caritas France

Poverty and exclusion continue to worsen while the economic and social systems continue to reproduce these phenomena. The new government faces the challenge of addressing social inclusion through reinsertion into the labour market and universal access to quality medical care. Regarding development cooperation, aid amounts are inflated by the inclusion of debt cancellation and artificial categories and bilateral efforts must be considered when looking at advances at the multilateral level.

The presidentialand legislation elections in 2007 provided an opportunity for the ALERTE civilsociety network to demand a clear commitment from the candidates in the fightagainst social exclusion.
Even though France is considered the fifth richest country in the world, povertyand exclusion persist and continue to worsen. After alternating between left andright wing governments, the situation has not clearly improved since 1994. Civilsociety organizations confirm that taking emergency measures does not work if atthe same time the economic and social systems continue to produce newexclusions.

There are still sevenmillion poor people in a country with a population of 60 million. Poverty hasbecome aggravated in some areas and precarious living conditions have becomemore generalized with the consequent loss of human, social and economiccapacities.

This failure was made possible because our society did not impede it. Even whengovernments have taken adequate measures, these have not been fully applied. Thepublic powers did not decide to prioritize the eradication of poverty, insteadtreating it as a misfortune.

The message of the ALERTEgroup through the election campaign was that “eliminating poverty requiresrelentless political will to eliminate exclusion at the highest level of theState. This condition is essential in mobilizing all citizens. It does not meanadministering exclusion but rather eradicating it, since it is counterproductivefor all.”[1]

It remains to be seen in which way new President Nicolas Sarkozy, the newgovernment and the new representatives will act with regards to this goal, andhow far they will go beyond their declarations.

Guarantee the universal right to social protection

Social protection inFrance refers to all collective precautionary mechanisms that permit people toface the financial consequences of social risks. It works along three lines oflogic: social insurance reserved to those who contribute (protection from lossof income: unemployment, illness, old age, work accidents); assistance (creationof a solidarity fund between persons: minimum wage, assistance to handicappedadults); and universal protection (family benefits). The French socialprotection system represents more than 30% of the gross domestic product.[2]

Employment: facilitating reinsertion intothe labour force and guaranteeing the right to receive training

The labour sector ischaracterized by increasing fragility due to unemployment, a rise in precariousemployment and unwanted part time employment. Of the seven million people wholive below the poverty line, three million are poor workers. An importantproportion of youth also live in poverty and are affected by massiveunemployment, abandon the education system with little training and lack socialcoverage in the face of the risk of unemployment. Conditions for employmentreinsertion and permanency are often rare (due to a lack of infrastructure forchildcare, transportation costs, short schedules and very long days).

social organizations request:

That the mechanisms used to reinsert thosepeople furthest from the labour market be simplified, reformulating andstreamlining the contracts and improving the public sector’s role in thepromotion of employment.
The equal right to training, accompanimentand tutoring be guaranteed, concentrating training in extensive programs anddirecting those who are looking for employment and waged labourers with lowlevels of training.

Health: guarantee universal access topreventative and quality health care

Thirteen percent of the metropolitan population admits to having declinedsome type of health care for economic reasons over the past 12 months with 20%of these cases being declined indefinitely, and the remainder being postponed.(IRDES, 2006) The number of cases in which treatment is denied to peoplebelonging to the Universal Health Coverage (CMU) and the State Health Assistance(AME) continues to be high. Access to our health system is not universal.

Our social organizations demand:

That prevention be considered a priority,raising health professional remuneration to an adequate level, improving healthattention at the school and labour levels, and making unemployed people thepriority.

Inequities in health care access,prevention and attention be reduced, developing the existing mechanisms for useof the medical care services and assuring that those people without socialcoverage can be oriented for a consultation.

Development of regional programmes toimprove access to medical prevention and attention that permits the coordinationof actions aimed at people in precarious situations.

A high level of coverage for healthinsurance that should continue to be an obligatory social insurance that eachperson pays according to their possibilities and receives what is necessary tosatisfy their health needs. The financial effort should be augmented exploringnew options such as a generalized and progressive social contribution or acompany contribution based on added value. Access to CMU and its complementaryservices should be broadened to all persons with income below the nationalpoverty line, and in particular to the current beneficiaries of the AME. All people with income lower than the minimum wage must be provided withhelp in order to access a quality complementary health service.

Penalization in cases where CMU and AMEbeneficiaries are denied medical attention.

Housing: no one should be obliged to live in the street or in precariousconditions

More than three million people live in precarious conditions or without aroof over their heads. After more than 25 years of insufficient construction anda lack of help from the state, there is a lack of at least 800,000 homes tosatisfy existing housing needs. The current reactivation is not adapted to themost modest portion of the population. Additionally, the number of unhealthyhomes has risen to 600,000.

Diverse housing laws are applied with much difficulty or not at all, inparticular the law that stipulates the provision of 20% of social housing intowns with more than 3,500 inhabitants.

Our organizations propose:

The creation of a right to housing, so thatit can be an effective right accessible by all.

That housing be considered a true priority,just like employment.

Social efficiency of the aid programmes topurchase homes be reinforced, and must remain under state control.

That a supply of economically accessiblerentals be guaranteed.

A universal system be implemented thatgrants security to those who face the risks of rental.

Development cooperation policy

Rise in aid: an optical illusion

According to the latestfigures from the Organisation for Economic Cooperation and
Development, in 2006 France assigned 0.47% of its gross national income (GNI),or EUR 8.3 billion (USD 11.4 billion) to official development assistance (ODA).The ODA rose 77% between 2001 and 2006. However, if we analyze these statisticsin detail, we can state that ‘real’ ODA, that is to say the costs thatreally contribute to financing development, progressed much more slowly. Inactual fact, the rise in French ODA can be greatly explained by an increase indebt cancellation, similar to what happened in many donor countries. For thisreason, ODA is inflated and could be qualified as ‘artificial’.

In 2006, debt relief represented 34% of French ODA (EUR 2.8 billion), rising450% since 2001. In many cases, these cancellations correspond to irrecoverabledebts which would never have been paid. For this reason, their cancellation onlyhas a limited impact on the budget of the beneficiary countries. They count moreas a simple accounting elimination rather than a real contribution to thefinancing of development. Overall, the
accounting for of these cancellations represents a problem since they do notreflect a real contribution to the development of the country.

Additionally, a growing part of the cancelled debts have been generated by anactive policy to support French exportation, whose logic is very different fromthat of development. For this reason, nothing justifies considering thesecancellations as ODA. France includes in its ODA the cost of students comingfrom developing countries to France for university studies. These costs reachedEUR 896 million in 2006, up 98% from 2001. French ODA also includes costsrelated to the administration of migration flows which reached EUR 458 millionin 2006, a 100% increase since 2001. Finally, the costs assigned to the Frenchoverseas communities of Mayotte, Wallis and Futuna (EUR 273 million) were alsoincluded in the ODA calculation. 'Real' help, which excludes 90% of the debtreductions in order to avoid distorting the ODA indicator, and the total of theartificial costs mentioned, does not represent more than 0.24% of GNI in 2006,at EUR 4.2 billion, and not increasing more than 27% since 2001. Unlike what isofficially announced, available development aid remains insufficient in order tofinance the Millennium Development Goals (MDGs) and social sectors inparticular.

Aid is insufficient for the primary needsof countries

During the period2004-2005, France designated around 63% of its aid to least developed countries(LDCs) and other low income countries. In the same period, 56% of its aid wasgranted to countries in Sub-Saharan Africa. This would suggest that Francerespects its promises to prioritize its aid to the poorest countries and toAfrica. However, the French overseas community Mayotte and four medium incomecountries are among its 10 primary beneficiaries, with these 10 concentratingone third of all French aid. One of these countries is Iraq, which wasbenefitted by important debt cancellations in 2005. Finally, only two of thebeneficiaries (Senegal and Madagascar) are LDCs. The other three low incomecountries which figure among the 10 primary beneficiaries of French aid were inreality benefited by reductions in debt during this period (Nigeria, Congo andCameroon).

Neither does the destination of French aid by sector fully reflect thecommitments made at the World Forum on Social Development in Copenhagen in 1995and the International Conference on Financing for Development in 2002 inMonterrey. In 2005, bilateral French investment remained low: only 4% wasdesignated to primary social sectors, 2.2% to primary education, and 0.4% toprimary health care.

Beginning in July 2004,France started a reform to concentrate its actions on meeting the MDGs, lookingfor a greater concentration of aid. In 2005, it adopted seven prioritystrategies and signed the Framework Partnership Documents (DCP) with each of theFrench aid beneficiary countries for the next five years. These DCP define twopriority sectors where a great part of the resources must be concentrated. Eventhough education forms part of the sectors of resource concentration in manycases, the same did not occur with health, potable water or sanitation.Additionally, despite concentration efforts, French aid remains very disperseand some transversal activities have remained outside of the concentrationsectors.

Multilateral actions working against abalanced commitment in health

In the area of health,France has made consecutive efforts through multilateral channels. Itscontribution to the Global Fund to fight HIV/AIDS, Tuberculosis and Malaria hasdoubled since 2005, with EUR 300 million assigned to this cause in 2007. Thismakes France the second highest contributor to the fund after the United States.France was also a pioneer in financing the fight against HIV/AIDs, malaria andtuberculosis through the implementation of innovative financing for developmentmechanisms. In 2006, and together with Brazil, Chile, Norway and the UnitedKingdom, France formed part of the initiative of the International Drug PurchaseFacility called Unitaid.[4] This facility, funded by an internationaltax applied to airline tickets, has the objective of offering long term accessto treatments against HIV/AIDS, tuberculosis and malaria and reducing theircosts. One of its great advantages lies in the stability and predictability ofits financing, guaranteed by the international rate mechanism. In 2007 Unitaidhad a budget of USD 300 million, an amount which could reach USD 500 million by2009.

Despite this consistent investment in the multilateral area, French bilateralefforts in the area of health are insufficient. It is regrettable that Francedoes not look more systematically for a better link between multilateralfinancing actions and bilateral activities. On the contrary, the embassies thatnegotiate the DCP often use the argument of multilateral efforts to explain therelative absence of health in concentration sectors of these macro agreements.Nevertheless, the French strategy in the area of health adopted in 2005 insistson the necessity of reinforcing health care systems and considers them one ofthe four areas to support on a bilateral level. This priority does not appear tohave been reflected in the facts until now.

In March 2007, the Conference on Social Security in Health in DevelopingCountries took place in Paris. This event, which was organized as a Frenchinitiative, developed on the reflections of the eight wealthiest countries inthe world (G8) from St. Petersburg in 2006 which called for “an accelerationin international discussions on the practical approaches that permit public,private and community based health insurance coverage in developingcountries.” We hope that this French initiative is a first step towardsrebalancing multilateral and bilateral aid in the health sector, and the benefitof the reinforcement of French actions in the improvement of health systems.


Institutde recherche et documentation en économie de la santé (IRDES) (2006). “Enquêtesanté, soins et protection sociale 2004: premiers résultats”. Questionsd’économie de la santé IRDES, Nº 110, julio. Available at:<www.irdes.fr/EspaceRecherche/Qes2006.html#n110>.


[1] <www.uniopss.asso.fr/gest-mail-uniopss/commun/Dossier_presse_ALERTE.pdf>
[2] <www.vie-publique.fr>
3 For a more detailed análisis of French aid, see the CoordinationSUD report L’APD française et lapolitique de coopération au développement: Etat des lieux, analyses etpropositions, 2006. Available at : <www.coordinationsud.org/spip.php?article2380>.
4 <www.unitaid.eu/en/>

For this report, Coordination SUD prepared the analysis of France’s support to social protection policies in the framework of its cooperation for development. Secours Catholique / Caritas France (member of the Alerte group) developed the national aspect of the report.