Health Ministry Names Réunion CHU National FASD Hub

The French health ministry has allocated a specific endowment to fund a national expert centre for fetal alcohol spectrum disorders at the CHU de La Réunion, with financing channelled through the regional health agency, ARS La Réunion. The decision marks a formal transfer of responsibility. A territory that has long managed the problem locally is now charged with setting standards for the whole country.

The new Centre Expert TSAF will carry a national vocation. Its mandate covers four areas: harmonising diagnostic practices across France, training professionals and disseminating tools to every territory, providing teleexpertise to clinicians facing complex cases, and developing clinical research. In institutional terms, the CHU moves from being a regional care provider to an office of national reference, accountable for how fetal alcohol spectrum disorders are identified and managed well beyond its own jurisdiction.

The condition itself is well defined. Fetal alcohol spectrum disorders, known as TSAF, result from prenatal exposure to alcohol and can produce physical, neurocognitive, behavioural or adaptive difficulties that may persist throughout life. Fetal alcohol syndrome, the most visible form, sits at the severe end of the spectrum. Health authorities regard these disorders as the leading preventable cause of neurodevelopmental handicap, since the total absence of alcohol exposure prevents them entirely.

The scale of the problem in La Réunion is documented in the 2023 dashboard of the Observatoire Régional de la Santé, based on data from the 2021 health barometer for the overseas territories run by Santé Publique France. At least 11 percent of women there report consuming alcohol during pregnancy. One child in 1,000 is affected by fetal alcohol syndrome, while more than one in 100 lives with a disorder from the broader spectrum. That is equivalent to one birth every two days, or 150 newborns each year.

That burden explains why the territory built an institutional architecture early. La Réunion has held a pilot role since 2015, and its system now links prevention, diagnosis and follow-up. The Centre Ressources TSAF serves as the regional support point for developing knowledge, training professionals and coordinating the network. Within the CHU, two specialised diagnostic centres operate in the Femme-Mère-Enfant departments in the north and south of the island, where close to a hundred children are evaluated each year.

Oversight of the care pathway extends beyond the hospital walls. The Équipe Mobile d’Appui TSAF travels across the entire island to reach children and adolescents from 0 to 18 years old who are suspected of having, or living with, one of these disorders. Its stated objectives are to ease access to diagnosis and treatment, coordinate the various interveners, support schooling and prevent breaks in the care pathway. At the end of July 2026, the team was following 168 children. The wider chain involves health professionals, the PMI maternal and infant protection service, health and medico-social establishments, child protection services, the Éducation nationale and the associative sector. The association Vivre avec le SAF supports families through listening and mutual aid while carrying the voice of those directly concerned.

The national designation rests on a measurable institutional achievement. TSAF remain frequently under-diagnosed elsewhere in France. The number of identified cases is higher in La Réunion than in other territories, but the disorders are not more frequent there; the gap reflects a stronger professional capacity to detect and diagnose, built through years of awareness and training work. The expertise behind the new centre was developed jointly by the CHU and the Fondation Père Favron.

For health authorities, the creation of the centre represents a major advance for patients and families across France. It also formalises a shift in the division of labour: La Réunion’s recognised territorial expertise becomes a national reference function, responsible for supporting professionals wherever they practice. The accountability now sits with the CHU, financed by the ARS under a ministry endowment, to deliver harmonised diagnostics, training and research at the scale the mandate demands. Whether the new national reference function can close the diagnosis gap across the rest of France will be the measure of its success.