Dix ans de partenariat et résultats
COLLECTION PROGRÈS ET IMPACT
Numéro 7 - septembre 2011
Avec le soutien de
Organisation mondiale de la Santé – www.who.int
Fonds des Nations Unies pour l’Enfance – www.unicef.org
Banque mondiale – www.worldbank.org
Programme des Nations Unies pour le développement (PNUD) – www.undp.org
Fonds mondial – www.theglobalfund.org
Initiative du Président américain contre le paludisme – www.pmi.gov
PATH – www.path.org
Université de Tulane – www.tulane.edu
Fondation Bill & Melinda Gates – www.gatesfoundation.org
Créé en 1998 par l’OMS, l’UNICEF, le PNUD et la Banque mondiale, le Partenariat Roll Back Malaria met en œuvre une action coordonnée pour la lutte contre le paludisme au niveau mondial.
Il se compose de plus de 500 partenaires regroupant les pays endémiques, leurs partenaires de
développement bilatéraux et multilatéraux, le secteur privé, des organisations non gouvernementales et communautaires, des fondations, ainsi que des institutions du monde universitaire et de la recherche.
www.rollbackmalaria.org
3DOXGLVPHSUÂYHQWLRQHWFRQWUÍOH3DOXGLVPHWKÂUDSHXWLTXH&RRSÂUDWLRQLQWHUQDWLRQDOH(YDOXDWLRQSURJUDPPH
$IULTXHVXEVDKDULHQQH,3DUWHQDULDW)DLUHUHFXOHUOHSDOXGLVPH
,6%1 FODVVLÚFDWLRQ1/0:&
2UJDQLVDWLRQPRQGLDOHGHOD6DQWÂ
7RXVGURLWVUÂVHUYÂV/HVSXEOLFDWLRQVGHOo2UJDQLVDWLRQPRQGLDOHGHOD6DQWÂVRQWGLVSRQLEOHVVXUOHVLWH:HEGHO206 ZZZZKRLQWRXSHXYHQWÃWUHDFKHWÂHVDXSUÁVGHV¢GLWLRQVGHO2062UJDQLVDWLRQPRQGLDOHGHOD6DQWÂDYHQXH
$SSLD*HQÁYH6XLVVHWÂOÂSKRQHWÂOÂFRSLHFRXUULHOERRNRUGHUV#ZKRLQW /HVGHPDQGHVUHODWLYHV¹ODSHUPLVVLRQGHUHSURGXLUHRXGHWUDGXLUHGHVSXEOLFDWLRQVGHOo206sTXHFHVRLWSRXUODYHQWH RXXQHGLIIXVLRQQRQFRPPHUFLDOHsGRLYHQWÃWUHHQYR\ÂHVDX[¢GLWLRQVGHO206YLDOHVLWH:HEGHO206¹ODGUHVVH KWWSZZZZKRLQWDERXWOLFHQVLQJFRS\ULJKWBIRUPHQLQGH[KWPO
/HVDSSHOODWLRQVHPSOR\ÂHVGDQVODSUÂVHQWHSXEOLFDWLRQHWODSUÂVHQWDWLRQGHVGRQQÂHVTXL\ÚJXUHQWQoLPSOLTXHQWGHODSDUW GHOo2UJDQLVDWLRQPRQGLDOHGHOD6DQWÂDXFXQHSULVHGHSRVLWLRQTXDQWDXVWDWXWMXULGLTXHGHVSD\VWHUULWRLUHVYLOOHVRX]RQHV RXGHOHXUVDXWRULWÂVQLTXDQWDXWUDFÂGHOHXUVIURQWLÁUHVRXOLPLWHV/HVOLJQHVHQSRLQWLOOÂVXUOHVFDUWHVUHSUÂVHQWHQWGHV IURQWLÁUHVDSSUR[LPDWLYHVGRQWOHWUDFÂSHXWQHSDVDYRLUIDLWOREMHWGXQDFFRUGGÂÚQLWLI
/DPHQWLRQGHÚUPHVHWGHSURGXLWVFRPPHUFLDX[QHVLJQLÚHSDVTXHFHVÚUPHVHWFHVSURGXLWVFRPPHUFLDX[VRQWDJUÂÂVRX UHFRPPDQGÂVSDUOo2UJDQLVDWLRQPRQGLDOHGHOD6DQWÂGHSUÂIÂUHQFH¹GoDXWUHVGHQDWXUHDQDORJXH6DXIHUUHXURXRPLVVLRQ XQHPDMXVFXOHLQLWLDOHLQGLTXHTXoLOVoDJLWGoXQQRPGÂSRVÂ
/o2UJDQLVDWLRQPRQGLDOHGHOD6DQWÂDSULVWRXWHVOHVSUÂFDXWLRQVUDLVRQQDEOHVSRXUYÂULÚHUOHVLQIRUPDWLRQVFRQWHQXHVGDQV ODSUÂVHQWHSXEOLFDWLRQ7RXWHIRLVOHPDWÂULHOSXEOLÂHVWGLIIXVÂVDQVDXFXQHJDUDQWLHH[SUHVVHRXLPSOLFLWH/DUHVSRQVDELOLWÂ GHOLQWHUSUÂWDWLRQHWGHOXWLOLVDWLRQGXGLWPDWÂULHOLQFRPEHDXOHFWHXU(QDXFXQFDVO2UJDQLVDWLRQPRQGLDOHGHOD6DQWÂQH VDXUDLWÃWUHWHQXHUHVSRQVDEOHGHVSUÂMXGLFHVVXELVGXIDLWGHVRQXWLOLVDWLRQ
&DUWHV_2UJDQLVDWLRQPRQGLDOHGHOD6DQWÂ,QIRUPDWLRQVGHVDQWÂSXEOLTXHHW6\VWÁPHVGoLQIRUPDWLRQJÂRJUDSKLTXH_
S0DODULD$WODV3URMHFW3URMHWGoDWODVGXSDOXGLVPH
3KRWRJUDSKLHV_&RXYHUWXUHGDQVOHVHQVGHVDLJXLOOHVGoXQHPRQWUHHQSDUWDQWGHODSKRWRJUDSKLHHQKDXW¹JDXFKH -RKQ%URZQ0DJJLH+DOODKDQ0DJJLH+DOODKDQ0DJJLH+DOODKDQ%RQQLH*LOOHVSLH3KLOLS0RVWHUWHW&KULVWHOOH7KRPDV_
SSHW0DJJLH+DOODKDQ_SSHW
81,&()_SSHW%RQQLH*LOOHVSLH_S2OLYHU/DVVHQ_S/DXUD1HZPDQ
&RQWDFW _ 6HFUÂWDULDW GX 3DUWHQDULDW 5%0 _ VLÂJHDQW ¹ Oo2UJDQLVDWLRQ PRQGLDOH GH OD 6DQWÂ _ $YHQXH $SSLD _
*HQÁYH_6XLVVH_7ÂO_)D[_(PDLOLQIRUEP#ZKRLQW
&UÂDWLRQPLVHHQSDJHPHVVDJJLR_&UÂDWLRQFRXYHUWXUH$&:_,PSULPÂHQ)UDQFH
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352*5¡6(7,03$&7
7$%/('(60$7,¡5(6
TABLE DES MATIÈRES
$EUÂYLDWLRQV
5HPHUFLHPHQWV
$YDQWSURSRV
3UÂIDFH
5ÂVXPÂHWSRLQWVFOÂV
,/HSDOXGLVPHFDUWRJUDSKLHPRQGLDOHHWVWUDWÂJLHVGoLQWHUYHQWLRQ
(QFDGUÂ,QWHUYHQWLRQVGHOXWWHFRQWUHOHSDOXGLVPH
,,/HVGL[DQQÂHVGX3DUWHQDULDW5%0
'HVHQJDJHPHQWVDXQLYHDXPRQGLDOGÁVOHPLOLHXGHVDQQÂHVHWXQHG\QDPLTXHLQDOWÂUDEOH (QFDGUÂ&RQWH[WHGHODVDQWÂPRQGLDOH¹OoDXEHGXQRXYHDXPLOOÂQDLUH (QFDGUÂ/DOXWWHFRQWUHOHSDOXGLVPHFRQWULEXHODUJHPHQW¹OoDWWHLQWH
GHV2EMHFWLIVGX0LOOÂQDLUHSRXUOH'ÂYHORSSHPHQW
/H3DUWHQDULDW5%0OHWHPSVGHODWUDQVLWLRQ
/DWUDQVIRUPDWLRQGHODOXWWHFRQWUHOHSDOXGLVPH
(QFDGUÂ0RELOLVDWLRQGHVUHVVRXUFHVGX)RQGVPRQGLDOHQYXHGoDWWHLQGUHOHVREMHFWLIVGH /DFRPPXQDXWÂVFLHQWLÚTXHHWOHVHFWHXUSULYÂDXVRXWLHQGX3DUWHQDULDW5%0 /HVSURJUÁVUÂDOLVÂVDXQLYHDXQDWLRQDOVRQWLQLWLDWHXUVGHFKDQJHPHQWV (QFDGUÂ2EMHFWLIVGHODOXWWHFRQWUHOHSDOXGLVPH¹OoÂFKHOOHPRQGLDOHSRXUODGÂFHQQLHs /oÂYROXWLRQGHVSURFHVVXVHWGHVSULRULWÂVGX3DUWHQDULDW5%0HQOoHVSDFHGoXQHGÂFHQQLH
8Q3DUWHQDULDWHQFRQVWDQWHÂYROXWLRQ
,,,'L[DQVGoLPSDFWDXQLYHDXPRQGLDO
¢WDWGHVOLHX[GHODOXWWHFRQWUHOHSDOXGLVPHHQOHUÂIÂUHQWLHO
SRXUPHVXUHUOHVSURJUÁVDFFRPSOLV
3URJUÁVUÂDOLVÂV¹OoÂFKHOOHPRQGLDOHGDQVODOXWWHFRQWUHOHSDOXGLVPH
¢OLPLQDWLRQGXSDOXGLVPH
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352*5¡6(7,03$&7
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352
7$%/('(60$7,¡5(6
,98QLPSDFWUÂHOHQ$IULTXHVXEVDKDULHQQH
0RUWDOLWÂWRXWHVFDXVHVFRQIRQGXHVGHVHQIDQWVGHPRLQVGHDQV
0RGÂOLVDWLRQPDWKÂPDWLTXHGHVYLHVVDXYÂHV
'RQQÂHVGHVÂWDEOLVVHPHQWVGHVRLQV
9&RPPHQWXQWHOLPSDFWDÂWÂSRVVLEOHHQ$IULTXHVXEVDKDULHQQH )LQDQFHPHQWGHODOXWWHFRQWUHOHSDOXGLVPHDXFRXUVGHODGÂFHQQLH 6XUODYRLHGHODFRXYHUWXUHXQLYHUVHOOHGHVLQWHUYHQWLRQVXQHGÂFHQQLHGHSURJUÁV
(QFDGUÂ6XLYLGHODFRXYHUWXUHGHVLQWHUYHQWLRQVDQWLSDOXGLTXHVJU»FHDX[HQTXÃWHVUÂDOLVÂHV
DXSUÁVGHVPÂQDJHVGXUDQWODGÂFHQQLH
(QFDGUÂ(IIRUWVKLVWRULTXHVGX1LJÂULDSRXULQWHQVLÚHUODFRXYHUWXUHHQPRXVWLTXDLUHV
LPSUÂJQÂHVGoLQVHFWLFLGHORQJXHGXUÂH
(QFDGUÂ0RXVWLTXDLUHVLPSUÂJQÂHVGoLQVHFWLFLGHHWSXOYÂULVDWLRQVLQWUDGRPLFLOLDLUHV
GoLQVHFWLFLGHV¹HIIHWUÂPDQHQW
9,/HVSHUVSHFWLYHVSRXUODYHQLU
(QFDGUÂ9LVLRQREMHFWLIVHWFLEOHVDFWXDOLVÂVGX3DUWHQDULDW5%0
$QQH[H$QQH[HWHFKQLTXH
(QFDGUÂ,QWHUSUÂWDWLRQGHVGRQQÂHVVXUOHWUDLWHPHQWGXSDOXGLVPHWHOOHVTXoLVVXHV
GHVHQTXÃWHVDXSUÁVGHVPÂQDJHV
(QFDGUÂ9HUVODFRXYHUWXUHXQLYHUVHOOH
$QQH[H$FWXDOLVDWLRQGHODYLVLRQGoDYHQLUGHVREMHFWLIVGHVFLEOHV
HWGHVMDORQVGX3DUWHQDULDW5%0
%LEOLRJUDSKLH
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352*5¡6(7,03$&7
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352
ABRÉVIATIONS
$&7 &RPELQDLVRQWKÂUDSHXWLTXH¹EDVHGoDUWÂPLVLQLQH
$/0$ $OOLDQFHGHVOHDGHUVDIULFDLQVFRQWUHOHSDOXGLVPH
$3' $LGHSXEOLTXHDXGÂYHORSSHPHQW
&$' &RPLWÂGoDLGHDXGÂYHORSSHPHQW
&'& &HQWUHVGHSUÂYHQWLRQHWGHFRQWUÍOHGHVPDODGLHV¢WDWV8QLV
&31 &RQVXOWDWLRQSUÂQDWDOH
''7 'LFKORURGLSKÂQ\OWULFKORURÂWKDQH
'),' 'ÂSDUWHPHQWGXGÂYHORSSHPHQWLQWHUQDWLRQDOGX5R\DXPH8QL ('6 (QTXÃWHGÂPRJUDSKLTXHHWGHVDQWÂ
(,3 (QTXÃWHVXUOHVLQGLFDWHXUVGXSDOXGLVPH
),1' )RQGDWLRQSRXUOo,QQRYDWLRQHQPDWLÁUHGH1RXYHDX['LDJQRVWLFV )RQGVPRQGLDO )RQGVPRQGLDOGHOXWWHFRQWUHOHVLGDODWXEHUFXORVHHWOHSDOXGLVPH
*0$3 3ODQGoDFWLRQPRQGLDOFRQWUHOHSDOXGLVPH
*0(3 3URJUDPPHPRQGLDOGoÂUDGLFDWLRQGXSDOXGLVPH
*03 3URJUDPPHPRQGLDOGHOXWWHDQWLSDOXGLTXHFUÂÂSDUOo206
*3$5& 3ODQGoDFWLRQPRQGLDOSRXUHQGLJXHUODUÂVLVWDQFH¹OoDUWÂPLVLQLQH +:* *URXSHGHWUDYDLOVXUOoKDUPRQLVDWLRQDXVHLQGX3DUWHQDULDW5%0 ,'$ $VVRFLDWLRQLQWHUQDWLRQDOHGHGÂYHORSSHPHQW
,3$ ,QFLGHQFHSDUDVLWDLUHDQQXHOOH
,9&& &RQVRUWLXPSRXUXQHOXWWHDQWLYHFWRULHOOHLQQRYDQWH /L67 2XWLOGH9LHV6DXYÂHV/LYHV6DYHG7RRO
0$&(3$ 3DUWHQDULDWSRXUOHFRQWUÍOHHWOoÂYDOXDWLRQGXSDOXGLVPHHQ$IULTXH 0DO(5$ 3URJUDPPHGHUHFKHUFKHSRXUÂUDGLTXHUOHSDOXGLVPH
0$:* *URXSHGHWUDYDLOVXUOHSODLGR\HUDXVHLQGX3DUWHQDULDW5%0
0(5* *URXSHGHUÂIÂUHQFHSRXUOHVXLYLHWOoÂYDOXDWLRQDXVHLQGX3DUWHQDULDW5%0 0,&6 (QTXÃWHSDUJUDSSHV¹LQGLFDWHXUVPXOWLSOHV
0,, 0RXVWLTXDLUHLPSUÂJQÂHGoLQVHFWLFLGH
0,/' 0RXVWLTXDLUHLPSUÂJQÂHGoLQVHFWLFLGHORQJXHGXUÂH 009 0HGLFLQHVIRU0DODULD9HQWXUH
09, ,QLWLDWLYH9DFFLQFRQWUHOHSDOXGLVPH
2&'( 2UJDQLVDWLRQGHFRRSÂUDWLRQHWGHGÂYHORSSHPHQWÂFRQRPLTXHV 20' 2EMHFWLIVGX0LOOÂQDLUHSRXUOH'ÂYHORSSHPHQW
206 2UJDQLVDWLRQPRQGLDOHGHOD6DQWÂ 218 2UJDQLVDWLRQGHV1DWLRQV8QLHV
3,' 3XOYÂULVDWLRQLQWUDGRPLFLOLDLUHGoLQVHFWLFLGHV¹HIIHWUÂPDQHQW 30, ,QLWLDWLYHGX3UÂVLGHQWDPÂULFDLQFRQWUHOHSDOXGLVPH
318' 3URJUDPPHGHV1DWLRQV8QLHVSRXUOHGÂYHORSSHPHQW 36& *URXSHGLQWÂUÃWGXVHFWHXUSULYÂDXVHLQGX3DUWHQDULDW5%0 5%0 3DUWHQDULDW5ROO%DFN0DODULD
566 5HQIRUFHPHQWGHVV\VWÁPHVGHVDQWÂ 613& 6\VWÁPHGHQRWLÚFDWLRQGHVSD\VFUÂDQFLHUV 7'5 7HVWGHGLDJQRVWLFUDSLGH
73,S 7UDLWHPHQWSUÂYHQWLILQWHUPLWWHQWSHQGDQWODJURVVHVVH 753 &RPLWÂWHFKQLTXHGoH[DPHQ7HFKQLFDO5HYLHZ3DQHO 81,&() )RQGVGHV1DWLRQV8QLHVSRXUOo(QIDQFH
81,7$,' 2UJDQLVDWLRQDIÚOLÂHDX[1DWLRQV8QLHVTXLDSRXUPLVVLRQGHFRQWULEXHU¹OoH[WHQVLRQ GHOoDFFÁVDXWUDLWHPHQWSRXUOH9,+VLGDOHSDOXGLVPHHWODWXEHUFXORVH
86$,' $JHQFHDPÂULFDLQHSRXUOHGÂYHORSSHPHQWLQWHUQDWLRQDO
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352*5¡6(7,03$&7
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352
5(0(5&,(0(176
REMERCIEMENTS
%GTCRRQTVCÅVÅRTÅRCTÅUQWUNoÅIKFGFW2CTVGPCTKCV|4$/4QNN$CEM/CNCTKCFCPUNGECFTGFGNoÅXCNWCVKQP FGURTQITÄURCTTCRRQTVCWZQDLGEVKHUFGFW2NCPFoCEVKQPOQPFKCNEQPVTGNGRCNWFKUOGGVCWZ1DLGEVKHU FW/KNNÅPCKTGRQWTNG&ÅXGNQRRGOGPV1/&
,ODÂWÂUÂGLJÂFRQMRLQWHPHQWSDU(PLO\:KLWH-RKDQVVRQ+ROO\1HZE\HW/LOLDQD&DUYDMDO)RQGVGHV1DWLRQV8QLHV SRXUOo(QIDQFH>81,&()@5LFKDUG6WHNHWHH3DUWHQDULDWSRXUOHFRQWUÍOHHWOoÂYDOXDWLRQGXSDOXGLVPHHQ$IULTXH
>0$&(3$@ XQ SURJUDPPH GH 3$7+ 5LFKDUG &LEXOVNLV 3URJUDPPH PRQGLDO GH OXWWH DQWLSDOXGLTXH FUÂÂ SDU Oo2UJDQLVDWLRQPRQGLDOHGHOD6DQWÂ>206*03@7KRPDV(LVHOHHW'DYLG/DUVHQ8QLYHUVLWÂGH7XODQH3UXGHQFH 6PLWK¢ULF0RX]LQ-DPHV%DQGD7LP)UDQFHHW7KRPDV7HXVFKHU6HFUÂWDULDWGX3DUWHQDULDW5%0/HVDXWHXUV DVVXPHQWOoHQWLÁUHUHVSRQVDELOLWÂGXFRQWHQXGHFHUDSSRUWPÃPHVoLOHVWHQULFKLGoLQIRUPDWLRQVIRXUQLHVSDUOHV SHUVRQQHVPHQWLRQQÂHVFLDSUÁV
/HVDXWHXUVUHPHUFLHQWYLYHPHQWOHVQRPEUHX[SDUWLFLSDQWV¹ODFROOHFWHHW¹OoDQDO\VHGHVLQIRUPDWLRQVVXUOHVSD\V FRQWHQXHVGDQVFHUDSSRUW8QHDLGHHWGHVFRPPHQWDLUHVSUÂFLHX[RQWÂWÂDSSRUWÂV¹ODUÂGDFWLRQGHFHUDSSRUWSDU (VWLIDQRV6KDUJLH5\XLFKL.RPDWVXHW'DQLHO/RZ%HHUGX)RQGVPRQGLDOGHOXWWHFRQWUHOHVLGDODWXEHUFXORVHHWOH SDOXGLVPH)RQGVPRQGLDO6KLOSD&KDOODHW-RKQ3DXO&ODUNGHOD%DQTXHPRQGLDOHHW5HQÂ6DOJDGRHW%HUQDUG1DKOHQ GHOo,QLWLDWLYHGX3UÂVLGHQWDPÂULFDLQFRQWUHOHSDOXGLVPH30,8QJUDQGPHUFL¹6LPRQ+D\&DUROLQH0R\HVHW :+7HPSHUO\GX3URMHWGoDWODVGXSDOXGLVPH8QLYHUVLWÂGo2[IRUGSRXUOHVFDUWHVPRQWUDQWOHQGÂPLFLWÂGXSDOXGLVPH 1RXVVRPPHVÂJDOHPHQWUHFRQQDLVVDQWV¹.DWKU\Q2o&RQQHOOHW7DQ\D6KHZFKXFN$&7ZDWFKGHQRXVDYRLUIRXUQL OHVGRQQÂHVUHODWLYHV¹OoXWLOLVDWLRQGHVPÂGLFDPHQWVHWGHVRXWLOVGHGLDJQRVWLFHW¹-RKQ0LOOLQHUGHOo$JHQFH DPÂULFDLQHSRXUOHGÂYHORSSHPHQWLQWHUQDWLRQDO86$,'SRXUOHVLQIRUPDWLRQVVXUODGLVWULEXWLRQGHPRXVWLTXDLUHV LPSUÂJQÂHVGoLQVHFWLFLGHGDQVOHVSD\V
/HVSHUVRQQHVFLWÂHVFLDSUÁVRQWÂJDOHPHQWIRXUQLGHVLQIRUPDWLRQVHWGHVFRPPHQWDLUHVHVVHQWLHOVHQSDUWLFLSDQW¹ ODUÂYLVLRQGHFHUDSSRUW$ODQ&RXUWHW6XSURWLN%DVX%XUHDXGHOo(QYR\ÂVSÂFLDOGX6HFUÂWDLUHJÂQÂUDOGHV1DWLRQV 8QLHVSRXUOHSDOXGLVPH5REHUW1HZPDQ206*039DOHQWLQD%XM1JDVKL1JRQJRHW5HQÂH9DQGH:HHUGW 81,&()0DU\VH%3LHUUH/RXLVHW-RKQ3DXO&ODUN%DQTXHPRQGLDOH5\XLFKL.RPDWVX(OLQH.RUHQURPS)RQGV PRQGLDO$FKX\W%KDWWDUDL%HUQDUG1DKOHQ5HQH6DOJDGRHW6WHYH<RRQ30,86$,'HWOHV&HQWUHVGHSUÂYHQWLRQHW GHFRQWUÍOHGHVPDODGLHV>&'&@GHV¢WDWV8QLV'DYLG%UDQGOLQJ%HQQHWW$OH[DQGUD)DUQXPHW(ULQ6KXWHV)RQGDWLRQ
%LOO 0HOLQGD*DWHV0HODQLH5HQVKDZ$OOLDQFHGHVOHDGHUVDIULFDLQVFRQWUHOHSDOXGLVPH>$/0$@$OEHUW.LOOLDQ 0DODULD&RQVRUWLXPHWOH*URXSHGHUÂIÂUHQFHSRXUOHVXLYLHWOoÂYDOXDWLRQ>0(5*@DXVHLQGX3DUWHQDULDW5%0
%UHPHQ/HDN8QLYHUVLWÂ-RKQV+RSNLQVHWOH*URXSHGHWUDYDLOVXUOHSODLGR\HU>0$:*@DXVHLQGX3DUWHQDULDW5%0 -HVVLFD 5RFNZRRG 'HYHORSPHQW )LQDQFH ,QWHUQDWLRQDO ,QF HW OH *URXSH GoLQWÂUÃW GX VHFWHXU SULYÂ >36&@ DX VHLQGX3DUWHQDULDW5%0.HQW&DPSEHOOHW&ULVWLQD+HUGPDQ0$&(3$$ZD0DULH&ROO6HFN6HFUÂWDULDWGX 3DUWHQDULDW5%0
&HUDSSRUWDÂWÂUÂYLVÂHWUHOXHQDQJODLVSDU&ULVWLQD+HUGPDQ/DXUD1HZPDQ0DQQ\/HZLV3$7+0$&(3$
/LVD0D\QDUGHW7HUL6FRWWFRQVXOWDQWVDXSUÁVGX3DUWHQDULDW5%0/oDGDSWDWLRQHWODJHVWLRQGHODYHUVLRQIUDQÀDLVH RQWÂWÂDVVXUÂHVSDU/DXUHQW%HUJHURQ0$&(3$7RXWHVOHVFDUWHVRQWÂWÂUÂDOLVÂHVSDU)ORUHQFH5XVFLDQR206 1RXVUHPHUFLRQVÂJDOHPHQW7LP)UDQFH6HFUÂWDULDWGX3DUWHQDULDW5%0HW¢ORGLH*HQHVW/LPRX]LQ0$&(3$SRXU OHXUVRXWLHQFRQVLGÂUDEOH¹ODSURGXFWLRQGHFHUDSSRUW
/H FRPLWÂ GH GLUHFWLRQ GX 3DUWHQDULDW 5%0 SRXU FHV UDSSRUWV HVW FRPSRVÂ Go$OH[DQGUD )DUQXP (ULND $UWKXQ 6XSURWLN%DVX9DOHQWLQD%XM$ZD0DULH&ROO6HFN$ODQ&RXUW &UDLJ-DJJHUV%UHPHQ/HDN'DQLHO/RZ%HHU 5REHUW1HZPDQ0DU\VH$QQH3LHUUH/RXLV-HVVLFD5RFNZRRGHW5LFKDUG6WHNHWHH
/oÂODERUDWLRQHWODSURGXFWLRQGHFHUDSSRUWRQWÂWÂÚQDQFÂHVHQSDUWLHSDUOD)RQGDWLRQ%LOO 0HOLQGD*DWHV /HVDXWHXUVGHPHXUHQWUHVSRQVDEOHVGHWRXWHHUUHXURXRPLVVLRQ
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352*5¡6(7,03$&7
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352
$9$17352326
/D'ÂFHQQLHGHV1DWLRQV8QLHVSRXU)DLUHUHFXOHU OHSDOXGLVPHDÂWÂSURFODPÂHSHXDSUÁVTXHWRXV OHV¢WDWV0HPEUHVVHVRQWHQJDJÂV¹OXWWHUFRQWUHOH SDOXGLVPHGDQVOHFDGUHGHODUÂVROXWLRQKLVWRULTXH DGRSWÂHSDUOo$VVHPEOÂHJÂQÂUDOHHQ/HSUÂVHQW UDSSRUW'L[ DQV GH SDUWHQDULDW HW UÂVXOWDWV UHWUDFH OHVSURJUÁVUHPDUTXDEOHVHQUHJLVWUÂVDXFRXUVGHV GL[GHUQLÁUHVDQQÂHVHQWHUPHVGHYLHVVDXYÂHVHW GHUHVVRXUFHVOLEÂUÂHVSRXUOXWWHUFRQWUHOHVDXWUHV PDODGLHV/HVHIIRUWVGHOXWWHDQWLSDOXGLTXHRQWDXVVL SHUPLVGHUÂGXLUHODEVHQWÂLVPHFKH]OHVÂFROLHUVHW OHVVDODULÂVDLQVLTXHGDPÂOLRUHUOoÂWDWGHVDQWÂGHV IHPPHVHQFHLQWHVHWGHOHXUVQRXYHDX[QÂV
/DFROODERUDWLRQHQWUHOHV\VWÁPHGHV1DWLRQV8QLHV OHV GLULJHDQWV QDWLRQDX[ OHV SURJUDPPHV GH OXWWH FRQWUH OH SDOXGLVPH GHV SD\V HQGÂPLTXHV DLQVL TXH OHV DXWUHV DFWHXUV GX 3DUWHQDULDW 5%0 5ROO %DFN 0DODULD D ÂWÂ IRQGDPHQWDOH SRXU DWWHLQGUH FHV UÂVXOWDWV (OOH D SHUPLV GoHQUHJLVWUHU GHV SURJUÁV VDQV SUÂFÂGHQW HQ PDWLÁUH GH OXWWH FRQWUH OH SDOXGLVPH HW OHV UÂVXOWDWV REWHQXV GÂSDVVHQWOHVDWWHQWHVOHVSOXVRSWLPLVWHVH[SULPÂHV LO \ D ¹ SHLQH GL[ DQV /H QRPEUH GH GÂFÁV GXV DX SDOXGLVPH GDQV OH PRQGH D GLPLQXÂ GH SUÁV GH HW GL[ SD\V Go$IULTXH DLQVL TXH OD SOXSDUW GHV SD\V HQGÂPLTXHV GHV DXWUHV UÂJLRQV RQW PÃPH UÂXVVL ¹ UÂGXLUH GoDX PRLQV OH QRPEUH GH FDV GH SDOXGLVPH HW GH GÂFÁV DVVRFLÂV 5LHQ TXoHQ $IULTXH VXEVDKDULHQQH OH QRPEUH GH GÂFÁV ÂYLWÂVFKH]OHVHQIDQWVGHPRLQVGHDQVVoÂOÁYH¹ PLOOLRQ 'H WHOOHV DYDQFÂHV QoDXUDLHQW SDV HX OLHX VDQV OH WUDYDLO TXRWLGLHQ GHV KRPPHV HW GHV IHPPHV TXL RQW SXOYÂULVÂ GHV LQVHFWLFLGHV UDSLÂFÂ GHV PRXVWLTXDLUHV RX SUHVFULW GHV WUDLWHPHQWV DQWLSDOXGLTXHV TXDQG LOV QDYDLHQW SDV ¹ OXWWHU HX[PÃPHVFRQWUHODPDODGLH
/DFUÂDWLRQGoLQLWLDWLYHVLQWHUQDWLRQDOHVLQQRYDQWHVHQ PDWLÁUHGHVDQWÂHWODQRPLQDWLRQGHOo(QYR\ÂVSÂFLDO GHV 1DWLRQV 8QLHV SRXU OH SDOXGLVPH RQW HQWUDÇQÂ XQH DXJPHQWDWLRQ FRQVLGÂUDEOH GHV ÚQDQFHPHQWV GLVSRQLEOHV 0DODGLH WURSLFDOH DXWUHIRLV QÂJOLJÂH OHSDOXGLVPHHVWHQÚQGHYHQXXQHSULRULWÂPRQGLDOH
HQ PDWLÁUH GH VDQWÂ /HV DYDQFÂHV SUREDQWHV HQUHJLVWUÂHV GDQV OD OXWWH FRQWUH OH SDOXGLVPH DX FRXUV GH OD GHUQLÁUH GÂFHQQLH HW OD G\QDPLTXH GH SOXV HQ SOXV IRUWH TXoHOOHV RQW VXVFLWÂH FRQVWLWXHQW HQ VRL XQH VRXUFH GoRSWLPLVPH VXSSOÂPHQWDLUH VXU OD YRLH GoXQ PRQGH VDQV SDOXGLVPH 3DU DLOOHXUV OH 3DUWHQDULDW 5%0 RIIUH DXMRXUGoKXL XQ EHO H[HPSOH GH FH TXH OoDSSOLFDWLRQ GH SULQFLSHV WHOV TXH OD FROODERUDWLRQ OoHIÚFDFLWÂ GH OoDLGH HW OoLQLWLDWLYH
8QH 218 WRXV XQLV GDQV OoDFWLRQ SHXW HQJHQGUHUHQWHUPHVGoKDUPRQLVDWLRQHWGoHIIRUWVGH GÂYHORSSHPHQW
'DQVOHPÃPHWHPSVFHUDSSRUWQRXVUDSSHOOHDXVVL TXH QRXV QH GHYRQV VXUWRXW SDV FRQVLGÂUHU FHV VXFFÁVIUDJLOHVFRPPHDFTXLV&RQVROLGHUOHVSURJUÁV UÂDOLVÂV QÂFHVVLWHUD XQ HQJDJHPHQW FRQVWDQW GHV LGÂHVQRYDWULFHVHWGHVVRXWLHQVÚQDQFLHUV
OoDXEHGoXQHQRXYHOOHGÂFHQQLHGHOXWWHFRQWUHOH SDOXGLVPH QRXV GHYURQV UHGRXEOHU GoHIIRUWV SRXU SUÂVHUYHUOHVEÂQÂÚFHVOLÂV¹ODSUÂYHQWLRQUÂGXLUH OHQRPEUHGoLQIHFWLRQVLQYHVWLUGDQVOHUHQIRUFHPHQW GHVFDSDFLWÂVHWJDUDQWLUOoDFFÁVXQLYHUVHODX[RXWLOV GH GLDJQRVWLF HW DX WUDLWHPHQW (Q SDUDOOÁOH QRXV GHYURQVQRXVDWWDFKHU¹ÂOLPLQHUOHSDOXGLVPHGDQV DXWDQWGHUÂJLRQVHWGH]RQHVTXHSRVVLEOH(QÚQHW FRPPHFHUDSSRUWOoLQGLTXHUDUHPHQWXQHLQLWLDWLYH GH VDQW SXEOLTXH QoDYDLW RIIHUW XQ WHO UHWRXU VXU LQYHVWLVVHPHQW*U»FHDX[HIIRUWVFRQVHQWLVDXFRXUV GHVGL[GHUQLÁUHVDQQÂHVQRXVDYRQVGÂVRUPDLVXQH EDVHVROLGHTXLSHUPHWWUDDX[SD\VHWFRPPXQDXWÂV DIIHFWÂV GoDWWHLQGUH GHV UÂVXOWDWV HQFRUH PHLOOHXUV GDQVOHVDQQÂHV¹YHQLU
%DQ.LPRRQ 6HFUÂWDLUH*ÂQÂUDOGHOo2UJDQLVDWLRQGHV1DWLRQV8QLHV
AVANT-PROPOS
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352*5¡6(7,03$&7
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352
35¢)$&(
PRÉFACE
,O\DGL[DQVODOXWWHFRQWUHOHSDOXGLVPHÂWDLWDXSRLQW PRUWHQ$IULTXHFRPPHGDQVGHQRPEUHXVHVDXWUHV UÂJLRQVGXPRQGH0ÃPHVLQXOQHVDYDLWH[DFWHPHQW FRPELHQ GH SHUVRQQHV ÂWDLHQW DIIHFWÂHV SDU FHWWH PDODGLHOHVHVWLPDWLRQVOHVSOXVSUXGHQWHVIDLVDLHQW ÂWDW Go PLOOLRQ GH GÂFÁV GXV DX SDOXGLVPH SDU DQ
$ORUVTXoLOWRXFKDLWOHVJURXSHVOHVSOXVYXOQÂUDEOHV HWOHVSOXVIUDJLOHVDXVHLQGoXQHSRSXODWLRQGÂPXQLH
¹VDYRLUOHVIHPPHVHQFHLQWHVHWOHVMHXQHVHQIDQWV OHSDOXGLVPHHVWUHVWÂHQGHKRUVGHOoDWWHQWLRQGHOD FRPPXQDXWÂLQWHUQDWLRQDOHSHQGDQWGHQRPEUHXVHV DQQÂHV
OoDXEH GX QRXYHDX PLOOÂQDLUH OH WRXW MHXQH 3DUWHQDULDW 5%0 D FRPPHQFÂ ¹ WLUHU OD VRQQHWWH GoDODUPHDXVXMHWGHODKDXVVHFRQVWDQWHGXQRPEUH GH GÂFÁV LPSXWDEOHV ¹ OD PDODGLH OoÂSRTXH LO QoH[LVWDLWDXFXQSODQGoDFWLRQJDUDQWLVVDQWODUÂXVVLWH GHFHWWHUÂFHQWHLQLWLDWLYHQLDXFXQHIHXLOOHGHURXWH H[SOLTXDQWDX[SDUWHQDLUHVFRPPHQWWUDYDLOOHUPDLQ GDQVODPDLQSRXUIDLUHIDFH¹OoÂSLGÂPLH%LHQSHX DXUDLHQWGoDLOOHXUVLPDJLQÂOHVVXFFÁVGÂFULWVGDQVFH UDSSRUW
$XMRXUGoKXLOH3DUWHQDULDWUHJURXSHGHVFHQWDLQHVGH SDUWHQDLUHVLQVWLWXWLRQQHOVYHQDQWGHVSD\VGoHQGÂPLH SDOXGLTXH GHV RUJDQLVDWLRQV PXOWLODWÂUDOHV HW GHV EDLOOHXUV GH IRQGV GHV UHSUÂVHQWDQWV GX VHFWHXU SULYÂ GHV RUJDQLVDWLRQV QRQ JRXYHUQHPHQWDOHV GHV IRQGDWLRQV GHV LQVWLWXWV GH UHFKHUFKH HW GHV XQLYHUVLWÂV *XLGÂHV SDU XQH VWUDWÂJLH XQLTXH HW FRQFHUWÂH OH3ODQ GoDFWLRQ PRQGLDO FRQWUH OH SDOXGLVPH*0$3OHVSULQFLSDOHVSDUWLHVSUHQDQWHV DJLVVHQWGHFRQFHUWHWIRUPHQWXQWRXWTXLYDXWELHQ SOXVTXHODVRPPHGHVHVFRPSRVDQWHV
*U»FH ¹ GHV DFWLRQV GH SODLGR\HU FRKÂUHQWHV OHV SDUWHQDLUHVRQWFROOHFWLYHPHQWFRQWULEX¹PXOWLSOLHU SDUGL[OHÚQDQFHPHQWLQWHUQDWLRQDOGHODOXWWHFRQWUH OHSDOXGLVPHHQXQHVHXOHGÂFHQQLHSRXUDWWHLQGUH 86PLOOLDUGHQ
'HV ÚQDQFHPHQWV SOXV LPSRUWDQWV LPSOLTXDLHQW GH PHLOOHXUHV SROLWLTXHV QDWLRQDOHV HW LQWHUQDWLRQDOHV GHV SROLWLTXHV SOXV ÂWURLWHPHQW OLÂHV GHV RXWLOV GH OXWWHFRQWUHOHSDOXGLVPHSOXVSHUIRUPDQWVXQDFFÁV VLPSOLÚÂDX[LQWHUYHQWLRQVGDQVOHVSD\VHQGÂPLTXHV DLQVL TXH GH PHLOOHXUHV PÂWKRGHV GH PHVXUH GHV SURJUÁVHWGoDQWLFLSDWLRQGHVEHVRLQV¹YHQLU
'ÂVRUPDLV OHV SD\V HQGÂPLTXHV GÂÚQLVVHQW HW PÁQHQWOHXUSURSUHVWUDWÂJLHQDWLRQDOHGHOXWWHFRQWUH OHSDOXGLVPH/HVSDUWHQDLUHVTXDQW¹HX[DSSRUWHQW OHXUFRQWULEXWLRQ¹OoÂFKHOOHGHFKDTXHSD\VDXWUDYHUV GH FROODERUDWLRQV FRKÂUHQWHV /o$IULTXH D DLQVL SX DYDQFHU ¹ JUDQGV SDV HW VXU OH FRQWLQHQW TXHOTXH PLOOLRQGHGÂFÁVRQWSXÃWUHÂYLWÂVHQWUHHW JU»FHDX[PHVXUHVGHOXWWHFRQWUHOHSDOXGLVPH6L HOOHVVRQWSRXUVXLYLHVFHVPHVXUHVSRXUUDLHQWVDXYHU PLOOLRQVGHYLHVVXSSOÂPHQWDLUHVGoLFL'DQVOHV SD\VRÒOoDFFÁVDX[LQWHUYHQWLRQVDQWLSDOXGLTXHVDOH SOXV DXJPHQWÂ OD PRUWDOLWÂ LQIDQWLOH D JOREDOHPHQW FKXWÂGoHQYLURQ
&HUDSSRUWVoDWWDFKH¹UDFRQWHUXQHKLVWRLUHTXLDXQ LQWÂUÃWSRXUWRXV(OOHSURXYHTXoXQSDUWHQDULDWFLEOÂ VXU XQH PDODGLH VSÂFLÚTXH SHXW DPÂOLRUHU OD VDQWÂ PDWHUQHOOHHWLQIDQWLOH(OOHVXJJÁUHDXVVLTXHFHW\SH GH SDUWHQDULDW SHXW RIIULU GHV EÂQÂÚFHV VDQLWDLUHV LPSRUWDQWV WRXW HQ VRXODJHDQW GHV V\VWÁPHV GH VDQWÂ VXUFKDUJÂV 3DU DLOOHXUV HOOH PRQWUH TXoXQH FRPPXQDXWÂ GoRUJDQLVDWLRQV SHXW UÂXVVLU O¹ RÒ GHV RUJDQLVDWLRQV LQGLYLGXHOOHV DYDLHQW ÂFKRXÂ SDU OH SDVVÂ )RUWH GHV OHÀRQV DSSULVHV ¹ OoRFFDVLRQ GHV FDPSDJQHV SUÂFÂGHQWHV OD FRPPXQDXWÂ DQWLSDOXGLTXH GoDXMRXUGoKXL DWWHLQW OHV REMHFWLIV DPELWLHX[TXoHOOHVoHVWÚ[ÂVHWGDQVFHUWDLQVFDVOHV GÂSDVVH&RPPHOHVSD\VHQGÂPLTXHVVRQWWRXMRXUV SOXVQRPEUHX[¹DWWHLQGUHODFRXYHUWXUHXQLYHUVHOOH HW ¹ UÂGXLUH OH QRPEUH GH GÂFÁV GXV DX SDOXGLVPH OH 3DUWHQDULDW 5%0 D UHGÂÚQL VHV REMHFWLIV SRXU OHV UHQGUH SOXV DPELWLHX[ SOXV VSÂFLÚTXHV HW SOXV FRKÂUHQWVSDUUDSSRUWVDX[GÂÚVGHGHPDLQ
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352*5¡6(7,03$&7
/HFKHPLQYHUVXQPRQGHVDQVSDOXGLVPHVHUDORQJ HWGLIÚFLOHHWOHVSURJUÁVDFFRPSOLVMXVTXoLFLUHVWHQW IUDJLOHV1RXVQHSRXYRQVGRQFSDVQRXVSHUPHWWUH GHQRXVDUUÃWHUPDLQWHQDQWQRXVFRXUULRQVOHULVTXH GHSHUGUHXQLQYHVWLVVHPHQWHVWLP¹86PLOOLDUGV HWGHUHYHQLUDX[KHXUHVVRPEUHVGHODOXWWHFRQWUH OHSDOXGLVPH/HVDYDQFÂHVGÂFULWHVGDQVFHUDSSRUW QoDXURQWVHUYL¹ULHQVLODYRORQWÂSROLWLTXHIDLEOLWRX VLGHVQLYHDX[GHÚQDQFHPHQWUHODWLYHPHQWPRGHVWHV QH VRQW SDV PDLQWHQXV 1RXV DYRQV DXMRXUGoKXL OD SRVVLELOLWÂGÂWHQGUHOHVUÂVXOWDWVREWHQXVUÂFHPPHQW HQPDWLÁUHGHOXWWHFRQWUHOHSDOXGLVPH¹WRXWHVOHV SRSXODWLRQV ¹ ULVTXH HW GH OHV SÂUHQQLVHU SHQGDQW SOXVLHXUV DQQÂHV 'DQV OH PÃPH WHPSV LO QRXV IDXWDQWLFLSHUHWIDLUHIDFHDX[PHQDFHVGHGHPDLQ S H[ OD UÂVLVWDQFH ÂPHUJHQWH DX[ SULQFLSDX[
PÂGLFDPHQWVHWLQVHFWLFLGHVPDLVDXVVLSRXUVXLYUH QRV HIIRUWV GH UHFKHUFKH HQ YXH GoLGHQWLÚHU GH QRXYHDX[ RXWLOV HW GH GÂÚQLU GHV SROLWLTXHV HW DSSURFKHVDGDSWÂHV
(QODFRPPXQDXWÂDQWLSDOXGLTXHHVWUDVVHPEOÂH QRQVHXOHPHQWDXWRXUGoXQHYLVLRQDPELWLHXVHPDLV SOXV FRQFUÁWHPHQW DXVVL DXWRXU GoXQH IHXLOOH GH URXWH FROOHFWLYH /H 3DUWHQDULDW 5%0 D UHQIRUFÂ VHV PÂFDQLVPHV DÚQ GH VRXWHQLU OD PLVH HQ yXYUH GHVLQWHUYHQWLRQVHWLODÂODERUÂGHVVROXWLRQVIDFH DX[ GÂÚV PDMHXUV TXL VH SUÂVHQWHQW ¹ OXL ,O SHXW VoHQRUJXHLOOLU GH UÂVXOWDWV FRQFUHWV HW GHV OHÀRQV WLUÂHV WRXW DX ORQJ GoXQH GÂFHQQLH GoHQJDJHPHQWV HW GoHIIRUWV FRPPXQV (Q VoDSSX\DQW VXU WRXV FHV DWRXWVQRWUHJÂQÂUDWLRQYDÃWUH¹PÃPHGHUÂGXLUH LQÂOXFWDEOHPHQW OH SRLGV GH OD PDODGLH HW GoRXYULU GHPDLQODYRLH¹XQPRQGHVDQVSDOXGLVPH
'U9LFWRU0ZDNZHQJH.DSXW 0LQLVWUHGHOD6DQWÂ 5ÂSXEOLTXHGÂPRFUDWLTXHGX&RQJR 3UÂVLGHQWGX3DUWHQDULDW5%0
3URIHVVHXU$ZD0DULH&ROO6HFN 'LUHFWULFHH[ÂFXWLYHGX3DUWHQDULDW5%0
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352*5¡6(7,03$&7
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352*5¡6(7,03$&7
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352
5¢680¢(732,176&/¢6
RÉSUMÉ ET POINTS CLÉS
/oDJHQW ÂWLRORJLTXH GX SDOXGLVPH VRQ F\FOH GH YLH HWVRQPRGHGHWUDQVPLVVLRQRQWÂWÂLGHQWLÚÂVLO\D XQSHXSOXVGoXQHFHQWDLQHGoDQQÂHV&LQTXDQWHDQV SOXVWDUGODFRPPXQDXWÂLQWHUQDWLRQDOHGHODVDQWÂ SXEOLTXH D PLV HQ yXYUH XQ SURJUDPPH DPELWLHX[
GoÂUDGLFDWLRQ GX SDOXGLVPH OHTXHO D FRQQX XQ YLI VXFFÁVGDQVSOXVLHXUVSD\VVDQVSRXUDXWDQWDWWHLQGUH VRQ REMHFWLI JOREDO LQLWLDO $X FRXUV GHV GÂFHQQLHV VXLYDQWHV OH IDUGHDX GX SDOXGLVPH VoHVW WHOOHPHQW DFFHQWXÂ TXoLO HVW GHYHQX XQ ÂQRUPH SUREOÁPH PRQGLDOQRQPDÇWULVÂPDOJUÂOHVGLYHUVSURJUDPPHV LQWHUYHQWLRQVRXDXWUHVVRXWLHQVRSÂUDWLRQQHOV'DQV OHVDQQÂHVODFRPPXQDXWÂDQWLSDOXGLTXHDDORUV UÂDIÚUPÂVRQHQJDJHPHQW¹LGHQWLÚHU¹WHVWHUHW¹ GÂPRQWUHUOoHIÚFDFLWÂGoXQHQVHPEOHGoLQWHUYHQWLRQV DPÂOLRUÂHVHWSHXFRÔWHXVHVTXLSRXUUDLHQWHQVXLWH ÃWUHGÂSOR\ÂHV¹JUDQGHÂFKHOOHDXVHLQGHVPÂQDJHV HW GHV FRPPXQDXWÂV (QÚQ GDQV OD'ÂFODUDWLRQ GH +DUDUHVXUOD3UÂYHQWLRQHWODOXWWHFRQWUHOHSDOXGLVPH GHOHVFKHIVGo¢WDWDIULFDLQVRQWODQFÂXQDSSHO¹ UHQRXYHOHUOHVHIIRUWVIDFH¹FHWWHPDODGLH
/oHQWKRXVLDVPH JÂQÂUÂ SDU OoHIÚFDFLWÂ GHV LQWHUYHQWLRQVHWODSULVHGHFRQVFLHQFHGHOoDPSOHXUGX SDOXGLVPHRQWHQWUDÇQÂODFUÂDWLRQGX3DUWHQDULDW5%0 HQ GÂFHPEUH VRXV OoLPSXOVLRQ GH Oo206 GH Oo81,&() GH OD %DQTXH PRQGLDOH HW GX 3URJUDPPH GHV 1DWLRQV 8QLHV SRXU OH GÂYHORSSHPHQW 318'
$ORUV TXH OH 3DUWHQDULDW 5%0 SUHQDLW VHV PDUTXHV
¹ OoDXEH GX QRXYHDX PLOOÂQDLUH OoDQQÂH D ÂWÂ FKRLVLHFRPPHUÂIÂUHQFHSRXUPHVXUHUOHVSURJUÁV DQWLFLSÂV /D G\QDPLTXH D JDJQÂ GX WHUUDLQ DX ÚO GHV DQQÂHV VXLYDQWHV PDLV FoHVW OoDXJPHQWDWLRQ LQFUR\DEOH GHV LQYHVWLVVHPHQWV FRQVHQWLV ¹ SDUWLU GH SDU OHV EDLOOHXUV GH IRQGV LQWHUQDWLRQDX[
HW OHV DJHQFHV PXOWLODWÂUDOHV TXL D WUDQVIRUPÂ OD IDÀRQ GRQW OHV SDUWHQDLUHV RQW FRPPHQFÂ ¹ HQYLVDJHUFROOHFWLYHPHQWFHTXLÂWDLWGXGRPDLQHGX SRVVLEOH1RPEUHGHSDUWHQDLUHVVRXWHQDLHQWGHSXLV ORQJWHPSV FHUWDLQV SD\V GDQV OHXUV HIIRUWV FRQWUH OHSDOXGLVPH&HSHQGDQWOHVFKDQJHPHQWVPDMHXUV
VXUYHQXV DX PLOLHX GHV DQQÂHV RQW UHKDXVVÂ OHV REMHFWLIV (QGLJXHU OH SDOXGLVPH HW FRQWULEXHU GH PDQLÁUH GÂFLVLYH DX[ 2EMHFWLIV GX 0LOOÂQDLUH SRXU OH 'ÂYHORSSHPHQW 20' RQW ÂWÂ UHVVHQWLV FRPPH GHV ÂWDSHV XUJHQWHV HW RQW VXVFLWÂ XQH SULVH GH UHVSRQVDELOLWÂV 'oXQH FRPPXQDXWÂ VDQV JUDQGHFRKÂVLRQOH3DUWHQDULDW5%0DGRQFÂYROXÂ UDSLGHPHQW SRXU GHYHQLU FH TXoLO HVW DXMRXUGoKXL ¹ VDYRLU XQ H[HPSOH GH SDUWHQDULDW LQWHUQDWLRQDO DX[
DVSLUDWLRQV WRXMRXUV SOXV DPELWLHXVHV 6oHQJDJHU IHUPHPHQW ¹ GÂÚQLU XQH YLVLRQ VWUDWÂJLTXH HW ¹ REWHQLUGHVGRQQÂHVSUREDQWHVPHWWUHOoDFFHQWVXU OHVRXWLHQDXSD\VHWOHOHDGHUVKLSQDWLRQDORQWÂWÂ GÁV OH GÂSDUW OHV SULQFLSHV FOÂV GH FH SDUWHQDULDW
&HV SULQFLSHV RQW ÚQDOHPHQW ÂWÂ VRXWHQXV SDU GHV ÚQDQFHPHQWV VXIÚVDQWV SRXU DVVXUHU GHV FKDQJHPHQWVHWHQWUDÇQHUXQLPSDFWUÂHO
7RXV OHV DVSHFWV GH OD OXWWH FRQWUH OH SDOXGLVPH RQW FRQQX GH JUDQGV ERXOHYHUVHPHQWV GHSXLV OoDQQÂH \ FRPSULV OHV LQWHUYHQWLRQV OHV VWUDWÂJLHV HW OHV SROLWLTXHV QDWLRQDOHV HW LQWHUQDWLRQDOHV OHV SDUWHQDULDWV OHV ÚQDQFHPHQWV HW OHV V\VWÁPHV GH VXLYL GH OoLQWHQVLÚFDWLRQ HW GHV SURJUÁV GHV SURJUDPPHV FI WDEOHDX ,O VXIÚW GH VXLYUHOoÂYROXWLRQGHVRXWLOVQRXYHOOHVPRXVWLTXDLUHV LPSUÂJQÂHVGoLQVHFWLFLGHORQJXHGXUÂH>0,/'@WHVWV GHGLDJQRVWLFUDSLGH>7'5@QRXYHDX[PÂGLFDPHQWV HWGHVVWUDWÂJLHVOoLQWHQVLÚFDWLRQGHVLQWHUYHQWLRQV SRXUXQLPSDFWUÂHOOoÂODUJLVVHPHQWGoXQHDSSURFKH FLEOÂH SRXU DWWHLQGUH OoHQVHPEOH GHV SRSXODWLRQV ¹ ULVTXHODGÂÚQLWLRQGoXQHVWUDWÂJLHGoÂOLPLQDWLRQGX SDOXGLVPHORUVTXHFoHVWSRVVLEOHSRXUVoDSHUFHYRLU TXHOH3DUWHQDULDWDWÍWIDLWGoDWWHLQGUHXQHFHUWDLQH PDWXULWÂ HW TXoLO D DFTXLV OD FDSDFLWÂ ¹ VoDGDSWHU
¹ GHV EHVRLQV HW ¹ GHV VLWXDWLRQV DXVVL GLYHUV TXH FKDQJHDQWV
1RPEUH GH SD\V RQW UDSLGHPHQW LQWHQVLÚÂ OHXUV SURJUDPPHV HW UÂXQL GHV GRQQÂHV SUREDQWHV HQ PDWLÁUHGoLPSDFWGHVLQWHUYHQWLRQV,OVHQVRQWDUULYÂV O¹ JU»FH ¹ XQ YUDL OHDGHUVKLS HW ¹ XQ HQJDJHPHQW LPSRUWDQWDXQLYHDXQDWLRQDOPDLVDXVVLJU»FH¹XQ ODUJHVRXWLHQGHVSDUWHQDLUHV/H3DUWHQDULDW5%0D
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352*5¡6(7,03$&7
ÂYROXÂ SRXU ODLVVHU SODFH ¹ GLYHUVHV FROODERUDWLRQV QDWLRQDOHVUÂJLRQDOHVHWLQWHUQDWLRQDOHV,OVoDSSXLH HQ HIIHW VXU OH VRXWLHQ SROLWLTXH ¹ KDXW QLYHDX GX
%XUHDX GH Oo(QYR\Â VSÂFLDO GX 6HFUÂWDLUH JÂQÂUDO GHV1DWLRQV8QLHVSRXUOHSDOXGLVPHHWGHOo$OOLDQFH GHV OHDGHUV DIULFDLQV FRQWUH OH SDOXGLVPH $/0$
VXUOoDVVLVWDQFHWHFKQLTXHGX3URJUDPPHPRQGLDOGH OXWWHDQWLSDOXGLTXHFUÂÂSDUOo206VXUOoDXJPHQWDWLRQ FRQVLGÂUDEOH GHV ÚQDQFHPHQWV GHV SURJUDPPHV QDWLRQDX[SDUOHELDLVGoRUJDQLVDWLRQVFOÂVELODWÂUDOHV HW PXOWLODWÂUDOHV OH )RQGV PRQGLDO OD %DQTXH PRQGLDOH 30, OH 'ÂSDUWHPHQW GX GÂYHORSSHPHQW LQWHUQDWLRQDO GX 5R\DXPH8QL >'),'@ OD )RQGDWLRQ
%LOO 0HOLQGD*DWHVHQWUHDXWUHVEDLOOHXUVGHIRQGV VXUOHGÂYHORSSHPHQWHWODSURGXFWLRQGoLQWHUYHQWLRQV HVVHQWLHOOHV SDU OD FRPPXQDXWÂ VFLHQWLÚTXH HW OH VHFWHXU SULYÂ DLQVL TXH VXU OH VRXWLHQ GHV RUJDQLVDWLRQV QRQ JRXYHUQHPHQWDOHV QDWLRQDOHV HW LQWHUQDWLRQDOHVGDQVOHGRPDLQHGHODVDQWÂSXEOLTXH
&oHVWODGLYHUVLWÂGHFHWWHSODWHIRUPHGHSDUWHQDULDW TXL D SHUPLV GH PHWWUH HQ SODFH OHV EDVHV JU»FH DX[TXHOOHV OD OXWWH FRQWUH OH SDOXGLVPH DWWHLQW DXMRXUGoKXL GHV UÂVXOWDWV VDQV SUÂFÂGHQW QRWDPPHQW
r XQHPXOWLSOLFDWLRQSDUGL[YRLUHSOXVGHVUHVVRXUFHV GLVSRQLEOHVSRXUOXWWHUFRQWUHOHSDOXGLVPHHQXQH GÂFHQQLH OD PDMHXUH SDUWLH GHV IRQGV D\DQW ÂWÂ FROOHFWÂV DX FRXUV GHV WURLV GHUQLÁUHV DQQÂHV VHXOHPHQW
r HQYLURQ PLOOLRQ GH GÂFÁV LQIDQWLOHV GXV DX SDOXGLVPH ÂYLWÂV HQ $IULTXH VXEVDKDULHQQH DX FRXUVGHVGL[GHUQLÁUHVDQQÂHV
r XQH GLPLQXWLRQ GH SOXV GH GHV FDV GH SDOXGLVPH HW GHV GÂFÁV OLÂV ¹ OD PDODGLH GDQV SD\V DIULFDLQV D\DQW FRQVLGÂUDEOHPHQW LQWHQVLÚÂOHXUVLQWHUYHQWLRQV
r XQHEDLVVHGHSOXVGHGHVFDVGHSDOXGLVPH HW GHV GÂFÁV DVVRFLÂV GDQV OD PDMRULWÂ PDLV SDV OD WRWDOLWÂ GHV SD\V HQGÂPLTXHV GHV DXWUHV UÂJLRQV LPSDOXGÂHV GX PRQGH KRUV $IULTXH
r DXFRXUVGHVTXDWUHGHUQLÁUHVDQQÂHVOo206DLQVFULW WURLVSD\V0DURF7XUNPÂQLVWDQHW¢PLUDWVDUDEHV XQLVVXUODOLVWHGHVSD\VD\DQWÂOLPLQÂOHSDOXGLVPH OHVWRXWSUHPLHUVSD\V¹REWHQLUFHWWHGLVWLQFWLRQHQ DQV
$X FRXUV GHV GL[ GHUQLÁUHV DQQÂHV OH ÚQDQFHPHQW LQWHUQDWLRQDO GH OD OXWWH FRQWUH OH SDOXGLVPH D PDQLIHVWHPHQWÂWÂOoXQGHVLQYHVWLVVHPHQWVOHVSOXV SURGXFWLIVMDPDLVUÂDOLVÂVGDQVOHGRPDLQHGHODVDQWÂ
&HSHQGDQWOHWUDYDLOHVWORLQGoÃWUHWHUPLQÂFDUFHUWDLQV SD\VQoRQWSDVHQFRUHFRPPHQF¹LQWHQVLÚHUOHXUV LQWHUYHQWLRQVDQWLSDOXGLTXHV'oDXWUHVRQWSDVVÂFH FDSPDLVLOVSHLQHQWDXMRXUGoKXL¹JDJQHUHQHIÚFDFLW GHIDÀRQ¹SRXYRLUSÂUHQQLVHUOHXUWDX[GHFRXYHUWXUH ÂOHYÂSXLV¹SUHQGUHOHVPHVXUHVQÂFHVVDLUHV¹XQH UÂGXFWLRQ VXSSOÂPHQWDLUH GH OD WUDQVPLVVLRQ GH OD PDODGLHHWGXQRPEUHGHGÂFÁVDVVRFLÂV3DUDLOOHXUV OD UÂVLVWDQFH DX[ PÂGLFDPHQWV HW DX[ LQVHFWLFLGHV IDLWSHVHUXQHPHQDFHVXUOHVDYDQFÂHVUÂDOLVÂHV¹FH MRXUHWOHVSDUWHQDLUHVLQWHUQDWLRQDX[VRQWFRQIURQWÂV DX[HIIHWVGXUDOHQWLVVHPHQWÂFRQRPLTXHPRQGLDOHW
¹OoÂYROXWLRQGHVSULRULWÂVGHVEDLOOHXUVGHIRQGVHQ PDWLÁUHGHÚQDQFHPHQWFHTXLPHWHQSÂULOFHUWDLQHV GHVLQLWLDWLYHVGHVDQWÂOHVSOXVDERXWLHV
7RXWHIRLVFRPSWHWHQXGHVDYDQFÂHV¹FHMRXUHWGHV UHWRXUVGoH[SÂULHQFHOH3DUWHQDULDW5%0DDFWXDOLVÂ VHVREMHFWLIVFROOHFWLIVSRXUÚQ¹VDYRLUDPÂOLRUHU OHVUÂVXOWDWVHWVoDOLJQHUGDYDQWDJHVXUOHV20''DQV FHWWHRSWLTXHLGHQWLÚHUODUÂGXFWLRQ¹]ÂURRXSUHVTXH GHVGÂFÁVGXVDXSDOXGLVPHGLPLQXHUOHQRPEUHGH FDVGHIDÀRQFRQVLGÂUDEOHHWÂOLPLQHUODWUDQVPLVVLRQ GDQV GL[ SD\V HW GDQV OD UÂJLRQ (XURSH GH Oo206 VRQW GHYHQXV OHV QRXYHDX[ REMHFWLIV SULQFLSDX[
(Q HIIHW OD SURFKDLQH ÂWDSH GH OD OXWWH FRQWUH OH SDOXGLVPHDGÂM¹FRPPHQFÂ(OOHH[LJHUDHQFRUHGHV HIIRUWV VXEVWDQWLHOV ¹ FRXUW WHUPH QRWDPPHQW GHV HQJDJHPHQWVLPSRUWDQWVGHODSDUWGHVSD\VHWGHWRXV OHVSDUWHQDLUHVDQFLHQVRXQRXYHDX[WDQWVXUOHSODQ ÚQDQFLHUHWWHFKQLTXHTXHGHVUHVVRXUFHVKXPDLQHV
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352*5¡6(7,03$&7
7DEOHDX
Évolution du contexte du paludisme, 2000–2010
3ROLWLTXHVHW VWUDWÂJLHVPRQGLDOHV GHOXWWHFRQWUHOH SDOXGLVPH
$XFXQH VWUDWÂJLH JOREDOH GH OXWWH FRQWUH OH SDOXGLVPH 'HV SROLWLTXHV GH WUDLWHPHQW H[LVWHQW PDLV HOOHV VRQW EDVÂHV VXU GHVPÂGLFDPHQWVLQHIÚFDFHVSHXGHSROLWLTXHVGHSUÂYHQWLRQ
$FFHQWPLVVXUOHVSRSXODWLRQVYXOQÂUDEOHV
3ROLWLTXHVGHOo206DFWXDOLVÂHV3ODQGoDFWLRQPRQGLDOFRQWUHOH SDOXGLVPHHQSODFHHWPLVHQyXYUHDGRSWLRQ¹JUDQGHÂFKHOOH GHVFRPELQDLVRQVWKÂUDSHXWLTXHV¹EDVHGoDUWÂPLVLQLQH$&7 WUDLWHPHQWSUÂYHQWLILQWHUPLWWHQWSHQGDQWODJURVVHVVH73,S GLVWULEXWLRQJUDWXLWHGH0,/'¹OoXWLOLVDWHXUÚQDOHWSROLWLTXHVGH SXOYÂULVDWLRQVLQWUDGRPLFLOLDLUHVGoLQVHFWLFLGHV¹HIIHWUÂPDQHQW 3,' FRXYHUWXUH XQLYHUVHOOH SRXU WRXWHV OHV SRSXODWLRQV ¹ ULVTXHHWLQWURGXFWLRQGHVUHFRPPDQGDWLRQVSRXUXQGLDJQRVWLF XQLYHUVHO
3DUWHQDULDWV 4XHOTXHV SDUWHQDULDWV ¹ OoÂFKHOOH QDWLRQDOH UÂJLRQDOH HW
PRQGLDOH 3DUWHQDULDWV ÂWHQGXV HW IRQFWLRQQDQW SDUIDLWHPHQW ¹ WRXV OHV
QLYHDX[
)LQDQFHPHQW )LQDQFHPHQW OLPLWÂ GHV SURJUDPPHV SDU OHV RUJDQLVDWLRQV ELODWÂUDOHV DYHF GHV ÂFDUWV LPSRUWDQWV HQWUH OHV SD\V HW GH QRPEUHX[ SD\V VDQV DXFXQ VRXWLHQ ÚQDQFLHU H[WHUQH RX SUHVTXH HQYLURQ 86 PLOOLRQV GLVSRQLEOHV HQ )RQGVOLPLWÂVSRXUODUHFKHUFKH
)LQDQFHPHQWPRQGLDOFRQVÂTXHQWSULQFLSDOHPHQWGHODSDUWGX )RQGVPRQGLDOGXSURJUDPPHGDFFÂOÂUDWLRQGHODOXWWHFRQWUH OH SDOXGLVPH GH OD %DQTXH PRQGLDOH %RRVWHU GH 30, HW GX '),' HQYLURQ 86 PLOOLDUG GLVSRQLEOHV HQ HW 86PLOOLRQVSRXUODUHFKHUFKH
,QWHUYHQWLRQV 0RXVWLTXDLUHV LPSUÂJQÂHV GoLQVHFWLFLGH0,,
'LVSRQLEOHVGHSXLVSHXHOOHVQÂFHVVLWHQWXQUHWUDLWHPHQWWRXV OHV¹PRLVH[SÂULHQFHHWXWLOLVDWLRQOLPLWÂHVGHV0,/' HOOHVVRQWGLVWULEXÂHVGHSUÂIÂUHQFHDX[IHPPHVHQFHLQWHVHW DX[MHXQHVHQIDQWVVRXYHQWGDQVOHFDGUHGHSURJUDPPHVGH PDUNHWLQJVRFLDORXYLDXQV\VWÁPHGHERQVGoÂFKDQJHIDLEOH FRXYHUWXUHGHODSRSXODWLRQHQYLURQGHVPÂQDJHVSRVVÁGHQW DXPRLQVXQH0,,
/HV0,/'VRQWGÂVRUPDLVFRXUDQWHVHWODUJHPHQWGLVWULEXÂHV DÚQGoDVVXUHUXQHFRXYHUWXUHWRWDOHGHODSRSXODWLRQHOOHVVRQW FRQVLGÂUÂHV FRPPH XQ ELHQ SXEOLF HW VRQW GLVWULEXÂHV JUDWXLWHPHQW ¹ OoXWLOLVDWHXU ÚQDO GDQV GH QRPEUHX[ SD\V DXJPHQWDWLRQFRQVLGÂUDEOHGXWDX[GHFRXYHUWXUHGHVPÂQDJHV GDQVEHDXFRXSGHSD\V¹GHVPÂQDJHVSRVVÁGHQW DXPRLQVXQH0,/'
3,' 0ÂWKRGHFRQQXHPDLVSHXXWLOLVÂHVXUWRXWHQ$IULTXHSUDWLTXH OLPLWÂH¹TXHOTXHV]RQHVXUEDLQHVHW¹FHUWDLQVSD\VGXVXGHWGH OD&RUQHGHOo$IULTXH
$XJPHQWDWLRQLPSRUWDQWHGHOoXWLOLVDWLRQGHOD3,'GDQVOHFDGUH GHVSURJUDPPHVQDWLRQDX[ÚQDQFHPHQWGLVSRQLEOHGHODSDUWGX )RQGVPRQGLDOGXSURJUDPPHGDFFÂOÂUDWLRQGHODOXWWHFRQWUH OHSDOXGLVPHGHOD%DQTXHPRQGLDOH%RRVWHUHWGH30,XQH JUDQGHSDUWLHGHVSRSXODWLRQVHVWSURWÂJÂHFKDTXHDQQÂHSDU OD3,'
73,S $GRSWÂ GDQV XQ VHXO SD\V 0DODZL HQ GDQV OD SOXSDUW GHVSD\VSURSK\OD[LH¹GRPLFLOHSDUODFKORURTXLQHWDX[GH FRXYHUWXUH IDLEOH WUDLWHPHQW PDO DFFHSWÂ SDU OHV IHPPHV HQFHLQWHV
/DUJHPHQWDGRSWÂGDQVOHFDGUHGHVSROLWLTXHVQDWLRQDOHVGDQV WRXWHOo$IULTXHHWGDQVFHUWDLQHVUÂJLRQV¹HQGÂPLFLWÂÂOHYÂHHQ GHKRUVGXFRQWLQHQWDIULFDLQWDX[GHFRXYHUWXUHWRXMRXUVWUÁV YDULDEOHSRXUOHWUDLWHPHQWDYHFDXPRLQVGHX[GRVHVDXFRXUV GHODJURVVHVVHGHPRLQVGH¹HQYLURQ
*HVWLRQGHVFDV
GLDJQRVWLF 0LFURVFRSLH GLVSRQLEOH /HV 7'5 VRQW GLVSRQLEOHV HQ SHWLWHV TXDQWLWÂV PDLV OHXU TXDOLWÂ HVW H[WUÃPHPHQW YDULDEOH HW LOV UHVWHQWPDOFRPSULVOHGLDJQRVWLFGHSUÂVRPSWLRQGXSDOXGLVPH HVWODQRUPHVXUWRXWSRXUOHVMHXQHVHQIDQWV
0LFURVFRSLH SOXV ÂWHQGXH /DUJHPHQW GLVSRQLEOHV OHV 7'5 RIIUHQW XQH DVVXUDQFH GH TXDOLWÂ HW GHV LQIRUPDWLRQV GH VHQVLELOLWÂHWGHVSÂFLÚFLWÂELHQFRQQXHVOo206UHFRPPDQGH OoXWLOLVDWLRQ XQLYHUVHOOH GHV RXWLOV GH GLDJQRVWLF SRXU OHV FDV VXVSHFWÂVGHSDOXGLVPHHWXQWUDLWHPHQWDSSURSULÂHQIRQFWLRQ GHVUÂVXOWDWVGXWHVW
*HVWLRQGHVFDV
WUDLWHPHQW /HV$&7VRQWGLVSRQLEOHVHQGHKRUVGHO$IULTXHOHWUDLWHPHQW SDUODFKORURTXLQHHVWXQÂFKHF¹OoÂFKHOOHPRQGLDOHÂFKHFSOXV OLPLWÂGDQVOHFDVGHVLQIHFWLRQV¹3ODVPRGLXPYLYD[UÂVLVWDQFH FURLVVDQWH GH OD VXOIDGR[LQHS\ULPÂWKDPLQH OHV SROLWLTXHV QDWLRQDOHV HQ PDWLÁUH GH WUDLWHPHQW GH SUHPLÁUH LQWHQWLRQ UHSRVHQWODUJHPHQWVXUGHVPÂGLFDPHQWVUÂVLVWDQWGHSOXVHQ SOXVDXSDUDVLWH
/HV$&7VRQWGLVSRQLEOHVDXSUÁVGHQRPEUHX[IDEULFDQWVHWVRXV SOXVLHXUVIRUPXODWLRQV'HVSROLWLTXHVVRQWHQYLJXHXUGDQVOD PDMRULWÂGHVSD\VHWOoXVDJHGHV$&7HVWHQSDVVHGHGHYHQLUOD QRUPHSRXUWUDLWHUOHSDOXGLVPHOLHQUHQIRUFÂHQWUHOHVFDVGH SDOXGLVPHFRQÚUPÂVHQODERUDWRLUHHWOHV$&7
)DUGHDXHWLPSDFW
7UDQVPLVVLRQ 3UDWLTXHPHQWLQFKDQJÂHGHSXLVOHVDQQÂHV (OOHHVWGL[IRLVLQIÂULHXUHJU»FHDX[0,,HWDX[3,'OHWUDLWHPHQW GHVFDVSDU$&7GLPLQXHÂJDOHPHQWODWUDQVPLVVLRQ 0RUELGLWÂFDVGH
SDOXGLVPHHW GoDQÂPLH
3DUDVLWÂPLH ÂOHYÂH GDQV OHV ÂWDEOLVVHPHQWV GH VRLQV HW OHV KÍSLWDX[FKH]OHVHQIDQWVODPDODGLHUHSUÂVHQWHVRXYHQW
¹ GHV FRQVXOWDWLRQV H[WHUQHVKRVSLWDOLVDWLRQV PDLV VRXYHQW VDQV FRQÚUPDWLRQ HQ ODERUDWRLUH OHV FDV GoDQÂPLH LQIDQWLOHQÂFHVVLWDQWGHVWUDQVIXVLRQVVDQJXLQHVVRQWFRXUDQWV
'HQRPEUHX[SD\VRQWHQUHJLVWUÂXQHEDLVVHFRQVLGÂUDEOHGX QRPEUHGHFDVGHSDOXGLVPHHWXQHUÂGXFWLRQLPSRUWDQWHGHV FDV GoDQÂPLH LQIDQWLOH VÂYÁUH HW GHV WUDQVIXVLRQV VDQJXLQHV SUDWLTXÂHVVXUOHVHQIDQWVXQHGLPLQXWLRQGHVFDVVXSÂULHXUH¹ GDQVSD\VDIULFDLQVODWUDQVLWLRQYHUVXQHFRQÚUPDWLRQ HQODERUDWRLUHGHVFDVGHSDOXGLVPHDSHUPLVGHQRUPDOLVHUOD QRWLÚFDWLRQGHVFDVPDLVDDXVVLFRQWULEX¹UÂGXLUHGHIDÀRQ FRQVÂTXHQWHOHQRPEUHGHFDV
0RUWDOLWÂ 7DX[GHPRUWDOLWÂHWQRPEUHGHGÂFÁVGXVDXSDOXGLVPHÂOHYÂV
! PLOOLRQDQ VXUWRXW HQ $IULTXH HW FKH] OHV MHXQHV HQIDQWVFHUWDLQVGÂFÁVVRQWGXV¹GHVFDVGHSDOXGLVPHVÂYÁUH
¹ SURJUHVVLRQ H[WUÃPHPHQW UDSLGH HW EHDXFRXS VRQW OLÂV ¹ XQHLQIHFWLRQUÂFXUUHQWHRXSHUVLVWDQWHXQHDQÂPLHVÂYÁUHHW GoDXWUHVLQIHFWLRQVLQIDQWLOHVVHSWLFÂPLHEDFWÂULHQQHPDODGLH UHVSLUDWRLUHRXGLDUUKÂLTXH
7DX[ GH PRUWDOLWÂ HW QRPEUH GH GÂFÁV IRUWHPHQW UÂGXLWV DQGLPLQXWLRQGHGDQVOHVSD\VSUÂVHQWDQWGHV WDX[ GH FRXYHUWXUH ÂOHYÂV GHV LQWHUYHQWLRQV SUÂYHQWLYHV HW XWLOLVDQWOHVRXWLOVGHGLDJQRVWLFHWOHV$&7UÂGXFWLRQVOHVSOXV QRWDEOHVSDUPLOHVMHXQHVHQIDQWVOHVSOXVWRXFKÂVDXSDUDYDQW
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352*5¡6(7,03$&7
Points clés
1. L’intensification rapide des interventions s’est traduite par une réduction remarquable de la morbidité et de la mortalité dues au paludisme à l’échelle régionale et mondiale.
$X FRXUV GH OD GHUQLÁUH GÂFHQQLH OD OXWWH FRQWUH OH SDOXGLVPH D HX XQ UHWHQWLVVHPHQW LPSUHVVLRQQDQW GDQVOHVSD\VRÒOHVLQWHUYHQWLRQVRQWÂWÂLQWHQVLÚÂHV /DVXUYLHLQIDQWLOHVoHVWDFFUXHGDQVOHPRQGHHQWLHU HW GDQV WRXWH Oo$IULTXH 6HORQ OHV HVWLPDWLRQV OD SUÂYHQWLRQ GX SDOXGLVPH D FRQWULEXÂ ¹ ÂYLWHU SOXV Go PLOOLRQ GH GÂFÁV GoHQIDQWV DIULFDLQV GHSXLV OD FUÂDWLRQGX3DUWHQDULDW5%0/HVHQTXÃWHVQDWLRQDOHV PHQÂHVDXSUÁVGHVSRSXODWLRQVHWGHVÂWDEOLVVHPHQWV GHVRLQVOHVLQIRUPDWLRQVVDQLWDLUHVGHURXWLQHDLQVL TXHFHUWDLQHVÂWXGHVVSÂFLÚTXHVRQWPLVHQOXPLÁUH ODEDLVVHFRQVWDQWHGXQRPEUHGHFDVGHSDOXGLVPH (OOHV RQW ÂJDOHPHQW VRXOLJQÂ XQH EDLVVH GX QRPEUH GH FDV GoDQÂPLH HW GH WUDQVIXVLRQV VDQJXLQHV XQH GLPLQXWLRQ GH OD PRUWDOLWÂ HW GHV FDV GH SDOXGLVPH VÂYÁUH XQH UÂGXFWLRQ QRWDEOH GH OD WUDQVPLVVLRQ \ FRPSULVOoÂOLPLQDWLRQGXSDOXGLVPHGDQVWURLVSD\V /oLPSDFWGHODOXWWHFRQWUHOHSDOXGLVPHDÂWÂUHVVHQWL GDQV WRXWHV OHV UÂJLRQV HQGÂPLTXHVD OHV REMHFWLIV YLVDQW¹UÂGXLUHGHPRLWLÂOHIDUGHDXGXSDOXGLVPH¹ OoÂFKHOOHPRQGLDOHRQWHXXQLPSDFWVSHFWDFXODLUHGDQV WRXWHVOHVUÂJLRQVGHOo206
'DQVODUÂJLRQ$IULTXHODOXWWHFRQWUHOHSDOXGLVPHD SHUPLVGoÂYLWHUSOXVGoPLOOLRQGHGÂFÁVGoHQIDQWVHQWUH OoDQQÂHHWODUÂGDFWLRQGHFHUDSSRUW'HVSURJUÁV UHPDUTXDEOHV VRQW UHFHQVÂV GDQV OHV SD\V RÒ OHV LQWHUYHQWLRQV RQW ÂWÂ FRQVLGÂUDEOHPHQW LQWHQVLÚÂHV
$XPRLQVSD\VRQWHQUHJLVWUÂXQHUÂGXFWLRQGHSOXV GHGHVFDVGHSDOXGLVPHHWGHVGÂFÁVDVVRFLÂV 'DQVODUÂJLRQ(XURSHODOXWWHFRQWUHOHSDOXGLVPH D IDLW ÂWDW GH SURJUÁV VSHFWDFXODLUHV OD PRUWDOLWÂ DVVRFLÂHHVWSUDWLTXHPHQWQXOOHHWODUÂJLRQHVWSUÃWH¹ ÂOLPLQHUODPDODGLHGDQVOHVFLQTDQQÂHV¹YHQLU 'DQVODUÂJLRQ$PÂULTXHVODPDMRULWÂGHVSD\VRQW DIÚFKÂ GHV SURJUÁV UÂHOV HW OD PRLWLÂ DX PRLQV RQW HQUHJLVWUÂXQHUÂGXFWLRQGHSOXVGHGHVFDVGH SDOXGLVPHHWGHVGÂFÁVDVVRFLÂV
'DQV OD UÂJLRQ 0ÂGLWHUUDQÂH RULHQWDOH GDQV OoHQVHPEOH FHWWH UÂJLRQ D HIIHFWXÂ GHV SURJUÁV
D
&HUDSSRUWIDLWUÂIÂUHQFHDX[UÂJLRQVGÂÚQLHVSDUOo206
SURJUÁV QRWDEOHV 7RXWHIRLV OHV SURJUÁV DX FRXUV GH FHWWH GÂFHQQLH GDQV FHUWDLQV JUDQGV SD\V RÒ OH SDOXGLVPHH[HUFHXQORXUGIDUGHDXWHOVTXHOD6RPDOLH RXOH6RXGDQVRQWPRGHVWHV¹FDXVHGHOoLQVWDELOLWÂ SROLWLTXHHWÂFRQRPLTXHTXL\UÁJQHPÃPHVLOH6RXGDQ UDSSRUWHGHWUÁVUÂFHQWVVXFFÁVGDQVOHGRPDLQHGH OoLQWHQVLÚFDWLRQGHODOXWWHFRQWUHOHSDOXGLVPH 'DQV OD UÂJLRQ $VLH GX 6XG(VW VXU OHV GL[ SD\V HQGÂPLTXHVFLQTRQWHQUHJLVWUÂXQHUÂGXFWLRQGHSOXV GHGHVFDVGHSDOXGLVPHRXGHVGÂFÁVDVVRFLÂV PDLV FHWWH PDODGLH HVW WRXMRXUV GÂYDVWDWULFH GDQV SOXVLHXUVJUDQGVSD\VHWRXIRUWHPHQWSHXSOÂVWHOVTXH OH%DQJODGHVKOo,QGHOo,QGRQÂVLHHWOH0\DQPDU 'DQV OD UÂJLRQ 3DFLÚTXH RFFLGHQWDO OD PRLWLÂ GHV SD\VRQWHQUHJLVWUÂXQHEDLVVHGHSOXVGHGHV FDV GH SDOXGLVPH RX GHV GÂFÁV DVVRFLÂV 8QH IRLV HQFRUH FHUWDLQV SD\V FRPPH OH &DPERGJH HW OD 3DSRXDVLH1RXYHOOH*XLQÂHYRQWSRXUWDQWGHYRLUIDLUH GHJURVHIIRUWVGoLQWHQVLÚFDWLRQGHVLQWHUYHQWLRQVDÚQ GoDWWHLQGUHXQHSURJUHVVLRQDXQLYHDXUÂJLRQDO
2. Le contexte de la lutte contre le paludisme a radicalement changé au cours des dix dernières années.
$XFRXUVGHODGHUQLÁUHGÂFHQQLHOH3DUWHQDULDW5%0 D FRQQX GHV FKDQJHPHQWV UDGLFDX[ GDQV WRXV OHV GRPDLQHVGHODOXWWHFRQWUHOHSDOXGLVPHQRWDPPHQW GHQRXYHOOHVSROLWLTXHVHWGHQRXYHDX[V\VWÁPHVSRXU OHV 0,, OD 3,' OD SUÂYHQWLRQ SHQGDQW OD JURVVHVVH OHGLDJQRVWLFHWOHWUDLWHPHQWDLQVLTXHOHVV\VWÁPHV GH VXLYL GHV DFWLRQV HW GHV SURJUÁV UÂDOLVÂV SDU OHV SURJUDPPHV$XMRXUGoKXLODOXWWHFRQWUHOHSDOXGLVPH QoDSOXVULHQ¹YRLUDYHFFHTXoHOOHÂWDLWLO\DWRXWMXVWH GL[DQV1RXVSRXYRQVGoDLOOHXUVQRXVDWWHQGUH¹FHTXH FHVFKDQJHPHQWVUDSLGHVHWQÂFHVVDLUHVVHSRXUVXLYHQW DX FRXUV GHV GL[ SURFKDLQHV DQQÂHV GH IDÀRQ ¹ SÂUHQQLVHU HW ¹ DPSOLÚHU OoLPSDFW GH OD OXWWH DQWLSDOXGLTXH
¢YROXWLRQ GX 3DUWHQDULDW 5%0 OH 3DUWHQDULDW 5%0 HVWQÂGDQVXQFRQWH[WHGHVDQWÂSXEOLTXHPRQGLDOH RÒ OHV SDUWHQDULDWV ÂWDLHQW FRQVLGÂUÂV FRPPH OHV VHXOHVSHUVSHFWLYHVGoDYHQLUPÃPHVLOHVH[LJHQFHV IRQGDPHQWDOHVTXDQW¹OHXUHIÚFDFLWÂUHVWDLHQWHQFRUH PDOGÂÚQLHV$XMRXUGoKXLOH3DUWHQDULDW5%0FRQVWLWXH XQH SODWHIRUPH VROLGH SHUPHWWDQW DX[ GLIIÂUHQWV SDUWHQDLUHVGHGÂÚQLUHWGoKDUPRQLVHUOHXUVREMHFWLIVHW
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352*5¡6(7,03$&7
DFWLRQVSURJUDPPDWLTXHVGoDOORXHUOHXUVUHVVRXUFHV HW GH PHWWUH HQ yXYUH OHXUV DFWLYLWÂV GH SODLGR\HU 6D VWUXFWXUH HW VRQ IRQFWLRQQHPHQW VHPEOHQW HQ IDLUHOoXQGHVPRGÁOHVGHSDUWHQDULDWOHVSOXVVROLGHV GDQVOHGRPDLQHGHODVDQWÂSXEOLTXHPRQGLDOHHWVRQ DGDSWDWLRQ UDSLGH HW VD WUDQVSDUHQFH HQ WHUPHV GH GÂYHORSSHPHQWWRXWFRPPHODFFHQWTXLOPHWVXUOH OHDGHUVKLSDXQLYHDXQDWLRQDOVRQWDXWDQWGDWRXWVQRQ QÂJOLJHDEOHV¹VDUÂXVVLWH
$PÂOLRUDWLRQ GHV SROLWLTXHV HW VWUDWÂJLHV GH OXWWH FRQWUHOHSDOXGLVPHGH¹OHVSD\VRQWSULV GHVPHVXUHVIRUWHVSRXUDOLJQHUOHXUVSROLWLTXHVGHOXWWH FRQWUHOHSDOXGLVPHVXUOHVUHFRPPDQGDWLRQVGHOo206 DGRSWHUODVWUDWÂJLHLQWHUQDWLRQDOHGÂÚQLHGDQVOH3ODQ GoDFWLRQ PRQGLDO FRQWUH OH SDOXGLVPH HW UÂSRQGUH ¹ OoDSSHO GX 6HFUÂWDLUH *ÂQÂUDO GHV 1DWLRQV 8QLHV HQ IDYHXU GH OD FRXYHUWXUH XQLYHUVHOOH QRWDPPHQW DX VXMHW GHV 0,, GDQV WRXWH Oo$IULTXH VXEVDKDULHQQH
OoRULJLQH OHV GLYHUVHV SROLWLTXHV FLEODLHQW OHV SRSXODWLRQVOHVSOXVYXOQÂUDEOHV¹VDYRLUOHVIHPPHV HW OHV MHXQHV HQIDQWV (OOHV RQW HQVXLWH ÂYROXÂ SRXU DSSRUWHUXQHVROXWLRQ¹OoHQVHPEOHGHVSRSXODWLRQVHW DWWHLQGUHDLQVLWRXWHVOHVSHUVRQQHV¹ULVTXHVXUWRXW FHOOHV TXL ÂWDLHQW VXVFHSWLEOHV GH WUDQVPHWWUH OHV LQIHFWLRQV3DUDOOÁOHPHQWODSUÂYHQWLRQHWOHWUDLWHPHQW GXSDOXGLVPHÂWDQWGHYHQXVXQELHQSXEOLFPRQGLDO
GRQWOHVSOXVGÂPXQLVGHYDLHQWSRXYRLUEÂQÂÚFLHUOD WUDQVLWLRQYHUVOHGÂSORLHPHQWGoLQWHUYHQWLRQV¹GHVSUL[
DERUGDEOHVVRXYHQWJUDWXLWHVDXSUÁVGHOoXWLOLVDWHXU ÚQDODÂWÂH[WUDRUGLQDLUHPHQWUDSLGH
$XJPHQWDWLRQ GX ÚQDQFHPHQW GH OD OXWWH FRQWUH OH SDOXGLVPH OHV HQJDJHPHQWV ÚQDQFLHUV HW OHV GÂFDLVVHPHQWVHQIDYHXUGHODOXWWHFRQWUHOHSDOXGLVPH RQWUÂHOOHPHQWFRPPHQF¹DXJPHQWHUDXPLOLHXGHOD GÂFHQQLH DYHF GHV PRQWDQWV PXOWLSOLÂV SDU VHSW HW PÃPHMXVTXo¹QHXIELHQTXoLOVUHVWHQWLQIÂULHXUVDX[
HVWLPDWLRQV GHV QLYHDX[ QÂFHVVDLUHV SRXU DWWHLQGUH XQHLQWHQVLÚFDWLRQJOREDOHGDQVOoHQVHPEOHGHVSD\V HQGÂPLTXHV/oDXJPHQWDWLRQGHVIRQGVGLVSRQLEOHVD SHUPLVGoDPÂOLRUHUWUÁVQHWWHPHQWODFRXYHUWXUHGHV SURJUDPPHV HW GH FUÂHU XQ LPSDFW FRQVLGÂUDEOH HQ PDWLÁUHGHVDQWÂ7RXWHIRLVFHVXFFÁVHVWIUDJLOHHW UHVWHLQH[WULFDEOHPHQWOL¹GHVÚQDQFHPHQWVGXUDEOHV 'DQV FHUWDLQHV UÂJLRQV OHV SURJUÁV DFFRPSOLV RQW YLWH GLVSDUX ORUVTXH OHV ÚQDQFHPHQWV RQW ÂW LQWHU URPSXV'DQVOHFRQWH[WHDFWXHO¹VDYRLUXQHVLWXDWLRQ ÂFRQRPLTXH PRQGLDOH LQVWDEOH GHV ÚQDQFHPHQWV FRQVÂTXHQWVVRQWQÂFHVVDLUHVSRXULQVFULUHOHVXFFÁV GDQVODGXUÂH
'HV LQWHUYHQWLRQV HW GHV V\VWÁPHV GH GLVWULEXWLRQ SOXV SHUIRUPDQWV OHV LQWHUYHQWLRQV GH OXWWH FRQWUH OH SDOXGLVPH RQW ÂYROXÂ HQ GL[ DQV /HV 0,, VRQW GÂVRUPDLV ¹ ORQJXH GXUÂH GoDFWLRQ HW QÂFHVVLWHQW XQ UHWUDLWHPHQW PRLQV IUÂTXHPPHQW /D 3,' HVW DSSOLTXÂHSOXVODUJHPHQWHQGHKRUVGHV]RQHVXUEDLQHV HW SÂULXUEDLQHV FH TXL SHUPHW GH SURWÂJHU XQ SOXV JUDQG QRPEUH GH IDPLOOHV 'DQV OHV ÂWDEOLVVHPHQWV GHVRLQVSUÂQDWDX[OHVIHPPHVHQFHLQWHVHWHQ»JH GHSURFUÂHUEÂQÂÚFLHQWGX73,SHWUHÀRLYHQWGHV0,, 'HVXUFURÇWIDLVDQWVXLWHDX[UÂFHQWVÂFODLUFLVVHPHQWV VXUODTXDOLWÂHWOoXWLOLWÂGHV7'5DLQVLTXHVXUOHXUSUL[
HQ EDLVVH Oo206 D ÂGLFWÂ XQH UHFRPPDQGDWLRQ TXL UHSUÂVHQWHXQHPXWDWLRQSURIRQGHGDQVODOXWWHFRQWUH OH SDOXGLVPH ¹ VDYRLU OoXWLOLVDWLRQ XQLYHUVHOOH HQ SUHPLÁUH LQWHQWLRQ GHV 7'5 SRXU WRXV OHV FDV VXVSHFWÂV GH SDOXGLVPH (QÚQ JU»FH DX[ $&7 GHV WUDLWHPHQWV ELHQ SOXV HIÚFDFHV VRQW DXMRXUGoKXL DFFHSWÂVGLVWULEXÂVHWXWLOLVÂV¹JUDQGHÂFKHOOH 8QH PHLOOHXUH ÂYDOXDWLRQ GHV SURJUÁV HQ OHV LQIRUPDWLRQV QÂFHVVDLUHV ¹ OoRULHQWDWLRQ GHV SURJUDPPHV IDLVDLHQW FODLUHPHQW GÂIDXW /oDWWHQWLRQ SRUWÂH ¹ OD FROOHFWH HW OD V\QWKÁVH GoLQIRUPDWLRQV SUÂFLVHV VoHVW GRQF IRUWHPHQW DFFUXH DX FRXUV GH OD GHUQLÁUH GÂFHQQLH 8Q PRGXOH SDOXGLVPH D ÂWÂ LQWÂJUÂDX[GLIIÂUHQWHVHQTXÃWHVQDWLRQDOHVHQTXÃWHV GÂPRJUDSKLTXHV HW GH VDQWÂ >('6@ HQTXÃWHV SDU JUDSSHV ¹ LQGLFDWHXUV PXOWLSOHV >0,&6@ HW OoHQTXÃWH VXU OHV LQGLFDWHXUV GX SDOXGLVPH (,3 D IDFLOLWÂ OD FROOHFWH GHV GRQQÂHV GDQV OHV SD\V RÒ FHV HQTXÃWHV QoDYDLHQW SDV ÂWÂ UÂDOLVÂHV /HV V\VWÁPHV QDWLRQDX[
GH VXUYHLOODQFH RQW ÂWÂ SHUIHFWLRQQÂV SRXU RSWLPLVHU OoDFWXDOLVDWLRQ HW OD TXDOLWÂ GHV LQIRUPDWLRQV UHFXHLOOLHV $XMRXUGoKXL OHV WHVWV GH GLDJQRVWLF GX SDOXGLVPH VRQW HQ WUDLQ GH WUDQVIRUPHU OD VXUYHLO ODQFH(QHIIHWOHVSD\VUDSSRUWHQWGÂVRUPDLVOHVFDV GHSDOXGLVPHFRQÚUPÂVSOXWÍWTXHOHVFDVVXVSHFWÂV RXOHVVLPSOHVÚÁYUHVSUÂVXPÂHVGXHVDXSDOXGLVPH /HV QRXYHOOHV WHFKQRORJLHV GH WÂOÂSKRQLH PRELOH HW ,QWHUQHWVLPSOLÚHQWOHVDSSURFKHVQRYDWULFHVHQPDWLÁUH GH VXUYHLOODQFH OHVTXHOOHV LQWÁJUHQW OD UHPRQWÂH HQ WHPSVUÂHOGoLQIRUPDWLRQV¹OoDWWHQWLRQGHVDJHQWVGH VDQWÂ WUDYDLOODQW HQ SUHPLÁUH OLJQH (QÚQ DORUV TXH OD WUDQVPLVVLRQ GX SDOXGLVPH GLPLQXH XQH PHLOOHXUH VXUYHLOODQFH HW GHV LQIRUPDWLRQV ORFDOHV DFWXDOLVÂHV YRQWGHYHQLUGHVÂOÂPHQWVHVVHQWLHOVGDQVOoRSWLTXHGH FRQWHQLUGDYDQWDJHSXLVÚQDOHPHQWGoLQWHUURPSUHOD WUDQVPLVVLRQ
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352*5¡6(7,03$&7
acceptées et considérées comme des priorités essentielles pour endiguer le paludisme.
/HVHIIRUWVFRQVHQWLVSRXUDWWHLQGUHOHVREMHFWLIVGH FRXYHUWXUH XQLYHUVHOOH GHV LQWHUYHQWLRQV WHOV TXH Ú[ÂVHQSDUOH6HFUÂWDLUH*ÂQÂUDOGHV1DWLRQV 8QLHVRQWÂWÂIUXFWXHX[GDQVGHQRPEUHX[SD\V /XWWHDQWLYHFWRULHOOH¹FHMRXUODTXDVLWRWDOLWÂGH ODSRSXODWLRQGHQRPEUHX[SD\VGo$IULTXHGLVSRVHGH 0,/''HPÃPHOD3,'VoHVWWUÁVODUJHPHQWÂWHQGXH GDQV XQ JUDQG QRPEUH GH SD\V 3RXUWDQW FHUWDLQV SD\VHQVRQWHQFRUHDXWRXWGÂEXWGHOoLQWHQVLÚFDWLRQ GHV LQWHUYHQWLRQV ,O OHXU PDQTXH OHV UHVVRXUFHV OoLQIUDVWUXFWXUH OHV FDSDFLWÂV WHFKQLTXHV HW OHV SURGXLWVQÂFHVVDLUHVSRXUDWWHLQGUHHWPDLQWHQLUXQ WDX[GHFRXYHUWXUHÂOHYÂ
3UÂYHQWLRQSHQGDQWODJURVVHVVHDORUVTXHOoDGRSWLRQ GHVSROLWLTXHVGHSUÂYHQWLRQGXSDOXGLVPHDXFRXUV GH OD JURVVHVVH VoHVW UDSLGHPHQW ÂWHQGXH DX FRXUV GHODGHUQLÁUHGÂFHQQLHODFRXYHUWXUHHQ73,SDÂWÂ SOXVOHQWH¹DXJPHQWHUHWFHWWHLQWHUYHQWLRQQoDSDV EÂQÂÚFLÂGHWRXWOHVRXWLHQSRVVLEOH,OYDGRQFIDOORLU UHGRXEOHUGoHIIRUWVGDQVFHGRPDLQHDÚQGHSURWÂJHU OHVIHPPHV¹ULVTXHHWOHXUVQRXYHDX[QÂV
7HVWVGHGLDJQRVWLFHQOo206DUHFRPPDQGÂGH SURFÂGHU¹GHVWHVWVGHGLDJQRVWLFSRXUWRXVOHVFDV VXVSHFWÂVGHSDOXGLVPHHWFHDYDQWGoDGPLQLVWUHUOH PRLQGUHWUDLWHPHQW,OVoDJLWGoXQHYÂULWDEOHUÂYROXWLRQ GDQVODOXWWHFRQWUHOHSDOXGLVPHGoXQHSDUWRQVDLW GÂVRUPDLV GÂSLVWHU OH SDOXGLVPH HW GoDXWUH SDUW RQ QHWUDLWHSOXVTXHOHVFDVFRQÚUPÂVSDURSSRVLWLRQ¹ WRXVOHVHQIDQWVD\DQWGHODÚÁYUH&RPPHRQOoDGÂM¹ YX DYHF GoDXWUHV UHFRPPDQGDWLRQV FHWWH SROLWLTXH GHYUDLWÃWUHUDSLGHPHQWHWWRWDOHPHQWLQWÂJUÂHGDQV OHVSUDWLTXHVTXRWLGLHQQHV
*HVWLRQGHVFDVPÃPHVLOoDGRSWLRQGHODSROLWLTXH GHWUDLWHPHQWGXSDOXGLVPHSDU$&7VoHVWUDSLGHPHQW ÂWHQGXH OH GÂSORLHPHQW GH FHV FRPELQDLVRQV WKÂUDSHXWLTXHV D ÂWÂ SOXWÍW OHQW MXVTXo¹ FHV GHX[
GHUQLÁUHV DQQÂHV HW OH WDX[ GH FRXYHUWXUH D GRQF SURJUHVVÂ DX PÃPH U\WKPH 3OXVLHXUV SD\V DIULFDLQV RQW UÂFHPPHQW RSÂUÂ XQ FKDQJHPHQW GH FDSHWOHWUDLWHPHQWSDU$&7HVWHQSDVVHGHGHYHQLU XQH SUDWLTXH FRXUDQWH $GPLQLVWUHU XQ WUDLWHPHQW DSSURSULÂDX[FDVGHSDOXGLVPHFRQÚUPÂVHWDWWHLQGUH WRXWHVOHVSHUVRQQHVTXLHQRQWEHVRLQVRQWGÂVRUPDLV OHVSURFKDLQHVÂWDSHVLPSRUWDQWHVHQPDWLÁUHGHOXWWH FRQWUHOHSDOXGLVPH
sont accomplis.
(QOH3DUWHQDULDW5%0DUHSHQVÂVDYLVLRQHW UHGÂÚQL VHV REMHFWLIV HQ PDWLÁUH GH OXWWH FRQWUH OH SDOXGLVPH(QHIIHWLODGÂFLGÂGHPHWWUHGDYDQWDJH OoDFFHQW VXU OHV DFWLRQV ¹ PHQHU SRXU DWWHLQGUH OHV 20' $X FRXUV GHV GL[ GHUQLÁUHV DQQÂHV OHV EXWVHWREMHFWLIVGÂÚQLVHQPDWLÁUHGHOXWWHPRQGLDOH FRQWUHOHSDOXGLVPHRQWGÂM¹FRQQXTXDWUHUÂYLVLRQV
¹ODKDXVVH'HSOXVHQSOXVDPELWLHXVHODGHUQLÁUH GHFHVUÂYLVLRQVWÂPRLJQHGXVHQVGHOoXUJHQFHTXL QHFHVVHGHFURÇWUHDXIXUHW¹PHVXUHTXHOHVSD\V VoDSSXLHQWVXUOHXUVVXFFÁVDQWÂULHXUV
5. Pérenniser les bons résultats demande la mise en œuvre des quatre stratégies suivantes : *s’appuyer sur ce qui a déjà fait ses preuves, *anticiper sans tarder le besoin en nouvelles stratégies et en nouveaux outils, ainsi que leur développement, *s’attaquer aux menaces qui pourraient compromettre les progrès accomplis et *s’assurer que le bénéfice lié aux investissements passés ne soit pas réduit à néant par des priorités mondiales concurrentes ou contradictoires.
6oDSSX\HUVXUFHTXLDGÂM¹IDLWVHVSUHXYHVOoLPSDFW FRQVLGÂUDEOHHWUDSLGHPHQWREWHQXSDUOoLQWHQVLÚFDWLRQ GHVLQWHUYHQWLRQVGHOXWWHFRQWUHOHSDOXGLVPHDXSUÁV GHV SRSXODWLRQV D ÂWÂ ODUJHPHQW GÂPRQWUÂ 3RXU FRQWLQXHU¹SURJUHVVHUGDQVFHGRPDLQHLOHVWGRQF HVVHQWLHOGHUHQIRUFHUOHVSURFHVVXVGHSODQLÚFDWLRQ GHODPLVHHQyXYUHGHVLQWHUYHQWLRQVOHVDFKDWVOD ORJLVWLTXH OHV V\VWÁPHV GoDSSURYLVLRQQHPHQW HW OHV PÂFDQLVPHVGHJHVWLRQÚQDQFLÁUH(QSOXVGoDVVXUHU XQH FRXYHUWXUH XQLYHUVHOOH GXUDEOH HQ 0,/' HW HQ 3,' OH FDV ÂFKÂDQW LO IDXGUD VH FRQFHQWUHU SOXV SDUWLFXOLÁUHPHQWVXUOoDXJPHQWDWLRQGHODFRXYHUWXUH HQ73,SHQWHVWVGHGLDJQRVWLFHWHQWUDLWHPHQWV
$QWLFLSHU VDQV WDUGHU OH EHVRLQ HQ QRXYHOOHV VWUDWÂJLHV HW HQ QRXYHDX[ RXWLOV DLQVL TXH OHXU GÂYHORSSHPHQW OD GÂFHQQLH ¹ YHQLU ULVTXH GoÃWUH ULFKH HQ QRXYHDXWÂV ,O HVW SRVVLEOH GoHQYLVDJHU XQ YDFFLQ FRQWUH OH SDOXGLVPH D\DQW XQH HIÚFDFLWÂ SDUWLHOOHGHQRXYHDX[WHVWVGHGLDJQRVWLFGHQRXYHDX[
PÂGLFDPHQWVHWGHVFRPELQDLVRQVPÂGLFDPHQWHXVHV LQÂGLWHVGHQRXYHOOHVJÂQÂUDWLRQVGoLQVHFWLFLGHVHWGH QRXYHOOHV PÂWKRGHV GoDSSURYLVLRQQHPHQW 3RXUTXRL QHSDVDQWLFLSHUDXVVLXQUHJDLQGoHQWKRXVLDVPHSRXU ODUÂGXFWLRQGHIR\HUVGHSDOXGLVPHGHYHQDQWGHSOXV HQ SOXV FLUFRQVFULWV DÚQ GH SURJUHVVHU YHUV OHXU ÂOLPLQDWLRQ " 'DQV WRXV OHV FDV OoDFWXDOLVDWLRQ GHV SROLWLTXHV QDWLRQDOHV OoKDUPRQLVDWLRQ GHV EXGJHWV QÂFHVVDLUHPHQW DVVRFLÂV HW XQH PLVH HQ yXYUH
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352*5¡6(7,03$&7
WRXMRXUVSOXVLPSRUWDQWHDXQLYHDXORFDOVRQWDXWDQWGH GÂÚVTXHFHVRXWLOVQRXYHDX[HWÂPHUJHQWVYRQWSRVHU DX[SD\VHWDX[SDUWHQDLUHV
/oÂOLPLQDWLRQ GX SDOXGLVPH GDQV XQ QRPEUH WRXMRXUV SOXVLPSRUWDQWGHSD\VHQSUHPLHUOLHXGDQVODUÂJLRQ (XURSH GH O206 IDLW SDUWLH GHV QRXYHDX[ REMHFWLIV GX3DUWHQDULDW5%0$ORUVTXHGoDXWUHVSD\VÚQLVVHQW GoLQWHQVLÚHU OHXUV LQWHUYHQWLRQV GH OXWWH FRQWUH OH SDOXGLVPHOHVSURFKDLQHVÂWDSHVGXSURJUDPPHYRQW QÂFHVVLWHUXQHÂWXGHPLQXWLHXVHGHVVWUDWÂJLHVHWGHV RXWLOVDFWXHOVHW¹YHQLUHQYXHGHUÂGXLUHGDYDQWDJH ODWUDQVPLVVLRQVXUODYRLHGHODSUÂÂOLPLQDWLRQSXLV GHOoÂOLPLQDWLRQ6oDJLVVDQWGXFRQWUÍOHGXSDOXGLVPH OHV SURJUÁV IXWXUV UHSRVHURQW VXU FHV VWUDWÂJLHV DFWXDOLVÂHV (Q HIIHW HOOHV EDOLVHQW OHV DFWLRQV GH GHPDLQHWSHUPHWWHQWGDOOHUSOXVYLWHHQVoDSSX\DQW VXUOHVVXFFÁVGoDXMRXUGoKXL
6oDWWDTXHUDX[PHQDFHVTXLSRXUUDLHQWFRPSURPHWWUH OHVSURJUÁVDFFRPSOLVSOXVLHXUVPHQDFHVSÁVHURQW VXU OD OXWWH FRQWUH OH SDOXGLVPH QRWDPPHQWL XQH HIÚFDFLWÂGÂFOLQDQWHGHVRXWLOVLLOHVGÂÚVLQKÂUHQWV DXVRXWLHQGHJUDQGVSD\VHWGHSD\VFRPSOH[HVTXLHQ VRQWHQFRUHDXGÂEXWGHOHXUVHIIRUWVGoLQWHQVLÚFDWLRQ GHSD\VLQVWDEOHVSROLWLTXHPHQWRXGHSD\VTXLVRQW OHWK»WUHGH]RQHVGHFRQÛLWLLLOHUHQIRUFHPHQWGHV V\VWÁPHVGoLQWHQVLÚFDWLRQHWGHPDLQWLHQGHVHIIRUWV LYOHVRXWLHQ¹GHVSD\VFKHUFKDQW¹UÂGXLUHSOXVHQFRUH OD WUDQVPLVVLRQ GX SDOXGLVPH DÚQ GH FRPPHQFHU OH WUDYDLO GH SUÂÂOLPLQDWLRQ RX GoÂOLPLQDWLRQ HWY OD FDSDFLW¹DLGHUOHVSD\VFRPPHLOÂWDLWSUÂYXGDQV XQFRQWH[WHGHÛXFWXDWLRQGHVUHVVRXUFHVGLVSRQLEOHV SRXUODVDQWÂPRQGLDOH
6oDVVXUHU TXH OH EÂQÂÚFH OLÂ DX[ LQYHVWLVVHPHQWV SDVVÂ QH VRLW SDV UÂGXLW ¹ QÂDQW SDU GHV SULRULWÂV PRQGLDOHV FRQFXUUHQWHV RX FRQWUDGLFWRLUHV OD OXWWH FRQWUH OH SDOXGLVPH FRQVWLWXH XQ H[FHOOHQW LQYHVWLVVHPHQW3RXUSOXVLHXUVPLOOLRQVGHPÂQDJHVHW GDQVOHFDGUHGHODSOXSDUWGHVSURJUDPPHVQDWLRQDX[
GHOXWWHFRQWUHOHSDOXGLVPHLOHVWDXMRXUGoKXLQRUPDO GoHVSÂUHU GRUPLU VRXV 0,, HW GH EÂQÂÚFLHU GoXQH 3,' 0DOJUÂ WRXW LO VXIÚUDLW TXH OHV HQJDJHPHQWV ÚQDQFLHUVGLPLQXHQWOÂJÁUHPHQWSRXUTXHOHVSURJUÁV UHPDUTXDEOHV DFFRPSOLV MXVTXoLFL VRLHQW UÂGXLWV ¹ QÂDQW /HV SDUWHQDLUHV 5%0 GRLYHQW GRQF FRQWLQXHU
¹ REWHQLU GHV UÂVXOWDWV HW ¹ OHV FRPPXQLTXHU DX[
GÂFLGHXUVGXVHFWHXUGHODVDQWÂHWDXGHO¹GHWHOOH VRUWH TXoLO VRLW LQFRQFHYDEOH GH UÂGXLUH OH VRXWLHQ
¹ODOXWWHFRQWUHOHSDOXGLVPH$XPÃPHWLWUHTXHOD YDFFLQDWLRQ PRQGLDOH FHV LQWHUYHQWLRQV HVVHQWLHOOHV HW H[WUÃPHPHQW HIÚFDFHV OLÂHV ¹ OD VXUYLH LQIDQWLOH GRLYHQW LPSÂUDWLYHPHQW FRQVHUYHU OHXU FDUDFWÁUH SULRULWDLUH HW XQLTXH GH VRUWH TXoHOOHV VRLHQW DFFHVVLEOHVDX[SOXVGÂPXQLVHWDX[SRSXODWLRQVOHV SOXVUXUDOHVHWPDUJLQDOLVÂHV
/oLPSXOVLRQ GHV SROLWLTXHV VXUWRXW GDQV OHV SD\V HQGÂPLTXHV VHUD LQGLVSHQVDEOH SRXU FRQVHUYHU OHV DFTXLV HW SRXU PDLQWHQLU OD OXWWH FRQWUH OH SDOXGLVPHFRPPHXQHSULRULWÂVXUOoDJHQGDQDWLRQDO HWLQWHUQDWLRQDO5ÂFHPPHQWODFUÂDWLRQGHOo$/0$
XQHFRDOLWLRQGHFKHIVGo¢WDWDIULFDLQVGÂFLGÂV¹ UÂGXLUH¹]ÂUROHQRPEUHGHGÂFÁVGXVDXSDOXGLVPH UHSUÂVHQWH XQH RSSRUWXQLWÂ VDQV SUÂFÂGHQW GH PDLQWHQLU OH QLYHDX GHV LQYHVWLVVHPHQWV FRQVHQWLV MXVTXoLFL
$PELWLRQ8QPRQGHOLEÂUÂGXIDUGHDXGXSDOXGLVPH 2EMHFWLI5ÂGXLUHSUDWLTXHPHQW¹]ÂUROHQRPEUHGH
GÂFÁVGXVDXSDOXGLVPHGDQVOHPRQGHGoLFL ÚQ
2EMHFWLI5ÂGXLUHGHSDUUDSSRUW¹OoDQOH QRPEUHGHFDVGHSDOXGLVPHGDQVOHPRQGH GoLFLÚQ
2EMHFWLI¢OLPLQHU OH SDOXGLVPH GoLFL GDQV GL[
SD\VVXSSOÂPHQWDLUHVSDUUDSSRUW¹ HWGDQVODUÂJLRQ(XURSHGHOo206
&LEOHV$WWHLQGUH OoDFFÁV HW OoXWLOLVDWLRQ XQLYHUVHOV GHV PHVXUHV GH SUÂYHQWLRQ PDLQWHQLU OoDFFÁV HW OoXWLOLVDWLRQ XQLYHUVHOV GHV PHVXUHV GH SUÂYHQWLRQ DFFÂOÂUHU OH GÂYHORSSHPHQW GHV V\VWÁPHV GH VXUYHLOODQFH DWWHLQGUH OD FRXYHUWXUH XQLYHUVHOOH HQ PDWLÁUH GH SULVH HQ FKDUJH GHV FDV GDQV OH VHFWHXU SXEOLFDWWHLQGUHODFRXYHUWXUHXQLYHUVHOOHHQPDWLÁUH GH SULVH HQ FKDUJH GHV FDV GDQV OH VHFWHXU SULYÂ RX GoRULHQWDWLRQ DSSURSULÂH YHUV GHV VHUYLFHV VSÂFLDOLVÂV DWWHLQGUH OD FRXYHUWXUH XQLYHUVHOOH HQ PDWLÁUHGHSULVHHQFKDUJHFRPPXQDXWDLUHGHVFDVGH SDOXGLVPH
Vision, objectifs et cibles du Partenariat RBM, tels que redéfinis en 2011
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352*5¡6(7,03$&7
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352
&+$3,75(,
LE PALUDISME : CARTOGRAPHIE MONDIALE ET STRATÉGIES D’INTERVENTION
'PNGRCNWFKUOGEQPUVKVWCKVWPRTQDNÄOGFGUCPVÅRWDNKSWGOCLGWTQOPKRTÅUGPVFCPUNCSWCUKVQVCNKVÅ FGU\QPGUVTQRKECNGU/CNCFKGGPFÅOKSWGFCPURNWUFGRC[UKNÅVCKVWPXÅTKVCDNGƝÅCWGP#HTKSWG UWDUCJCTKGPPGTÅIKQPFCPUNCSWGNNGÅVCKGPVTGEGPUÅUNCOCLQTKVÅFGUECUGVFGUFÅEÄU&GRWKUNQTUFG PQODTGWZRC[UQPVHCKVFGURTQITÄUEQPUKFÅTCDNGUFCPUNGFQOCKPGFGNCNWVVGCPVKRCNWFKSWG¼UCXQKT SWoKNUQPVTÅFWKVNCVTCPUOKUUKQPFGHCÃQPUWDUVCPVKGNNGQPVFKOKPWÅNGWTVCWZFGOQTDKFKVÅGVFGOQTVCNKVÅ CUUQEKÅGUGVRQWTVTQKUFoGPVTGGWZQPVÅNKOKPÅNCOCNCFKG2QWTVCPVKNTGUVGGPEQTGFGPQODTGWZRTQITÄU
¼HCKTG.GRCNWFKUOGGUVWPGOGPCEGSWKRÄUGUWTSWGNSWGOKNNKCTFUFGRGTUQPPGUUWTNCRNCPÄVGKNGUV TGURQPUCDNGFGFGUFÅEÄUKPHCPVKNGU¼NoÅEJGNNGOQPFKCNGGVUWTNGUGWNEQPVKPGPVCHTKECKPQÕ NGUKPHGEVKQPUNCOQTDKFKVÅGVNCOQTVCNKVÅCVVGKIPGPVNGUPKXGCWZNGURNWUÅNGXÅU
/DÚJXUHLOOXVWUHODFDUWRJUDSKLHGHOoHQGÂPLFLWÂGX SDOXGLVPH¹3ODVPRGLXPIDOFLSDUXPFDXVHGHPDODGLH ODSOXVVÂYÁUHHW¹3ODVPRGLXPYLYD[VHFRQGWDX[GH SUÂYDOHQFH GH OD SDUDVLWÂPLH SDOXVWUH /D SOXSDUW GHVFDVGHPRUELGLWÂVÂYÁUHHWGHPRUWDOLWÂOLÂHVDX SDOXGLVPHÂWDQWGXV¹XQHLQIHFWLRQ¹3IDOFLSDUXP
FH UDSSRUW WUDLWH HVVHQWLHOOHPHQW GH FH SDUDVLWH HW GH OD ]RQH JÂRJUDSKLTXH RÒ OD WUDQVPLVVLRQ HVW OD SOXVLQWHQVH&HWWH]RQHUHSUÂVHQWH¹HOOHVHXOHSOXV GH GX IDUGHDX PRQGLDO GX SDOXGLVPH $IULTXH VXEVDKDULHQQH
)LJXUH
Répartition mondiale du risque de paludisme à Plasmodium falciparum et Plasmodium vivax
/DWUDQVPLVVLRQSDU3IDOFLSDUXPGRPLQHSDUPLOHVSRSXODWLRQVGHWRXWHOo$IULTXHVXEVDKDULHQQHDORUVTXHOHVGHX[SDUDVLWHV 3IDOFLSDUXPHW3YLYD[VRQWSUÂVHQWVSDUWRXWDLOOHXUV
6RXUFH3URMHWGoDWODVGXSDOXGLVPH
Transmission faible, incidence parasitaire annuelle (IPA) < 0,1 % Faible susceptibilité au parasite P. vivax
Sans paludisme
Transmission élevée, IPA
≥
0,1 %2NCUOQFKWOHCNEKRCTWO
2NCUOQFKWOXKXCZ
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352*5¡6(7,03$&7
/HVMHXQHVHQIDQWVLVVXVGHVFRPPXQDXWÂVUXUDOHV GÂPXQLHV VRQW OH SOXV ¹ ULVTXH GH FRQWUDFWHU OH SDOXGLVPHHWGHVRXIIULUGHVHIIHWVOHVSOXVJUDYHVGH ODPDODGLH$XMRXUGoKXLHQFRUHPDOJUÂOoDPÂOLRUDWLRQ GH OD OXWWH DQWLSDOXGLTXH OHV WDX[ OHV SOXV ÂOHYÂV GoLQIHFWLRQSDOXVWUHGHPRUELGLWÂHWGHPRUWDOLWÂVRQW
FRQVWDWÂVSDUPLFHVFRPPXQDXWÂVSDXYUHVYLYDQWHQ PLOLHXUXUDOFIÚJXUH,OHVWGRQFHVVHQWLHOTXHOHV SURJUDPPHVDQWLSDOXGLTXHVDWWHLJQHQWOHVSRSXODWLRQV OHVSOXV¹ULVTXHHWDVVXUHQWXQHUÂSDUWLWLRQÂTXLWDEOH GHVVHUYLFHVHWGHOHXUDFFHVVLELOLWÂ
)LJXUH
Pourcentage d’enfants de 6 à 59 mois vivant dans les zones urbaines et rurales, et souffrant d’une infection palustre confirmée en laboratoire, analyse dans dix pays africains sur la période 2007–2010
/HSDOXGLVPHQoHVWSDVXQHPDODGLHÂTXLWDEOH(Q$IULTXHOHWDX[GoLQIHFWLRQFKH]OHVMHXQHVHQIDQWVHVWVRXYHQWDXPRLQV GHX[IRLVVXSÂULHXUGDQVOHV]RQHVUXUDOHVSDUUDSSRUWDX[]RQHVXUEDLQHVHWOHVGLIIÂUHQFHVLQÂJDOLWÂVWHQGHQW¹VoDFFURÇWUH DXIXUHW¹PHVXUHTXHOoLQWHQVLWÂJOREDOHGHODWUDQVPLVVLRQDXJPHQWH
D5ÂIÂUHQFH¹GHVLQIHFWLRQVSDOXVWUHVGÂWHFWÂHVSDUXQ7'5WRXVOHVDXWUHVFDVÂWDQWGÂWHUPLQÂVSDUPLFURVFRSLH E5ÂIÂUHQFH¹GHVHQTXÃWHVPHQÂHVVXUGHVHQIDQWV»JÂVGH¹PRLV
6RXUFH('6HW(,3SRXUsLQFOXDQWOHGÂSLVWDJHGHVLQIHFWLRQVSDOXVWUHV
0 10 20 30 40 50 60 70 80 90 100
Taux de parasitémie (%)
Malawi 2010
Ouganda 2009 (b)
Mozambique 2007
Libéria 2008-2009
Angola 2006-2007 (a)
République-Unie de Tanzanie 2007-2008 (a)
Zambie 2010
Sénégal 2008-2009
Rwanda 2007-2008
Éthiopie 2007
Djibouti 2008-2009 (a)
Zones rurales Total Zones urbaines
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352*5¡6(7,03$&7
Encadré 1 - Interventions de lutte contre le paludisme
,O H[LVWH DXMRXUGoKXL SOXVLHXUV LQWHUYHQWLRQV DQWLSDOXGLTXHVH[WUÃPHPHQWHIÚFDFHVHWDSSOLTXÂHV
¹JUDQGHÂFKHOOHGDQVOHVUÂJLRQVHQGÂPLTXHV/XWWHU FRQWUHOHSDOXGLVPHFRQVLVWH¹SUÂYHQLUOoLQIHFWLRQ¹ VRXPHWWUHOHVFDVVXVSHFWÂVGHSDOXGLVPH¹XQWHVW GH GLDJQRVWLF UDSLGH HW ¹ DGPLQLVWUHU XQ WUDLWHPHQW HIÚFDFH XQH IRLV OoLQIHFWLRQ FRQÚUPÂH ,O HVW FODLU TXoXQHSUÂYHQWLRQHIÚFDFHGRLWFRQVWLWXHUXQHSULRULWÂ FDU HOOH SHUPHW GH OLPLWHU OD PDODGLH HW GH UÂGXLUH GH IDÀRQ FRQVLGÂUDEOH OHV EHVRLQV HQ WUDLWHPHQW 7RXWHIRLV OoLQWHQVLWÂ GH OD WUDQVPLVVLRQ HVW WHOOH GDQV FHUWDLQHV UÂJLRQV HQGÂPLTXHV QRWDPPHQW HQ $IULTXH TXH OD SRSXODWLRQ HVW H[SRVÂH ¹ XQH SLTÔUHGHPRXVWLTXHLQIHFWÂFKDTXHQXLWRXSUHVTXH 3RXU UÂGXLUH OD IUÂTXHQFH GX ULVTXH GH SLTÔUH SRWHQWLHOOHPHQWLQIHFWLHXVH¹XQHVHXOHWRXVOHVWURLV
¹TXDWUHPRLVOHVPHVXUHVSUÂYHQWLYHVGRLYHQWGLYLVHU OHV QLYHDX[ GH WUDQVPLVVLRQ SDU 3DU FKDQFH LO VHPEOH TXH OoDVVRFLDWLRQ GHV RXWLOV SUÂYHQWLIV HW WKÂUDSHXWLTXHVGLVSRQLEOHVVRLWHQPHVXUHGHJDUDQWLU XQHWHOOHUÂGXFWLRQGHODWUDQVPLVVLRQHWGHVSURJUÁV FRQVLGÂUDEOHVVRQWUÂDOLVÂVDXMRXUGKXLPÃPHGDQV OHVUÂJLRQV¹WUDQVPLVVLRQÂOHYÂH
/DSUÂYHQWLRQLPSRVHGHVoLQWÂUHVVHU¹OoLQWHUDFWLRQ HQWUHOHPRXVWLTXHGHW\SHDQRSKÁOHHWOoKRPPH/H PRXVWLTXHIHPHOOHDJÂQÂUDOHPHQWEHVRLQGoXQUHSDV VDQJXLQWRXVOHVWURLVMRXUVSRXUGLVSRVHUGHVSURWÂLQHV HWGHOoÂQHUJLHQÂFHVVDLUHV¹ODIRUPDWLRQSXLV¹OD SRQWHGHVHVyXIV/RUVTXoLOSDUYLHQW¹SLTXHUXQÃWUH KXPDLQOHPRXVWLTXHIHPHOOHUHPSOLWVRQDEGRPHQGH VDQJ,OSÁVHDORUVSOXVLHXUVIRLVVRQSRLGVQRUPDOHWLO OXLIDXWGRQFWURXYHUXQHQGURLWSURFKHSRXUGLJÂUHU/H PRXVWLTXHGHW\SHDQRSKÁOHDSSUÂFLHSDUWLFXOLÁUHPHQW OHVVXUIDFHVYHUWLFDOHVVLWXÂHVGDQVXQHQGURLWFKDXG VRPEUH KXPLGH HW SURWÂJÂ FRPPH XQ PXU RX XQ ULGHDX ¹ OoLQWÂULHXU GoXQH PDLVRQ 8QH IRLV TXoLO D GLJÂUÂVRQUHSDVVDQJXLQLOSDUW¹ODUHFKHUFKHGoXQ SRLQWGoHDX¹SUR[LPLWÂVXVFHSWLEOHGoDEULWHUVHVyXIV /HVSDUDVLWHVGXSDOXGLVPHLQJÂUÂVSDUXQPRXVWLTXH GRLYHQWVHGÂYHORSSHUSHQGDQWSOXVGHGL[MRXUVDYDQW TXHOHPRXVWLTXHQHSXLVVHWUDQVPHWWUHOoLQIHFWLRQ¹ XQ DXWUH ÃWUH KXPDLQ 6L OHV PHVXUHV GH SUÂYHQWLRQ UÂGXLVHQW OD VXUYLH GHV PRXVWLTXHV ¹ PRLQV GH
GL[ MRXUV OD WUDQVPLVVLRQ SHXW ÃWUH LQWHUURPSXH
&RPPH OD PDMRULWÂ GHV PRXVWLTXHV YHFWHXUV GX SDOXGLVPHHQ$IULTXHSLTXHQWSHQGDQWODQXLWHWFRPPH LOV VH UHSRVHQW ¹ OoLQWÂULHXU GHV KDELWDWLRQV DSUÁV VoÃWUHQRXUULVODOXWWHDQWLYHFWRULHOOHSDUOHELDLVGHV 0,,HWGHV3,'HVWWUÁVHIÚFDFH
3UÂYHQWLRQ
0RXVWLTXDLUHVLPSUÂJQÂHVGoLQVHFWLFLGHODSOXSDUW GHV0,,IDEULTXÂHVDXMRXUGoKXLVRQWGHV0,/'D\DQW VXEL XQ SUÂWUDLWHPHQW DYHF XQ LQVHFWLFLGH (OOHV QH QÂFHVVLWHQWDXFXQDXWUHWUDLWHPHQWDXFRXUVGHOHXU GXUÂHGHYLHJÂQÂUDOHPHQWHVWLPÂH¹WURLVDQVPÃPH VLHOOHYDULHGHIDÀRQFRQVLGÂUDEOH/oXQHGHVPÂWKRGHV GHSUÂYHQWLRQGXSDOXGLVPHOHVSOXVHIÚFDFHVFRQVLVWH
¹ GRUPLU VRXV 0,, /oXWLOLVDWLRQ UÂJXOLÁUH GH 0,, D SURXYÂVRQHIÚFDFLWÂHQUÂGXLVDQWOHVGÂFÁVLQIDQWLOHV GoHQYLURQVHORQOHVHVWLPDWLRQVGDQVOHVUÂJLRQV HQGÂPLTXHV 'HV GRQQÂHV UÂFHQWHV VXJJÁUHQW PÃPH OD SRVVLELOLWÂ GoXQH EDLVVH SOXV LPSRUWDQWH GH OD PRUWDOLWÂ /RUVTXoXQ PRXVWLTXH HVVDLH GH SLTXHU XQH SHUVRQQH GRUPDQW VRXV PRXVWLTXDLUH LO VHSRVHVXUOHVPDLOOHVGHODPRXVWLTXDLUHHQWUHHQ FRQWDFW DYHF OoLQVHFWLFLGH HW PHXUW SHX DSUÁV 'HV HVVDLVVFLHQWLÚTXHVFRQWUÍOÂVGDQVGLIIÂUHQWHV]RQHV SUÂVHQWDQW GHV ULVTXHV GH WUDQVPLVVLRQ GLIIÂUHQWV GHIDLEOHV¹WUÁVÂOHYÂVRQWPRQWUÂOHVEÂQÂÚFHVGH OoÂOLPLQDWLRQGHVPRXVWLTXHV¹VDYRLUODUÂGXFWLRQGH ODWUDQVPLVVLRQHWXQHDXJPHQWDWLRQGXWDX[GHVXUYLH LQIDQWLOH (Q RXWUH ORUVTXoXQH SDUWLH LPSRUWDQWH GH ODFRPPXQDXWÂXWLOLVHGHV0,,FHVGHUQLÁUHVRQWXQ FHUWDLQ HIIHW SURWHFWHXU SRXU OHV PÂQDJHV TXL QoHQ XWLOLVHQW SDV HW TXL YLYHQW ¹ SUR[LPLWÂ GH FHX[ TXL OHV XWLOLVHQW &HFL HVW SUREDEOHPHQW GÔ ¹ OD IDLEOH SURSRUWLRQ GH PRXVWLTXHV IHPHOOHV TXL VXUYLYHQW DVVH]ORQJWHPSVSRXUWUDQVPHWWUHOHSDOXGLVPH3RXU ÃWUHHIÚFDFHVOHV0,,GRLYHQWÃWUHLPSUÂJQÂHVGoXQ LQVHFWLFLGHGHTXDOLWÂHWÃWUHXWLOLVÂHVUÂJXOLÁUHPHQW
OoRULJLQH OHV 0,, ÂWDLHQW GHVWLQÂHV DX[ JURXSHV
¹ ULVTXH ÂOHYÂ TXH VRQW OHV MHXQHV HQIDQWV HW OHV IHPPHV HQFHLQWHV 'ÁV ORUV TXoRQ D FRPPHQFÂ ¹ PLHX[ FRPSUHQGUH OH ULVTXH GH SDOXGLVPH DX VHLQ
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352*5¡6(7,03$&7
GHODSRSXODWLRQHWTXHOHVUHVVRXUFHVRQWDXJPHQWÂ HQPDWLÁUHGHSUÂYHQWLRQGXSDOXGLVPHRQDÚQLSDU DGPHWWUHTXHODFRXYHUWXUHXQLYHUVHOOHGHVPÂQDJHV HQ0,,FRQVWLWXDLWXQHDSSURFKHMXGLFLHXVHGoXQSRLQW GH YXH VFLHQWLÚTXH 'DQV OHV UÂJLRQV HQGÂPLTXHV OHV UHFRPPDQGDWLRQV DFWXHOOHV GH Oo206 VWLSXOHQW TXH OoHQVHPEOH GH OD SRSXODWLRQ GRLW GRUPLU VRXV 0,, SHQGDQW OD RX OHV VDLVRQV GH WUDQVPLVVLRQ GX SDOXGLVPH$XVHLQGHVPÂQDJHVQHGLVSRVDQWSDVGoXQ QRPEUHVXIÚVDQWGHPRXVWLTXDLUHVOHVMHXQHVHQIDQWV HW OHV IHPPHV HQFHLQWHV GRLYHQW ÃWUH SULRULWDLUHV ,O HVWSDUDLOOHXUVHVVHQWLHOGoXWLOLVHUOD0,,FKDTXHQXLW GH VRUWH TXH OHV PRXVWLTXHV LQIHFWLHX[ HQWUHQW HQ FRQWDFWDYHFOoLQVHFWLFLGH(QÚQHWFRPPHPHQWLRQQÂ SUÂFÂGHPPHQWLOHVWELHQVÔUSUÂIÂUDEOHTXHWRXVOHV PHPEUHVGXPÂQDJHGRUPHQWVRXV0,,
3XOYÂULVDWLRQLQWUDGRPLFLOLDLUHGoLQVHFWLFLGHV¹HIIHW UÂPDQHQWOD3,'FRQVLVWH¹DSSOLTXHUXQLQVHFWLFLGH ORQJXHGXUÂHVXUOHVPXUVLQWÂULHXUVGHVKDELWDWLRQV HW GHV DXWUHV VWUXFWXUHV XWLOLVÂHV SRXU GRUPLU DÚQ GH WXHU OHV PRXVWLTXHV ORUVTXoLOV Vo\ SRVHQW &HWWH DSSURFKHGHSUÂYHQWLRQGXSDOXGLVPHHVWH[WUÃPHPHQW HIÚFDFHGDQVOHV]RQHVRÒHOOHHVWDSSURSULÂHVXUOH SODQ ÂSLGÂPLRORJLTXH HW ORJLVWLTXH /D SXOYÂULVDWLRQ GRLW ÃWUH HIIHFWXÂH DYDQW OH GÂEXW GH OD VDLVRQ GH WUDQVPLVVLRQXQHRXGHX[IRLVSDUDQVoLOH[LVWHXQH VDLVRQFRQWLQXHRXSOXVLHXUVVDLVRQVGHWUDQVPLVVLRQ SDUXQHÂTXLSHGoRXYULHUVTXDOLÚÂVTXLVHGÂSODFHQW DX VHLQ GH OD FRPPXQDXWÂ SRXU WUDLWHU WRXWHV OHV VWUXFWXUHVDSSURSULÂHV&HWWHSURFÂGXUHHVWIDFLOLWÂH VLOHVKDELWDWLRQVVRQWSURFKHVOHVXQHVGHVDXWUHV FRPPHGDQVOHV]RQHVXUEDLQHVRXSÂULXUEDLQHV(Q RXWUHDÚQGHUÂGXLUHODSUROLIÂUDWLRQGHVPRXVWLTXHV UÂVLVWDQW DX[ LQVHFWLFLGHV OHV SURJUDPPHV GH 3,' GRLYHQWXWLOLVHUGHVLQVHFWLFLGHVGLIIÂUHQWV¹FKDTXH F\FOHGHSXOYÂULVDWLRQ
7UDLWHPHQW SUÂYHQWLI LQWHUPLWWHQW SHQGDQW OD JURVVHVVHDVVRFL¹OoXWLOLVDWLRQUÂJXOLÁUHGH0,,OH 73,SHVWHVVHQWLHO¹ODSUÂYHQWLRQGXSDOXGLVPHFKH]
OHVIHPPHVHQFHLQWHVGDQVOHVUÂJLRQVHQGÂPLTXHV /HWUDLWHPHQWVHFRPSRVHGoDXPRLQVGHX[GRVHVGoXQ PÂGLFDPHQW DQWLSDOXGLTXH HIÚFDFH DGPLQLVWUÂHV DXFRXUVGHVGHX[LÁPHHWWURLVLÁPHWULPHVWUHVGHOD JURVVHVVH /D PLVH HQ yXYUH GH FHWWH LQWHUYHQWLRQ UÂGXLW FRQVLGÂUDEOHPHQW OH WDX[ GH SDOXGLVPH SODFHQWDLUH HW GoDQÂPLH OLÂH DX SDOXGLVPH FKH] OHV
IHPPHVHQFHLQWHVDLQVLTXHOHQRPEUHGHQDLVVDQFHV SUÂPDWXUÂHV HW GH QRXYHDX[QÂV GH IDLEOH SRLGV GH QDLVVDQFH$XMRXUGoKXLODVXOIDGR[LQHS\ULPÂWKDPLQH HVWFRQVLGÂUÂHFRPPHXQPÂGLFDPHQWVÔUHWDSSURSULÂ SRXUOHWUDLWHPHQWLQWHUPLWWHQWSHQGDQWODJURVVHVVH GDQVOHVUÂJLRQVHQGÂPLTXHV
'LDJQRVWLFHWWUDLWHPHQW
'LDJQRVWLF HW WUDLWHPHQW UDSLGHV HW HIÚFDFHV GX SDOXGLVPHXQWHVWGHFRQÚUPDWLRQGXGLDJQRVWLFHWXQ WUDLWHPHQWUDSLGHVGHSUÂIÂUHQFHGDQVOHVKHXUHV VXLYDQW OoDSSDULWLRQ GHV V\PSWÍPHV SDU XQ DJHQW DQWLSDOXGLTXH HIÚFDFH VRQW QÂFHVVDLUHV SRXU ÂYLWHU GHV FRPSOLFDWLRQV SRWHQWLHOOHPHQW PRUWHOOHV $YDQW WRXW WUDLWHPHQW Oo206 UHFRPPDQGH XQ GLDJQRVWLF VWDQGDUG SDU PLFURVFRSLH RX OoXWLOLVDWLRQ GoXQ 7'5 GHTXDOLWÂJDUDQWLHSRXUFRQÚUPHUOHGLDJQRVWLFGXQ FDVGHSDOXGLVPH/HV$&7VRQWUHFRPPDQGÂVSRXUOH WUDLWHPHQWGHVLQIHFWLRQVFRQÚUPÂHV¹3IDOFLSDUXP VDQV FRPSOLFDWLRQV PDLV OD FKORURTXLQH UHVWH WUÁV HIÚFDFHSRXUODSOXSDUWGHVLQIHFWLRQV¹3YLYD[
/H WHVW GH GLDJQRVWLF HW OH WUDLWHPHQW UDSLGHV GX SDOXGLVPH VRXOÁYHQW TXHOTXHV TXHVWLRQV 3UHPLÁUHPHQW GH QRPEUHXVHV SHUVRQQHV DWWHLQWHV GH SDOXGLVPH WDUGHQW ¹ FRQVXOWHU HW EHDXFRXS VH IRQW VRLJQHU HQ GHKRUV GHV VWUXFWXUHV GH VDQWÂ IRUPHOOHV/HVSURJUDPPHVGRLYHQWGRQFÂWXGLHUOHV SRVVLELOLWÂVGoLGHQWLÚFDWLRQHWGHWUDLWHPHQWGHVFDV GHSDOXGLVPHO¹RÒOHSDWLHQWVHSUÂVHQWHSDUH[HPSOH DXSUÁV GHV DJHQWV GH VDQWÂ FRPPXQDXWDLUHV RX GX VHFWHXU SULYÂ IRUPHO RX LQIRUPHO 'HX[LÁPHPHQW OHVFDVGHÚÁYUHIDLVDLHQWHQFRUHUÂFHPPHQWOoREMHW GoXQWUDLWHPHQWSDUSUÂVRPSWLRQGXSDOXGLVPHHWGH QRPEUHX[SURJUDPPHVQDWLRQDX[HWSUHVWDWDLUHVGH VDQWÂ DVVLPLODLHQW OD ÚÁYUH FKH] OHV HQIDQWV ¹ GHV FDV GH SDOXGLVPH &HSHQGDQW DYHF ODXJPHQWDWLRQ GH OD SUÂYHQWLRQ GX SDOXGLVPH HW XQ PHLOOHXU DFFÁV DX[WHVWVGHGLDJQRVWLFFHWWHSUDWLTXHHVWGÂVRUPDLV FRQVLGÂUÂH FRPPH LQHIÚFDFH HW DVVLPLOÂH ¹ XQ VXUWUDLWHPHQW GX SDOXGLVPH (Q RXWUH OH WUDLWHPHQW GH OD ÚÁYUH SDU SUÂVRPSWLRQ QoHVW SDV DSSURSULÂ DX[ SDWLHQWV QRQ DWWHLQWV GH SDOXGLVPH OHVTXHOV QÂFHVVLWHQWXQWUDLWHPHQWWKÂUDSHXWLTXHGLIIÂUHQW/H GLDJQRVWLFGXSDOXGLVPHSDUPLFURVFRSLHRX7'5HVW GRQFMXJÂHVVHQWLHO
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352*5¡6(7,03$&7
(QÚQOoHIÚFDFLWÂGHVPÂGLFDPHQWVDQWLSDOXGLTXHVHVW SULPRUGLDOH/HVSDUDVLWHVGXSDOXGLVPHVRQWGHSXLV ORQJWHPSV FDSDEOHV GH GÂYHORSSHU XQH UÂVLVWDQFH DX[ PÂGLFDPHQWV DQWLSDOXGLTXHV FH TXL PHQDFH OoHIÚFDFLWÂ GHV LQWHUYHQWLRQV /HV SURJUDPPHV GRLYHQW VH EDVHU VXU OHV RXWLOV GH GLDJQRVWLF SRXU OLPLWHUOoXWLOLVDWLRQGHPÂGLFDPHQWVDQWLSDOXGLTXHV¹ FHX[TXLHQRQWYUDLPHQWEHVRLQHWVXUYHLOOHUOHIIHW GHVPÂGLFDPHQWVDXÚOGXWHPSVSRXUVDVVXUHUTXLOV XWLOLVHQWOHVSOXVHIÚFDFHV
$XWUHVLQWHUYHQWLRQV
6XUYHLOODQFH UHFKHUFKH GHV FDV GÂWHFWLRQ GHV LQIHFWLRQVHWUÂGXFWLRQGHODWUDQVPLVVLRQ¹PHVXUH TXH OHV SD\V SURJUHVVHQW HQ PDWLÁUH GH SUÂYHQWLRQ HW GH FRQWUÍOH GX SDOXGLVPH LOV SHXYHQW UÂGXLUH GH IDÀRQFRQVLGÂUDEOHODWUDQVPLVVLRQGHODPDODGLHHW SDUFRQVÂTXHQWOHQRPEUHGHFDV'DQVFHFRQWH[WH XQGÂSLVWDJHDFWLIGHVLQIHFWLRQVSDOXVWUHVUHVWDQWHV QRQ VHXOHPHQW OHV FDV PDLV DXVVL OHV LQIHFWLRQV DV\PSWRPDWLTXHV VHUD WUÁV FHUWDLQHPHQW OH PR\HQ HIÚFDFHHWQÂFHVVDLUHGHUÂGXLUHHQFRUHGDYDQWDJH OD WUDQVPLVVLRQ &HWWH DSSURFKH D ÂWÂ XWLOLVÂH DYHF
VXFFÁV GDQV OHV DQQÂHV HW GDQV OH FDGUH GX 3URJUDPPH PRQGLDO GoÂUDGLFDWLRQ GX SDOXGLVPH
*0(3 GH Oo206 FI FLGHVVRXV HW HOOH VoDYÁUH ¹ QRXYHDXSHUWLQHQWHSRXUOHVSD\VTXLVRQWDXMRXUGoKXL HQURXWHYHUVOoÂOLPLQDWLRQGXSDOXGLVPH'HVSODQVGH PLVHHQyXYUHGHFHVQRXYHOOHVLQWHUYHQWLRQVGRLYHQW ÃWUHÂODERUÂVDXSOXVWÍWGHIDÀRQ¹ÃWUHRSÂUDWLRQQHOV OHPRPHQWYHQX
%LHQTXoLOH[LVWHGoDXWUHVLQWHUYHQWLRQVDQWLSDOXGLTXHV OHXU DGRSWLRQ SDU OHV SURJUDPPHV QDWLRQDX[ QoHVW SDV UHFRPPDQGÂH SDU OD FRPPXQDXWÂ GDQV VRQ HQVHPEOH 3DU H[HPSOH OoXWLOLVDWLRQ GHV UÂSXOVLIV DQWLPRXVWLTXHVSHXWUÂGXLUHODIUÂTXHQFHGHVSLTÔUHV PDLVFHWWHLQWHUYHQWLRQHVWVXUWRXWFRQVLGÂUÂHFRPPH XQHLQLWLDWLYHLQGLYLGXHOOH'HPÃPHOoDSSOLFDWLRQGH ODUYLFLGHVVXUOHV]RQHVGHUHSURGXFWLRQGHVPRXVWLTXHV SHXW SUÂYHQLU GH PDQLÁUH HIÚFDFH OoDSSDULWLRQ GH QRXYHDX[ PRXVWLTXHV 7RXWHIRLV OD IUÂTXHQFH GDSSOLFDWLRQVUHTXLVHSDUFHWWHLQWHUYHQWLRQOHFRÔW KXPDLQHWÚQDQFLHUDVVRFLÂHWOHQRPEUHGH]RQHV¹ WUDLWHUQHUHQGHQWFHWWHDSSURFKHSHUWLQHQWHTXHGDQV TXHOTXHVHQGURLWVWUÁVORFDOLVÂV
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352*5¡6(7,03$&7
',;$16'(3$57(1$5,$7(75¢68/7$76&2//(&7,21352
