Access to diagnosis for vulnerable populations is the Mérieux Foundation’s main area of intervention. This strategy is based on the reinforcement of clinical biology laboratories in regions that are particularly at risk. As one of the cornerstones of a robust health system, diagnosis lies at the heart of public health and biomedical analysis laboratories play a crucial role in disease detection, patient monitoring, and health surveillance.
Diagnosis of a sample in Madagascar
For more than 20 years now, the Mérieux Foundation has been supporting the reinforcement of biomedical analysis laboratories through collaborations with national and international organizations. In our complex and changing world in which conflicts, epidemics, and population displacement are becoming more commonplace, the Foundation has established a reputation over the years for its expertise in biology and infectious diseases. It makes an active contribution to reinforcing biomedical analysis laboratories as a means of tackling infectious diseases and, more specifically, antimicrobial resistance.
In addition to improving infrastructure and equipment and developing skills, the Foundation also supports health authorities with setting up or improving efficient laboratory systems, helping them to reinforce and optimize the diagnostic services they provide for the population and thus have a direct impact on public health.
This support is provided in four key areas:
Infrastructure and equipment
Strengthening the skills and expertise of laboratory staff
Sustainability of structures
Establishment of networks and laboratory systems
In 2023, the political and security situation in several of the areas in which the Mérieux Foundation operates became even more complicated, with some countries becoming difficult to access and requiring a review of operations. To ensure the continuity of its activities, the Foundation relies on a solid network of institutional partners and on the ability of its teams to adapt and fulfill their missions while respecting the security conditions in place.
In 2023, the Mérieux Foundation’s expertise in reinforcing clinical biology laboratories was deployed in more than 40 projects in 22 countries:
Infrastructure expertise
Virology expertise
Bacteriology expertise
Educational engineering expertise
Quality management system expertise
Biosafety and biosecurity expertise
Laboratory IT systems expertise
Expertise in health surveillance based on laboratories
Improving the availability of healthcare and epidemiological surveillance
The French Red Cross and the Burundi Red Cross, in partnership with Amref Health Africa and the Mérieux Foundation, launched the AMAGARU YACU (meaning “our health”) project in 2023, with a view to contributing to the Burundi government’s efforts to improve the country’s health system.
Amagara Yacu project launch ceremony
Funded by the Agence Française de Développement (AFD, French Development Agency) and the French Embassy, the project will help to improve the quality of primary health care and epidemiological surveillance. AMAGARA YACU includes a component dedicated to considering the gender inequalities that are hampering the right to good health and access to health care.
The Mérieux Foundation is providing its expertise to the National Reference Laboratory run by the Institute of Public Health at the Ministry of Health in Burundi, thus helping to reinforce infrastructure, equipment, skills, and quality, biosafety, and biosecurity procedures. An initial audit phase for the quality management system was carried out in order to formulate an action plan and help the laboratory with its certification process. An assessment of the requirements for renovating existing infrastructure has also been carried out.
Reinforcing the surveillance capacities of the laboratory system
Launched in the midst of the health crisis, the C19-HaitiLab project was designed to enable the health system in Haiti to monitor the Covid-19 epidemic.
Gathering for the first C19-HaitiLab steering committee in the Dominican Republic.
The project aims more globally to strengthen the role of biomedical analysis laboratories in ensuring surveillance and control in the event of an epidemic threat. Funded by the Agence Française de Développement (AFD, French Development Agency), the project combines a decentralized approach in favor of peripheral laboratories in association with the National Public Health Laboratory (LNSP) and a centralized approach to improve the energy performance at GHESKIO centers (Haitian Group for the study of Kaposi’s Sarcoma and other opportunistic infections).
In 2023, the first steering committee organized in Santo Domingo in the Dominican Republic confirmed the need to continue providing support for health structures despite the particularly critical security context in Haiti. Unlike other projects, C19-HaitiLab remains operational thanks to the determination and dynamism of local partners. The close collaboration of the National Public Health Laboratory and GHESKIO centers, along with the experience of the Mérieux Foundation, have been underlined as key factors in its success.
Regional approach to assessing the risks of hemorrhagic fever
Launched in 2021, COHWA is a One Health project to assess the risks linked with hemorrhagic fever viruses in West Africa for humans, animals, and the environment.
“One Health” experts at the COHWA project gathering
This is an international collaboration based on targeted surveillance in high-risk areas for the early identification of the viruses (particularly the Lassa fever virus, Ebola, Rift Valley fever, and Crimean-Congo hemorrhagic fever). The project is operated with the financial support of the US Defense Threat Reduction Agency via Pennsylvania State University.
Activities carried out in 2023 included missions to collect samples from humans and animals, wildlife training, and a workshop on ecological niche modeling (which refers to the position occupied by a species within an ecosystem). The COHWA consortium is made up of 10 institutions in the United States and West Africa (including the Mérieux Foundation USA and the Charles Mérieux Center for Infectious Disease in Mali). The local Mérieux Foundation team in Senegal also provides its support in terms of logistical and operational management.
Optimization of the network of diagnostic laboratories
The Mérieux Foundation was mandated by the Global Fund to map the availability of diagnosis services in Madagascar, with a view to introducing the Diagnostic Network Optimization (DNO) system that the Global Fund wants to use to improve the operation of the laboratory network in the country.
Participants at the DNO workshop.
This is a geospatial analysis system using geographical and health data to propose the optimal network architecture accessible to as many people as possible. With this in mind, the Foundation is working closely with the Laboratories Department at the Ministry of Health and with all the parties concerned to form a consensual view in line with the National Strategic Plan for the development of laboratories. Various workshops have taken place to define the scope of the tests concerned and the target to reach in terms of service availability. Some of the data has already been successfully collected, despite a complex electoral and security environment.
“This is a very innovative approach and, with the help of local stakeholders, we will work together to establish the country’s priorities for the analyses to be carried out to meet the population’s needs.” Luciana Rakotoarisoa, Madagascar Country Manager at the Mérieux Foundation
Facilitating patient access to hiv viral load testing
Having set up the first HIV viral load testing platform in Madagascar in 2015, the Mérieux Foundation has now established a network of sampling circuits between the provinces and the capital.
Donation to the EVAMAD project to extend HIV viral load testing
Benefiting from the support of Expertise France, the EVAMAD project has two objectives: to expand the geographical coverage of viral load testing and improve the care of people living with HIV/Aids in Madagascar. Renewed in 2020, the project came to an end in November 2023.
The transfer of routine analysis activities from the Charles Mérieux Center for Infectious Disease (CICM) in Antananarivo to the Ministry of Public Health laboratory was completed in 2023 at the request of the Ministry. The emergency system (for dealing with accidental exposure to the virus, particularly mother to child transmission) was initially set up at the CICM and in two pilot maternity units (Itaosy and Ankiriri hospitals). Refurbishment work was carried out at the Itaosy hospital (renovation of the reception area and the prenatal consultation room). Information and awareness campaigns were also continued in local associations and communities to increase the number of people benefiting from viral load testing.
EVAMAD was managed in collaboration with the Ministry of Public Health in Madagascar, the Global Fund, the Initiative, the National HIV/Aids and STI program, the MAD’AIDS association, UNAIDS, Population Service International, and UNICEF.
The project was the subject of two publications, as well as presentations at international conferences:
In Laos, the Mérieux Foundation was appointed to run the Fleming Fund’s activities in the field of human health, with the aim of strengthening capacities for the diagnosis and surveillance of antimicrobial resistance (AMR) in 11 hospitals in the country.
Ministry of Health and the National Center for Laboratory and Epidemiology (NCLE), the project incorporates the One Health dimension and encourages the sharing of knowledge on AMR and the reasonable use of antimicrobials across the human and animal health sectors. Initially planned to end in December 2022, the project was extended to run until September 30, 2023.
The main activities of the program included: improving infrastructures and laboratory equipment, supplying reagents, strengthening the capacities of laboratory health professionals and those working in clinical services (mentoring, conferences, training sessions with expert biologists from the Mérieux Foundation), and introducing a control and supervision process with the advice of a local team and the support of expert clinicians, biologists, and epidemiologists at headquarters.
From May 29 to 31, 2023, the Mérieux Foundation organized a workshop on antimicrobial resistance, which was attended by 80 participants from 12 hospitals in Laos, including directors, clinicians, doctors, pharmacists, biologists, and nurses, as well as representatives of health institutions such as the Department of Communicable Diseases Control, the Food and Drug Department, the WHO and the LOMWRU (Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit).
The workshop highlighted the importance of collaboration between clinicians, microbiologists, practitioners, and pharmacists for the development of sustainable and effective antibiotic management and usage programs.
British program for tackling antimicrobial resistance
The Fleming Fund is a British aid program for improving the surveillance and prevention of AMR and for promoting the appropriate use of antibiotics. The program is deployed by the Department of Health and Social Care in more than 25 countries, including Laos.
Global program for leadership training in laboratories
GLLP is a training program for laboratory staff with technical, management, and leadership components based on a local mentoring system.
GLLP participants with their certificates
The program aims to strengthen the voice of laboratories working in human, animal, and environmental health, thus enabling a community of active leaders to emerge. The training program was developed by a consortium of six major international organizations* and the project was funded by the Global Fund. The Mérieux Foundation was selected to implement the training program in Mali, Guinea, and Chad, with 10 to 15 beneficiaries and 4 to 6 mentors per country.
In 2023, the last year of the program, activities were deployed in the three target countries and 43 improvement projects were implemented by the participants with the support of their mentors. These covered subjects including biosafety, waste management, and quality. Several meetings between the different countries were organized throughout the year to allow the sharing of experiences and the establishment of practical communities. The results of the projects were presented to evaluation juries and closing ceremonies for the program were held in each country, during which GLLP certificates were awarded to the 40 graduates of the program.
Particularly satisfied with the implementation of the project in Mali, Guinea, and Chad, the Global Fund invited the teams to present their projects to the annual conference of the African Society of Laboratory Medicine (ASLM), which took place in Cape Town, South Africa, from December 12 to 15, 2023.
Successful deployment thanks to the Mérieux Foundation’s expertise in the field
To ensure the success of this ambitious project, the Mérieux Foundation was able to rely on its long-term local partners, its understanding of laboratory systems, and its many years of experience in managing projects in the field.
The program included the development of an individual project by each participant to tackle the issues concerning the laboratory system. The participants were closely supported by mentors trained by the Mérieux Foundation to guarantee the application of their newly acquired theoretical knowledge.
Feedback from the Les Pensières Center for Global Health
As a partner of the GLLP program, the Mérieux Foundation organized a meeting between members of the consortium and those in charge of its implementation in more than 15 countries. Held on September 3, 2023, at the Les Pensières Center for Global Health in France, this workshop led to the identification of the program’s strengths, including the complementary nature of teams of national and international trainers and the One Health approach.
*Association of Public Health Laboratories, Centers for Disease Control and Prevention, European Centre for Disease Prevention and Control, World Organization for Animal Health, UN Food and Agriculture Organization and the World Health Organization (WHO).
In April 2023, the Mérieux Foundation launched the second phase of the LabMyNet (Laboratory Myanmar Network) project, in the context of a severe deterioration in the health system in Myanmar.
Mandalay laboratory before renovation as part of the LabMyNet project
Continuing the measures the Foundation has been implementing for more than 20 years to support the structuring of the laboratory network and, since 2018, to reinforce HIV viral load quantification in support of the National HIV/Aids program, this new phase of support aims to enhance HIV viral load testing and diversify virological diagnosis services to improve the handling of other epidemics and endemics. Initially, diagnosis will focus on the hepatitis B virus and SARSCoV-2.
These activities are carried out by the eight operational and multi-functional molecular platforms set up during the first phase of the project (2015–2018), which will benefit from new reinforcement measures (staff training, purchase of new equipment, etc.).
Supported by the Expertise France Initiative, LabMyNet operates alongside local entities supporting the fight against HIV/Aids and in partnership with the NGO The Union, Medical Action Myanmar, UNOPS (United Nations Office for Project Services), the NGO Save The Children International, Asian Harm Reduction Network, PSI (Population Service International), MSF Holland, MSF Switzerland, and the Myanmar Positive Group.
OASIS is a One Health project that forms part of the European JPIAMR (Joint Program Initiative for Antimicrobial Resistance) initiative launched in 2020 and coordinated by the Amsterdam Institute for Global Health and Development.
Participants in the OASIS scientific workshops.
The project brings together partners involved in human and animal health with the objective of evaluating a new method of estimating antimicrobial resistance based on statistical sampling. The Mérieux Foundation is in charge of coordinating the component liked with human health, which is based on the inclusion of 16 community health centers in Burkina Faso and Togo, thanks to the support of the Lomé University Hospital and the Souro Sanou University Hospital.
OASIS uses the LQAS (Lot Quality Assurance Sampling) method of monitoring populations based on analyzing a batch of samples to assess the resistance of certain bacteria to the selected antibiotics. In the context of the analysis of the project’s preliminary results, the Foundation organized scientific workshops attended by about ten representatives of project partners, which took place in Lomé between February 28 and March 2, 2023.
Establishment of 40 new epidemiological surveillance centers
Given the regional dimension of the REDISSE program, the West African Health Organization (WAHO) wanted to reinforce the surveillance capacities of health districts by setting up Epidemiological Surveillance Centers (ESCs) covering human, animal, and environmental health.
Microscope and spectrometer maintenance training in Benin
These aim to improve the collection, processing, and analysis of data on a peripheral level to guide decision-making and improve the way epidemics are managed. Funded since 2016 by the World Bank and the WAHO, REDISSE has already been given two mandates, resulting in the creation of a network of 107 ESCs in ten African countries.
The third REDISSE mandate launched in May 2023 aims to establish 40 new centers in three beneficiary countries: Benin, Nigeria, and Togo. As for the first two phases, the Mérieux Foundation and the Canadian NGO Santé Monde were appointed to oversee the program’s activities, including training, supervision, development of the network, and acquisition of equipment. Eighty laboratory technicians were trained according to the Mérieux Foundation’s methodology, which consists of training national trainers who then take responsibility for training laboratory staff.
The establishment of the 40 new centers concluded with the organization of debrief meetings on August 28 and 29, 2023. The strong commitment of all the parties involved in the project, and especially of local parties, enabled the project to be successfully concluded in a particularly short time frame.
Supporting a regional network governing biomedical services
Set up in 2009 on the initiative of the Mérieux Foundation, RESAOLAB is a project to support biological diagnosis based on a regional approach in seven West African countries: Benin, Burkina Faso, Guinea, Mali, Niger, Senegal, and Togo.
Group work during RESAOLAB technical workshops
The project provides the governance bodies in charge of laboratories within the Ministries of Public Health in these seven countries with concrete resources for improvement in several areas – governance, technical capacities, continuous training, external quality assessment, and the establishment of networks. The third phase of the program, launched in 2019 with funding from the Agence Française de Développement (AFD, French Development Agency), was particularly active in 2020 in supporting national strategies to respond to the Covid-19 health crisis.
In 2023, RESAOLAB members were involved in the launch of the AFD’s cluster analysis involving several campaigns in favor of investment in laboratories. This resulted in the identification of RESAOLAB’s strengths, based on five project assessment criteria: pertinence, coherence, effectiveness, efficiency, and sustainability. The Foundation was also asked to participate in the AFD’s strategic review of laboratories, a cornerstone of the strategy to improve health security at a global level.
Finally, a report on the role played by laboratories in the response to the Covid-19 crisis in RESAOLAB countries was completed at the end of 2023. Its conclusions demonstrate the crucial role played by the authorities in charge of laboratories in managing the epidemic in West Africa. The network helped to develop response plans, identify operational needs, prioritize interventions, and decentralize diagnostic resources, leading to the improvement of geographical coverage. The report also reveals the importance of institutional support – one of RESAOLAB’s historic activities – in preparing authorities to deal with epidemics. This principle was included in the new strategy for the Africa Centres for Disease Control and Prevention (Africa CDC).
Due to the evolution of the geopolitical context in the region and at the request of the Ministry for Europe and Foreign Affairs, AFD funding for activities in Mali was stopped in mid-November 2022 and suspended in Niger and Burkina Faso from the beginning of August 2023.
Extra support during the health crisis
During the Covid-19 crisis, laboratories in the countries in the network were supplied with additional equipment, reagents, and consumables, thanks to the support of the member states and of several partners, including the AFD. Each country benefited from individual assistance and a more general support plan was also introduced across the network, thanks in particular to the sharing of information and training.
Establishing a network of laboratories in South-east Asia
Launched in 2020 with financial support from the Australian government (Department of Foreign Affairs and Trade), SEALAB is a project for strengthening regional health surveillance based on laboratories in three South-East Asian countries: Laos, Cambodia, and Myanmar.
Sample analysis as part of the SEALAB project
The objective of the project, which drew to a close in May 2023, was to reinforce the laboratory systems in these three countries so that they could participate effectively in preventing and responding to emerging infectious diseases, particularly those with zoonotic or epidemic potential. In collaboration with the designated ministries and institutions in the respective countries, SEALAB led to the deployment of supervision, mentoring, training, and data management activities as part of a One Health approach to global health, targeting human and animal laboratory networks. It should be noted that in Myanmar, where the geopolitical context of the coup d’état led to the significant disruption of public laboratory services, the project evolved to include the private laboratories in the network.
Taking on the role of leading the SEALAB consortium, the Mérieux Foundation oversaw the technical support, collaboration with partners, and coordination activities of the consortium.
In 2023, SEALAB laboratory professionals attended the Asia Pacific Quality Summit organized by the NRL on April 27 and 28. The project was also presented at the OHSEA (One Health in South-East Asia) colloquium held in Hanoi from April 24 to 26, 2023, and at the national coordination meeting for monitoring antimicrobial resistance organized by the National Center for Laboratory and Epidemiology and the WHO on May 5, 2023.
Applied research
By strengthening research capacities, the Mérieux Foundation supports the development of projects addressing the basic needs of local populations in the countries in which it operates. With this in mind, the Foundation prioritizes operational research relying on the implementation of community programs to benefit the most fragile groups of people.
Handling of a sample at the Charles Mérieux Infectiology Center in Laos
The Mérieux Foundation’s activities for reinforcing research focus on three main public health issues: antimicrobial resistance (AMR), tuberculosis and respiratory infections, as well as emerging pathogens. This work relies in particular on an outstanding network of units located in the heart of the most exposed regions. The GABRIEL network, coordinated by the Mérieux Foundation, plays an increasingly important role in the control and surveillance of epidemics and several of its members have officially been designated “national reference laboratories” in their countries.
The reinforcement of local applied research capacities relies on three pillars of intervention:
Strengthening the capacities of the laboratories in the GABRIEL network, in compliance with the most exacting international standards.
Training researchers through the organization of courses and conferences focusing on major public health issues.
Convinced of the need to act in synergy with the scientific ecosystem engaged in tackling infectious diseases, the Mérieux Foundation is a partner of three research organizations operating in countries with limited resources:
The French National Research Institute for Sustainable Development (IRD) for the introduction of support measures for young researchers and collaborative programs.
The Pasteur Network (Réseau International des Instituts Pasteur), including the participation of the Pasteur Center in Cameroon in the implementation of the APRECIT project involving the Institut Pasteur in Madagascar, the Pasteur Center in Cameroon, and the Mérieux Foundation.
The SHARENET network for multicentric research projects to identify the main determinants for the emergence and propagation of antimicrobial resistance. This is a network of scientific experts from Cambodia, Ivory Coast, Madagascar, Burkina Faso, Laos, Senegal, and Mauritania.
Created in 2008 by the Mérieux Foundation, the GABRIEL network (Global Approach to Biology Research, Infectious diseases, and Epidemics in Low-income countries) is an international scientific network working in synergy to develop research capacities and improve the surveillance of infectious diseases that have a significant impact on public health.
Participants at the 12th GABRIEL network international meeting in Yaoundé
The GABRIEL network covers 22 institutions in 16 countries in Africa, South-East Asia, the Middle East, South America, and the Caribbean: nine Rodolphe Mérieux Laboratories (whose construction is financed and managed by the Mérieux Foundation before being transferred to local healthcare providers) and academic, university, and hospital research institutes. The Charles Mérieux Center for Infectious Disease in Rio Branco, Brazil, which has its own Rodolphe Mérieux Laboratory, joined the network in November 2023. Having played a major role in the diagnosis of Covid-19, teams working at the Center are now developing their work in TB, respiratory infections and hepatitis, in collaboration with the three other Brazilian members of the GABRIEL network.
EVAg consortium
The GABRIEL network is a member of the EVAg (European Virus Archive global) consortium, which collects, characterizes, produces, and distributes viruses and derived products. This platform provides essential resources for the response to epidemics.
GABRIEL network’s key figures
20 20 research projects in progress (7 TB, 4 AMR, 6 ARI, 3 COVID)
77 77 collaborative publications (2012–2022)
1002 1002 scientists trained (57 training sessions through mentoring schemes and 55 training workshops)
10 10 online training modules on epidemiology, clinical research, molecular biology, the diagnosis of arboviruses, and biobanks
New developments in the GABRIEL network in 2023 include:
The 12th international meeting of the network organized in Cameroon from May 31 to June 2 (80 participants) on preparing for epidemics: vector-borne diseases, emerging pathogens, neglected tropical diseases, etc.
Publication of the results of the collaborative South-South study on the impact of the Covid-19 pandemic on the propagation of antimicrobial resistance.
Provision of scientific and technical assistance in the field of sequencing, bioinformatics, analysis, and the evaluation of results.
The organization of a training week on bioinformatics in Madagascar with Quality Assurance modules delivered to 11 members of the GABRIEL network, within the framework of the ISO 15189 accreditation of medical analysis laboratories.
Two new members joined the network: the CICM Brazil in Rio Branco and the INRB in Goma, Democratic Republic of the Congo
Funding of PhD research grants
To support young researchers, the Mérieux Foundation encourages the establishment of post-graduate programs within the GABRIEL network by funding PhD research grants (€15,000/year for three years). Four PhD programs are currently underway in Lebanon (Covid-19), Madagascar (HIV/AIDS), Brazil (emerging viruses); and Burkina Faso (TB).
Mérieux Foundation/IRD grants
In 2022, a new grant program was launched between the Foundation and the IRD. The grants support theses carried out in association with an IRD team and for which half of the time was spent in a GABRIEL network laboratory. In 2023, the second call for funding applications resulted in the selection of a new fellow in Burkina Faso (tackling AMR).
Structure and autonomy of the network
Since 2020, attention has increasingly been focused on strengthening local facilities and boosting the autonomy and initiatives of the laboratories. Within this framework, the Foundation helps to structure the GABRIEL network and improve its visibility with partners and funders thanks to:
The mapping of expertise associated with priority research topics. In 2023, this expertise was used to create a database (technological platforms, clinical connections, current and past achievements, collaborations, etc.).
Support for the submission of projects to help laboratories respond to calls for projects as coordinators or partners in international consortia. In 2023, nine projects were submitted to funders, including the JPI-AMR, the European Union, the Bill & Melinda Gates Foundation, CDCs (Centers for Disease Control), etc.
The development of collaborative projects in the field of respiratory infections and emerging pathogens. In 2023, two projects (Bangladesh and Brazil) in collaboration with the Christophe Mérieux Laboratory were selected. The first of these projects is a study of the diversity of the respiratory microbiome in acute upper respiratory infections after the Covid-19 pandemic and the epidemic characteristics of respiratory pathogens after the Covid-19 pandemic. The second project is on the identification and evaluation of human biomarkers associated with the clinical severity or the diagnosis of infection with the respiratory syncytial virus.
Collaboration with WANIDA, the West African Network of Infectious Diseases centers of excellence
In 2023, the GABRIEL and WANIDA networks identified their first two areas of collaboration: the organization of shared training and the search for funding for projects involving members of both networks. The GABRIEL network presented its activities at the WANIDA symposium in March 2023 and the WANIDA network participated in the 12th international meeting of the GABRIEL network.
GABRIEL Young Researchers Prize
Created to support the careers of promising young scientists in the network, the Young Researchers Prize was awarded in 2023 to:
Clausjeans Chastel Mfoutou Mapanguy from the Congolese Foundation for Medical Research, for his study on “The Surveillance of SARS-CoV-2 and other pathogens in the Republic of the Congo”
Nono Vanessa Ninkeh from the Pasteur Center in Cameroon for her work on “The prevalence of isoniazide-resistant TB strains”
Tuberculosis
In partnership with National TB Control Programs, civil society organizations, and research institutes, the Foundation develops studies to improve screening and care for TB patients.
Antimicrobial resistance (AMR)
An increasing threat to public health, putting the prevention and treatment of bacterial diseases at risk, the WHO has a global action plan for tackling antimicrobial resistance, for which the Foundation offers its support in terms of research and surveillance, in accordance with the global One Health strategy.
Acute respiratory infections
Pneumonia (acute lower respiratory) infections are a major public health issue in low-income countries and are the leading cause of infant mortality worldwide. Several research programs are underway within the GABRIEL network: on viral and bacterial co-infection and on the incidence and etiology of pneumonia infections.
Public health interventions based on data are one of the cornerstones of the WHO’s action plan for dealing with AMR. Two members of the GABRIEL network – the Charles Mérieux Center for Infectious Disease in Madagascar and the Souro Sanou university hospital in Burkina Faso – are creating an AMR surveillance platform based on robust tools for the collection and analysis of data.
Its objective is to share results with the medical community and decision-makers in order to help them define the relevant indicators for monitoring the impact of public health measures on AMR.
The Mérieux Foundation is providing technical support, in particular for the IT and security aspects, and is coordinating activities alongside the Bill & Melinda Gates Foundation, which is supporting the call for projects to participate in the “Grand Challenges 2022” dedicated to public health interventions based on data.
Monthly meetings were organized throughout 2023 with the stakeholders in both countries, in particular to define the requirements, expectations, roles and responsibilities of each partner (ministries, scientific societies, associations, etc.). The next stage will be the presentation of the beta version of the Data Science Center in 2024.
Following on from the APRECIT project for the treatment of tuberculosis infection (the silent form of the disease formerly known as latent tuberculosis), the Mérieux Foundation, the Institut Pasteur in Madagascar, and the Pasteur Center in Cameroon are now deploying the APRECIT-BIS project with funding from ANRS Emerging Infectious Diseases.
Participants in the APRECIT-BIS technology transfer and training workshop
The aim is to assess new strategies for screening for TB infection, which will allow health authorities to identify the beneficiaries of preventive treatment in accordance with the WHO’s recommendations, allowing action to be taken before the disease even appears.
APRECIT-BIS relies on the analysis of biological samples collected during a previous operational research project called APRECIT, which was financed by the Initiative between 2020 and 2024. The objective is to transfer and evaluate three innovative blood tests in Madagascar and Cameroon for detecting tuberculosis infection and to predict the progression from a silent form to the disease itself: the TASA (T-cell Antigen-Specific Activation assay) test, the RISK6 test, and a mix of several plasma proteins. All the tests present interesting and promising characteristics for deployment on a wide scale in countries with limited resources.
Technology transfer workshop in Madagascar
Within the framework of the APRECIT-BIS project, a technology transfer and training workshop on the new screening tests for TB infection took place from June 27 to July 5, 2023, at the Institut Pasteur in Madagascar, attended by the project’s operational partners: the Institut Pasteur in Madagascar, the Pasteur Center in Cameroon, SATVI (South African Tuberculosis Vaccine Initiative) at the University of Cape Town, Hospices Civils de Lyon, and the Mérieux Foundation.
Diagnosis of pediatric and extra-pulmonary tuberculosis
Launched in 2022, the DEDICATE project aims to combat the underdiagnosis of two specific forms of tuberculosis: pediatric tuberculosis and extra-pulmonary tuberculosis.
Project members gathered at the International Center for Diarrhoeal Disease Research in Bangladesh
These paucibacillary forms of the disease, presenting small quantities of pathogens, are difficult to detect using conventional methods based on analyzing sputum samples. The DEDICATE study in Bangladesh is assessing the performance of two molecular blood tests.
The study is based on monitoring two cohorts in a hospital environment: children under the age of 15 with suspected pulmonary tuberculosis and cases of suspected extra-pulmonary tuberculosis. The recruitment of all participants was finalized in March 2023: 406 children, around 80% of whom are under 2 years old, for the first cohort, and 403 for the second. In both cohorts, patients diagnosed with tuberculosis disease were monitored for the duration of their treatment (six months for forms sensitive to antibiotics, nine months for resistant forms) and samples were taken to assess the pertinence of the tests as a monitoring and prognostic tool.
Carried out with financial support from the AnBer Foundation, DEDICATE is led with the operational support of the icddr,b (International Center for Diarrheal Disease Research, Bangladesh) and Cepheid. The results of this study will soon be submitted for publication in an international peer-reviewed scientific journal.
Two tests assessed by the DEDICATE study
DEDICATE is assessing two blood tests for screening for paucibacillary forms of TB:
The RISK6 test, which was given a promising evaluation for pulmonary TB in adults within the GABRIEL network (HINTT multicentric research project for which the results were published in 2021).
The Xpert-MTB-HR test developed by the molecular diagnosis company Cepheid
DiLAO-TB proposes to use modern technologies for diagnosing resistance to antibiotics with a view to improving treatment for TB patients and preventing the spread of the disease and its resistant forms.
Analysis of tuberculosis prevalence rate with tNGS tests
Deployed in Laos, which has one of the highest prevalences of TB in Asia Pacific, the project relies on strengthening capacities for genotyping multidrug-resistant strains of Mycobacterium tuberculosis using the tNGS (targeted next-generation sequencing) test developed by Oxford Nanopore Technologies.
In 2023, training was provided in using the test and analysis and comparison studies were drawn up and published. The next stage is to support the scaling up of this approach, as well as its roll-out to other partner countries of the GABRIEL network.
The project is led by a consortium made up of the Center of Infectiology Lao Christophe Mérieux, which is run by the Ministry of Health in Laos, the National Center for TB Control, the French National Research Institute, and the Mérieux Foundation. DiLAO-TB benefits from funding from the FSPI-R (a solidarity fund for innovative projects).
The challenge of antimicrobial resistance
Multidrug-resistant tuberculosis is a form of TB for which treatment with isoniazide and rifampicine, the two main antibiotics used to treat TB, is not effective.
Poor treatment of tuberculosis (premature end to treatment, administration of ineffective formula) may lead to increased drug resistance.
Drug resistance can be detected using specific molecular or culture-based tests detecting the sensitivity of bacteria to drugs or resistance patterns.
Launched in 2023, the EBC-LAM project proposes to evaluate a breath test based on the analysis of an Exhaled Breath Condensate (EBC) rather than sputum, as is the case in routine tests, which are particularly difficult to collect from children.
Non-invasive and relatively inexpensive, this test is easy to roll out at the lowest levels of sanitation and can be carried out by staff with little or no training. The speed with which it can be carried out means results can be obtained during the consultation, improving the care provided for patients.
EBC-LAM is the result of a collaboration with the Institute of Pharmacology and Structural Biology (IPBS) at the CNRS (University of Toulouse), whose preliminary work identified a marker for TB (lipoarabinomannane or LAM) in exhaled air. The project aims to confirm the potential of this innovation on a wider scale by evaluating its performance in real-life situations.
The clinical study for the validation of the concept was designed and developed with the support of Dr. Jérôme Nigou from the IPBS, the icddr,b (International Center for Diarrheal Disease Research, Bangladesh) and FINDdx (a foundation affiliated with the WHO).
Launched during the health crisis, the FDP-COVID19 research program aims to study the prevalence of SARS-CoV-2 in a refugee camp, where living conditions accelerate the spread of infectious diseases.
The FDP-COVID19 project team gathered in an IDP camp
The project covers the analysis of the transmission of the virus at the Rohingya refugee camp in Cox’s Bazar, in the Ukhia region of Bangladesh.
The data is currently being analyzed and initial results suggest very high exposure to the virus. Once finalized, this study will describe in detail the circulation of SARS-CoV-2 and the seroprevalence situation in the refugee camp, as well as the risk factors that accentuate transmission. These results will help to define new health strategies to improve the management of the epidemic in situations of humanitarian crisis, with the introduction of prevention and control measures, particularly through vaccination.
The FDP-COVID19 study is being conducted with the Institute for Developing Science and Health Initiatives in Bangladesh (ideSHi) with the support of the WHO and several humanitarian institutions and organizations in the field.
In 2023, the Mérieux Foundation launched a pilot study on the transmission of extended-spectrum beta-lactamase (ESBL) producing enterobacteriaceae, classified by the WHO as global health priority.
These multidrug-resistant enterobacteriaceae can be found in humans, in animals, and in the environment, and can be responsible for serious infections. As cats and dogs have been reported as an important source of AMR, this pilot study aims to determine whether exposure to a pet is a risk factor for the emergence and spread of E. coli ESBL in humans.
The surveillance protocol will determine the prevalence of these bacteria in healthy pregnant women living in homes with or without pets, recruited in urban prenatal and perinatal health centers. Risk factors will be studied in the women and in their pets and the genetic determinants of resistance will be characterized by next-generation sequencing in order to demonstrate their potential phylogenetic relationship.
The recruitment of pregnant women with and without pets has begun in three countries in the GABRIEL network: in Bangladesh with the Institute for Developing Science & Health Initiatives (IdeSHi), in Brazil with the University of Sao Paulo, and in Paraguay with the University of Ascension.
Reducing the nosocomial transmission of SARS-CoV-2
While lockdown restrictions were still in place in some countries, the GABRIEL network took over a multicentric study to evaluate the risks of the transmission of SARS-CoV-2 in healthcare institutions.
Intervention for the NOSO-COR epidemiological study in Bangladesh
Based on the NOSO-COR research protocol established by the Mérieux Foundation and Hospices Civils de Lyon, the project was carried out in seven countries: Mali, Ivory Coast, Guinea, Madagascar, Bangladesh, Brazil, and Lebanon. The Mérieux Foundation managed the implementation of the research protocol in these countries with the financial support of the Bill & Melinda Gates Foundation.
This epidemiological study made it possible to document Covid-19 cases (around 2,700 in total), chains of transmission, risk factors, and the impact of prevention measures in the hospital environment. NOSO-COR also led to the mapping of expertise in hospitals to identify the interventions necessary for limiting cases of nosocomial infection.
The project was completed in 2023 with the analysis of results and publication in the scientific magazine, the American Journal of Tropical Medicine and Hygiene. Lessons learned from NOSO-COR will enable the proposal of solutions to reduce the risk of transmission and will contribute towards a better understanding of the impact of the COVID-19 pandemic in low- and middle-income countries, for which little data has been available until now.
An extension of the WHO’s Tricycle project, TRIUMPH is a One Health program for the surveillance of bacterial strains that are resistant to antibiotics in Malaysia, Pakistan, and Madagascar.
Analysis of samples taken as part of the TRIuMPH project in Madagascar
TRIUMPH targets two Enterobacteriaceae declared a critical priority by the WHO for their ability to render certain classes of antibiotics inactive. These are Enterobacteriaceae-producing extended-spectrum beta-lactamases (ESBL) and Carbapenemase-producing Enterobacteriaceae (CPE), which can be found in the human body, in the environment and in the food chain.
The Mérieux Foundation is responsible for the molecular characterization of isolated CPE strains in the human sector in Madagascar. The project is being conducted in 10 hospital laboratories in the RESAMAD network and the Charles Mérieux Center for Infectious Disease in Antananarivo. In 2023, sampling activities were finalized, and the analysis of genomes will be carried out in 2024.
TRIUMPH benefits from financial support from the European JPI-AMR initiative (Joint Programming Initiative on Antimicrobial Resistance) and the Swedish agency for development and cooperation.
Knowledge sharing
Transferring expertise across national borders and disciplines is one of the Mérieux Foundation’s key missions. This commitment acknowledges the absolute necessity of sharing knowledge so that together we can take effective action adapted to the needs of countries with limited resources.
Participants during the Advanced Course on Diagnostics in Africa (Afro-ACDx) in Senegal
Knowledge sharing has long been a cornerstone of the Mérieux Foundation’s commitment. It means promoting exchanges, training, and collaboration in order to make progress in tackling infectious diseases. This activity involves all the departments and areas of intervention of the Mérieux Foundation and is based on international, interdisciplinary cooperation prioritizing six main themes: vaccinology, diagnostics, infectious diseases, antimicrobial resistance, cholera, and rabies.
The resumption of activities following the pandemic continued in 2023, with face-to-face knowledge sharing reaching the same levels as before the health crisis. The portfolio of training courses was expanded with the launch of Epi-course, an advanced course on epidemiology to help experts deal with complex emergency situations in the field. The Mérieux Foundation now offers five intensive training programs for health professionals and representatives of public authorities in charge of developing and implementing public health policies.
Knowledge sharing activities rely on the Les Pensières Center for Global Health, owned by the Foundation, which continues to build on its international reputation in global health. In 2023, 200 events were hosted at the Les Pensières Center, bringing together a total of more than 8,000 people. These included the Foundation’s advanced courses, McMaster University’s course on antimicrobial resistance, the EUROPIT course on the pituitary gland, and the Merck course on vaccinology. The Center also hosted several international conferences, including GTFCC meetings on cholera, a conference on the Global Leadership Laboratory Program (GLLP), the Aspen Europe-Africa conference, and seminars on HIV/Aids.
Les Pensières Center for Global Health
Les Pensières is an international public health center situated beside Lake Annecy in France, with expertise based on over 40 years’ experience in dialog and a commitment to tackling infectious diseases at a global level. Designed as a space for sharing and reviewing knowledge, it provides the ideal working environment for health organizations, associations, and institutions sharing the same values as the Mérieux Foundation (with conference rooms, catering facilities, and accommodation). On a local level, it also plays an important role in raising awareness of key social and environmental issues.
Advanced training courses
In 2023, the Mérieux Foundation launched its fifth intensive training course. This course on epidemiology is in addition to the existing courses on vaccination (ADVAC), diagnostics (ACDx), and antimicrobial resistance (AMR), each of which is organized every year at the Les Pensières Center for Global Health. The Afro-ACDx course, which is a French-speaking version of ACDx and also includes some GLLP modules, is aimed at French-speaking African professionals and is held in Senegal. This local involvement reflects the Foundation’s desire to adapt to different contexts and its ability to relocate a training activity to meet learners’ needs in the best possible way.
As well as formal learning, these training courses also offer a platform for making contacts and creating networks of alumni, so that participants can establish valuable and long-lasting professional relations.
Public health initiatives
The Mérieux Foundation contributes to several global public health initiatives. By combining complementary areas of expertise, optimizing resources, and creating synergies, these partnerships play an essential role in the fight against infectious diseases. They also make it possible to include issues affecting countries with limited resources in major international initiatives.
Organized jointly by the Mérieux Foundation and the London School of Hygiene & Tropical Medicine since 2009, the Advanced Course on Diagnostics aims to promote the role and value of diagnostics and to reinforce decision-making capacities in low-income countries.
12th ACDx course at Centre des Pensières
The course focuses on difficulties accessing high-quality diagnostics, particularly for tackling antimicrobial resistance and preparing for epidemics, as well as on encouraging social and technological innovation.
ACDx is an intensive course in English and is aimed at the decision-makers and scientists involved in developing disease control strategies and tools. The 12th edition took place from September 17 to 22, 2023, and was attended by 25 participants from 17 countries. Three of them benefited from funding from the Mérieux Foundation.
In 2023, the program included the historic resolution of the World Health Assembly on strengthening diagnostics capacity, approved in May 2023. Two new subjects were also introduced: the first on the climate crisis and diagnostics, a key issue at the moment, and the second on the importance of communication in programs for accessing diagnosis. The course is supported by sponsorship and educational grants from bioMérieux, Cepheid, Illumina, FIND, and DTRA (US Defense Threat Reduction Agency).
Acknowledged as one of the most prestigious courses in its field, ADVAC is an intensive training program in vaccinology, which was set up by the Mérieux Foundation and the University of Geneva in 2009.
Participants in the 23ème ADVAC course held at the Centre des Pensières
Geared towards managers from all levels of the health care system, ADVAC aims to facilitate critical decision-making in vaccinology, by providing participants with a complete overview of the sector, from immunology to the development of vaccines, as well as covering the social, economic, political, and ethical issues associated with vaccination.
The 23rd edition of ADVAC took place from May 8 to 19, 2023, and was attended by 74 participants from 41 countries. The participants were also able to attend the 7th Lambert lecture and the 15th Plotkin lecture, addressing the future of vaccines based on T CD8+ cells and monkeypox respectively. Each year, European training credits are requested from the European Accreditation Council for Continuing Medical Education (EACCME). In 2023, 66 credits were awarded.
“The future of immunization is in your hands. As leaders, you have a voice that will be heard!” Violaine Mitchell, Director of the Immunization program at the Bill & Melinda Gates Foundation, at the 23rd edition of ADVAC
ADVAC 2023
11 11 days of training
74 74 participants
80 80 reputable experts
1 1 network of 1,400 alumni
A dynamic network of alumni
Two meetings of former students were organized in 2023 in the form of webinars: on the challenges of eliminating measles and rubella in South-East Asia (April 12) and on the economic perspectives for vaccination programs (September 20).
Following on from the success of the first two editions, the Mérieux Foundation and the Institut Pasteur in Dakar organized the third Afro-ACDx course in 2023.
Participants in the 3rd edition of the Afro-ACDx course at the Institut Pasteur in Dakar.
This French-speaking version of the international ACDx program was developed to strengthen the leadership skills of laboratories in West and Central Africa as part of a One Health approach. The course is aimed at laboratory managers and decision-makers in the field of diagnostics in public health. In 2023, the historic resolution of the World Health Assembly on strengthening diagnostics capacity, approved in May 2023, was included in the program.
Held from November 19 to 24 in Saly, Senegal, the 2023 edition of Afro-ACDx brought together 31 participants from 12 countries. A visit to the African Center for Resilience to Epidemics (CARE) was organized and several production and analysis sites at the Institut Pasteur in Dakar opened their doors to the students. Afro-ACDx benefits from the financial support of bioMérieux, Cepheid, and Illumina.
Course on antimicrobial resistance – a One Health challenge
Based on the objectives of the WHO’s Global Action Plan on antimicrobial resistance, the AMR course developed in 2019 by the Mérieux Foundation and Paris Cité University aims to support the fight against AMR and strengthen decision-making as part of an interdisciplinary approach.
Lecture at the 4th edition of the AMR course
The fourth AMR One Health Challenge took place from November 6 to 10, 2023, and brought together 40 doctors, vets, environmentalists, and experts in biological sciences, human and social sciences, and public health from 20 countries in Asia, Africa, and the Middle East, all of whom were selected for their commitment to tackling AMR in their countries.
In 2023, the program offered an-depth study of the WASH (Water, Sanitation, Hygiene) and IPC (Infection Control and Prevention) components, with contributions by experts from UNICEF, the WHO, and the FAO. The Oxford Institute, Sanofi, IFPMA, and bioMérieux supported the participation of several candidates from low-income countries.
The Mérieux Foundation supports the MERACON regional network for rabies control in the Middle East, Eastern Europe, Central Asia, and North Africa.
Set up in 2018, MERACON took over from the MEEREB (Middle East, Eastern Europe, Central Asia and North Africa Rabies Expert Bureau) network, which had been managed by the Mérieux Foundation since 2012. MERACON is led by the Global Alliance for Rabies Control (GARC), in close collaboration with the Foundation.
MERCACON provides scientific expertise, planning, and operational support to help governments and decision-makers commit to improved programs for controlling and eliminating rabies.
“Zero by 30” objective
Regional networks for controlling rabies play an important role in implementing the global strategic plan to end human deaths from dog-mediated rabies by 2030, in accordance with the WHO’s “Zero by 30” objective.
The Mérieux Foundation has been involved in the Global Task Force on Cholera Control since 2017, along with more than 50 organizations, including GAVI and the Bill & Melinda Gates Foundation.
10th Annual GTFCC Meeting
GTFCC’s objective is to develop measures to control the disease at regional level. This multi-sector partnership has set itself the objective of reducing the number of deaths from cholera by 90% by 2030, thanks to a shared global road map.
The Mérieux Foundation is involved in the implementation of activities linked with knowledge sharing, taking responsibility for the website, and the organization of meetings, including the annual meeting at the Les Pensières Center for Global Health and meetings of the themed working groups (see inset).
In 2023, the 10th annual meeting of the GTFCC was held on June 26, 27, and 28 and was attended by 214 people in person and remotely. This hybrid format was also adopted for meetings of the themed working groups so that discussions could also include people working in the field.
GTFCC themed workshops 2023
WASH (Water, Sanitation, Health) working groups 8th meeting, March 20 and 21, 2023, New York – 55 participant
Surveillance working groups (epidemiology and laboratory) 8th meeting, May 2 to 5, 2023, Maputo, Mozambique – 160 participants
Oral cholera vaccine working groups 10th meeting, October 11 to 13, 2023, Seoul, South Korea – 122 participants
Cholera emergency
Due to the effects of climate change and an increasing number of conflicts, there has been an upsurge in the number of cholera cases. According to the WHO, the number of cases more than doubled between 2021 and 2022 to reach 473,000, and increased to more than 700,000 in 2023. Several epidemic alerts have been reported, particularly in the Democratic Republic of the Congo, Malawi, and South Africa.
Advanced course on epidemiology in complex emergency situations
The first edition of the Advanced Course on Epidemiology, Epi-Course, organized jointly by the Mérieux Foundation and Epiconcept, took place from March 20 to 24, 2023, and was attended by 22 participants from 12 French-speaking countries.
Participants in the first advanced epidemiology course
The program was developed with the help of a scientific committee made up of representatives of the Hospices Civils de Lyon, GAVI, the Institut Pasteur, the WHO, the WAHO (West African Health Organization), and the Nazi Boni University in Burkina Faso.
Epi-Course was set up to fulfill the need to strengthen capacities in epidemiology, after the last two epidemics (Covid and Ebola) revealed shortfalls in warning, surveillance, and investigation systems. The aim is to establish a community of French-speaking epidemiologists working in human, animal, and environmental health, who are able to provide a multidisciplinary and international response to complex emergency epidemic situations.
This first edition was a resounding success, with 97% of participants declaring that the course fulfilled their expectations. After the course, the participants continued their discussions by organizing four webinars. Epi-Course benefited from grants allocated by bioMérieux and Illumina.
Set up in 2013, Asia Dengue Voice and Action (ADVA) is a scientific working group dedicated to the prevention and control of dengue in Asia.
Participants at the 6th Asian Dengue Summit in Bangkok
Thanks to a collaboration with the government, universities, industry, and non-governmental organizations, ADVA is continuing its mission to fight dengue throughout Asia with numerous workshops and webinars to provide information and raise awareness.
In this context, the Mérieux Foundation was a partner for the 6th Asia Dengue Summit held in Bangkok on June 15 and 16, 2023. 170 dengue experts from all over the world came to share their knowledge in order to improve the prevention and control of the disease on a global scale. The event was organized jointly by ADVA, the Global Dengue and Aedes-transmitted Diseases Consortium (GDAC), the South-East Asian Ministers of Education Tropical Medicine and Public Health Network (SEAMEO TROPMED), and the International Society for Neglected Tropical Diseases (ISNTD).
Launched by the Mérieux Foundation in 2008, the Vaccine Acceptance Initiative campaigns for the adoption of vaccines and shares information on instruments that encourage the understanding, introduction, and adoption of vaccines.
Meeting as part of the Vaccine Acceptance Initiative
The COVID-19 pandemic revealed how mistrust in vaccination can be an obstacle to preventing the burden of infectious diseases. In order to help restore confidence, the Vaccine Acceptance Initiative aims to create opportunities for dialog on issues relating to the resilience of immunization programs.
A series of meetings on social and behavioral determinants and the lessons learned from the introduction of the COVID-19 vaccine was organized at the Les Pensières Center for Global Health on October 30 and 31 and November 1, 2023, and attended by 40 participants. These events benefited from the support of Sanofi and MSD.
The Mérieux Foundation, Every Breath Counts, the Malaria Consortium, the International Vaccine Access Center (IVAC), and Save the Children, in partnership with the Chad Ministry of Public Health and Prevention hosted an in person Workshop from 13 to 15 September.
This workshop aimed to bring together the stakeholders to support the governments of Chad, Guinea, Somalia, and South Sudan after they expressed their commitment to introducing the pneumococcal conjugate vaccine (PCV) and rotavirus vaccine.
The two vaccines have the potential to prevent the deaths of tens of thousands of children across the four countries by 2030, boosting each country’s progress to achieving the Sustainable Development Goal for child survival.
With more than 80 national, regional and international participants, the workshop was the occasion to troubleshoot barriers and advance solutions, facilitate scale-up and enable the four governments to obtain the guidance and the support they needed.
In 2022, the Mérieux Foundation formed a partnership with the Every Breath Counts coalition, the world’s first public-private partnership against pneumonia, which is the biggest infectious killer worldwide.
Workshop in N’Djamena to facilitate the introduction of PCV
Made up of UN agencies, businesses, donors, academic institutions, and NGOs, Every Breath Counts supports governments in countries most at risk from pneumonia and campaigns for urgent action to reduce the burden of the disease.
In 2023, in the context of the introduction of two pediatric vaccines against respiratory infections in Chad, Guinea, Somalia, and South Sudan, a support project was set up by the Mérieux Foundation, Every Breath Counts, the Malaria Consortium, the International Vaccine Access Center (IVAC), and Save the Children. In partnership with the Ministry of Public Health and Prevention in Chad, a workshop was organized from September 13 to 15 in N’Djamena, which was attended by 80 participants. The objective of this workshop was to facilitate the introduction of the PCV (pneumococcal conjugate vaccine) and the rotavirus vaccine in the four countries and to help governments submit their funding requests to GAVI in 2024.
Global Forum on childhood pneumonia
The Mérieux Foundation was involved in the second Global Forum on Childhood Pneumonia, held in Madrid on April 26 and 27, 2023. Activities to support the introduction of two pediatric vaccines in Chad, Guinea, Somalia, and South Sudan were presented at the forum.
Mothers & children
The Mérieux Foundation supports projects to help the most disadvantaged populations, especially women and children, who are the primary victims in crisis situations. This commitment covers their basic human needs as part of a global health approach.
In the waiting room of Kindia Hospital, Guinea
In situations of insecurity or severe poverty, the Mérieux Foundation is committed to supporting local partners as they improve the living conditions of fragile populations. These projects cover access to healthcare, education, and basic needs such as hygiene, food, and housing.
The Foundation’s commitment covers two types of intervention:
Support for associations working in the field with long-running partnerships such as with Akamasoa in Madagascar and Enfants du Mékong in Cambodia.
The development of new projects, with operations run by the Mérieux Foundation and its teams, resulting primarily in the establishment of primary health centers and maternity units, such as in Lebanon where a second health center is currently under construction. The Mérieux Foundation also responds to emergency situations in the event of conflicts or natural disasters.
Improving access to healthcare for vulnerable people
The Mérieux Foundation provides its expertise directly in the field to improve the living conditions of the most vulnerable communities, as part of a global healthcare approach covering physical, mental, and social health. Several community health centers have thus been built or renovated thanks to the support and expertise of the Foundation working alongside local health authorities.
Distributive projects in favor of partners in the field
Within the framework of historic partnerships or one-off actions in response to emergency situations, the Mérieux Foundation finances projects run by local associations to improve living conditions in the poorest communities.
In partnership with the Congolese Foundation for Medical Research, and under the guidance of Pr Ntoumi, winner of the Prix Christophe Mérieux 2016, the Mérieux Foundation is funding the construction of a maternity unit in Brazzaville, DRC.
This maternity unit will also have a pediatrics department and will be located in a two-story building next to a health center and medical analysis laboratory.
The Mérieux Foundation is providing technical support for the development and interior design of the new building: review and selection of available options, monitoring of associated costs, and supervision of the building site. The major structural works were completed in December 2022. The delivery of the building that will house the future maternity unit was celebrated on April 10, 2023, during a visit by a delegation from the Mérieux Foundation. The maternity unit will become operational in 2024.
Construction of a primary health center in Baalbek
In 2023, a new construction project for a community health center was launched in Baalbek, Lebanon, with the objective of improving maternal and infant health in the most vulnerable populations, including military personnel in the Lebanese army and their families.
Continuing the Mérieux Foundation’s activities promoting access to healthcare in the region, this project draws on the experience gained at the Duris health center.
Once architectural and geotechnical studies had been carried out and the building site had been validated, the project was approved, and construction work is scheduled to begin in 2024. The project is being carried out in association with the Governorate of Baalbek-Hermel and the Lebanese army.
Launched in 2005 in Mali with the Fondation Christophe et Rodolphe Mérieux, support for Samusocial was extended to Senegal and Burkina Faso in 2009.
Mr Mérieux’s visit to Senegal as part of the SamuSocial project
The program helps children and young people in situations of social exclusion and focuses on actions providing medical and psychosocial treatment and educational initiatives.
In 2023, the Mérieux Foundation supported Samusocial in Mali, Burkina Faso, and Senegal with a global grant paid to Samusocial International. This donation supported mobile teams working at the three units, who carried out more than 2,000 rounds throughout the year, as well as providing medical care and social and psychological support (more than 16,000 beneficiaries). It also helped to provide emergency accommodation (more than 1,600 people in 2023) and supported projects to get people off the streets: reconnecting with their families, education, professional training, etc.
Development of a mother & child center in Thiadiaye
A new project launched in 2023 covers the establishment of a specific healthcare circuit for mothers and children, with the creation of a specialist wing at the health center in Thiadiaye, western Senegal.
The objective is to facilitate access to the Mother & Child center and to the medical biology laboratory in order to improve maternal, newborn, and infant health. The project, the first of its kind in the country, is based on an inclusive and holistic approach covering clinical, psychological, and social care, as well as parenting support. By the end of 2023, the memorandum of understanding had been signed with the Ministry of Health and Social Action, plans had been approved, service providers selected, and the laying of the foundation stone had been celebrated. Construction work will begin in 2024.
This project was developed in close collaboration with the Ministry of Health and Social Action, the Thiès regional health department, the health district, and associations. It is being funded with the support of the Department of International Cooperation of the Principality of Monaco and the AnBer Foundation.
Following the initial construction and launch phase completed in 2021, the second phase of support for the Duris health center in the Beqaa Valley in Lebanon was finalized at the end of 2023.
Mother and child health center in Douris, to be built in 2021
This support was directed at increasing the capacity of the center and expanding its healthcare services, with a component on awareness and prevention (infectious diseases, cancer, and mental health). Progress made in 2023 includes the development of new spaces, the recruitment of new areas of expertise (nutritionist, speech therapist, and nurses), and the integration of the center in the national network of primary health centers in Lebanon. At the same time, a study was carried out by the Foundation in order to capitalize on this experience and use it as a model to replicate in similar contexts.
Under the supervision of the Ministry of Public Health, the project is being coordinated by the Mérieux Foundation with the support of the Department of International Cooperation of the Principality of Monaco. The center is managed by the local NGO AMEL International, with the help of the Governorate of Baalbek-Hermel and the Municipality of Duris.
The Mérieux Foundation’s Small Grants program is a €50,000-a-year fund that awards grants of up to €5,000 to small organizations with a strong local impact. Two application review sessions are held each year.
Maternity ward at the Sombo health post in the DRC, rehabilitated by Fondation Mérieux
Ten projects were selected in 2023:
Support for primary healthcare structures
Improving the quality of healthcare provided at the maternity unit in Ngougoumou, Cameroon, thanks to the supply of solar power (Mengbwa Actions Jeunes)
Renovation of the maternity unit at the health outpost in Sombo in the Democratic Republic of the Congo (Baptist Community of the Congo River)
Education and awareness
Training in maternal and infant health for healthcare staff and pregnant women in Haiti (Club des Jeunes Progressistes pour le Développement Social de Carrefour-Feuilles)
Reinforcing the resilience of women and children affected by conflict through the prevention, diagnosis, and treatment of infectious diseases in North-West Cameroon (Community Action for Advancing Sustainable Development)
Health education (infectious diseases, reproductive health, etc.) to improve maternal and infant health in the Sinjar region in Iraq (Doctors of Peace)
Global health actions (WASH & Nutrition)
Tackling waterborne diseases by renovating latrines in primary schools in Uvira, Democratic Republic of the Congo (Aide Rapide aux Victimes des Catastrophes)
Improving the living conditions of HIV-positive widows and their children in Kibeho, Rwanda, by providing learning support and income-generating activities (Artisans de la Paix)
Controlling infectious diseases by treating contaminated water sources and raising awareness in communities in Benin (Vidécon Environnement)
Supporting the maternal health of Sudanese refugees in Egypt through the distribution of dignity kits and infant milk (Rawsa Women Alliance)
Creation of a laboratory preparing Madagascan essential oils in Antsirabe, Madagascar, to support vulnerable populations (Aromathérapeutes du Vakinankaratra)
In 2022, the Mérieux Foundation started supporting the association Go Paga in Burkina Faso, which helps the widows and orphans of soldiers.
Vocational training with the Go Paga association
The deterioration of the security situation in the country since 2015 has led to more than a million deaths in the defense and security forces, leaving many families without a source of income. Go Paga was set up to support the social, economic, and professional integration of widows and orphans through two main actions:
support for education and the organization of extracurricular activities
professional training and support for the development of income-generating activities
In 2023, the Mérieux Foundation’s support allowed 100 orphaned children to attend school for the 2023/2024 school year, as well as covering enrollment for summer holiday camps. The Foundation also contributed to the training of 60 widows (dressmaking and business leadership) and to the allocation of 25 kits for setting up small businesses.
Actions Santé Femmes (ASF) is a French NGO committed to the health of women in severe difficulty all over the world.
Workshops for pregnant women and training of midwife referents in maternity wards
In 2023, the Mérieux Foundation provided the ASF with financial support for implementing its “Health of Armenian women in the Shirak and Syunik Provinces” project in order to improve gynecological and obstetric health services for women in the most precarious situations through training for professionals in primary health centers.
This support contributed to activities in the field in both provinces:
Workshops for pregnant women and training for lead midwives in maternity units (on pregnancy, childbirth, postpartum care, relations between men/women, cancer screening, etc.)
Consultations by ASF teams working alongside Armenian gynecologists and obstetricians.
Educational support for teaching staff at the medical college in Gyumri State in training student midwives.
Since 2010, the Mérieux Foundation and the Fondation Christophe et Rodolphe Mérieux have been supporting the Doctor Christophe Mérieux University Center in Phnom Penh, managed by the NGO Enfants du Mékong.
Graduation ceremony at the University Center supported by Fondation Mérieux
This center was developed to offer students from disadvantaged backgrounds the possibility of pursuing further education and since 2013 has also provided places for nursery school children. In 2023, the Mérieux Foundation’s support enabled 120 students and 55 nursery school children to attend the center and social support was also provided for 350 other children. Free English lessons were also organized for children living near the center.
Since 2018, the Foundation’s funding has enabled Enfants du Mékong to run a “Mother & Child” social project to help families gain financial independence and guarantee a safe emotional and physical environment for children. Almost 250 families living in poverty were given support in 2023 (distribution of food and hygiene kits) and 114 mothers in difficulty benefited from the distribution of breast milk for their newborns. Training sessions in budget management, first aid, and parenthood were organized for more than 200 parents and 26 construction/renovation projects were financed to improve families’ living conditions.
Support for the microcredit activities of GHESKIO centers
Since 2005, the Mérieux Foundation has supported the “Microcredit and training program for women living with HIV and vulnerable women in Haiti” program implemented by the GHESKIO Centers in collaboration with the microfinance institution ACME (Action pour la Coopération avec la Microfinance).
Training at a GHESKIO center
This initiative is aimed at communities in difficult situations and offers global support: medical and psychosocial care, access to education, and income-generating activities.
The Foundation’s support, renewed for another year from April 1, 2023, allowed a new phase of the program to be launched, benefiting more than 900 women and 100 children (650 training courses in small businesses, 258 professional training courses, 88 educational grants, etc.). The Foundation’s aid has also enabled 114 families who were forced to move for safety reasons to be rehoused and provided ongoing training for 22 primary school teachers at GHESKIO Centers.
Historic Partnership with GHESKIO Centers
Set up in 1982, GHESKIO Centers (Haitian Group for the Study of Kaposi’s Sarcoma and other Opportunistic Infections) are dedicated to operational research, training, and services linked with diseases having a major impact on public health in Haiti (HIV, TB, sexually transmitted diseases, and diarrheal illnesses). The Mérieux Foundation is a partner of GHESKIO in numerous projects carried out in Haiti, across all its areas of intervention.
Inaugurated in October 2022, the extension of the Saint Gabriel de Conakry clinic in Guinea was provided with additional support from the Mérieux Foundation in 2023.
Patients at the Saint Gabriel dispensary
The Saint Gabriel clinic has a primary health center and a maternity unit, which itself has a prenatal center for women living with HIV/AIDS and their children, providing them with follow-up care.
In 2023, the Mérieux Foundation provided financial support for several of the clinic’s projects:
The creation of a waiting room and consultation room to allow pregnant women to have scans at minimum cost.
The acquisition of a neonatal resuscitation table and electrical backup batteries to limit the impact of power cuts on the maternity unit.
The creation of a training room and an ongoing learning module for the medical team.
Saint Gabriel, a maternity unit and primary healthcare clinic
Saint Gabriel is a key healthcare structure and one of the busiest in Guinea. The clinic specializes in HIV screening for pregnant women. In 2012 a PMTCT program (prevention of mother-to-child transmission of HIV) was launched in collaboration with the DREAM program (a model for the integration of services for maternal and infant healthcare).
In 2022, the extension funded by the ADP Foundation, the DREAM program, and the Mérieux Foundation (an additional story with a surface area of 78 m²) allowed an increase in the clinic’s capacities for screening and treating people living with HIV.
Since 2014, with the help of the Fondation Christophe et Rodolphe Mérieux, the Mérieux Foundation has supported the Madagascan association for tackling poverty, Akamasoa (“good friends”), which works towards improving living conditions in the villages surrounding Antananarivo.
Courses at Saint Vincent de Paul-Akamasoa University
Each year, a grant is allocated to support infrastructure projects promoting access to hygiene, education, and healthcare.
Following the inauguration of the Saint Vincent de Paul-Akamasoa University in 2022, work was completed in 2023, as well as the construction of a four-story library and 40 residences. The campus of this English and French language university has a capacity for 1,000 students from poor families from all provinces on the island.
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