Search results

Tobacco-relateddiseasesmainly affect the respiratory system, the first system in contact with the air that is inhaled, making tobacco a leading cause of death and illness, closely linked to the chronic obstructive pulmonary disease of which it is responsible in 90% of cases. It isalsoresponsible for the impoverishment of the population, given the heavyeconomicburdenit imposes. The purpose of the studyisto estimate the economic cost of chronic obstructive pulmonary disease attributable to smoking in 2018, whether it is related to the medical management of the disease, or the loss of productivity following the disease itself or a premature death. An approach based on the specific cost to COPD caused by smoking for 62 patients hospitalized in the Department of Pneumology at Moulay Youssef Hospital in Rabat. The direct medical costs are obtained according to the stay, acts and examinations specific to the university hospital center. Drugs not available at this hospital and purchased externally are calculated at the market price of private pharmacies. For non-medical costs, in our case the transport of patients was estimated by using the prices of the means of transport existing in their most used places of residence. Regarding indirect costs related to loss of income following illness, it's calculated on the basis of the average annual income of the individual and the period of his disability.Another indirect cost, that of the loss of productivity following the premature death of the patient, this one is calculated at the base of the years of life lost compared to the life expectancy in Morocco and the lost income during these years, discounted at a rate of 3%. Since the specificity of the study is smoking, an attributable fraction was used in the direct and indirect costs calculations, which was derived from Tachfouti's 2014 study of the estimated mortality attributed to tobacco in Morocco, based on the 2006 Marta study on the prevalence of smoking and the relative risk associated with the quantities of tobacco smoked. After collecting essential data for our study and using the previous calculation methods, we were able to estimate the following costs. The overall economic cost of COPD attributable to smoking in 2018 is 1784503,74 MAD (168667,65 Euro).The direct cost of COPD attributable to smoking is: 389 973,33 MAD ( 36 859,48 Euro), and the indirect cost of COPD attributable to smoking is: 1394530,41 MAD ( 131808,17 Euro). Indirect cost accounts 78 % of the economic cost of COPD linked to tobacco. In the case of conflict between health and economy, this type of study helps guide public decision-makers in the formulation of health system strategies and policies, in a context of prevention and control of non-transmissible diseases. Our study addresses a preventable chronic disease by acting on the major risk factor that is tobacco, all with the aim of controlling expenditure in the face of limited financial resources, and avoiding economic losses for society, the system of health and the country's economy. JEL Classification : G21 Paper type : Empirical research ; Les pathologies liées au tabac touchent principalement le système respiratoire, le premier système en contact avec l'air respiré, ce qui rend le tabac l'une des principales causes de décès et de maladies, étroitement liées aux broncho-pneumopathies chroniques obstructives dont il est responsable dans 90% des cas. Il est aussi responsable de l'appauvrissement des populations vu la lourde charge économique qu'il impose.Le but de l'étude est d'estimer le coûttotalde la broncho-pneumopathie chronique obstructive imputable au tabagisme en 2018, qu'il soit lié à la prise en charge médicale de la maladie, ou à la perte de revenu suite à la maladie elle-même ou bien à un décès prématuré. Une approche basée sur le coût spécifique à la BPCO causée par le tabagisme pour 62 patients hospitalisés au service de Pneumologie au CHU Moulay Youssef de Rabat. Les coûts directs médicaux sont obtenus selon la tarification du séjour, des actes et examens propres au CHU MY. Les médicaments non disponibles au CHU et achetés à titre externe sont calculés au prix du marché des officines privées. Pour les coûts non médicaux, dans notre cas, le transport des patients a été estimé en employant les prix des moyens de transport existant dans leurs lieux de résidence les plus utilisés. En ce qui concerne les coûts indirects liés à la perte de revenu suite à la maladie, ils sont calculés sur la base du revenu annuel moyen de l'individu et de la période de son invalidité. Autre coût indirect, celui de la perte de revenu suite au décès prématuré du patient, celui-ci est estimé à la base des années de vie perdues par rapport à l'espérance de vie au Maroc, et le revenu perdu durant ces années actualisées selon un taux de 3%. Puisque la spécificité de l'étude est le tabagisme, une fraction attribuable est utilisée lors des calculs du coût direct et indirect, dérivé de l'étude de Tachfouti en 2014 sur l'estimation de la mortalité attribuée au tabac au Maroc, en se basant sur l'étude Marta de 2006 sur la prévalence du tabagisme, et sur le risque relatif associé aux quantités de tabac fumées. Après collecte de données essentielles à notre étude et usage des précédentes méthodes de calcul, nous avons pu estimer les coûts suivants: Le coût économique global de la BPCO attribuable au tabagisme de l'an 2018 est de: 1784503,74 MAD (168667,65 Euro).Le coût direct de la BPCO liée au tabac est de389 973,33 MAD (36 859,48 Euro) et le coût indirect de la BPCO liée au tabac est de: 1394530,41MAD (131808,17 Euro).Le coût indirect représente alors 78 % du coût économique de la BPCO liée au tabac. Dans le cas de conflit entre la santé et l'économie, ce genre d'étude permet d'orienter les décideurs publics dans la formulation de stratégies et de politiques du système de santé, dans un contexte de prévention et de maîtrise des maladies non transmissibles. Notre étude traite une maladie chronique évitable en agissant sur le facteur de risque majeur qui est le tabac, tout cela dans le but de maîtriser les dépenses face à des ressources financières limitées, et d'éviter les pertes économiques pour la société, le système de santé et l'économie du pays. Classification JEL : O33, L2, H83. Type de l'article: Recherche empirique

Dans le cadre des études de sites et sols pollués et de l'interprétation de l'état des milieux (IEM), les bureaux d'études et les services déconcentrés de l'État sont demandeurs de valeurs de référence locales pour les teneurs en éléments traces métalliques : le but étant de comparer le sol d'étude avec des sols naturels situés à proximité et pédologiquement similaires. La BDETM 2009, fruit de la deuxième collecte nationale des analyses en éléments traces métalliques, rassemble des résultats pour plus de 73 000 échantillons et peut, dans une certaine mesure, répondre à ces attentes. Mais différentes questions préalables se posent : sur quels territoires faut-il établir des statistiques, où et comment fixer des seuils ? Ces réponses seront forcément locales car une teneur élevée mesurée dans un sol peut être naturelle pour ce sol et résulter d'une pollution pour un autre. La région Centre (analyses collectées pour 5 913 horizons labourés) a été utilisée dans cette étude pour illustrer la démarche qui consiste en l'établissement de statistiques par régions agricoles (à condition que le nombre d'analyses disponibles soit jugé suffisant). Ces territoires paraissent être les plus pertinents au point de vue de leur homogénéité géologique et pédologique et ils peuvent donc servir de territoires de référence. Par la suite, afin de savoir si les valeurs mesurées sur le site étudié sont d'origine naturelle ou anthropique (ce qui implique a priori des dangers différents), une étude géologique et pédologique locale ainsi que l'historique des sources de pollution potentielles viendront affiner le diagnostic. ; New French legislation for the management of potentially polluted sites requires that "the state of the environment" (i.e. of the soils and waters of the industrial site under study) be compared to the state of neighbouring natural environments or to regulatory management values established by public authorities. Within the framework of urban planning projects or conversion of former industrial sites, many studies are daily carried out in order to assess the risk to the population. Departments responsible for public health are recipients of these and must put forward an opinion. In the absence of statutory values, everyone tries to find local or regional data relating to trace metal concentrations in the soil (often called 'background values'), to use as points of comparison and thereby estimate the contamination level of the soil under study. Unfortunately, in such an industrial or urban context, it is very difficult to find "natural soils" located in the vicinity, which are similar enough from a pedological standpoint. More often than not, these assessments can at best be carried out with reference to soils considered to be relatively little-contaminated, namely the closest agricultural soils. In France, a large data collection was carried out on a national scale (known as BDETM 2009). These data were provided by analyses, undertaken mainly within the framework of sewage sludge spreading plans and of some research programmes. The samples were taken from surface horizons of ploughed soils. These analyses only involved Cd, Cr, Cu, Hg, Ni, Pb and Zn and were taken from more than 73,000 sites throughout France. These are the only data available in large numbers. Due to their origins, (topsoil analyses from agricultural soils of various types), these analyses very largely correspond to "usual agricultural contents" i.e. natural pedogeochemical concentration + local additional contamination by farming practices and diffuse atmospheric deposition. These "usual agricultural contents" correspond to the lowest concentrations that it is possible to measure in an urban or peri-urban soil, close to an industrial site. Beforehand different questions arise : on which territories statistics must be established, where and how thresholds must be fixed ? The answers are to be given necessarily at the local level because the same high concentration observed in a soil could be natural in one particular case and anthropogenic in another. The data collected on the area of the region Centre for 5 913 sites have been processed and stratified according to "agricultural districts", territories much less heterogeneous from geological and pedological standpoints than administrative subdivisions. The usual measures of position (percentiles) and of dispersion (upper whiskers) have been determined for each agricultural district. This collection provides objective points of comparison for any institution or consultancy office wishing to confront the results of an analysis with various statistical indicators to decide whether the measure is anomalous or not. If the available data are sufficiently numerous, these statistics generated stratifying by agricultural districts are the most pertinent. Finally, the diagnosis as to whether a value is truly natural or anthropogenic (hence different risk levels) will have to be based on a pedologically and geologically thorough point study of the site, without forgetting a historical inventory of possible sources of pollution. ; En el cuadro de los estudios de sitios y suelos contaminados y de la interpretación del estado de los medios (IEM), las oficinas de estudios y los servicios desconcentrados del estado piden valores de referencias locales para los contenidos en elementos traza metálicos : el objetivo está comparar el suelo de estudio con los suelos naturales situados a proximidad y pedológicamente similares. La BDETM 2009, fruto de la segunda colecta nacional de los análisis en elementos traza metálicos, reuní resultados para más de 73 000 muestras y puede, en cierta medida, responder a estas demandas. Pero se plantean diferentes preguntas previas : ¿sobre cuales territorios se puede establecer estadísticas, donde y como fijar umbrales ? Estas repuestas estarán inevitablemente locales ya que un contenido elevado medido en un suelo puede ser natural para este suelo y resultar de una contaminación para otro. Se utilizó la región centro (análisis colectados para 5 913 horizontes arados) en este estudio para ilustrar el enfoque que consiste en el establecimiento de estadísticas por regiones agrícolas (con condición que el numero de análisis disponibles estará jugado suficiente). Estos territorios parecen estar los más pertinentes del punto de vista de su homogeneidad geológica y pedológica y pueden entonces servir de territorios de referencia. Después, afín de saber si los valores medidos en el sitio estudiado están de origen natural o antrópico (lo que implica a priori peligros diferentes), un estudio geológico y pedológico local así que los antecedentes de las fuentes de contaminación potenciales vendrán afinar el diagnostico.

Depuis la vulgarisation de certains concepts comme la globalisation ou la mondialisation, le secteur agroalimentaire a connu une expansion fulgurante et un engouement incessant pour la commercialisation d'aliments entre les peuples à travers le monde. Ce phénomène, contribuant significativement à l'accroissement économique des marchés, n'est toutefois pas sans risque. Pendant ce temps, les dangers de sources microbiologiques, notamment les pathogènes, sont véhiculés par des matrices alimentaires et voyagent d'un pays à l'autre, ce qui augmente le risque de contamination pour les consommateurs. Conséquemment, on assiste à une augmentation des cas d'allergies alimentaires, d'intoxications ou de toxi-infections alimentaires dont les agents étiologiques peuvent venir des quatre coins du monde. À cet effet, les organismes réglementaires comme l'Agence canadienne d'inspection des aliments (ACIA), Santé Canada, la Food and Drug Administration (USFDA) américaine ou d'autres autorités internationales compétentes comme l'Organisation des Nations unies pour l'alimentation et l'agriculture(FAO) et l'Organisation mondiale de la santé (OMS) multiplient leurs efforts afin de mettre en place des normes et politiques réglementaires pour aider l'industrie agroalimentaire à renforcer les contrôles depuis la fabrication jusqu'à la commercialisation des aliments. Les dangers microbiologiques venant de pathogènes comme Bacillus cereus demeurent un risque de santé publique majeur qu'il faut maîtriser afin d'assurer la protection des consommateurs. Bien que de nombreuses techniques de contrôle (e.g., additifs alimentaires, haute pression hydrostatique, rayonnements ionisants, procédés thermiques, etc.) ont été développées et utilisées pour assurer la salubrité et l'innocuité des aliments, dans certains cas cela n'a pas permis de produire des aliments totalement exempts de bactéries responsables de la dégradation/altération des aliments et de pathogènes causant des intoxications alimentaires comme c'est le cas avec B. cereus. En effet, cette bactérie pathogène est ubiquitaire, aérobie et anaérobie facultative. Elle est capable de produire dans une grande variété d'aliments et d'ingrédients comme les épices des spores très résistantes ainsi que différents types de toxines pouvant causer la diarrhée, la nausée, le vomissement et même la mort. Dans cette optique, et vue la grande difficulté à maitriser la contamination des aliments causée par ce pathogène, l'objectif général de cette recherche a été d'utiliser la technologie d'électro-activation, une branche appliquée de l'électrochimie qui s'intéresse notamment à la réactivité des solutions aqueuses, comme méthode alternative et potentiellement efficace pour lutter contre B. cereus afin de produire des aliments plus sécuritaires avec une grande valeur nutritionnelle et organoleptique. Pour y parvenir, des solutions aqueuses de sels d'acides organiques de lactate de calcium, d'ascorbate de calcium et de leur mélange équimolaire ont été électro-activées dans un réacteur soumis à un courant électrique continu avec des intensités de l'ordre de 250, 500 et 750 mA pendant un maximum de temps de 30 minutes afin de produire les acides organiques conjugués respectifs; de l'acide lactique et de l'acide ascorbique. Dans la première partie de ce travail de recherche, les caractéristiques physicochimiques (e.g., pH, acidité titrable, pKa) des solutions électro-activées (SÉA) ont été étudiées et leurs profils moléculaires comparés à ceux d'acides standards respectifs en utilisant différentes techniques (e.g., FTIR, HPLC, DSC, DPPH), ce qui a permis de confirmer la production d'acides organiques conjugués respectifs des sels utilisés. Ces SÉA avaient un pH très bas, une acidité titrable élevée, notamment pour l'ascorbate de calcium et le mélange. En plus, une activité antioxydante élevée a été observée pour la solution électro-activée d'ascorbate de calcium et du mélange. Dans la deuxième partie de l'étude, les SÉA traitées à 250, 500 et 750 mA pendant 10, 20 et 30 min ont été retenues pour être mises en contact avec des cellules végétatives de Bacillus cereus ATCC 14579 en conditions modèles (contact direct) afin d'évaluer leurs effets antimicrobiens sur ce pathogène. Les cellules ont été testées en contact direct avec les SÉA pendant 5, 30 et 60 secondes. Le même traitement a été également réalisé par contact direct avec des acides organiques standards (lactique, ascorbique) pendant 5, 30, 60, et 120 secondes afin de faire des comparaisons. Les SÉA et les acides organiques standards correspondants avaient les mêmes valeurs d'acidité titrable. Par la suite, les cellules ont été observées au microscope (coloration au bleu de méthylène et fluorescence) afin d'évaluer les effets inhibiteurs/destructeurs de ces solutions. Également, les SÉA ont été diluées avec de l'eau distillée pour obtenir des solutions possédant 10 à 90% de l'acidité titrable (force) initiale pour être ensuite testées contre les cellules de B. cereus. Les résultats ont démontré que toutes les SÉA avaient une grande efficacité contre les cellules végétatives de B. cereus. Également, même à des taux de dilution représentant en moyenne 20% de la force initiale des SÉA, l'effet antimicrobien était très élevé pour les différentes solutions. L'observation de B. cereus au microscope a permis de confirmer les effets létaux des SÉA. Dans ce volet avec des cellules végétatives de B. cereus, l'efficacité des SÉA a été estimée à une réduction de 4–7 log UFC/mL. En plus, il a été démontré que le pouvoir antibactérien des SÉA était nettement plus élevé que celui des acides lactiques et ascorbiques standards (conventionnels). Dans la troisième partie de cette étude, des solutions électro-activées de lactate de calcium, d'ascorbate de calcium et de leur mélange équimolaire à 750 mA pendant 30 minutes ont été retenues et utilisées contre des spores de Bacillus cereus ATCC 14579 en conditions modèles et dans du saumon Atlantique frais. Les spores traitées ont été analysées à l'aide de microscopes électroniques à balayage et à transmission pour évaluer les effets sporicides des SÉA. Les résultats obtenus ont clairement montré un grand pouvoir sporicide des SÉA utilisées sur les spores de B. cereus avec une réduction de 7 à 9 log en utilisant une population initiale de spores de 10⁹ UFC/mL, dépendamment des conditions évaluées; à savoir : en contact direct (2–30 min), dans du saumon utilisé comme matrice alimentaire(2–7 min), ainsi qu'en combinaison avec de la chaleur modérée de 60, 70, 80 et 90 °C pendant 0.5–2 min. Également, il a été observé que la capacité sporicide des SÉA augmentait avec la température et le temps de contact. La microscopie électronique à balayage et à transmission a permis de constater que les SÉA pouvaient provoquer la destruction totale des cellules de B. cereus, et notamment la perforation de la membrane (cortex et manteau), ainsi que le reflux de différentes composantes de la structure des spores de B. cereus. Tenant compte des résultats obtenus dans cette étude, nous pouvons conclure que les solutions électro-activées à base de lactate de calcium, ascorbate de calcium et leur mélange, notamment celles électro-activées à 750 mA–30 min, pourraient être d'une grande contribution afin de renforcer la capacité de l'industrie alimentaire à lutter contre B. cereus ATCC 14579 et de produire des aliments plus sécuritaires pour le consommateur. ; Since the popularization of concepts like globalization, the agri-food sector has experienced a huge expansion and a ceaseless craze for the marketing of food between the peoples worldwide. This phenomenon, contributing significantly to the economic growth of the markets, is not without risk, however. Meanwhile, microbiological hazards, including pathogens, are carried through food matrices and travel from one country to another, increasing the risk of contamination for consumers. Consequently, we are also witnessing an increase in cases of food allergies, foodborne illnesses and outbreaks, with etiological agents coming from all over the world. Thus, regulatory organisms such as Canadian Food Inspection Agency (CFIA), Health Canada, United States Food and Drug Administration (USFDA) or competent international authorities like Food and Agriculture Organization of the United Nations (FAO) and World Health Organization (WHO) are stepping up efforts to put in place regulatory standards and policies in order to help the food industry to strengthen controls from the processing to the marketing of foods. Microbiological hazards from pathogens like Bacillus cereus remain a major public health risk that must be controlled in order to ensure consumers protection. Although many techniques of control (e.g., food additives, high hydrostatic pressure, ionizing radiation, thermal processes, etc.) have been developed and used to ensure the safety and security of foods, in some instance this has not allowed to produce food products that are completely free of bacteria responsible for degradation/spoilage of food and pathogens causing food poisoning as is the case with B. cereus. Indeed, this pathogenic bacterium is ubiquitous, aerobic and facultative anaerobic. It is able to produce, in a wide variety of foods and ingredients such as spices, highly resistant spores as well as different types of toxins that can cause diarrhea, nausea, vomiting, and even death. In this context, and given the great difficulty in controlling the contamination of food caused by this pathogen, the general objective of this research was to use the electro-activation technology, an applied branch of electrochemistry which is particularly interested in the reactivity of aqueous solutions, as an alternative and potentially effective method to fight against B. cereus in order to produce safer foods with high nutritional and organoleptic values. To achieve this, aqueous solutions of organic acid salts of calcium lactate, calcium ascorbate and their equimolar mixture were electroactivated in a reactor subjected to a direct electric current with intensities of 250, 500 and 750 mA for a maximum time of 30 minutes in a bid to produce the respective conjugated organic acids, lactic acid and ascorbic acid. In the first part of this research work, the physicochemical characteristics (e.g.,pH, titratable acidity, pKa) of the electro-activated solutions (EAS) were studied and their molecular profiles compared to those of respective standard acids using different techniques (e.g., FTIR, HPLC, DSC, DPPH), which helped to confirm the production of conjugated organic acids from the respective salts used. These EAS had a very low pH, a high titratable acidity, particularly for the calcium ascorbate and the mixture. In addition, a high antioxidant activity was observed for the electro-activated calcium ascorbate solution and the mixture. In the second part of the study, the EAS treated at 250, 500 and 750 mA for 10,20 and 30 min were selected to be brought into contact with vegetative cells of Bacilluscereus ATCC 14579 under model conditions (direct contact) in order to evaluate their antimicrobial effects on this pathogen. The cells were tested in direct contact with the EAS for 5, 30 and 60 seconds. The same treatment was also carried out by direct contact with standard organic acids (lactic, ascorbic) for 5, 30, 60, and 120 seconds in order to make comparisons. The EAS and the corresponding standard organic acids had the same titratable acidity values. There after, the cells were observed under microscope (Methylene blue and fluorescence) to evaluate the inhibitory / destructive effects of these solutions. Also, the EAS were diluted with distilled water to obtain solutions with 10 to 90% of the initial titratable acidity (strength) to be tested against B. cereus cells. The results demonstrated that all the EAS made were highly effective against the vegetative cells of B.cereus. Also, even at dilution rates averaging 20% of the EAS initial strength, the antimicrobial effect was very high for the different solutions. In addition, the microscopic observation of B. cereus has confirmed the lethal effects of EAS. In this part with the vegetative B. cereus cells, the efficacy of the EAS was estimated to a reduction of 4–7 log CFU/mL. In addition, the antibacterial power of the EAS has been shown to be significantly higher than that of the standard (conventional) lactic and ascorbic acids. In the third part of the study, electro-activated solutions of calcium lactate, calcium ascorbate and their equimolar mixture at 750 mA for 30 min were selected and used against the spores of Bacillus cereus ATCC 14579 under model conditions and in fresh Atlantic salmon. The treated spores were analyzed using scanning and transmission electron microscopes to evaluate the sporicidal effects of EAS. The results obtained clearly showed a great sporicidal power of the EAS used on B. cereus spores with a reduction of 7 to 9 log using an initial spore population of 10⁹ CFU/mL, depending on the conditions assessed; namely: in direct contact (2–30 min), in salmon used as a food matrix (2–7 min), as well as in combination with moderate heat of 60, 70, 80 and 90 ℃ for 0.5–2 min. Also, it was observed that the sporicidal capacity of the EAS increased with temperature and contact time. Scanning and transmission electron microscopy showed that the EAS could cause the total destruction of B. cereus cells, including perforation of the membranes (cortex and coat), as well as the reflux of different components of the structure of B. cereus spores. Taking into account the results obtained in this study, we can conclude that the electro-activated solutions made with calcium lactate, calcium ascorbate and their mixture, especially those electro-activated at 750 mA–30 min, could be of a great contribution to reinforce the capacity of the food industry to control B. cereus ATCC 14579 and produces safer foods for the consumer.

Although various pieces of European secondary law law use the terms "mise en concurrence" ("calling for competition" or "competitive tendering procedure") they provide no definition of the expression "obligation de mise en concurrence" ("obligation to call for competition"). At the very beginning, the author therefore defines what is meant thereby in his thesis, i.e. "a more or less formalized action which a public or a private person has to follow in order to provoke a competition or a contest between potentially interested persons that perform an economic activity, in order to grant an individual advantage to one or several of them". The first part of the work deals with the regime of competitive tendering of the public procurement directives which the Court of Justice has considered "as a whole" to be the "core" of European law on public contracts. First, this part examins the development of the public procurement directives from 1971 on. The author shows that the puzzling evolution of the personal scope of the public procurement directives is guided by the personal scope of European primary law. While considering the remedies directives, the author examines to what extent they introduce requirements beyond the principle of effective judicial protection. While some of their requirements obviously do so, the remedies directives however remain very far from standardizing the means of redress at national level. Due to the member States' judicial autonomy, the compelling force of EU primary law differs from one member State to another. The same applies within the scope of the remedies directives as they let the member States a large degree of autonomy. The author then turns to examine the contribution of the procurement directives 2004/17/CE, 2004/18/CE and 2009/81/CE, their scope of application, as well as the concepts of public works concession and service concession. Various other questions are dealt with in the first part, such as the use of functional interpretation, the power of the European legislator to adopt regulations on public procurement and the impact of the Agreement on Government Procurement (GPA), the Revised GPA and other international agreements. At last the author explores the issue of electronic procurement and the Commission's proposals for replacing the public procurement directives 2004/17/CE and 2004/18/CE and its proposal concerning the award of concession contracts. The second part of of the thesis focuses on primary public procurement law. After having described the origin of the obligation to call for competition under EU primary law which the Court of Justice derives from articles 49 and 56 TFEU as well as from the principles of equal treatment and non-discrimination on the grounds of nationality, the author strives to determine whether this obligation is well-founded. This examination brings to light that the rationale behind the requirement to call for competition under EU primary law is rather fragile. Amongst others, the author comes to the conclusion that the condition of a certain cross-border interest of each public contract individually as a condition for the application of the primary law obligation to call for competition lacks relevance The author then reviews and examines other possible bases for an obligation to call for competition under EU primary law such as the right to good administration, the freedom of enterprise and the right to property, which are protected by the Charter of Fundamental Rights, and the rights guaranteed by the European Convention on Human Rights. Finally, it seems that only article 102 TFEU (abuse of a dominant position) could to a limited extent give rise to an obligation to call for competition. However, once a situation is governed by EU secondary law, it enters the scope of European law. Hence, the principles of equal treatment and of non-discrimination on the grounds of nationality apply even if a situation involves no cross-border interest. If the Court of justice's case law were followed consistently, these principes should lead to require calls for competition in a number of purely internal situations. According to the author, deducing as precise consequences as does the Court of justice from the principal of equal treatment and other fundemental principles can hardly be justified. After that examination, the material rules of public procurement primary law stated by the Court of Justice and the General Court are successively reviewed. The pages that follow are about the exceptions to the obligation to call for competition under the public procurement directives and under primary law, as for instance articles 51 and 52 TFEU, overriding reasons of general interest and article 106, paragraph 2, TFEU. The author thereafter addresses the question whether primary law applies within the scope of secondary law. He comes to the conclusion that it does even when secondary law represents an exhaustive body of rules. Notwithstanding some ambiguous judgements of the Court of justice there is no support for the doctrine of priority of application of secondary law in the Court's case law. In what follows, the author tries to answer the question whether, in order to stay consistent with the case law developed in the wake of Telaustria, the obligation to call for competition which the case law of the Court of Justice requires for public works, service and supply contracts ought to be extended to other operations (sale or lease of real estate, design contests outside the scope of the public procurement directives, employment contracts, subsidised contracts awarded by private entities outside the scope of the public procurement directives, grants, …). The end of the second part deals with the personal scope of the primary law of public procurement which corresponds to that of EU primary law. The rules concerning State aid are addressed in detail in the third part of the thesis. The examination in that part shows that the public procurement directives, the primary law of public procurement and the EU state aid rules apply cumulatively. The EU State aid rules require efficency when awarding public contracts. Nevertheless, in order to avoid the categorization as State aid, a call for competition is never formally required. The Commission however insists on calls for competition in order to declare certain aids compatible with the internal market. Aids include by definition an advantage for their recipients. This remains true even though an aid has been authorised by the Commission pursuant to article 107, paragraphe 3, TFEU. Given the very broad scope the Court of Justice gives to the freedom of establishment and the free movement of services, aid measures give generally rise to obstacles to the freedom of establishment and the free movement of services. At the risk of rendering article 107, paragraph 3, TFEU unnecessary, the fact that an aid measure impedes the fundamental freedoms of the internal market should therefore not prevent the Commission to declare it compatible with the internal market. This applies in particular to aids consisting in the award of a public contract that is covered only by EU primary law. That solution seems however excluded for public contracts within the scope of the public procurement directives. The Commission has adopted a broad concept of what is an "advantage" in the sense of the State aid rules. This leads the Commission to consider certain grants for environmental protection as State aid measures even though it may be difficult to dectect any kind of advantage. The Commission claims to control these measures in accordance with the rules of State aid control. On that occasion the Commission tends to make its consent subject to a call for competition in order to identify the projects that will be subsidized. A broad approach of the concept of undertaking leads to class as State aid various public infrastructure investments insofar they do not satisfy the private investor test. The Commission tends to make its consent to these investments subject to calls for competition. Such is notably the case regarding public investments in broadband network facilities. In the fourth part, the author examines a variety of secondary legislation imposing calls for competition other than the public procurement directives. These texts cover a wide range of areas and provide for competitive awards of various form and diverse content. Sometimes a requirement for competitive tendering is overtly expressed. At other times, it is implicit, indirect or just inchoate. Some advantages are awarded without a genuine competition or without any competition at all. Directive 2012/34/CE establishing a single European railway area for instance sets principles for the allocation of "infrastructure capacity" (i.e the right to use a railway network). It does not employ such terms as "calling for competition". Where the infrastructure capacity is insufficient it has to be allocated in a fair and non discriminatory manner. The fee for using the railway network cannot be used as an award criterion. In some areas, competition in terms of price is the very basis of the system. This is true for the greenhouse gas emissions trading scheme. It happens that competitive assignment occurs incidentally and in a non compulsory way as in the case of the milk quota regime. In other cases, e.g. certain situations covered by the internal electricity market regime, the system excludes calls for competition whereas they should be required according to primary procurement law principles. Under still other circumstances, i.e. the award of public service contracts for public passenger transport services, competitive tendering only needs to be strictly complied with after a transitional period. This can hardly be reconciled with the principles of primary procurement law. In some cases the rules in place are such, for example when awarding the universal postal service, that it seems doubtful that a competitive bidding following objective and transparent criteria is really possible. The European greenhouse gas emissions trading scheme relies on auctions for the allocation of gaz emission authorisations. At first, it does so to a limited extent. Such authorisations, called "allowances", are freely transferable. Thus a reallocation of allowances according to market mechanismes is made possible. The author sheds light on some major inconsistencies of the greenhouse gas emission trading scheme. The late deadline for surrendering allowances gives rise for several years to a surplus of allowances over the greenhouse gas emissions considered in the scheme. On the other hand, the costs for same amounts of greenhouse gas emitted at the same time may vary. This gives rise to a problem of equality. The author comes to the conclusion that the scheme has little capacity to reach the objective of reducing greenhouse gas emissions at least cost to the economy. The designation of the universal postal service providers implies to lay down rules as to how the net cost of the universal service is to be calculated, as well as to define appropriate award criteria. These steps face considerable difficulties. A similar situation can be found in other areas such as electronic communications and electricity or natural gas transmission or distribution systems. In the latter case, the risk of a change of transmission or distribution tariffs due to decisions of national regulatory authorities leaves the competitors in the dark on a crucial point. The legislation regarding the internal electricity market and the internal gaz market puts the transmission and distribution system operators in a position very similar to that of service or public works concession holders. In some cases the principles which underlie these schemes exclude competitive tendering as required by primary procurement law. The networks being freely transferable, ownership of networks and hence, in principle, their operators are determined by private market mechanismes mainly through the level of the proposed sales price. This is not consistent with the principles of primary procurement law stated by the Court of Justice (advertising requirements, award criteria linked to the subject matter of the contract, .) . Neither does it seem compatible with these principles that the development of the networks belongs automatically to the transmission and distribution system operators. The assessment of conformity of secondary legislation with primary law is less strict than the conformity assessment of national law. The Court of Justice has allowed the European legislator a wide margin of discretion when establishing the internal market and seems to have tacitely acknowledged a form of conformity presumption of secondary law. Save in exceptional cases, it seems unlikely that the Court will put into question secondary law regimes differing from primary law procurement rules. Thus, the European legislator may adopt such solutions without incurring major legal risks.