In a context of heightening tensions on a global scale, with conflicts, security concerns, social divisions, and climate issues damaging the usual channels of cooperation, the Mérieux Foundation has confirmed its commitment to helping fragile populations. The teams working at the Foundation have proved their strong capacity to adapt their strategies, in particular by integrating the increasing complexity of administrative tasks and by making sure that community-wide actions are prioritized. Five new programs were launched in 2023, with the inclusion of a new beneficiary country, Burundi.
New institutional partnerships
Lebanon
Signature of a collaboration agreement with the Ministry of Public Health
On February 27, 2023, at the Mérieux Foundation’s head office, the Lebanese Minister of Public Health, Dr. Firas Abiad, and Alain Mérieux, President of the Mérieux Foundation, signed a memorandum of understanding with the aim of defining the national policy for public health laboratories in the country. Present in Lebanon since 2008, the Foundation is officially recognized as an operational and technical partner for its expertise in strengthening diagnostic capacities.
Brazil
Renewal of an historic partnership
Almost 50 years after the start of a collaboration to combat the widespread meningitis epidemic in Brazil, a new cooperation agreement was signed by the Mérieux Foundation with Fiocruz and the Acre State Hospital Foundation. Signed on October 9, 2023, the agreement covers support for research activities, training healthcare staff, access to diagnosis, and infectious disease surveillance.
Operational capacities enabling action in times of crisis
Haiti
Review of the C19-HaitiLab project
The first steering committee of the C19-HaitiLab project took place in Santo Domingo in the Dominican Republic on April 12, 2023. The parties involved in the project (AFD, Mérieux Foundation, the Haiti National Public Health Laboratory, and the GHESKIO centers) confirmed the continuation of activities despite the worsening security situation and commended the strength of this collaboration, which makes the project an exception in the humanitarian landscape in Haiti.
Democratic Republic of the Congo
Inauguration of the Rodolphe Mérieux Laboratory in Goma
The Rodolphe Mérieux Laboratory in Goma, a regional public health laboratory, was inaugurated on April 13, 2023, by the National Biomedical Research Institute. Funded with the support of the USAID agency following the 10th Ebola epidemic in RDC (2018 to 2020), this state-of-the-art structure complies with the latest international standards and will help to reinforce the diagnosis and surveillance of infectious diseases.
Moldova
Renovation of the laboratory at Toma Ciorba Hospital
Renovation work at the microbiology laboratory at the Toma Ciorba hospital began in 2023, as part of the Foundation’s support for Moldova, a country facing an influx of Ukrainian refugees. The work involves improving the quality of diagnosis, absorbing larger volumes of analyses, and offering students a renovated platform for training and research in clinical microbiology.
A network dynamic fueled by flagship projects
Benin, Nigeria & Togo
Establishment of 40 new Epidemiological Surveillance Centers
On August 28 and 29, 2023, the third phase of the REDISSE epidemiological surveillance project concluded with debrief meetings held in the three countries involved: Benin, Nigeria, and Togo. The establishment of 40 new centers follows on from previous project phases, which led to the creation of a network of 107 surveillance centers in 10 African countries.
Benin
RESAOLAB meeting in Cotonou
From September 13 to 15, 2023, the Mérieux Foundation organized technical workshops for RESAOLAB, the West African network of biomedical analysis laboratories set up by the Foundation in 2009. With the help of the Ministry of Health in Benin and the AFD, this meeting brought together 35 network members to discuss issues relating to external quality assessment.
Brazil
The Rodolphe Mérieux Laboratory in Rio Branco joins the GABRIEL network
The Charles Mérieux Center for Infectious Disease in Brazil, with its Rodolphe Mérieux Laboratory, has become the 22nd member of the GABRIEL network of research laboratories and the 4th Brazilian member. Part of the largest hospital in the state of Acre in Rio Branco, the laboratory is situated in an isolated region, far from any major cities.
Madagascar
14th edition of the RESAMAD workshops
From October 23 to 27, 2023, the RESAMAD network of laboratories in Madagascar organized the 14th RESAMAD workshops, with the support of the Foundation and the Madagascan Ministry of Public Health. Always keenly anticipated by all the partners in the network, this collaborative event offers various discussion formats, including plenary sessions, working groups, presentations, and question & answer sessions.
A policy of innovation and openness
Les Pensières Center of Global Health
First Epi-Course, an advanced course in epidemiology
With a satisfaction rate of 97%, the launch of the advanced course on epidemiology in complex emergency situations, Epi-Course, confirmed its positioning in favor of developing skills in epidemiology as part of a One Health approach. Organized jointly by the Foundation and Epiconcept, Epi-Course was attended by 22 participants from 12 French-speaking African countries from March 20 to 24, 2023.
Burundi
Launch of the Amagara Yacu project
Officially launched on May 30, 2023, in Bujumbura, the Amagara Yacu project will help to improve the quality of primary healthcare and epidemiological surveillance in Burundi, a new country to benefit from the Mérieux Foundation’s support. Its experts are supporting the National Reference Laboratory by reinforcing its infrastructure, skills, and laboratory processes.
2023 focus: overcoming the challenges of diagnosing TB
To address shortfalls in TB screening and prevention in low-income countries, the Mérieux Foundation’s commitment in the field focuses on identifying, transferring and assessing diagnostic innovations that allow the identification of new cases, improvements in treatment, and prevent the spread of the disease. This intervention is carried out within the framework of the WHO’s END-TB strategy via multiple collaborations with the health authorities in each country, research institutes, industry, and local civil society organizations involved in community programs.
Handling of samples as part of the APRECIT-Bis project in Cameroon
Tuberculosis
Caused by the Mycobacterium tuberculosis bacillus, tuberculosis or TB is a transmissible disease which generally affects the lungs but may also affect other organs (extra-pulmonary tuberculosis). It is one of the main causes of death worldwide (1.3 million deaths per year).
Effective antibiotics were developed in the 1940s but current resistant and multi-resistant forms of the disease require longer, more expensive treatments with more side effects.
Screening for silent forms of the disease is a key issue, since 10% of those infected are likely to develop the active form of the disease in their lifetime, with a much higher probability for people living with HIV and those affected by risk factors such as malnutrition, diabetes, smoking, and alcohol consumption.
The Mérieux Foundation has made combating tuberculosis one of its priority areas of intervention, with eleven projects carried out in ten or so countries in 2023. The Foundation supports national TB control programs with implementing the WHO’s recommendations. The objective is to improve the diagnosis and treatment of the disease in the most vulnerable populations, with two main areas of intervention:
Reinforce capacities for diagnosis and surveillance, in particular via the GABRIEL network (22 members, including nine Rodolphe Mérieux Laboratories in Bangladesh, Brazil, China, Haiti, Laos, Lebanon, Madagascar, and Mali). In Lebanon, for example, the Rodolphe Mérieux Laboratory in Beirut has been appointed the national reference laboratory for TB.
Facilitate access to innovative diagnosis methods, with operational research projects aiming to evaluate the tests under real-life conditions in order to improve the prevention and treatment of the disease in all its forms. The HINTT multicentric study conducted since 2017 by five members of the GABRIEL network (Bangladesh, Georgia, Lebanon, Madagascar, and Paraguay) led to the identification of two blood tests that could improve the diagnosis and treatment of TB.
WHO recommendations
To achieve the objectives of the END-TB strategy aiming to drastically reduce the mortality and incidence of TB by 2035, the WHO recommends preventing, diagnosing, and treating both forms of TB – tuberculosis disease and tuberculosis infection. The first is the active form of the disease, which is contagious and potentially fatal. The second is the silent form of the disease, constituting a pool conducive to the appearance of active TB cases.
Operational research is a priority
Tuberculosis presents multiple challenges in that there is no effective vaccine and no rapid, portable, reliable, and non-invasive test for the disease. To help fulfill the need to improve diagnosis techniques, the Foundation’s research projects are pursuing three objectives:
Prevention, of both the transmission and evolution of the disease in infected individuals, with projects aiming to assess the positioning and performance of tests allowing the identification of people with a silent form of infection associated with an increased risk of developing an active form of the disease. The APRECIT project, carried out in Cameroon and Madagascar since 2020, assesses the pertinence of a large-scale screening strategy involving community intervention, training in carrying out tests, and the treatment of TB sufferers and contact cases. Since 2022, APRECIT-BIS has been evaluating the performance of two blood tests for screening for TB infection and identifying more precisely those who may benefit from preventive treatment.
Diagnosis of complex forms: pediatric tuberculosis (need for an alternative to sputum-based tests), extra-pulmonary tuberculosis, and forms that are resistant to TB medication. In Bangladesh, the DEDICATE project is evaluating a new method of diagnostic blood testing in children and the EBC-LAM program launched in 2023 covers the evaluation of a rapid and non-invasive breath test for adults and children.
Epidemiological surveillance of resistant forms of TB. In Laos, the DiLAO-TB project is currently studying the feasibility of incorporating modern technologies for the genome sequencing of mycobacteria to rapidly characterize the level of resistance to antibiotics of strains of Mycobacterium tuberculosis. These tools could support Reference Laboratories for TB with epidemiological surveillance at national level.
“According to the latest estimates, around a quarter of the world’s population is carrying the Mycobacterium tuberculosis bacterium without realizing it and around 10% of those with the silent form of the disease have an increased risk of developing TB disease in their lifetime.” Jonathan Hoffmann, in charge of coordinating the TB program at the Mérieux Foundation
An integrated approach
Analysis of a Petri dish to discover the tuberculosis bacteria
TB control is a public health priority in the countries in which the Foundation operates, and all areas of the Foundation are involved in diagnosis, interventional research in the field, and knowledge sharing. Since 2020, these activities have expanded considerably across all areas of intervention, through multiple local, national, and international collaborations. With a reputation for expertise and community intervention, the Mérieux Foundation works in synergy with the global ecosystem for combating the disease. It has made an important contribution to USAID’s Infectious Disease Detection and Surveillance project (IDDS program 2019–2024).
Experts from the Foundation monitor technological developments to identify any diagnostic solutions under development that might provide reliable screening solutions, working alongside industrialists in the sector and reputable international research teams in the field of tuberculosis. This is how the miniaturized blood test was identified, currently the subject of a pediatric study in Bangladesh (DEDICATE program).
In 2023, the Foundation joined the Stop TB Partnership, an international consortium of parties involved in the fight against TB and communities affected by the disease. The Foundation is also a partner of The Union, a global organization fighting tuberculosis and lung diseases, and participated in its conference in Paris from November 15 to 18, 2023, the most important event on respiratory infections in the world.
Symposium on unmet needs in diagnosis
On September 28, 2023, the Mérieux Foundation and the Milken Institute at the George Washington University organized a symposium on the challenges of diagnosing TB in low-income countries. Several experts presented new approaches to prevention based on community intervention models adapted to the restrictions that exist in the most isolated areas.
Dr. Nicolas Zeller1
Medical & Scientific Director & Deputy Director General
Dr. Philippe Vanhems2
Medical & Scientific Director
Clélia Lebayle
Secretary General & Director of Support Functions
Dr. François-Xavier Babin
Director of International Operations
Dr Pascal Vincelot3
Director of Cooperation & Prospectives Programs
Bénédicte Pansier
Director of Les Pensières Center for Global Health
1Since Septembre 2023 2Ad intérim since January 2023 3Until March 2023
Scientific Advisory Board
Dr. Marie-Paule Kieny
President Inserm (France)
Dr. Valérie D’Acremont
Swiss Tropical and Public Health Institute (Switzerland)
Prof. Abdullah Brooks
Johns Hopkins Bloomberg School of Public Health, Baltimore (United States)
Dr. Kevin De Cock
CDC (Centers for Disease Control and Prevention) (Kenya)
Pr. Hubert Endtz
Erasmus University Rotterdam (Netherlands)
Dr. Rana Hajjeh
WHO Regional Office for the Eastern Mediterranean (Egypt)
Prof. Francine Ntoumi
Congolese Foundation for Medical Research (Congo)
Prof. Jean-William Pape
GHESKIO Centers (Haiti)
Dr. Firdausi Qadri
International Centre for Diarrhoeal Disease and Research (Bangladesh)
Dr. Voahangy Rasolofo
Institut Pasteur Madagascar (Madagascar)
Dr. Wenhong Zhang
Huashan Hospital of Fudan University (China)
Financial partners
“Building on our expertise in biology, we are working closely with international and local partners as part of multidisciplinary, complementary and, above all, concerted approaches with a long-term perspective.”
Alain Mérieux
To successfully carry out its development projects in LMICs and ensure they produce sustainable results, the Mérieux Foundation brings together national and international public and private partners with local organizations. The trust and commitment of its new or long-standing partners have made it possible for the Foundation to help local stakeholders in their fight against infectious diseases. The Mérieux Foundation thanks them warmly for their support.
In K€, excluding depreciation, provisions, financial expenses and future engagements
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