Annie Thébaud-Mony
Honorary Director of the Inserm

Madam Minister,

Madame Cécile Duflot
Minister of Equality of the Territories and Housing,
Hotel de Castries
72 rue de Varenne – 75 007 Paris

In your letter of the 20^th of July, 2012, you informed me formally of my nomination to the Legion of Honour and mentioned that you were the originator of this nomination. I am moved by your attention, and wish to thank you for honouring me for my contributions both as a citizen and professionally. However, - all the while conscious of the meaning of your choice - I cannot accept this honour and will provide you with an explanation in this letter.

Professionally, for the past thirty years, I have conducted research in public health, on the health of workers, and on social inequalities in health, in particular in the field of cancer. The institutional recognition that I could have expected concerned not only the evolution of my own career, but also the recruitment of young researchers in my field, given the utmost urgency of this research agenda. In my personal case, I was blocked from promotion for the last ten years of my career. I was never promoted to the first class standing of director of research. Of even more concern, many brilliant young researchers with whom I have worked have had institutional doors closed to them due to lack of support from my unit directors, and live, still today, - despite the quality of their work- in professionally precarious positions. As to the scientific programme that we have built over the past ten years at Seine Saint Denis on occupational cancer, which is renowned nationally and internationally for the high quality of its scientific work, it remains in a precarious position even though it has institutional support [1]. I have been, over all these years, the only tenured investigator. While assuring the continuity of the research programme and trying, as much as possible to create stable employment for the young researchers, I had to constantly seek funding - an activity that may be described as “scientific begging”, - all the while resisting any form of conflict of interest in conducting publicly funded research.

Finally, given that research in public health is designed to lead to action, I have conducted my own work with the hope of seeing that our research leads to a transformation of working conditions and the implementation of prevention programmes. After thirty years of research I can not help but note that working conditions continue to deteriorate, that awareness of the health disaster that is asbestos has not led to a strategy to counter the epidemic of work-related and environmental cancers, that hazardous jobs are sub-contracted and undertaken by the poorest and most precarious workers, salaried or independent, labouring in industry, agriculture, services or the public sector. These workers are subjected to an accumulation of physical, organizational, or psychological risks, in the context of a terrible indifference. It is the responsibility of public health researchers to sound the alarm, which I have tried to do through my scientific work, but also in my civic engagement in networks for the defense of the fundamental rights to life, health and dignity.

Because these engagements are inscribed in collective action I cannot accept an individual recognition directed at me personally, even though I understand that you have, through my nomination, recognized the importance of the collective mobilizations of which I am a part. I have, over thirty years, participated in different networks in struggle against the health effects of industrial hazards. These networks are made up of activists, be they researchers, workers, farmers, journalists, lawyers, physicians or others... Each of us deserves recognition for our accomplishments as defenders of the public interest. This includes the associations which have struggled for fifteen years at Aulnay-sous-bois for the dismantlement - in compliance with prevention standards - of an asbestos processing factory which has contaminated the environs, killed former students at the local school, former workers and those living in the surrounding neighbourhood. [2] The same need for recognition is true for the union members at France Telecom, Peugeot and Renault, who struggle for the recognition of industrial cancers or work related suicide and the ex workers of Amisol - the first, in the 1970’s to denounce the use of asbestos in French factories - who continue to struggle for the right to a post-employment follow- up of the workers exposed to carcinogens. So it is with workers exposed to chemicals, sub- contractors working in nuclear facilities, seasonally employed agricultural workers or families who are victims of lead poisoning... We all contribute our time, intelligence and experience to aid in the emergence of that which is invisible, that which has been known as the ‘collateral damage of progress’’ ’, both in France and beyond the borders of the developed world.

We would like to talk with you, Madam minister, about the recognition that we are awaiting. We would like to be taken seriously when we speak about deterioration of working conditions, as mentioned above, about the ongoing drama of work accidents and occupational disease, but also about the impasses on environmental issues related to asbestos, pesticides, nuclear waste or chemicals... Lets stop the truly false controversies about low dose health effects. Public policies, including criminal policy must become protective against the deliberate endangerment of life. You have recently expressed your desire, in the National Assembly, to write laws that are “more equitable, more effective and more sustainable.” As the Minister of Equality of the Territories and Housing, you have the power not only to increase the number of housing units but also to adopt legislative measures for healthy housing, and you may also act against the impunity that is protecting those responsible for industrial crimes.

In memory of Henri Pézerat who was pioneered social commitment in which I take part today and in the name of the association that bears his name [3], the recognition that I wish for would be to see the French courts condemn those responsible for industrial crimes to the true degree of their responsibility, so that prevention may one day become a reality.

For all these reasons, Madam Minister, I reiterate my thanks, but ask that you accept my refusal to be decorated with the Legion of Honour. With the Association that I preside, I am at your disposal, to inform you about our activities and about the problems about which we hope to solicit you.

Please accept, Madam Minister, the expression of my gratitude and respect.

Annie Thébaud-Mony