Reinforcing the capacities of laboratory staff

The BoliLab project, supported financially by the Coopération Luxembourgeoise and in close collaboration with the leading national laboratory, the National Center for Laboratory and Epidemiology, aims to strengthen the capacities of health services in Laos. Launched following the construction of the new provincial hospital in Bolikhamxay, the initial project aimed to improve the quality of diagnosis in the province and integrate the hospital’s laboratory into the national network.

Since 2023, the extension of the project includes the deployment of an interprovincial skills development program, as well as the refurbishment and creation of new laboratories in the provinces of Bolikhamxay, Vientiane, and Khammouane. In 2024, many initiatives were carried out with the support of the Mérieux Foundation: coaching program on leadership and laboratory management, training modules facilitating the understanding of test results, meetings between prescribers and the laboratory to exchange experiences, etc. The Foundation also awarded four scholarships enabling four provincial managers to participate in an intensive course on leadership at the Faculty of Associated Medical Science of Chiang Mai University in Thailand. A new group of students is expected to access the program in 2025.

Strengthening the capacity to respond to the threat of an epidemic

Funded by the Agence française de développement (AFD, French Development Agency), the C19-HaitiLab project aims to strengthen the capacities of the system of medical biology laboratories in Haiti in a comprehensive and sustainable way, so that it can respond effectively to an epidemic emergency. 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).

Despite the particularly critical security context in Haiti since 2023, C19-HaitiLab has remained operational thanks to the determination and dynamism of local partners and the experience of the Mérieux Foundation team. In 2024, activities in favor of laboratories were finalized, including the installation of microbiological safety stations, the provision of vehicles for the transport of samples, and the creation of a health database. Associated training sessions were also provided for technicians. Unfortunately, travel to the area of Port-au-Prince where GHESKIO is located was not possible, so the planned renovation work was postponed to 2025.

Supporting national governance with regards to tackling AMR

Designed to support skills development among practitioners and decision-makers involved in AMR surveillance in the disciplines of human, animal, and environmental health, the Fleming Fund’s Fellowship Scheme encourages peer-to-peer learning and the creation of One Health communities of practitioners. Fellows are primarily selected from governmental public institutions to reinforce national capacities for responding to AMR. The Mérieux Foundation oversees Fellowship Scheme activities in Senegal and Laos.

In Senegal, the Foundation hosts a mentee and coordinates the program. The Foundation is responsible for selecting the ten host institutions and mentors (including from Assistance Publique-Hôpitaux de Paris, the University of Limoges, ANSES, and VetAgro Sup). It then helps to develop work plans and select collaborative research projects for the mentees to work on as part of the project.

In Laos, the Mérieux Foundation offers two types of mentorships: professional mentorships focusing on the development of technical skills, and leadership mentorships focusing on the management and governance of AMR. Ten fellows were selected and five of them participated in the third edition of the Advanced Course on Antimicrobial Resistance, which was organized at the Mérieux Foundation’s Les Pensières Center from November 11 to 15, 2024

Strengthening the capacities of clinical biology to combat AMR

The Mérieux Foundation was selected by the Fleming Fund to lead the consortium responsible for coordinating the regional clinical engagement project to tackle antimicrobial resistance launched in February 2024 and covering eleven African countries. The consortium consists of the Mérieux Foundation and the British Universities of Oxford and City St George.

Program objective: to enhance patient care through skills development and improved interactions within the healthcare teams of health institutions (clinicians, nurses, laboratory staff, specialists in infectious diseases, etc.). The project also aims to collect and analyze laboratory data to guide healthcare recommendations and infection prevention and control measures. By conducting surveys on antibiotic prescribing practices, the project will further guide the implementation of Antimicrobial Stewardship technical committees, i.e. promoting the prudent and responsible use of antimicrobials.

Strengthening the surveillance of antimicrobial resistance

The Fleming Fund’s national grant program aims to improve the capacity of beneficiary countries to diagnose antimicrobial-resistant bacteria, generate data, and shed light on policies and practices at national and international level. The Mérieux Foundation was selected as the program leader in Laos and Senegal. Deployed in collaboration with Ministries of Health, these activities integrate the One Health dimension and encourage knowledge sharing on AMR and the reasonable use of antibiotics.

In Senegal, the project was launched at the end of 2024 with the organization of coordination meetings, the assessment of the needs of sentinel sites, and the political and economic analysis of AMR.

In Laos, where the project was initiated in 2020, phase II was launched in 2024 to focus on the production, analysis, and sharing of quality data in human health. It is being deployed in collaboration with the LOMWRU (Lao Oxford Mahosot Hospital Wellcome Trust Research Unit). The progress made in 2024 includes improving laboratory maintenance and inventory management, implementing training, and raising clinicians’ awareness of the importance of taking samples before prescribing antibiotics.

Organizing the detection and surveillance of infectious diseases

Conducted in more than 20 countries in sub-Saharan Africa and Asia with the goal of reducing global health risks linked to infectious diseases, the United States Agency for International Development (USAID) Infectious Disease Detection and Surveillance (IDDS) project ended in 2024. The Mérieux Foundation, via the Mérieux Foundation USA, participated in the project as an implementing partner in Madagascar, within a consortium led by the company ICF.

On January 31, 2024, the closing ceremony for the IDDS project took place in Antananarivo, marking a significant milestone in the fight against infectious diseases in Madagascar. Activities were carried out in collaboration with biologists and technicians of the RESAMAD network, created at the initiative of the Mérieux Foundation. The project also benefited from the support of several departments of the Madagascan Ministry of Public Health, in particular the Laboratory Development Department. Over five years, IDDS made it possible to develop bacteriology capacities in Madagascar and to raise the level of quality compliance of laboratory structures in accordance with the ISO 15189 standard. As part of the project’s development in the DRC, the Rodolphe Mérieux Laboratory at the National Institute of Biomedical Research (INRB) in Goma played a key role as the reference laboratory for the eastern part of the country.

Supporting the scientific excellence of the National Biomedical Research Institute

Resulting from bilateral collaboration between the Democratic Republic of the Congo and France, the support program for the National Biomedical Research Institute (INRB) in Kinshasa is funded by the Agence française de développement (AFD, French Development Agency), which has appointed the Mérieux Foundation to manage the project. One of the key challenges addressed by the project is reducing gender inequalities in access to health services by taking gender more into consideration in the INRB’s organizational practices, governance, and activities.

Planned over three years and carried out in conjunction with the Ministry of Public Health, Hygiene, and Social Prevention, the project will contribute to strengthening the INRB in its role as a National Public Health Laboratory (in particular in the fields of bacteriology and parasitology), to revitalizing its role of providing technical support to hospitals (in the field of antimicrobial resistance and malaria), and to improving the training of biologists. The construction of an administrative building is also part of the project. Activities began in 2024, including the launch of a study on the use of the innovative MalarIA software solution to reinforce the remote monitoring of malaria diagnosis.

Developing skills in the field of AMR

After a first phase deployed between 2020 and 2022, the QWArS (Qualifying the Workforce for AMR Surveillance) program continued in 2024 with the start of phase II in Laos and Cambodia. Implemented by a consortium of partners, including the Mérieux Foundation, QWArS is supported by the Fleming Fund. The program is based on developing the microbiology and epidemiology skills of human and veterinary laboratory professionals, in line with the One Health approach. By training qualified personnel working in national public health infrastructures and focusing on transdisciplinary and cross-border collaboration, QWArS aims to enable participants to contribute effectively to AMR surveillance.

The training courses are provided online and in the classroom for about ten participants in each country and will enable them to obtain a post-graduate qualification. The project is based on the expertise of a consortium of partners: the African Society for Laboratory Medicine, project leader, the African Center for Disease Control, the American Society for Microbiology, the International Pasteur Network and the Institute for Health Research, Epidemiological Surveillance, and Training.

Improving surveillance based on laboratory data

To help five countries strengthen their health systems (Angola, Democratic Republic of the Congo, Chad, Congo, and Central African Republic), the Economic Community of Central African States received support from the World Bank as part of the 4th phase of the REDISSE project (a regional project to strengthen disease surveillance systems). Concluded in December 2024, REDISSE IV was based on an integrated “One Health” approach targeting human, animal, and environmental health. Thanks to its experience, the Mérieux Foundation was selected to contribute its expertise, in particular by mobilizing key players involved in RESAOLAB, the West African Network of Medical Biology Laboratories.

The Mérieux Foundation was in charge of technical support aimed at strengthening the quality of biological diagnosis, defining national medical biology strategies, and improving regional cooperation. Following a review of the local and regional context (identification of key players and evaluation of laboratory systems), the Mérieux Foundation team participated in defining improvement initiatives adapted to each country on the three major themes for strengthening laboratories: data management, quality, and training.

REDISSE IV relied on the active contribution of national players, including primarily the health ministries of the beneficiary countries, in order to guarantee the sustainability of the project and pave the way for harmonized and coordinated intervention policies at a regional level.

Improving the quality of medical biology services

RESAOLAB (West African Network of Medical Biology Laboratories) is the first regional initiative to take into account all the factors that affect the governance and performance of laboratories (technical capacities, continuous training, external quality assessment, networking, etc.). Set up in 2009 on the initiative of the Mérieux Foundation, RESAOLAB is managed in collaboration with the Ministries of Health in seven West African beneficiary countries: Benin, Burkina Faso*, Guinea, Mali*, Niger*, Senegal, and Togo.

The third phase of the program, launched in 2019 with the support of the Agence Française de Développement (AFD, French Development Agency), continues to strengthen the capacities of medical biology laboratories in order to meet the needs of the population and contribute to global epidemiological surveillance tools. In 2024, the findings of the study on “The Importance of Governance for Strengthening Laboratory Systems in West Africa” were published and presented at the international steering committee meeting held in Conakry, Guinea.

*Due to the changing geopolitical context in the sub-region, the financing of activities by AFD funding was stopped in Mali in November 2022, and in Niger and Burkina Faso in January 2024.

Ensuring diagnosis activities in the context of a crisis

The Mérieux Foundation has supported the diagnosis and research activities of the National Tuberculosis Program (NTP) in Lebanon since 2018, with the objective of guaranteeing patient care despite the increasing deterioration of healthcare infrastructure in the country. In 2024, the Foundation continued to provide logistical support for transporting samples and undertook the work required to secure the continuity of operations (equipment to provide backup during frequent power cuts, supply of critical consumables to avoid stock shortages, etc.). This project is managed in partnership with the WHO, the Lebanese Ministry of Public Health, and the Faculty of Pharmacy at Saint Joseph University, and benefits from financial support from the International Organization for Migration (IOM).

In 2024, the Mérieux Foundation, the Rodolphe Mérieux Laboratory in Beirut, and the NTP finalized a study on tuberculosis infection taking into account demographic and epidemiological specificities related to the presence of high-risk populations in Lebanon: migrants, health workers, contact cases, and prisoners. This study, published in 2024, led to the establishment of new recommendations for the screening of tuberculosis infection, which will come into force in 2025.