[Training in tropical medicine in France].

Tropical medicine was a key element of the medical structures provided by France to our former colonies and, later; to countries within the scope of our international cooperation. hI recent decades, France has drastically reduced its bilateral commitments to countries in the tropics, and especially in sub-Saharan Africa. At the same time, the teaching of tropical medicine, which was highly regarded even beyond our borders, has lost a good deal of its expertise. Initially available in a few large French centers, and ensured by teachers with extensive field experience, training in tropical medicine is now offered in many universities. However; their programs and educational objectives, focusing mainly on infectious and parasitic diseases, no longer meet the healthcare priorities of southern countries, which are facing an epidemiological transition and the rise of non communicable diseases. Few teachers now have recognized expertise in tropical medicine. These changes have had negative consequences for research programs in tropical medicine and for the image of French assistance to developing countries. In this context, the followving perspectives should be considered: 1) training in tropical medicine should be enhanced by the creation of a national diploma recognized by international bodies. 2) The creation of a doctoral course in tropical medicine is a prerequisite for achieving this goal, and the future diploma must include a significant research component. 3) Teaching in tropical medicine must become more practical and be ensured by teachers with extensive field experience. 4) Training in tropical medicine should be part of a bilateral relationship with countries in the tropics, each party contributing its expertise while respecting that of its partners. 5) Training in tropical medicine should be backed uip by high-level scientific research based on enhanced synergy of our current networks (Institute for Research and Development, Network of overseas Pasteur Institutes, universities, etc.). 6) Teaching of tropical medicine should be coordinated by a supra-university structure whose mission is to ensure coherence. 7) Success in all these objectives will require strong political commitment. This is the only way to restore the enviable position which France occupied in the recent past.