French Authorities Research Articles

The French customs authority system is an example of effective combatance against customs offenses for Ukraine

The article analyzes the structure and functioning of French customs authorities, emphasizing their role in combating offenses in the customs sphere and the possibility of adapting their experience for Ukraine. The French customs service consists of several units responsible for various aspects of customs control, from intelligence to investigations and technical support. Special attention is paid to the use of innovative technologies, such as risk analysis systems and «smart borders», which significantly increase the efficiency of customs operations. These technologies allow accurate control of goods, vehicles and passengers, which ensures prevention of customs offenses. The results show that the structure of the French customs authorities, divided into specialized directorates (intelligence, operations, investigations and technical support), significantly contributes to the prevention of fraud, illegal trade and security threats. Active use of risk analysis systems and cooperation with international organizations helps France manage cross-border risks and ensure compliance with European standards. The French model offers a valuable plan for the modernization of the customs service of Ukraine and its integration into European and world standards. On the basis of the analysis of the experience of France, conclusions were drawn regarding the possible directions of development of the Ukrainian customs service, in particular through the introduction of modern technologies, automation of processes and strengthening of international cooperation. The integration of advanced risk management methods and automated control systems will allow Ukraine to improve the transparency, security and efficiency of customs operations, reducing the number of offenses and corruption.

Saudi Arabia’s Efforts to Revive the Hijaz Railway from 1925 to 1982

Abstract This study addresses the attempts by the Kingdom of Saudi Arabia to restore the Hijaz Railway that extended from Damascus to Madinah. The Hijaz Railway was destroyed during the events of the Arab Revolt in 1915; King Abdulaziz attempted to restore it, and so did his sons after him. This study sheds light on the official efforts by the Saudi kings and the discussions held with relevant countries concerning the railway, including the British and French authorities. Moreover, the study reveals the most important meetings and conferences that were held to restore the railway and their outcomes.

“The Revival of Islam”: a French view of the Islamic Revolution in Iran

In this article, the author investigates the responses of French diplomats and experts to the events occurring in Iran during 1978–1979 and their consequences. This analysis is conducted primarily in the context of the rising prominence of religious considerations in international relations. To this end, the author draws on materials from the archives of the French Ministry of Foreign Affairs. In France, the dual nature of these events was acknowledged. Firstly, there was a notable “re-Islamisation” of the populations in Muslim countries. In many of them, Islam became an influential factor in the formation of national identities after independence, serving to unify and stabilise communities. Secondly, French diplomats emphasised that while religion played a part in these developments, it was not the sole driving force. Rather, it was employed by local leaders as a political tool to advance their own agendas. The French experts demonstrated a tendency to overestimate the degree of Western influence on educated and wealthy sections of Muslim populations, while simultaneously underestimating the capacity of nationally oriented Islamic leaders and movements to modernise their respective countries. Furthermore, these experts also underestimated the ability of these leaders and movements to defend their right to development in accordance with their own customs and traditions. It is notable that many of the conclusions drawn by French diplomats at the turn of the 1970s and 1980s do not align with the contemporary interpretations of the French authorities. A review of the French Foreign Ministry notes from 1978 to 1979 revealed no mention of the issue of Islamic influence and its radical form in the Maghreb and the Middle East on the Muslim community in France.

“Islam” and “Muslimisme” in the official discourse and categorical apparatus of the French authorities in the 1920s

Throughout history, France and the Muslim world have been connected in various ways. Their interactions have ranged from constructive collaboration to colonial (or semi-colonial) domination and mutual animosity. In this article, the author seeks to examine the nuances of the discursive mobilisation and contextualisation of terms such as “Islam” and “Muslimisme” within the public and secret documents of French diplomacy and colonial administration during the 1920s. He attempts to address the following questions: What was the terminological and semantic conflict surrounding the aforementioned concepts? What were the objectives of the French officials in articulating one or another aspect of “Islam” and “Muslimisme”? Contemporary neocolonialism and a necessity to study its historical genesis and forms determine relevance of the article. The author makes use of insufficiently researched archival and published material. This, in conjunction with the nature of the research question, provides the rationale behind the originality of the analysis presented in the essay. He employs the methodology of the “history of concepts” and comparative-historical analysis to examine the intricate interrelationship between the discursive mobilisation of “Islam” and “Muslimisme”, on the one hand, and the practical policies of Paris, on the other. The author draws on a range of sources to inform his analysis, including French diplomatic documents, the notes and reports of Marshal Hubert Lyautey, books and pamphlets by various French experts and public figures, and material from the French and Algerian press. He concludes that the semantic colouring of “Islam” and “Muslimisme” in the French official discourse of the 1920s was not homogeneous. This perception included a sense of superiority close to Orientalism, a perception of the backwardness of “Islamic civilization” and its incompatibility with the Western socio-political order, and a perception of “Islam” as a potential danger, especially if it was combined with other religious (pan-Islamism) and/or socio-political challenges (pan-Turkism, Bolshevism). Concurrently, the Third Republic’s authorities frequently regarded Islam as a means of securing Muslim allegiance and enhancing France’s “soft power”.

Cost-Effectiveness of Empagliflozin (JARDIANCE®) in the Treatment of Patients with Chronic Kidney Disease in France, Based on the EMPA-KIDNEY Clinical Trial.

The efficacy and safety of empagliflozin in the treatment of chronic kidney disease (CKD) were demonstrated in the EMPA-KIDNEY trial, which showed a 28% reduction in combined risks of kidney disease or death from cardiovascular causes (hazard ratio, 0.72; 95% confidence interval, 0.64-0.82; p < 0.001) compared with placebo. Based on these results, the present study aimed to assess the cost-effectiveness of empagliflozin + standard of care (SoC) compared with SoC alone in the treatment of CKD in France. A Markov state microsimulation model was adapted to compare the health and economic outcomes in France, considering a healthcare system perspective, in patients treated with empagliflozin in addition to SoC versus patients treated with SoC alone. The model simulated the intention-to-treat population of the trial, transitioning between 18 mutually exclusive and collectively exhaustive health states defined based on the Kidney Disease: Improving Global Outcomes classification. For each arm, the model estimated (over a 25-year time horizon) the number of events and deaths, and the costs associated with these events, to calculate the incremental cost-effectiveness ratio. The resources used were derived using French authorities reports, literature, and French CKD guidelines. Both economic and health outcomes were discounted at a 2.5% annual rate according to French guidelines. The model predicted that using empagliflozin + SoC to treat patients with CKD would prevent CKD-related complications and deaths associated with a cardiovascular event or all-cause deaths while in kidney replacement therapy, resulting on average in a discounted gain of 1.29 years in overall survival (9.48 years vs. 8.19 with SoC alone). Empagliflozin costs (treatment, events, and disease management) were completely offset by the cost savings from avoided kidney failure events. Overall, empagliflozin + SoC would be more effective and less costly than SoC alone and would therefore be the dominant treatment strategy. The sensitivity analyses conducted support the results' robustness in showing the dominance of empagliflozin + SoC over SoC alone. The base-case results indicate that empagliflozin + SoC is a dominant strategy compared with the current SoC for the management of CKD in France. Empagliflozin + SoC would have a positive impact on patients with CKD by slowing CKD progression and leading to the prevention of kidney failure events on top of all-stages CKD complications.

Damage Control Training: A Cross-sectional Survey of Health care Personnel of French Emergency Medicine Structures.

Terrorist threats are a worldwide phenomenon. The injuries caused with military weapons or explosives are multiple and unusual for civilian care services. Damage control (DC) training has then become a critical need. In response to the November 2015 attacks, the French authorities launched a national DC training campaign for emergency care personnel. The aim was to describe the implementation of DC training campaign and its perception according to the respondent's profession, DC teaching levels, and the history of terrorist attacks in the last decade of the hospital center's activities. A survey was distributed to all Casualty Department staff in France. The answers were collected between June 9, 2020 and July 22, 2020. The project was qualified as not involving humans and participation was on voluntary basis. The study is out of the French Jardé law. Two-thirds of the 1,525 respondents considered themselves trained in DC (emergency physicians [76.8%], nurse anesthetists [68.1%], and ambulance drivers [65.3%]). Less than half considered their theoretical (41.1%) and practical (44.7%) knowledge excellent or good. More than 95% of the untrained personnel wanted to receive this type of training. Trained personnel were in favor of annual refresher training (95.7%) and training for practical applications (95.1%). Personnel at teaching centers were more frequently trained than personnel at nonteaching centers (respectively 75.3% and 64.3%, P < .0001) and had applied their knowledge significantly more often (50.1% vs. 43.4%, P = .038). They often considered their knowledge to be excellent (respectively 50.8% vs. 42.4%, P = .064). The training of emergency personnel in DC is far from being generalized in France. Among the trained personnel, it was often deemed insufficient, in theory and in practice. There was an inequity of training in favor of those in teaching centers. It is therefore essential that training in DC techniques in France be continued, generalized, improved, and standardized throughout the country in order to guarantee an optimal response from the health care systems in the event of new terrorist attacks.

Family, global conflict, and imperial migration: Paul Messi’s First World War

ABSTRACT The German Empire collapsed at the end of the First World War, necessitating a re-negotiation of the legal and social status of its former imperial subjects. This article discusses the wartime experience of Paul Messi, a Cameroonian language assistant at the Colonial Institute, Hamburg. Messi moved to Germany in 1913 to succeed his uncle, Karl Atangana who had returned to Cameroon to become Paramount Leader of the Ewondo and Bane. Atangana had secured the position in Germany for his nephew along with providing him with a stipend. The outbreak of war saw Messi stranded in Hamburg, suffering from ill health and cut off from financial assistance. However, due to Atangana’s petitioning to the German government, his daughter Katharina, and Messi were reunited in Madrid before repatriation in 1919. The return to Cameroon was difficult, Messi, despite his desire to leave Germany, was treated as a suspect person by the French authorities. Focusing on Messi’s account of his experiences, this paper highlights how the war not only disrupted intra-empire familial connections but also how these connections enabled a negotiated return to Mandate Cameroon in the early post-war period.

French Imperial Statecraft, Capital, Corporate Taxation, and the Tax Haven that Wasn’t, 1920s–1950s

Abstract Towards the mid-1920s, a growing number of colonial firms began to transfer their headquarters from the metropole to French colonies to evade taxation on investment capital income. These transfers threatened to transform French colonies into tax havens. Why was this averted? This article explores the politics of corporate tax planning in the French colonial empire and shows that French colonial tax havens could have materialized on a large scale at two critical junctures: first in the inter-war period and then in the aftermath of the Second World War. It argues that they eventually did not come into being because successive administrations within the French Ministry of Finance did not let it happen. Broader structural determinants — the relative weakness of the French metropolitan fiscal state in the inter-war period and the unwillingness to let international capital dictate French development strategies in the late colonial period — crucially influenced the positions taken by the Ministry of Finance. Post-war dreams of restored grandeur made French authorities much more reluctant to outsource development and let go of state prerogatives. This unrealized possibility sheds light on the role of state power in the making and unmaking of tax havens and contributes to a fast-expanding historiography.

A transversal cross-sectional study of factors related to HPV vaccination status and cancer screening participation among French women aged 25–40

BackgroundIn 2020, uterine cervical cancer (UCC) was the 12th most common cancer among women in France and the 4th worldwide. French health authorities wanted to increase Human Papilloma Virus (HPV) vaccination and screening rates. There were still many barriers to these measures among young women, their families, and health professionals and teachers. Between 2014 and 2019, international studies found inconsistent effects of HPV vaccination on UCC screening. In 2022, a survey was conducted among women aged 25 to 40 in the Nord-Pas-de-Calais region to assess participation 1) in HPV vaccination and its barriers, 2) in UCC screening as a function of HPV vaccination status.MethodsData were collected using an anonymous online questionnaire distributed by QR code in 80 general practices randomly selected in the Nord-Pas-de-Calais region between January and June 2022. Results were analyzed bivariately using the Chi2 test, multivariately when numbers allowed, and in age subgroups (sensitivity analysis).Results407 complete questionnaires (for 602 participating women) were analyzed. In our sample, 41% of women aged 25 to 40 in the Nord-Pas-de-Calais region were vaccinated against HPV viruses in 2022. The risk factors for non-vaccination, after multivariable adjustment, were: the periods of eligibility for vaccination in the early days of French vaccination (2007–2012: odds ratio OR = 0.04 [95% CI, 0.02–0.09]; 2012–2017: OR = 0.5 [0.3–0.8]), information received from non-medical sources (OR = 0.3 [0.2–0.6]), and absence of information about vaccination (OR = 0.12 [0.05–0.27]). In our sample, 90% of women were screened for UCC. In bivariate analysis, women at risk of not being screened were those who were youngest, had been vaccinated against HPV, were not heterosexual, lived alone, had gynecological follow-up by their general practitioner, and did not have regular gynecological follow-up. Sensitivity analysis showed that the only risk factor significantly correlated with non-screening regardless of age group was lack of regular gynecological follow-up.ConclusionsParticipation in HPV vaccination and UCC screening is improved by medical education and gynecological follow-up. This multicenter study, limited by the relative youth of vaccination in France, should be repeated after 2037 to assess the possible effect of vaccination on screening.

Choosing asylum seekers from afar: the case of Lebanon-France humanitarian corridors

This article explores the mechanisms of the French humanitarian corridors in Lebanon, examining the stages of evaluation and selection of candidates for this program. The author develops a network approach by presenting the interrelation-ships between the signatory associations of the HC and the French authorities. With the development of legal channels at European level, the author presents the context in which these HC were created. The concept of vulnerability, used in the assessment of candidates for the corridors, is then examined and explained at the various stages of selection, based on a fieldwork in Lebanon. The vulnerability evaluation carried out by the associations and then by the French authorities tends to legitimize the delivery of a form of asylum from afar, outside the borders of the European Union.

Complete DPYD genotyping combined with dihydropyrimidine dehydrogenase phenotyping to prevent fluoropyrimidine toxicity: A retrospective study.

In April 2019, French authorities mandated dihydropyrimidine dehydrogenase (DPD) screening, specifically testing uracilemia, to mitigate the risk of toxicity associated with fluoropyrimidine-based chemotherapy. However, this subject is still of debate as there is no consensus on a standardized DPD deficiency screening test. We conducted a real-life retrospective study with the aim of assessing the impact of DPD screening on the occurrence of severe toxicity and exploring the potential benefits of complete genotyping using next-generation sequencing. All adult patients consecutively treated with 5-fluorouracil (5-FU) or its oral prodrug at six cancer centers between March 2018 and February 2019 were considered for inclusion. Dihydropyrimidine dehydrogenase deficiency screening included gene encoding DPD (DPYD) genotyping using complete genome sequencing and DPD phenotyping (uracilemia or dihydrouracilemia/uracilemia ratio) or both tests. Associations between each DPD screening method and (i) severe (grade ≥3) early toxicity and (ii) fluoropyrimidine dose reduction in the second chemotherapy cycle were evaluated using multivariable logistic regression analysis. Furthermore, we assessed the concordance between DPD genotype and phenotype using Cohen's kappa. A total of 551 patients were included. Most patients were tested for DPD deficiency (86%) including DPYD genotyping only (6%), DPD phenotyping only (8%), or both (72%). Complete DPD deficiency was not detected in the study population. Severe early toxicity events were observed in 73 patients (13%), with two patients (0.30%) presenting grade 5 toxicity. Despite the numerically higher toxicity rate in untested patients, the occurrence of severe toxicity was not significantly associated with the DPD screening method (p = 0.69). Concordance between the DPD genotype and phenotype was weak (Cohen's kappa of 0.14). Due to insufficient numbers, our study was not able to demonstrate any added value of DPYD genotyping using complete genome sequencing to prevent 5-FU toxicity. The optimal strategy for DPD screening before fluoropyrimidine-based chemotherapy requires further clinical evaluation.

“Обнаженная” публичность литературы русской эмиграции (И.А. Бунин в центре публичной сферы)

In this article, Jürgen Habermas’s concepts of literary publicity and the literary public sphere opposed to political publicity are applied to self-consciousness and forms of literary process organization in Russian first-wave emigration. In the absence of political publicity, literary publicity absorbed its functions and turned into autonomous, “naked” publicity, the only kind possible. In this situation, literary publicity was forced to look for objects of controversy and confrontation, and found them in the émigré politicians, the authorities in the USSR, and the local (French) authorities. From this point of view, émigré writers acquire the key function of the official representation of the “lost” Russia. I.A. Bunin is a major example of this. The influence of this paradigm on the outlook of emigration is traced using examples from memoirs and fiction.

Polscy emigranci polistopadowi w zachodniej Francji i projekt wyprawy portugalskiej z 1833 r.

Polish Post-November refugees in western France and the 1833 Portuguese expedition project The idea produced by general officer Józef Bem and price Adam Jerzy Czartoryski to form a Polish Legion in Portugal in 1833 is an interesting subject in the context of international situation, French policy towards Polish post November refugees and as far as the situation within Polish emigration is concerned. Polish Legion was intended to participate in the Portuguese civil war on the side of the liberals and the supporters of constitutional monarchy. The Poles wanted to fight for the freedom of nations and were attracted by the perspective of military service in the Portuguese Army. French government informally supported the Poles expedition to Portugal perceiving it as a prospect of limiting expenditures on political refugees as well as an opportunity for calming down social anxiety, since the presence of Polish refugees in France caused numerous manifestations and riots. The Poles were allowed to gather on the West Coast of France. Initially, more than a dozen people went to the Breton island of Belle-Île where they spent a year and a half waiting for the opportunity to depart. Later on, the Poles were gathering in Nantes. As general officer Józef Bem’s idea was becoming less and less probable, some of them were directed to settle in Côtes-du-Nord department. Those determined to leave headed for the city of La Rochelle. The article presents the preparations for the Portuguese Expedition mostly from the perspective of the French authorities: how government decisions regulated the issues of the possible leave of the Poles and the engagement of French local authorities in this Polish project.

Uses of scientific discourses and markers in shark attack risk management on Reunion Island

The article discusses how the uses of scientific discourses and markers, by activists and policymakers have been perceived by scientific experts and journalists and generated tensions related to science use in managing shark attack risk on Reunion Island. Following a series of shark attacks in 2011, a scientific research program was funded by French authorities to help political decision-making to reduce shark attack risk on the island's west coast, from 2011 to 2015. This program collected a large set of data to understand the ecology of the shark species implied in the attacks. The authorities have also funded a selective fishing program as an operational management device, which opposed activists from sea users' NGOs requiring shark fishing and environmental NGOs requiring sharks' protection. Based on sixteen semi-directional interviews led with local scientific experts, activists, journalists and a mandated fisherman, the study explores how activists and policymakers are perceived as having reappropriated scientific discourses to legitimize their position on shark risk management in Reunion Island. The scientific experts’ perception of activists depends on the epistemology of their discipline and the values they carry about the management of living beings. Otherwise, the political shark risk management strategy on Reunion Island is perceived as preferring to use scientific rationality instead of social claims to justify public policies. These uses of science generated conflicts between scientific experts, policymakers and sea users, and argue for the need of a dialogical process between parties to manage shark attack unpredictable risk, by better considering its social interpretation.

A peacetime battleground: national symbols, patriotism and prestige in the French-occupied Rhineland, 1920–23

Abstract Tensions and violence were central to the French interwar occupation of the Rhineland. This article examines symbolic opposition and violence carried out by locals, as perceived by the French authorities, mainly involving attacks on flags, singing banned patriotic songs, or displaying German patriotic colours. Although rarer than physical violence, the ways in which French officials documented and responded to such incidents allow for an insight into the mindset of the French occupiers. The victorious but sensitive French were especially concerned with notions of prestige, dignity and authority, drawing on colonial ideas, and quick to punish attacks on symbols of French power. Even during the beginning of the organized ‘passive resistance’ campaign in 1923, French authorities were as concerned with songs and flags as with demonstrations and physical violence. French sensitivity around national symbols betrayed deeper insecurities and uncertainties regarding their role both in the occupied territory and the wider world.

Saidia : La perle Bleue de la méditerranée

The article has chosen to talk about the city of Saidia, the Blue Pearl of the Mediterranean. Ajroud was the name of this coastal town in eastern Morocco which underwent a modification before its foundation in 1883. The strategic border position of the Kasabah of Saidia gives it a crossroads location that connects the cities of: Oujda - Ahfir - Berkane - Nador. According to the historical thread of this Moroccan region, the Kasabah of Saidia has often aroused the interest of colonial forces, such as Germany in 1870. The foundation of the Kasabah "Saidia" is carried out, following a cooperation between the tribes of the eastern region under the supervision of the governor of Oujda. April 18, 1907, is the date of the French colonial occupation of Saidia, maintaining the position of Caid of Saidia and chief of the tribe of Ouled Mensour, (indigenous people of Saidia), to former rulers in order to secure peace and ward off rebels. Following the unique charm of Saidia beach, the French authorities have programmed several tourist projects for French residents in Morocco. This has led to changes within the space of the Kasabah. Today, the Kasabah forms the center of the city of Saidia. It has benefited from three restorations during the years: 1998 -2004 - 2012. The enhancement of the material heritage of Saidia calls for a concerted approach to local development which includes the following aspects: restoration, culture and living heritage.

L’innovation sociale en lien avec les autorités locales : l’impératif de transformer la gouvernance publique locale

Drawing on the context of French local authorities, this article contributes to understanding whether and how social innovation transforms public governance. Based on a multiple case study, our results show that the nature of social innovation requires a transformation in local public governance. This evolution can take different forms, ranging from governance that is both bottom-up and top-down (also known as bottom-linked governance) to governance that advocates shared responsibility between public, private and civil society actors. We propose new recommendations for policy-makers and territorial public managers, so that local authorities can successfully achieve their objectives through social innovation.

Facilitating the access to HIV testing at lower costs: "To the laboratory without prescription" (ALSO), a pilot intervention to expand HIV testing through medical laboratories in France.

A pilot HIV testing programme, Au Labo sans Ordo (ALSO; "to the laboratory without prescription") was implemented in two French Fast-Track Cities Initiative areas from 07/2019 to 12/2020. ALSO aimed to remove barriers to HIV testing by providing free testing with widespread access through all laboratories, extended opening hours, and no prescription requirements. Assessing the ALSO programme in terms of testing activity, user characteristics, and costs, compared to other HIV testing offers. Laboratories and STI clinics reported the monthly numbers of tests performed and positive tests. Two short surveys were carried out 12 months apart in people who sought HIV testing. In each offer, the mean costs of HIV testing have been estimated according to negative or positive results using a microcosting approach. During the study period, 214/264 laboratories reported performing 38,941 ALSO tests that accounted for 7.2% of laboratory HIV testing activity. Positivity rates of ALSO and prescribed tests were similar (2.2/1000) but lower than that in STI clinics (6.0/1000). Heterosexual men, and individuals with multiple sexual partners, poor health insurance and few visits to GPs were more likely to use the ALSO offer than tests upon prescription. Compared to ALSO, STI clinic users were younger, more exposed to HIV and with a less favourable socio-economic situation. ALSO had low costs: €13 for a negative test, €163 for a positive test and €5,388 to identify an HIV-positive person (versus €9,068 in STI clinics and €20,126 with prescribed tests). ALSO has attracted users less likely to visit STI clinics or to seek a prescribed test, particularly heterosexual men. Activities, user profiles and costs suggested the complementarity of the HIV testing offers and the relevance of making them coexist. French health authorities have decided to maintain and expand this programme to complement existing HIV testing offers.

Does the 80 km/h speed limit save lives in France?

Introduction: Speeding is considered to be a major contributor to road fatalities and injuries worldwide. Inappropriate speeding behavior is associated with a high casualty burden. It could be responsible for at least 30% of road accidents. Method: In 2018, the French authorities decided to introduce a new speed limit. They lowered the speed limit to 80 km/h on the unseparated interurban network. The aim was to reduce the number of fatalities and injuries and to implement some measures in line with international commitments. This paper uses different econometric models applied to time series for different groups of counties. Results: The results show a significant positive contribution of the new speed limit. The estimated number of lives saved is between 300 and 350. The overall reduction in the number of fatalities is 10%. The results also show a differentiated impact according to the local context and the different dynamics at play. Conclusions and Practical Applications: The results of this paper are in line with the scientific literature on speed limit reductions. They represent a validation of a debated public decision, while at the same time consolidating the body of knowledge on the subject, helping the decision-maker to adopt an appropriate measure to improve road safety performance.

Atgam Efficacy and Safety in Moderate-to-Very Severe Acquired Aplastic Anemia: Outcome of a Large Multicenter Cohort of 634 Children and Adults from the French Authorization for Temporary Use Surveillance Program

Introduction Acquired aplastic anemia (AA) is a rare immunological disease leading to bone marrow failure. First-line treatment in patients aged &amp;gt;40 years or without a matched related donor is immunosuppressive therapy (IST) based on anti-human T lymphocyte immunoglobulin (ATG) plus cyclosporine. This ATGAM Temporary Use Authorization program was a retrospective, multicenter study to report safety and efficacy surveillance data on ATGAM use in patients with AA. Methods This study collected surveillance data from the ATGAM Named Patients Program for French authorities ahead of ATGAM registration. Patients were treated with ATGAM 40 mg/kg for 4 days in addition to cyclosporine. Safety and efficacy data were collected from patients treated from September 2011 to August 2022 and reported to the French authority every 6 months. Patients were classified as severe AA if they had 2 of the following criteria: neutrophil count &amp;lt;0.5x10 9/L, platelet count &amp;lt;20x10 9/L, or reticulocyte count &amp;lt;60x10 9/L. Very severe AA: same as severe except neutrophil count &amp;lt;0.2x10 9/L. Patients not meeting criteria for very severe/severe AA were classified as moderate. Patient response was evaluated using the RACE study criteria (Peffault de Latour, et al [2022]), for severe AA: complete response was defined as: hemoglobin &amp;gt;100g/L, neutrophil count &amp;gt;1.0x10 9/L, and platelet count &amp;gt;100x10 9/L; partial response: no longer meeting criteria for severe disease; no response: still severe AA and/or transfusion dependent. For moderate AA (Marsh, et al [1999]), complete response was defined as: neutrophil count &amp;gt;2.0x10 9/L and platelet count &amp;gt;100x10 9/L; partial response: neutrophil count &amp;gt;1.0x10 9/L and platelet count &amp;gt;30x10 9/L; no response: transfusion dependent. Patients were classified as receiving first-line treatment (never received ATG), refractory (failed to respond to previous IST with ATG within 12 months before initial ATGAM), or relapse (recurrence of AA after a positive response to IST with ATG), regardless of AA severity. Results In total, 634 patients with moderate-to-very severe AA were treated with ATGAM (n=537 first-line; n=68 refractory/relapse; n=29 not classified) in addition to cyclosporine (40 first-line patients also received eltrombopag) from January 2012 to August 2022. By severity, n=124 were moderate, n=317 severe, n=133 very severe, and n=60 severity unknown. Patient demographics are shown in Table 1. Overall response (partial+complete) in patients on first-line therapy at 3, 6, and 12 months was 22.5% (n=78), 50.6% (n=156), and 79.2% (n=164), respectively. By severity, overall response rates in first-line therapy for moderate and severe/very severe cohorts, respectively, were: 25.0% (n=20) and 21.7% (n=58) at 3 months; 56.8% (n=42) and 48.7% (n=114) at 6 months; and 74.1% (n=40) and 81.0% (n=124) at 12 months. Overall response at 6 and 12 months by age and AA severity in patients on first-line treatment is shown in Table 2. Median duration of follow-up was 12.4 months. Overall survival (95% confidence interval) at 12 months for all patients was 91.5% (88.8-93.6). The treatment was well tolerated, and no new safety signals were observed with ATGAM. Cumulatively, 1,087 adverse events were reported in 364 patients over the entire program period, the majority of which were disease related. Conclusion This real-world, retrospective study utilizing surveillance data showed response rates in line with the recent RACE study (Peffault de Latour, et al [2022]) for patients with first-line severe AA treated with a combination of ATGAM and cyclosporine. No new safety risks were identified in this large cohort of patients. Treatment with ATGAM remains of benefit in patients with moderate-to-very severe AA.