Regional health policies: role, levers and action perspectives of the Regions in health matters

📜🔗LINK to the source

🎥 https://www.youtube.com/watch?v=fiTDIMUFF5s

J'ai rédigé des cas adaptées à la situation française (notamment pour cet article) pour travailler cette question, à titre promotionnel vous pouvez les télécharger suer cette page - https://www.pratiquesensante.com/blog/actualites-17/les-cas-de-terrain-de-pratiques-en-sante-6027

1. ANALYTICAL SUMMARY

A central role but weakened by the lack of dedicated resources

Since the NOTRe law (2015) and the Biodiversity law (2016), the Regions are leaders in biodiversity and responsible for major planning documents (SRADDET, SAR, PADDUC). They manage regional natural reserves, regional natural parks, regional biodiversity agencies and, since 2023, exclusively terrestrial Natura 2000 sites (full report p.8-13). However, they remain the only level of local authority without dedicated funding for this competence, unlike Departments which have the development tax allocated to sensitive natural areas (p.10). The document documents this growing gap between responsibilities and resources, against a backdrop of biodiversity collapse and climate pressures.

A quantified advocacy accompanied by proposals and concrete examples

The white paper mobilises the 2026 survey of the Observatory of regional policies to establish a financial overview (€221 million in regional biodiversity spending in 2025, +43% in ten years) and then formulates 11 proposals structured around three priorities: finalising decentralisation, affirming leadership, securing funding (p.22-28). It illustrates these requests with 18 regional action sheets — species preservation, reserves, tree plans, nature in the city, digital tools, biodiversity certificates — and twelve testimonies from institutional partners. The whole serves a clear objective: to obtain a readable steering framework and sustainable fiscal resources.

2. KEY POINTS OF THE DOCUMENT

1. A real financial effort but structurally insufficient. The Regions have committed nearly €2 billion from their own funds between 2016 and 2025 for biodiversity, with their own effort increasing from €138 million (2016) to €197 million (2025) on a like-for-like basis, representing +43% — and €221 million in total biodiversity spending in 2025 (full report p.17-18; brochure p.12, p.15). This growth is due to the creation of RNR/PNR, ARB, the Natura 2000 transfer, and the implementation of regional strategies.
2. Natura 2000: a transfer presented as unfinished and underfunded. Since 1st January 2023, the Regions manage 1,501 terrestrial sites. The overall budget reaches €56 million/year over 2023-2027, while the need is estimated at €89-90 million/year over 2028-2034 — an effort that should be doubled, with an annual deficit estimated at €34 million (p.19-20; brochure p.13). National support credits are scheduled to stop in 2027.
3. An inequality of resources compared to other levels. The Departments have the ENS development tax (average rate 1.9%, ≈ €353 million in 2024); rural municipalities have the 'rural amenities' grant (€110 million in 2025); the State has programmes and operators (OFB, water agencies, Green Fund). The Regions, however, receive no dedicated revenue (p.10-11). The European Commission also estimates the funding gap for nature conservation at €37 billion/year at the European level (p.10).
4. 11 proposals around 3 priorities. Finalise the decentralisation of the competence, affirm the role of leader, secure financially — broken down into simplified governance (CRB, integrative regional strategy), expanded competencies (ENS, national nature reserves, Natura 2000, PNR) and funding (dedicated tax resource, Natura 2000 compensation, transferred Green Fund) (p.22-28; brochure p.18-19).
5. 18 directly transferable regional action sheets. Royal Milan in Auvergne-Rhône-Alpes, listing of Val Suzon on the IUCN Green List (Bourgogne-Franche-Comté), nature reserves (Brittany), CRST directing 10% towards biodiversity (Centre-Val de Loire), tree plans (Hauts-de-France), nature in the city and SDRIF-E (Île-de-France), AI serving life with Gaïa Predict (Occitanie), Nature Fund and territorial biodiversity certificates (Nouvelle-Aquitaine, AURA/Grand Est) (p.29-49; brochure p.20-35).

3. ACTION PATHS FOR LOCAL ACTORS

1. Rely on the Regional Biodiversity Strategy (SRB) as an integrative framework to align its own projects with regional priorities and ensure their coherence with the SRADDET and the green and blue framework (proposal 1, p.22-23).
2. Mobilise the contractualised biodiversity-targeted mechanisms : the model of the CRST Centre-Val de Loire now requires a minimum of 10% of contractualised credits on preservation/restoration projects, without fungibility — a reproducible lever to anchor stable funding (p.33; brochure p.25).
3. Request the engineering of the Regional Biodiversity Agencies and regional collectives (11-12 ARB, ≈ 170 people, covering ≈ 80 % of communities) for methodological support, educational land areas and network facilitation (p.27 ; brochure p.14).
4. Locally adapt the national species action plans, similar to the Royal Milan (PNA 2018-2027) and the territorial action plans for "insects" in Corsica — a progress area explicitly recommended by partners (p.29, p.34-35, p.57).
5. Integrate biodiversity into urban planning and development documents (SCoT, PLUi, PCAET, municipal biodiversity atlas): the Region-intercommunalities tandem is presented as essential, with operational protection falling under the infrarregional level (p.23, p.54).
6. Articulate nature, health and climate adaptation in development projects (cool islands, de-sealing, nature in the city) by drawing inspiration from the Île-de-France objectives (30 % of full land, 10 m²/person of green space) (p.41-42 ; brochure p.30).

Identified unmet needs: knowledge remains very patchy in overseas territories (80 % of French biodiversity is concentrated there); observation and monitoring systems for environments are insufficiently structured; the systematic regional adaptation of national species action plans remains an open project (p.57).

4. ADDITIONAL REFERENCES

🔍➕ For more information, see the articles referenced by "Health Practices" on the One Health theme - One Health ➡️🔗 https://www.pratiquesensante.com/une-seule-sante-one-health

1. ORS Île-de-France — One Health. From concepts to territorial implementation, Focus Health, September 2025. Methodological synthesis on the territorialisation of the « One Health » approach, complementary to the biodiversity-health angle of the white paper. Verified URL: https://www.institutparisregion.fr/fileadmin/DataStorageKit/ORS/Etudes/2025/onehealth/ORS_Focus_une_seule_sante_vd.pdf
2. Cerema / Ministry — Nature in the City Plan 2024-2030 (planning tools portal). National framework and methodological tools to renature, green and articulate nature, climate and health in urban areas. Verified URL: https://outil2amenagement.cerema.fr/actualites/plan-nature-en-ville-2024-2030
3. Biodiversité.gouv.fr — Measure 29 of the SNB 2030: « Integrate the One Health approach into public policies and territories ». National strategic complement linking biodiversity, health and territorial action. Verified URL: https://biodiversite.gouv.fr/mesure-29-integrer-lapproche-une-seule-sante-dans-les-politiques-publiques-et-dans-les-territoires

5. FREQUENTLY ASKED QUESTIONS (FAQ)

1. Since when have the Regions been leaders in biodiversity?
   Since the MAPTAM law of 2014, confirmed and strengthened by the NOTRe law of 7 August 2015 (p.8, p.62).
2. Why does the document mention an « inconsistency » regarding resources?
   Because the Regions bear the most responsibilities in terms of protecting natural spaces while being the only level without any dedicated tax revenue for biodiversity (p.9-10, p.18).
3. What is the main blockage regarding Natura 2000?
   The 2023 transfer (1,501 terrestrial sites) is deemed underfunded: €56 million/year available against €89-90 million/year needed for 2028-2034, with accompanying credits scheduled to cease in 2027 (p.19-20).
4. What do the Regions concretely request in terms of funding?
   The allocation of a dedicated tax resource (share of development tax, tourist tax or fee for use), the reassessment of Natura 2000 compensation and the transfer of management of the Green Fund (proposals 7, 8, 11, p.25-28).
5. What operational tools can a local authority mobilise today?
   Regional biodiversity strategies, ARB, targeted contractualised mechanisms (type CRST), regional nature reserves and territorialised species action plans (sheets p.29-49).
6. Does the document address the biodiversity-health link?
   Yes, in a cross-cutting manner: biodiversity is presented as a condition for public health, food security and well-being, particularly through urban nature and climate adaptation (editorial p.5-6; sheets Île-de-France, Centre-Val de Loire, Hauts-de-France).
7. How do partners assess regional action?
   Positively regarding coordination and territorial anchoring, but with a unanimous reservation: inequalities between territories and a lack of financial and human resources, due to the absence of dedicated taxation (testimonies p.50-60).

6. REWRITING IN EASY TO READ LANGUAGE

Who takes care of nature in the regions?

The Regions protect nature. They take care of parks and nature reserves. They help animals and plants. Since 2015, they have been the ones coordinating this work.

What is the main problem?

The Regions have many responsibilities. But they do not have money set aside for nature. The Departments do have a tax for that. The Regions do not have that money set aside.

How much do the Regions spend?

The Regions have spent almost 2 billion euros in 10 years. That's a lot of money. But it's not enough to properly protect nature.

What the Regions are asking for:

• A tax reserved for nature.
• A clear and recognised role.
• More money for Natura 2000.

Why is it important?

Nature helps us live. It provides clean water and clean air. It also protects our health. Protecting nature means protecting people.

7. CROSS-ANALYSIS — VALUES OF HEALTH PRACTICES

• Literacy: the document proposes an accessible version (illustrated brochure with key visual figures) distinct from the technical report, but does not develop FALC tools intended for the general public.
• Empowerment: beneficiaries mainly appear through regional reserves (45% engage in citizen mobilisations, participatory sciences), without formal association in the design of regional policies (p.20-21).
• Participation: co-construction is present at the level of co-constructed regional strategies (e.g. SRB Normandy, consultation Guadeloupe > 80 partners) but dialogue bodies like the CRB are described as "recording bodies" in need of reform (p.12, p.23-24).
• Community health: the collective dimension is integrated through environmental education, access to natural spaces and nature in the city, linked to the well-being of populations (p.15-16).
• Ethics: the document honestly identifies its limits (incomplete data overseas, unfinished Natura 2000 transfer); little analysis of cultural or social biases in access to nature.
• Human rights: equity and inclusion are evident through the accessibility of reserves (95% open to the public, 70% with facilities for people with disabilities) (p.21).
• Intersectorality: strongly present — articulation of health, water, agriculture, urban planning, economy, with numerous partners (OFB, CEN, CBN, PNR, associations, water agencies).
• Partnership: numerous formalised models (ARB/OFB agreements, public-private Nature Fund, cooperation pacts, AI consortiums), documented by 12 partner testimonies.
• Fight against discrimination: the document mentions support for audiences "distanced from environmental issues for socio-economic reasons" (p.15-16), without in-depth treatment of discrimination or non-judgment.

8. EVALUATION OF RESOURCE RELIABILITY

Scientific relevance: high for advocacy. The financial data comes from a controlled survey (Observatory of regional policies, May 2026, 15 Regions; some figures relate to 14 Regions), with cited external sources (SDES, IGEDD, IGF, Natural reserves of France). The legal framework is precisely referenced (annex "legal sources"). Caveat: several amounts are estimates from Regions of France explicitly noted, and the document takes an advocacy stance — the findings of "under-funding" are more of an institutional argument than an independent evaluation.

Operational relevance: good for understanding the system of actors and identifying the levers; more limited as a guide for direct implementation, since it is a strategic document. The 18 regional fact sheets and key figures nonetheless provide concrete and transferable benchmarks.