2015 ANNUAL REPORT MESSAGE DU PRÉSIDENT

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ANNUAL REPORT

3 2015 ANNUAL REPORT MESSAGE DU PRÉSIDENT

Infectious diseases cause 17 million deaths each year around the world, predominantly in developing countries.

For over 45 years, Fondation Mérieux, an independent family foundation, has been taking action to ensure that every“ man, woman and child has fairer access to essential healthcare.

1 CONTENTS ***

ANNUAL REPORT PRESIDENT’S P.05 MESSAGE

PRESENTATION P.06 OF FONDATION MÉRIEUX

RESPONDING P.08 TO THE MIGRANT CRISIS IN THE MIDDLE EAST

DIRECTOR GENERAL’S P.13 EDITORIAL

SUPPORT P.17 * RESAOLAB ///// P.19 * WARDS ///// P.20 * AFRICA P.15 FOR CLINICAL BIOLOGY P.21 * AMERICAS ///// P.22 * ASIA ///// P.23 * MIDDLE EAST LABORATORIES

* COLLABORATIVE P.26 EMERGING PATHOGENS LABORATORY P.25 * * RESEARCH PROGRAMS P.27 GABRIEL NETWORK // P.28 THE 2015 CHRISTOPHE MÉRIEUX PRIZE P.29 * RESEARCH PROJECTS KNOWLEDGE-SHARING P.35 AND PUBLIC HEALTH P.36 * TRAINING ///// P.39 * SCIENTIFIC CONFERENCES PARTNERSHIPS P.42 * SUPPORT FOR INNOVATIVE PUBLIC HEALTH INITIATIVES

FONDATION MÉRIEUX P.45 * AFRICA ///// P.52 * AMERICAS ///// P.54 * ASIA P.44 WORLDWIDE P.58 * MIDDLE EAST

P.60 GOVERNANCE

P.61 MAIN PARTNERS

P.62 2015 ACCOUNTS & KEY FIGURES

03 2015 ANNUAL REPORT PRESIDENT’S MESSAGE

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PRESIDENT’S MESSAGE Alain Mérieux •

Building on our expertise in biology, we are working closely with international and local partners as part of multidisciplinary, complementary and, above all, concerted approaches with a long-term perspective.

The geopolitical upheavals that marked with shelter is also essential. And we must take action in the 2015 and the unprecedented migration economic realm as well, providing the most vulnerable patients crisis facing Middle Eastern countries have with the treatment they need and access to education. In this had major public health rami cations. context, social reintegration programs such as micro-credit loans These con ict zones are fertile ground for or the creation of schools are important success factors. infectious diseases, which thrive on more vulnerable populations. Building on our expertise in biology, we are working closely with As a result, refugee camps have been hard hit by respiratory international and local partners as part of multidisciplinary, infections, TB cases, and diarrheal illnesses caused by insalubrity... complementary and, above all, concerted approaches with a and children are the foremost victims. In some of the most long-term perspective. troubled regions where vaccine coverage is decreasing because “ One such example is our initiative with displaced persons in Iraq, of obscurantism and insecurity, new polio cases have emerged, in collaboration with other foundations in the Rhône-Alpes along with other diseases that were considered nearly eradicated. region, to strengthen diagnostic capacities, house displaced We can of course provide emergency solutions, particularly in the families, and educate children. Unfortunately the need is still eld of diagnostics, to improve patient care and better control immense, which is why we have decided to bolster our efforts in epidemics. But our foundations must sometimes take more Lebanon, Iran and Tunisia. comprehensive action to provide assistance that goes beyond I have, however, great con dence in the health needs. mobilization of our networks in these We cannot resolve public health problems by focusing just on countries facing absolute tragedy, and medical care. While it’s obviously at the core of response efforts, in the ability of teams from different bringing remarkable innovations in prevention, diagnostics and backgrounds and cultures to work therapy, health professionals must also take a broader approach. together to lessen suffering and restore It is important to address the safety of water, the environment, hope.“ food, and more generally nutrition. For countries in crisis, ensuring the physical safety of populations and providing them ...... Alain Mérieux

05 2015 ANNUAL REPORT PRESENTATION OF FONDATION MÉRIEUX

CONTRIBUTING TO PUBLIC HEALTH WORLDWIDE BY STRENGTHENING LOCAL CAPACITIES IN DEVELOPING COUNTRIES • n 20 COUNTRIES IN WHICH WE ARE ACTIVE n 13 TRAINING AND RESEARCH CENTERS n 18 APPLIED RESEARCH UNITS FEDERATED IN THE GABRIEL NETWORK n 27 COLLABORATIVE RESEARCH PROGRAMS n 14 CONFERENCES n 10 COURSES AND TRAINING SESSIONS ORGANIZED IN FRANCE AND ABROAD n 32 LABORATORIES RENOVATED, INCLUDING 5 IN 2015 n 13 LABORATORIES BUILT, INCLUDING 1 IN 2015 n 92 PEOPLE MOBILIZED IN 14 COUNTRIES n A 20 MILLION EURO BUDGET

06 2015 ANNUAL REPORT PRESENTATION OF FONDATION MÉRIEUX

A PUBLIC HEALTH MISSION •

REDUCE THE IMPACT OF INFECTIOUS DISEASES n 20 COUNTRIES IN WHICH WE ARE ACTIVE n 13 TRAINING AND RESEARCH CENTERS n 18 APPLIED RESEARCH UNITS FEDERATED IN THE GABRIEL NETWORK n 27 COLLABORATIVE RESEARCH PROGRAMS Fondation Mérieux, an independent family foundation with public interest status, n 14 CONFERENCES n 10 COURSES AND TRAINING SESSIONS ORGANIZED IN FRANCE AND ABROAD is committed to ghting against infectious diseases affecting developing countries n 32 LABORATORIES RENOVATED, INCLUDING 5 IN 2015 n 13 LABORATORIES BUILT, INCLUDING 1 IN 2015 n 92 PEOPLE MOBILIZED IN 14 COUNTRIES n A 20 MILLION EURO by reinforcing their clinical biology capabilities. The foundation’s action is focused BUDGET on diagnosis, an essential aspect of patient care and an indispensable tool for disease surveillance and control. In the eld, the foundation helps the most vulnerable, with a particular emphasis on mothers and children. Fondation Mérieux works closely with Fondation Christophe et Rodolphe Mérieux, an independent family foundation under the aegis of the Institut de France, sharing the same public health goals.

A PHILOSOPHY OF ACTION BASED ON:

3 PRIMARY OBJECTIVES * a collaborative dynamic supported by partnerships with the • local players in healthcare, international organizations, academic research, companies, etc., Increasing vulnerable populations’ access to * diagnostics by strengthening clinical biology a long-term vision, with continued support leading to auto- nomy and local appropriation of infrastructures and programs, laboratories in national healthcare systems, * the development of networks, fostering South-South Creating and enhancing local applied research cooperation to share experience and pool skills, capabilities by training researchers, creating diagnostic tools and developing collaborative * an approach without borders between human and veterinary programs for diseases that affect developing medicines. countries, Encouraging knowledge-sharing among health professionals, contributing to the emergence of innovative public health initiatives.

077 2015 ANNUAL REPORT RESPONDING TO THE MIGRANT CRISIS IN THE MIDDLE EAST

* EMERGENCY AID IN IRAQ * RESEARCH PROJECT IN LEBANON * ETIOLOGY OF RESPIRATORY INFECTION IN SYRIAN REFUGEES •

Black Sea

TURKEY Caspian Sea Gaziantep Mosul Aleppo Erbil Tripoli SYRIA Beirut LEBANON Damascus IRAN Baghdad Mediterranean Sea Amman IRAQ JORDAN

SAUDI ARABIA

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RESPONDING TO THE MIGRANT CRISIS IN THE MIDDLE EAST •

In ful lling its mission to ght infectious diseases, Fondation Mérieux cannot overlook the often extreme conditions in which vulnerable populations live. Over the years, Fondation Mérieux’s teams in the eld have collaborated with local NGOs working to ensure the health and well-being of populations in distress, with a particular emphasis on mothers and children suffering the consequences of poverty, conict and natural disasters. These actions reect the Foundation’s holistic approach to health, and its determination to address the speci c needs of the countries in which it operates.

EMERGENCY AID IN IRAQ • With the support of Fondation Christophe et Rodolphe Mérieux, Fondation Mérieux has been working in the Middle East, since the outbreak of the crisis in Iraq, to support populations eeing Isis. An evaluation mission was conducted in several internally displaced person (IDP) camps in the Kurdistan Region of Iraq in August 2014. This resulted in the delivery of 13 tons of emergency food aid (through a partnership with the Auvergne-Rhône-Alpes In 2015, the three foundations decided to continue their collaborative Region) and one ton of drugs supplied by the NGO Tulipe (Inter- efforts, this time focusing on education. With additional support national Emergency and Solidarity by Healthcare Companies). from Fondation AnBer and the Auvergne-Rhône-Alpes Region, These drugs have been used to stock dispensaries, which now see the Saint-Irénée school was of cially opened on June 28, 2015. more than 500 patients each day, around half of whom are children. The school has 18 classrooms and accommodates around 1,100 pupils Again in 2014, Fondation Mérieux joined forces with Fondation each day. Fondation Mérieux drew up the plans and employed Saint-Irénée, Fondation Raoul Follereau, the Auvergne-Rhône-Alpes people from local IDP camps to help build the school. A sports eld Region, the City of Lyon, and Grand Lyon to help build 250 new was also created close to the school and efforts are currently ongoing homes in Erbil, providing decent housing for more than 1,000 people. to introduce income-generating activities for displaced persons.

09 2015 ANNUAL REPORT RESPONDINGMESSAGE TO THE MIGRANT DU CRISISPRÉSIDENT IN THE MIDDLE EAST

RESPIRATORY INFECTION RESEARCH PROJECT IN LEBANON •

Lebanon is a country of 4.5 million people, yet it is currently home to some 1.8 million Syrian refugees. Its population has risen by about 10% in the space of just a year. This situation has led to a humanitarian ACCESS TO DIAGNOSIS crisis, which was exacerbated by a FOR DISPLACED particularly cold winter. In response to Médecins Sans Frontières’ reports of an POPULATIONS outbreak of respiratory infections, primarily • affecting children, Fondation Mérieux has decided to conduct a study to identify the In 2016, Fondation Mérieux decided to cause of these infections. The aim of this introduce a new project to support IDPs research project, involving experts from in Erbil living in unsanitary conditions. the Rodolphe Mérieux Laboratory in The project involves the construction of a Beirut, is to urgently adapt treatment maternal and child health center, staffed by protocols in order to improve patient care. volunteer doctors and specialists, with The Foundation has established a local support from the charity, Œuvres Ponti cales consortium of project stakeholders: AMEL Missionnaires de Lyon. The 400 m2 building and El Bashaer (two Lebanese NGOs), will include a medical analysis laboratory, Saint Joseph University, Lebanese University which will provide diagnostic testing to target and the University of Oxford. Two patient treatment. Fondation Mérieux will exploratory missions were conducted help to fund the construction of the building, between July and December 2015, in as well as the purchase of equipment and Tripoli, the Bekaa plain and Beirut. The training. The Iraqi government will framework agreement, which sets out the subsequently take over responsibility for operational implementation arrangements paying the staff, thereby securing the for the study, was signed in December long-term viability of the project. 2015.

10 2015 ANNUAL REPORT RESPONDINGMESSAGE TO THE MIGRANT DU CRISISPRÉSIDENT IN THE MIDDLE EAST

SUPPORTING LOCAL INITIATIVES •

HAITI

MADAGASCAR

ETIOLOGY

OF RESPIRATORY MALI INFECTION IN SYRIAN REFUGEES • CAMBODIA

Lebanon’s Ministry of Health has formally The Foundation has developed local partnerships throughout approved this study as part of its efforts the world in an effort to support disadvantaged populations. to stem the proliferation of respiratory * Some examples of these partnerships are detailed below. infections among Syrian refugees. Samples will be taken from patients selected from four BANGLADESH The Foundation supports Fondation Mérieux have been assisting recruitment centers. These samples will then surgical missions by the NGO AMD with reconstruction efforts and working undergo rapid tests, performed by BioFire (Aide Médicale et Développement) with various local population support Diagnostics. the mother and child hospital in facilities (orphanages, professional- Chittagong. training center, dispensary, micro- The initial results will help to inform public nance support, etc.). CAMBODIA The Foundation is working health policy from 2016 onwards. Other with Magna-Children at Risk, an NGO MADAGASCAR The Foundation is providing studies are also in the pipeline, with a particular that supports children living with HIV, nancial assistance for a project that emphasis on tuberculosis – a disease that is and with 1001 Fontaines, an NGO that aims to improve hygiene conditions in resurging at an alarming rate. is currently implementing a drinking remote villages and to ensure that water access project in villages and vulnerable women and children have schools. access to healthcare. HAITI Since the devastating earthquake MALI SENEGAL PERU Fondation Mérieux that hit the country in 2010, Fondation supports Samusocial International’s work Christophe et Rodolphe Mérieux and with socially excluded street children.

11 2015 ANNUAL REPORT MESSAGEDIRECTOR GENERAL’S DU PRÉSIDENT EDITORIAL

12 2015 ANNUAL REPORT MESSAGEDIRECTOR GENERAL’S DU PRÉSIDENT EDITORIAL

DIRECTOR GENERAL’S EDITORIAL Benoît Miribel •

Supporting innovative public health initiatives

The last Ebola crisis, and more recently In 1972, long before the development of initiatives such as the Zika virus, have shown how important GABRIEL, RESAOLAB, PDC and GloPID-R, Fondation Mérieux it is to be able to rapidly channel institutional created the Agence de Médecine Préventive (AMP) in the eld funding towards research priorities to of epidemiology. Fondation Mérieux also created Bioforce, respond to epidemic risks as quickly as in 1983, to train health logistics professionals for international possible. In the midst of a health crisis, only network-based colla- humanitarian work. Dr. Charles Mérieux favored this kind of boration between international public and private stakeholders cross-disciplinary approach involving a variety of complementary will allow us to react more quickly and effectively to imminent partners and was known for his development of innovative public danger. This is why the European Union’s Global Research Colla- health initiatives. boration for Infectious Disease Preparedness (GloPID-R) initiative “was created, with Fondation Mérieux and the University of Oxford Following in his grandfather’s footsteps, Dr. Christophe Mérieux jointly managing the secretariat. This innovative public health initia- initiated LyonBiopole in 2005 and planted the seed for the tive is just the most recent among all those that Fondation Mé- GABRIEL network, which we created in 2008 to connect rieux has become associated with in recent years. the Rodolphe Mérieux Laboratories and foster collaborative applied research across borders. The Partnership for Dengue Control (PDC) initiative was also born of the desire to develop a holistic approach to dengue, with As we approach Fondation Mérieux’s partners - universities, foundations, non-pro t organizations, and 50th anniversary, this cross-disciplinary companies - that are pooling their resources to achieve common approach focused on innovative public objectives. Fondation Mérieux has managed the secretariat of this health initiatives is more relevant initiative for the past two years. than ever to successfully combat the infectious diseases that we are all By providing the resources needed to strengthen local capacity, mobilized to overcome.“ these partnerships make it possible to durably change the scale of the response and meet speci c local needs for organizing and structuring public health activities...... Benoît Miribel

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SUPPORT FOR CLINICAL BIOLOGY LABORATORIES •

IMPROVING ACCESS TO BIOLOGICAL DIAGNOSIS AND STRENGTHENING EPIDEMIOLOGICAL SURVEILLANCE

Since 2007, the Foundation has been taking a holistic approach to supporting clinical biology infrastructure in developing countries. A total of eight medical biology laboratories were renovated in 2015, in Cameroon, Madagascar, Mali, Bangladesh and Cambodia. To reach compliance with international quality and biosafety standards, these facilities receive dedicated training and support to ensure the improvement in the quality of their service lasts over time. The Foundation has also launched and participated in a range of other projects to improve and expand access to diagnostic testing for disadvantaged populations.

HOLISTIC, LONG-TERM SUPPORT

Fondation Mérieux’s clinical biology n supporting epidemiological capacity building efforts focus on surveillance through electronic data DIAGNOSTIC TESTING the following interventions: transmission and the establishment of sample transport circuits, INFRASTRUCTURE n renovating existing laboratory infrastructure and designing new n auditing facilities and producing IMPROVEMENTS facilities, data maps, with a view to establishing SINCE 2005 n supporting governance by helping a baseline situation and identifying • to de ne national development needs, 29 facilities renovated policy, n creating laboratory networks to pool expertise and resources, 13 technical assistance missions n delivering initial training and Continuing Professional Development n strengthening biosafety + 23 expertise projects conducted (CPD) to laboratory staff, and biosecurity, on behalf of partners, including n introducing standardized quality n providing laboratory WHO and the UN management systems to improve computing resources to improve quality, data management and reliability.

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STRENGTHENING LOCAL CAPACITIES FOR DIAGNOSIS THROUGH TRAINING • BACHELOR OF SCIENCE DIPLOMA OF SPECIALIST IN BIOLOGICAL AND APPLIED STUDIES (DES) IN MEDICAL MEDICAL SCIENCES BIOLOGY

The Bachelor of Science in Biological and In Cambodia, Fondation Mérieux has Applied Medical Sciences (BAMS) program supported the Diploma of Specialist Studies is currently running in Mali (9th year) and (DES) in Medical Biology awarded by the in Haiti (5th year). The course is delivered in University of Health Sciences since 2003. partnership with the School of Biology, This course is open to physicians and Biochemistry and Biotechnology (ESTBB) pharmacists going into careers as biologists. of the Catholic University of Lyon. The seven students who began the course The program is intended for senior laboratory in 2014 completed their second year in technicians, and aims to improve their 2015. The DES receives support from the theoretical, practical and organizational Institut Pasteur du Cambodge, Fondation skills, with a view to enhancing service AnBer, and French universities from which quality. 28 students from West Africa and lecturers are seconded. The program will 18 Haitians completed the course in 2015. be converted into a Master’s of Medical In Mali, the course is currently being Biology in 2016. incorporated into the program of the Ministry of Teaching and Scienti c Research (conversion into a Master I course).

FOCUSING ON INTERNATIONAL HEALTH SECURITY CHALLENGES GHSA FUNDING FOR * TWO PROJECTS IN AFRICA Diagnosis is the rst stage of the healthcare In recognition of its experience and its Fondation Mérieux obtained funding pathway. success in scaling up the RESAOLAB from the Global Health Security This activity, performed by clinical biology laboratory network in West Africa, Fondation Agenda for two projects in 2015: laboratories, also plays an important role Mérieux has been invited to participate in in epidemiological surveillance. It is a key a number of epidemic risk containment n a project in Mali to evaluate the component of the WHO International projects. national laboratory network and Health Regulations (IHR), which seek to These actions also contribute to attainment strengthen biosecurity/biosafety prevent serious risks to global public health. of the United Nations Development capacities, as part of a consortium Strengthening global surveillance capacities Programme’s (UNDP) Sustainable Deve- with two other NGOs (Catholic Relief has been a major priority since the 2014 lopment Goals (SDGs), with a particular Services and Mali Health), emphasis on goal 3 - “good health and Ebola epidemic. Efforts in this area have n a project in Senegal to support well-being”. attracted substantial funding and have the implementation of a laboratory been subject to various calls for projects, policy and a strategic plan, and particularly from U.S. CDC (Centers for to strengthen the activities of Disease Control and Prevention) and USAID (United States Agency for International the National Laboratories Directorate, Development) under the Global Health in partnership with the NGO PATH. Security Agenda (GHSA).

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RESAOLAB EFFECTIVE TREATMENT THROUGH RELIABLE AND ACCESSIBLE DIAGNOSIS

The West African Network of Biomedical Analysis Laboratories (RESAOLAB), was launched by Fondation Mérieux in 2009. The aim of the network is to strengthen national medical biology laboratory systems through a regional approach that incorporates all factors impacting laboratory governance and performance.

The RESAOLAB network now includes more than 500 public and private facilities across seven countries (Benin, Burkina Faso, Guinea, Mali, Niger, Senegal and Togo), and makes an active contribution to epidemic surveillance.

It played a crucial role during the Ebola outbreak in 2014, delivering training to health workers, distributing biosafety equipment and establishing a system for diagnostics.

MALI NIGER SENEGAL

BURKINA FASO GUINEA BENIN TOGO

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RESAOLAB TRAINING SINCE 2013 • 7 training centers 120 Continuous Professional Development training courses with 20 laboratory professionals in each course 13 training modules approved (5 new modules in 2015) 29 DES grants awarded

In 2015, RESAOLAB sought to strengthen capacities RESAOLAB GOVERNANCE * in its key priority areas, including: AND FUNDING n construction work on a new training n allocating training grants for the RESAOLAB is rmly aligned with the regional center in Togo, on a new technical and DES in Medical Biology for physicians health policy established by the West African administrative center in Guinea, and on and pharmacists. Health Organisation (WAHO). This policy new premises for the future National was developed in conjunction with the WHO Laboratories Directorate in Niger, Regional Office for Africa, and with the n providing training programs and Ministries of Health of the seven member grants for laboratory technicians, countries. RESAOLAB is supported by the Agence Française de Développement (AFD), n strengthening Quality Assurance the Islamic Development Bank, the Department by helping 250 laboratories to implement of International Cooperation of the Principality a quality assurance process, establishing of Monaco, the Stavros Niarchos Foundation quality supervision teams, and conducting and Fondation Mérieux. 14 external quality assessment sessions, The program underwent its rst nancial n supporting epidemiological audit in May 2015, when auditors from surveillance by overhauling the Lab- KPMG formally approved the program’s Book laboratory information management *The external quality assessment process involves a comparison of the test results from a given laboratory accounts for the 2013-2014 period. software (used by 45 laboratories within with an external benchmark, thereby providing objective the network), evidence of the quality of laboratory results.

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WARDS EPIDEMIOLOGICAL SURVEILLANCE IN ECOWAS COUNTRIES

In recognition of the success of RESAOLAB, the World Bank and WAHO have asked Fondation Mérieux to coordinate laboratory support activities under the WARDS (West Africa Regional Disease Surveillance) program. The aim of this program is to strengthen the epidemiological surveillance system in West Africa, and in particular to establish surveillance centers at the district level. The Foundation is providing expertise and technical assistance to help improve the skills of laboratory personnel in the eight member countries of the Economic Community of West African States (ECOWAS) that are not currently covered by the RESAOLAB network (Cape Verde, Côte d’Ivoire, The Gambia, Ghana, Guinea-Bissau, Liberia, Nigeria and Sierra Leone).

WARDS: AN AMBITIOUS PROJECT In 2015, Fondation Mérieux conducted eight eld evaluation IN THE 15 ECOWAS MEMBER STATES missions (Cape Verde, Côte d’Ivoire, Ghana, Guinea-Bissau, Nigeria, Sierra Leone and The Gambia) to learn more about existing n Two key components: national systems and to prepare to roll out activities. • strengthening regional capacities The rst trainer training session, for French speakers, was held in • improving the skills of surveillance center staff Abidjan (Côte d’Ivoire). The WARDS project also helped to organize at the peripheral level the rst regional laboratory policy workshop, with the support of WAHO and with expert input from RESAOLAB. n 60 new epidemiological surveillance centers will be fully equipped and operational n 6 partners: Centre for International Cooperation in Health CAPE VERDE and Development (CCISD), University of Oslo, WHO, THE GAMBIA U.S. CDC, University of Ghana and Fondation Mérieux n US$ 11.5 million of funding (co-funded by the World Bank GUINEA-BISSAU and WAHO), including US$ 1 million for the laboratory component coordinated by Fondation Mérieux SIERRA LEONE LIBERIA GHANA CÔTE D’IVOIRE NIGERIA

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>>>>>>>>>>>>>>>>>>>>>>>>>>>>> COUNTRY INITIATIVES AFRICA ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• GUINEA MALI

LAB-NET: HIGH-SECURITY SUPPORT FOR COMMUNITY HEMORRHAGIC FEVER MOBILE LABORATORY HEALTH CENTER LABORATORIES SURVEILLANCE Under a joint French and German In 2011, Fondation Mérieux signed a In 2015, Fondation Mérieux began working Ebola control initiative, the German partnership agreement with the Depart- on the LAB-NET project. This project Partnership Program for Excellence in ment of International Cooperation of the was initiated by Guinea’s Ministry of Biological and Health Security provided Principality of Monaco. Under this Health, in partnership with the Institut funding for a mobile biological agent agreement, the partners launched the Pasteur, and is overseen by Expertise France. diagnosis laboratory. The project was LABOMEDCAMP project (which stands The initiative is funded by France’s implemented by the GIZ (German Federal for “Laboratoire Médical de Campagne”, Ministry of Foreign Affairs, and seeks to Enterprise for International Cooperation), or country medical laboratory). The aim establish a dedicated surveillance in partnership with Fondation Mérieux of this project is to improve the quality system for viral hemorrhagic fevers. and the German Armed Forces Microbiology of infectious disease diagnosis in An exhaustive evaluation was conducted, Institute. The laboratory is managed by community health centers in Mali. The covering all medical biology laboratories, the Charles Mérieux Infectiology Center project is implemented by Fondation with a view to establishing a baseline and can be deployed in the eld at short Mérieux in partnership with the NGO situation and a map to pinpoint the needs notice (particularly for Ebola virus, Lassa Santé Sud, the Charles Mérieux Infectiology for each lab. The results of this evaluation fever, Zika virus and Rift Valley fever Center of Mali, Mali’s National Laboratory are used to develop a laboratory upgrading testing). Network and National Health Directorate, program and a national medical biology RESAOLAB, and the Association des policy. Médecins de Campagne (country doctors’ association). The partners presented the outcomes of the project in 2015, which included the creation of 10 medical analysis laboratories and the incorporation of these laboratories into the national quality control and epidemiological surveillance systems.

...... MALI

THE CHARLES MÉRIEUX * INFECTIOLOGY CENTER CELEBRATES TEN YEARS

The Charles Mérieux Infectiology Center was created in Bamako in 2005, in partnership with Mali’s Ministry of Health and Public Hygiene. The center celebrated its 10th anniversary on September 17, 2015. The ceremony The new biosafety level-3 laboratory, center team to contribute more effec- was led by Mali’s Minister of Health funded by Fondation Christophe et tively to the ght against the most and Public Hygiene, and was followed Rodolphe Mérieux, was inaugurated at dangerous diseases. It will provide, in by two open house days and a series the same ceremony. This laboratory is a particular, the capability to diagnose of scienti c conferences. cutting-edge facility that will enable the drug-resistant tuberculosis.

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>>>>>>>>>>>>>>>>>>>>>>>>>>>>> COUNTRY INITIATIVES AFRICA ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• SENEGAL MADAGASCAR

EPIDEMIOLOGICAL EXPANSION DATA MANAGEMENT OF THE LABORATORY NETWORK In 2015, Fondation Mérieux launched the I-LAB project in an effort to help Senegal’s National Laboratory Directorate implement an automated system for collecting epidemiological data from laboratories. The aim of the project is to conduct real- time surveillance of diseases of epidemic potential, using a dedicated software application. A total of 26 laboratories within the national network received training on how to use this system in 2015, and 97% of these laboratories now submit Fondation Mérieux is continuing to in Sambava, and the laboratory at Andapa their data on a weekly basis. There are plans support infectious disease diagnosis and Adventist Hospital. These interventions to roll out this system to all 120 laboratories surveillance efforts in 14 public and are jointly funded by Agence Française de within the national network by July 2017. private hospitals in Madagascar. Développement (AFD) and implemented The project was initiated at the request of In 2015, three hospital laboratories were in partnership with the Laboratory Deve- Senegal’s National Laboratories Directorate, renovated under the RESOILAB project: lopment Department of Madagascar’s in partnership with the NGO PATH. The the bacteriology laboratories at the Ministry of Public Health and the Indian I-LAB project is entirely funded by the University Hospital Center in Befelatanana Ocean Commission. Skoll Foundation. and the Regional Referral Hospital Center

AMERICAS •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• BRAZIL

CONSTRUCTION OF A CHARLES MÉRIEUX INFECTIOLOGY CENTER Work begun on the construction of the Charles Mérieux Infectiology Center and the Rodolphe Mérieux Laboratory in 2015. Hosted at the Fundhacre Hospital in Rio Branco, the Acre State capital (in the Amazon rainforest in western Brazil), this will be the eighth Rodolphe Mérieux Laboratory to open, following the inau- guration of the seventh laboratory in Chittagong (Bangladesh) in 2015. These laboratories of excellence play a driving role within GABRIEL, an international scienti c network that seeks to pool and transfer essential knowledge and expertise to support medical advances in infectious diseases.

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>>>>>>>>>>>>>>>>>>>>>>>>>>>>> COUNTRY INITIATIVES AMERICAS••••••••• ASIA •••••••••••••••••••••••••••••••••••••••••• HAITI BANGLADESH

INAUGURATION OF THE RODOLPHE MÉRIEUX LABORATORY The seventh Rodolphe Mérieux Laboratory was inaugurated on April 9, 2015 at the Bangladesh Institute of Tropical and Infectious Diseases (BITID) in Chittagong. The 250 sq. m laboratory features cutting- edge applied research, training and biological analysis equipment. The laboratory will conduct research programs focusing on tuberculosis (one of the major health threats facing the The SPHaïtiLAB project, which country), respiratory diseases and enteric seeks to help improve the infections (which are particularly severe * among children). Fondation Mérieux built health of Haiti’s population by conducting analyses and offering the laboratory in partnership with BITID, strategic advice on laboratory policy, the International Centre for Diarrhoeal commenced in 2015. Disease Research of Bangladesh, the Institute for Developing Science and The ve-year project is funded by the Health Initiative, and the Mahidol Oxford European Union and implemented by Tropical Medicine Research Unit. Fondation Mérieux, in partnership with the Ministry of Public Health and Population (MSPP) (including the Department of Epidemiology, Labo- CHINA ratories and Research (DELR) and the National Public Health Laboratory TUBERCULOSIS DIAGNOSIS (LNSP)), GHESKIO (Haitian Group for AND TREATMENT the Study of Kaposi’s Sarcoma and PARTNERSHIP WITH The first phase of the tuberculosis Opportunistic Infections), and the THE CHINESE ACADEMY OF diagnosis decentralization program * African Institute of Public Health MEDICAL SCIENCES was implemented in Zhejiang and (IASP). Heilongjiang provinces. The program Fondation Mérieux, the Chinese In 2015, a GHESKIO-led pilot study to continued in 2015, with rollout in Xinjiang Academy of Medical Sciences (CAMS) assess the prevalence of multidrug- and Guangxi provinces. The project, launched and the Charles Mérieux Infectiology resistant tuberculosis (MDR-TB) was in 2008, aims to improve tuberculosis Center of Mali signed three collabo- initiated by the training of the organi- diagnosis and treatment (including drug- rative research agreements in 2015. zations involved and the supervision resistant forms) at the local level. Fondation The rst agreement was signed in of participating hospitals. The MSPP Mérieux, with nancial assistance from Paris on June 30th, between Fondation began preparing for an evaluation of bioMérieux China, is working with China’s Mérieux and CAMS, in the presence 30 biomedical analysis laboratories Ministry of Health and the Chinese Center of the Chinese and French Prime planned in January 2016. The data for Disease Control and Prevention (China Ministers. The second and third produced by these two activities will CDC) to help deploy new, more powerful agreements between the three partners be used to develop a National Applied diagnostic tools (LED microscopy, liquid were signed on September 17th Research Policy and a National culture media, molecular diagnostics for in Bamako and on October 6th in Laboratories Policy respectively. drug resistance). Around 14,000 patients Cape Town. were screened at treatment centers in the cities of Liuzhou and Kashgar in 2015.

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>>>>>>>>>>>>>>>>>>>>>>>>>>>>> COUNTRY INITIATIVES ASIA •••••••••••••••••••••••••••••••••••••••••• CAMBODIA MYANMAR

LABORATORY CAPACITY BUILDING TECHNOLOGY TRANSFER FOR HIV SCREENING Under the CAMLAB project, which aims to support Cambodia’s public hospital Fondation Mérieux, MSF-Holland and the laboratory network, Fondation Mérieux Yangon National Health Laboratory have renewed the external quality assessment signed a partnership agreement with the program in 2015, in partnership with aim of improving treatment for people U.S. Naval Medical Research Unit Two living with HIV/AIDS in Myanmar. (NAMRU-2), WHO and CDC. Based on the Fondation Mérieux has transferred viral results of these assessments, all 32 public load testing technology, developed by laboratories participating in the program ANRS (France’s National Agency for received training to help them implement AIDS Research), by providing training the required remedial action. The Ministry and purchasing the necessary equipment. of Health also received assistance in the This cutting-edge technology is used development and publication of the to measure the amount of the virus in National Strategic Plan for Laboratories the body and to verify the ef cacy of 2015-2020. antiretroviral therapy (ART). In 2015, staff received two training sessions in preparation for the commencement of laboratory activities. The Foundation has MIDDLE EAST••••••• also signed a partnership agreement with MSF-Switzerland in Dawei, to extend access to viral load testing in the IRAN south of the country. PARTNERSHIPS WITH INSTITUT PASTEUR

Fondation Mérieux signed two partnership LAOS agreements with Institut Pasteur in 2015, covering the construction of a biosafety level-3 laboratory at the Institut Pasteur SUPPORT FOR KHAMMOUANE ANTIRETROVIRAL research center in Tehran and a training PROVINCE’S LABORATORIES RESISTANCE STUDY center and a BSL2 laboratory in Zahedan Fondation Mérieux and the Auvergne- Results are now available from the in the southeast corner of the country, Rhône-Alpes Region are continuing to crosscutting multi-center study close to the border with Pakistan and support district hospital laboratories in the conducted in 2014 by Fondation Mérieux, Afghanistan. Khammouane Province, with operational in partnership with the Christophe Mérieux support from the laboratory of Thakhek Infectiology Center of Laos and CHAS Provincial Hospital and in partnership with (Laos’ national HIV program). The study the Provincial Health Directorate. In 2015, covered nine HIV treatment centers in all laboratories in the province were ins- the country. The samples analyzed by the pected and audited and staff received Christophe Mérieux Infectiology Center customized training based on the speci c showed limited prevalence of primary problems encountered, with a view to resistance to antiretrovirals (in the reverse- standardizing diagnostic capacities. transcriptase inhibitor class), thereby con rming the suitability of rst-line treatment and underscoring the need to conduct this study at regular intervals.

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COLLABORATIVE RESEARCH PROGRAMS •

STRENGTHENING AND COORDINATING LOCAL RESEARCH CAPABILITIES

Local research capacity-building is a strategic focus for Fondation Mérieux. It seeks to achieve this through a unique international collaboration framework, drawing on the expertise of the Emerging Pathogens Laboratory in Lyon, which coordinates and supports the work of the laboratories belonging to the GABRIEL (Global Approach to Biological Research, Infectious diseases and Epidemics in Low-income countries) network. The Rodolphe Mérieux Laboratories form part of this network. These laboratories of excellence are located in infectious disease hot spots in developing countries and meet the most exacting international standards. Their role is to conduct epidemiological surveillance and research, and to deliver training. The eighth Rodolphe Mérieux Laboratory was of cially opened in Bangladesh in 2015 (see page 21).

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THE EMERGING PATHOGENS LABORATORY A LABORATORY OF EXCELLENCE AT THE CENTER OF LYON’S SCIENTIFIC ECOSYSTEM

The Fondation Mérieux’s Emerging Pathogens Laboratory in Lyon-Gerland works closely with the nearby P4 Jean Mérieux-Inserm Laboratory and is able to access this BSL4-level facility for research purposes. The Emerging Pathogens Laboratory held a series of workshops in 2015, with the aim of setting out a research strategy and timetable focusing on two priority themes: respiratory infections (including tuberculosis), and foodborne diseases (including typhoid). The research program also covers two crosscutting themes: resistance to antibiotics and emerging diseases.

The Emerging Pathogens Laboratory is a member of several scienti c networks of excellence, including AVIESAN (French National Alliance for Life Sciences and Health), ISARIC (International Severe Acute Respiratory TWO ACTION AREAS and Emerging Infection Consortium), and the THE EMERGING European Union’s Horizon 2020 research * PATHOGENS n Developing and transferring program. In 2015, the laboratory team was LABORATORY IN 2015 technologies for the diagnosis of cially recognized as a member of the and epidemiological surveillance CIRI International Center for Infectiology n 8 publications in international of infectious diseases. Research (CIRI). This recognition was peer-reviewed scientific awarded by all of CIRI’s supervisory entities: n Supporting the careers of journals Ecole Normale Supérieure de Lyon, Université researchers in developing Claude Bernard Lyon I, CNRS (French National n 13 presentations at national countries by establishing Center for Scienti c Research) and Inserm and international scientific partnerships and collaborative (French National Institute of Health and conferences research programs, and Medical Research). In 2015, the Emerging n 2 priority research themes: delivering training. Pathogens Laboratory was also assessed respiratory infections by HCERES (High Council for Evaluation and foodborne diseases of Research and Higher Education), which described the laboratory as having a “very good clinical and translational research team”.

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GABRIEL NETWORK LOCAL RESPONSES TO LOCAL HEALTH CHALLENGES

The GABRIEL network was created by Fondation Mérieux in 2008 and now has 18 members in 16 countries. The network brings together the Rodolphe Mérieux Laboratories of excellence, local reference laboratories, and academic, university and hospital research institutes. Its members work in developing countries and conduct research projects that target local infectious disease priorities (respiratory infections and fevers, waterborne and foodborne diseases, and neglected diseases).

Global Approach to Biological Research, Infectious diseases and Epidemics in Low-income countries

THE GABRIEL NETWORK MORE THAN 100 SCIENTISTS IN 2015 TRAINED IN 2015

2 NEW MEMBERS: In 2015, the GABRIEL network delivered n King George’s Medical University, a range of training modules for staff at Lucknow (India) laboratories within the network,Global as well as Approach to academics and health professionals.Biological These n Centre Pasteur du Cameroun Research on Infectious diseases included: a molecular immunologyand Epidemics module in ISO 15189 MORE THAN 60 SCIENTIFIC Low-income * in Mali; a molecular biologycountries module in QUALITY ACCREDITATION PUBLICATIONS Haiti, Cambodia and Madagascar; and a (articles available at workshop on recombinant proteins at the n New training programs were www.gabriel-network.org) Christophe Mérieux Laboratory in Beijing delivered in 2015, in conjunction (a joint unit with the Institute of Biology at with Mérieux Université, as part

AN HONOR AWARDED the Chinese Academy of Medical Sciences). of the adoption of the ISO 15189 The Paraguayan Congress of Infectious The Emerging Pathogens Laboratory also quality management standard Diseases awarded an Honorary Title hosted a series of workshops on molecular by GABRIEL network laboratories to Instituto de Investigaciones en diagnostics used in tuberculosis and n Members from Madagascar, Ciencias de la Salud (National University typhoid projects. Scientists working at the Lebanon, Mali and Haiti of Asunción), a GABRIEL network Rodolphe Mérieux Laboratory in Beirut took part member in Paraguay, for its research (Lebanon) received training on the use of on meningitis. a biosafety level 3 laboratory.

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* RAPID TEST CAPACITY-BUILDING

In 2015, Fondation Mérieux’s Scienti c Department opened a new Access to Diagnosis for Neglected Diseases unit. This unit seeks to improve access by ensuring that effective and accessible tests are deployed in areas with limited healthcare services, and that suitably trained staff are present. The Foundation intends to build on its existing technology transfer activities in developing countries and to introduce new skills transfer modules. Two key areas were approved in 2015: modules on the development, industrialization and Efforts continued in 2015 to develop Lateral production of rapid tests, and modules on Flow Immuno Assay (LFIA) rapid tests test evaluation and control. for typhoid, leptospirosis (an under-dia- gnosed bacterial disease), and Ebola virus disease.

2015 CHRISTOPHE MÉRIEUX PRIZE •

THE 2015 CHRISTOPHE MÉRIEUX PRIZE WAS AWARDED TO PROFESSOR JEAN-JACQUES MUYEMBE-TAMFUM FOR HIS RESEARCH WORK ON EBOLA HEMORRHAGIC FEVER IN THE CONGO BASIN

Professor Muyembe-Tamfum was involved Jean-Jacques Muyembe-Tamfum is in the initial discovery of the virus, and Professor of Microbiology at the University his research now focuses on the clinical, of Kinshasa’s Faculty of Medicine, Director- epidemiological and virological aspects General of the National Institute for of the disease. The control measures that Biomedical Research (INRB), and scienti c he helped to develop are now used to adviser to WHO. manage epidemics in Africa.

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RESEARCH PROJECTS •

FOODBORNE DISEASES

EUROPEAN EXTENSION OF SCHISTOSOMIASIS COMMISSION COMPARE THE TYPHOID SCREENING PREVALENCE STUDY PROJECT PROJECT IN AFRICA IN MADAGASCAR

Having developed a molecular typhoid In 2015, Fondation Mérieux began screening test from clinical samples from working on a new project to establish the several sites in Bangladesh, the Emerging prevalence of schistosomiasis among Pathogens Laboratory compared the children in Madagascar. performance of this test with the standard Schistosomiasis is transmitted by a blood culture technique in 2015. freshwater mollusc and is the world’s Based on the initial results, Fondation second most common endemic parasitic Mérieux received new funding from the disease after malaria. Around 600 samples Bill & Melinda Gates Foundation in 2015 were taken at 12 primary schools, with to continue working on the project and more than 120 positive cases identi ed. to test the approach in an African These patients were then treated in Fondation Mérieux is a partner of the context (in Burkina Faso, Ghana and accordance with the WHO recommended COMPARE project (COllaborative Malawi). If the performance levels are protocol. The Foundation also introduced Management Platform for detection and con rmed, the test will be included in a training program for staff at community Analyses of (Re-) emerging and foodborne the Bill & Melinda Gates Foundation health centers, covering the risk factors outbreaks in Europe), funded by the surveillance network. associated with the disease and measures European Commission’s Horizon 2020 for raising awareness among the population. program. The aim of this project is to develop a global platform to speed up the detection of infectious diseases using next generation sequencing technology. The project involves a consortium of 29 partners (public and animal health research groups, food safety institutes) and is coordinated by the Technical University of Denmark and Erasmus MC. Fondation Mérieux is working closely with GABRIEL network members in TYPHOID Bangladesh, focusing on three types of • foodborne infection: Typhoid is an infection caused by n Escherichia coli (ETEC) with the Institute Salmonella bacteria. The infection is for Developing Science and Health transmitted by ingesting contaminated Initiatives (ideSHi), food or water. n Diarrheal diseases, as part of a surveillance program run by the International Centre for It is suspected to be involved in various Diarrhoeal Disease Research, Bangladesh, co-infections, including malaria. n Salmonella Typhi and Paratyphi A bacteria, with the Child Health Research Foundation.

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RESEARCH PROJECTS •

TUBERCULOSIS AND OTHER MYCOBACTERIAL DISEASES

TUBERCULOSIS LEPROSY TROPICAL CONTROL DRUG RESISTANCE MYCOSIS CONTROL IN BANGLADESH SURVEILLANCE IN MADAGASCAR PRISONS IN MADAGASCAR Despite the high number of cases reported by physicians throughout the country, the Tuberculosis risk is especially high in prisons Leprosy is a major public health concern gures do not re ect the true prevalence throughout the world. Moreover, the prison in Madagascar, where more than 1,500 cases of tropical mycoses in Madagascar. environment favors the emergence of are reported each year (9% of which are drug-resistant strains of the disease. children). The fungi responsible for these diseases are found in the soil and on plants, and A project conducted in the largest prison The rst phase of this project involved the condition is contracted through in Dhaka (Bangladesh) is seeking to the delivery of training on early screening, contact with a wound. A study to analyze identify the underlying transmission with a view to improving leprosy diagnosis. the incidence of these diseases was chains and risk factors and to produce a The second component of the project launched in 2013, in partnership with set of recommendations for prison focuses on leprosy antibiotic resistance Université Joseph Fourier in Grenoble, and health authorities. surveillance. In 2015, the Charles Mérieux the Charles Mérieux Infectiology Center, This study, supported by the Foundation’s Infectiology Center in Madagascar received and the Dermatology Department of the Emerging Pathogens Laboratory, has new microscopy and molecular biology University Hospital Center in Befelatanana revealed the major impact of interventions equipment. (Antananarivo). implemented by ICDDR,B (International This work was conducted in partnership This work has led to improvements in Centre for Diarrhoeal Disease Research, with the Dermatology Department of the diagnosis, through the provision of simple Bangladesh). Prisoners are actively screened University Hospital Center in Befelatanana and accessible molecular technologies on arrival and throughout their imprison- (Antananarivo), Fondation Raoul Follereau, and the creation of a network of clinicians ment, and this has led to a dramatic decline the National Leprosy Program, the National and biologists capable of identifying and in the tuberculosis transmission rate Reference Center for Mycobacteria and treating patients. The study is being between prisoners. Three years after the Mycobacterial Resistance to Tuberculosis conducted by a post-doctoral researcher, program was introduced, transmissions Drugs, the Ministry of Health, and the who has received an ARTS (Research in prison accounted for less than 25% of WHO Country Of ce in Madagascar. Grant for a Thesis in the South) grant, all tuberculosis cases, compared with jointly funded by Fondation Mérieux and over 50% previously. the French Institut de Recherche pour le Développement (IRD). l l l l l l l l l l l l l l

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RESEARCH PROJECTS •

RESPIRATORY DISEASES

CHARACTERIZATION OF PEDIATRIC PNEUMONIA CASES IN CAMBODIA

As part of efforts to introduce a Strepto- coccus pneumoniae vaccine in Cambodia, a study was conducted to determine the characteristics of the disease, particularly among children under 15. The project is being carried out in conjunction with the Cambodia-Oxford Medical Research Unit (COMRU) and the Wellcome Trust. The study bene ts from operational support from the Rodolphe Mérieux Laboratory in Phnom Penh and the Angkor Hospital for Children (pediatric hospital in Siem Reap Province). Around 1,000 cases have been analyzed and the results will be used to assess the impact of vaccination. MULTI-CENTER PEDIATRIC PNEUMONIA STUDY

The initial results of the multi-center study on the causes of pneumonia among children under 5 in developing countries were presented at the American Society of Microbiology’s Interscience Conference on Antimicrobial Agents AN UNPRECEDENTED NEW COLLABORATIVE and Chemotherapy (ICAAC) on STUDY RESEARCH IN September 20, 2015. • LEBANON These results indicate that almost half of pneumonia cases can be attributed The multi-center study, designed and • to Streptococcus pneumoniae, while the funded by Fondation Mérieux, was In 2015, Fondation Mérieux joined remaining cases are viral in origin. It conducted by GABRIEL network research forces with several local partners to should therefore be possible to signi cantly centers in eight countries on three respond to the outbreak of respiratory reduce the disease burden of pneumonia continents. The aim of the study is to infections among Syrian refugees in in developing countries by vaccinating help reduce pneumonia-related child Lebanon, launching a collaborative against Streptococcus pneumoniae and mortality. The disease is the leading research project to identify the origins developing a vaccine for human respiratory syncytial virus (RSV). cause of death among children under of these infections and to improve five in developing countries. treatment protocols (see page 11). These results were included in two scientific publications in 2015, and a number of other publications are currently being prepared for 2016.

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RESEARCH PROJECTS •

RESPIRATORY DISEASES

VACCINE INFLUENZA PREVENTION EFFICACY IN TOGO SURVEILLANCE IN BRAZIL OF VIRAL AND BACTERIAL CO-INFECTIONS The PneumoTone project, funded by the A program of active influenza Agence de Médecine Préventive (AMP), surveillance among hospitalized entered its second phase in 2015, with the patients was conducted at three sites in This PhD research project (viva completed aim of analyzing the impact of several Brazil (Fortaleza, Rio de Janeiro and in October 2015) sought to identify vaccination campaigns on respiratory Curitiba), as part of a collaborative project prognostic biomarkers of the severity infections in the city of Dapaong (Togo). with the GIHSN (Global Inuenza Hospital of respiratory co-infections among children. The rst phase of the project identi ed Surveillance Network) and with nancial S. pneumoniae and S. aureus as the principal support from Sano Pasteur. The samples The study monitored a group of patients bacteria responsible for pneumonia cases. were analyzed at the Fiocruz Foundation’s in Paraguay, from the cohort that took Two vaccination campaigns were then Laboratório de Vírus Respiratório e part in the GABRIEL network multi-center conducted among infants and children Sarampo, a member of the GABRIEL study. This in vitro research method was under 4. network. based on an understanding of changes The aim of the project is to document the that occur in the immune system during The preliminary results suggest that co-infection (viral and bacterial). The vaccinating young children helps to reduce prevalence of severe inuenza among hospitalized patients and to assess the results identi ed two potential biomarkers the prevalence of respiratory infections involved in inammation control: a pro- among the population. ef cacy of vaccination. Around 600 patients were recruited in 2015 and 6% of these inammatory chemokine and a micro RNA. tested positive for inuenza.

STUDY OF RESPIRATORY INFECTIONS IN LAOS

The LaCoRIS project was launched in 2014 with funding from the U.S. Naval Medical Research Unit Two (NAMRU-2). The aim of the project is to measure the incidence of acute respiratory infections in Vientiane and to identify the pathogens responsible for these infections. In 2015, a total of 280 samples were taken and analyzed by the microbiology laboratory at Mahosot Hospital and by the Christophe Mérieux Infectiology Center in Laos. The study forms part of a wider scienti c collaboration program with the Wellcome Trust, the Mahosot Research Unit in Vientiane, the London School of Hygiene & Tropical Medicine eld of ce in Bangkok, and the Emerging Pathogens Laboratory. In total, the study will cover 540 patients with symptoms of a respiratory infection.

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RESEARCH PROJECTS •

HEMORRHAGIC MENINGITIS CERVICAL FEVERS CANCER CRIMEAN-CONGO TREATMENT CERVICAL HEMORRHAGIC OF PEDIATRIC MENINGITIS CANCER SCREENING FEVER VIRUS IN MADAGASCAR IN LAOS PATHOGENESIS STUDY The meningitis surveillance project in Madagascar has now entered the analysis phase, having completed and validated the transfer of real-time multiplex PCR diagnostic technologies developed by the Emerging Pathogens Laboratory. Around 300 samples were taken at the Tsaralalana Mothers & Children’s University Hospital, and the samples were then analyzed at the Charles Mérieux Infectiology Center in Antananarivo. The aim of this study, conducted in partnership with the WHO Country Of ce in Mada- gascar, is to improve patient treatment, monitor strain circulation, and inform vaccination strategy. Cervical cancer is the second most common form of cancer among women aged 15-44 in Laos. However, only 3.9% of this population group receive a screening test. Women living with HIV are ve times more likely to develop this form of cancer. Since 2009, in collaboration with the BACTERIAL The aim of the LaoCol-VP project, funded French Armed Forces Biomedical MENINGITIS by the French National Cancer Institute Research Institute and Inserm, Fondation (INCa) and Fondation Mérieux, is to Mérieux’s Emerging Pathogens Laboratory • compare the efficacy of two cervical has been conducting a research project Bacterial meningitis is a major public cancer screening strategies: the detection on Crimean-Congo hemorrhagic fever, a health concern. of high-risk human papillomavirus (HPV) viral disease transmitted by ticks. An estimated 1.2 million cases occur strains using the careHPV™ test, and the This study focuses on the pathogenesis each year worldwide, leading to over cervical smear method. This crosscutting of the virus through in vitro infection of 300,000 deaths. multi-center study was conducted on a cell lines. The project will seek to gain a cohort of more than 600 women between better understanding of the autophagy The majority of meningitis cases are February 2014 and May 2015. The results phenomenon observed during replication caused by several bacterial strains, were presented at three conferences (in of the virus and will look to identify most commonly Streptococcus India, Laos and the United States) in potential treatment targets and strategies. pneumoniae, Neisseria meningitidis 2015, and will be published in 2016. The The study was presented at the and Haemophilus influenzae b. partners have agreed to extend the project 5th Autophagy Scienti c Days, an event in order to continue offering surgical organized by the CFATG (French Auto- treatments and to monitor high-risk HPV phagy Society) on October 5-7, 2015. carriers.

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KNOWLEDGE-SHARING AND PUBLIC HEALTH PARTNERSHIPS •

SUPPORTING GLOBAL HEALTH THROUGH KNOWLEDGE-SHARING AND TRANSFER

Knowledge-sharing and transfer are two core components of Fondation Mérieux’s strategy. The Foundation organizes high-level scienti c symposia and conferences as part of its efforts to disseminate medical advances worldwide, with equal access for the North and the South. It also delivers training to health workers in developing countries, helping to transfer key skills that will ensure the long-term viability of its eld interventions. The Foundation also engages in innovative partnerships to support global public health.

SUPPORTING GLOBAL HEALTH THROUGH GLOBE NEW TECHNOLOGIES

In 2009, Fondation Mérieux created an online information-sharing EN 2015 and training tool for healthcare professionals in developing countries – the GLOBE (Global Link for Online Biomedical Expertise) • portal. The portal is available in French and English, and features 11 expertise networks a range of resources and distance-learning modules based on the • programs of the Foundation and its partners. The GLOBE portal 12 distance-learning modules, played a key role in disseminating information and sharing best including 2 new modules on combating practice during the Ebola outbreak in 2014. counterfeit medicines in 2015 • 33,000 visitors from 188 countries • 1,600 members

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TRAINING PROGRAMS

As part of its capacity-building efforts in developing countries, Fondation Mérieux supports the delivery of several international, regional and local training programs, speci cally tailored to meet a diverse range of needs: • intensive courses on key aspects of vaccinology and the diagnosis of infectious diseases; • degree courses to strengthen clinical biology capabilities (BAMS and DES in Medical Biology, see p. 16); • short courses related to speci c projects and networks.

FONDATION MÉRIEUX INTENSIVE TRAINING IN 2015 • More than 200 participants from 40 different countries completed an intensive course

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INTENSIVE COURSES •

ADVANCED VACCINOLOGY ADVANCED COURSE COURSE ON DIAGNOSTICS FRANCE • LES PENSIÈRES FRANCE • LES PENSIÈRES 16TH CLASS 6TH CLASS Fondation Mérieux’s ADVAC (Advanced The ACDx (Advanced Course on Vaccinology Course) program is delivered Diagnostics) program is organized by in partnership with the University of Fondation Mérieux in partnership with Geneva. The aim of the course is to provide the London School of Hygiene & Tropical participants with an overview of vaccination- Medicine. 26 students participated in the related issues to facilitate vaccinology course in 2015. decision-making. The aim of the ACDx program is to make A total of 72 students took part in the diagnostics a central component of global program in 2015. The ADVAC program public health interventions and to receives support from the Bill & Melinda strengthen local decision-making Gates Foundation, the European capacities. ACDx is supported by the Commission, WHO, CDC, ESPID (European ASLM (African Society for Laboratory Society for Paediatric Infectious Diseases), Medicine) and the WHO TDR (Special ECDC (European Centre for Disease Programme for Research and Training in Prevention and Control), the Johns Hopkins Tropical Diseases). Bloomberg School of Public Health, the Fogarty International Center and the NVPO (National Vaccine Program Of ce). LES PENSIÈRES: * A PUBLIC HEALTH HUB

A FLOURISHING The Les Pensières conference center, ADVAC ALUMNI located in Annecy (France), * hosts a range of scientific conferences NETWORK IN 2015 and training sessions throughout * Close to 1,000 former students the year, including the international * 5 meetings and discussions held ADVAC and ACDx programs. in Leipzig, Geneva, San Diego It also hosts symposia and seminars and Rio de Janeiro for organizations and businesses that * 3 newsletters for teachers share Fondation Mérieux’s values. and alumni In 2015, some 3,500 people attended * 2 “Special Lecturers” podcasts 98 public health conferences and posted on GLOBE training sessions at Les Pensières.

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INTENSIVE COURSES •

VACCINOLOGY INTEGRATED SHORT IN AFRICA WATER/HYGIENE/NUTRITION COURSES TRAINING PROGRAM AFRICA Fondation Mérieux’s local teams offer a range of thematic short courses for 3RD CLASS MALI professionals from clinical diagnostic Following the success of the rst two 2ND CLASS and research laboratories: sessions of the Vaccinology in Africa * In 2015, the Bioforce Institute delivered Via the GABRIEL network: courses on course, held in Ghana and Kenya, the diagnostic tools, research protocols third course took place in Mali in 2015. its Nutrition Project Management and Water-Hygiene-Sanitation Project and immunology, The 41 participants bene ted from a Management courses at the Charles * Via the RESAOLAB network in West training program delivered jointly by the Mérieux Infectiology Center in Mali. Africa: 14 modules in total, including a Mali Faculty of Medicine’s Malaria dedicated Ebola course and a series of Research and Training Center (MRTC) The program is jointly funded by UNICEF and Fondation Mérieux, under new programs launched in 2015 that and the Charles Mérieux Infectiology include laboratory data management, Center in Bamako. The initiative is overseen a partnership with Action Against Hunger and Antenna Mali. A total of 41 students preparation of liquid culture media by the Jenner Institute (a partnership and laboratory management, between the University of Oxford and from 10 African countries took part in * Via the Quality Initiative: courses on the Pirbright Institute in the UK) and is the course in 2015. The Charles Mérieux biosafety, quality standards and supported by Fondation Mérieux and Infectiology Center also hosted other processes, and rollout of the initiative several industrial partners (GSK, P zer Bioforce Institute short courses, including to ve new sites in 2015 (Bangladesh, and Merck). the Emergency WASH (Water, Sanitation and Hygiene) program. Haiti, Laos, Mali and Paraguay).

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SCIENTIFIC CONFERENCES

Each year, Fondation Mérieux works with a network of international experts to organize scienti c conferences in France and abroad on themes related to global public health. In doing so, the Foundation seeks to help disseminate the latest advances, develop expert networks and strengthen international synergies.

Some of these conferences are regular events. These include the “Cent Gardes” Conference, launched by Dr. Charles Mérieux in 1986, and the Charles Mérieux Conference, a global health conference rst held in 2007 and hosted in Haiti in 2015.

2015 SCIENTIFIC CONFERENCES • 9 events held at Les Pensières • 5 events held outside France • More than 1,400 participants

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CONFERENCES & WORKSHOPS FOCUS ON… AT LES PENSIÈRES •

EBOLA VACCINE: WHERE ARE WE? EBOLA VACCINE: HOW TO MOVE FORWARD? WHERE ARE WE? In partnership with AVIESAN (French National Alliance for HOW TO MOVE FORWARD? Life Sciences and Health) and WHO (January 2015) JANUARY 12-13, 2015 • LES PENSIÈRES 15TH “CENT GARDES” CONFERENCE 60 PARTICIPANTS On HIV/AIDS research, in partnership with ANRS and Inserm The aim of this event was to assess (French National Institute of Health and Medical Research) * the most promising options for (October 2015) Ebola vaccines, confronting the challenges faced by researchers with those faced by international, governmental and GFBR MEETING non-governmental organizations working in Global Forum for Bioethical Research with the support of the the field to respond to the Ebola epidemic in Wellcome Trust, the National Institutes of Health (NIH) and the West Africa. The discussions focused on Bill & Melinda Gates Foundation (November 2015) progress and next steps in the development of three vaccine candidates in clinical trials. WORKSHOP ON THE SHARING OF RESEARCH DATA AND BIOLOGICAL SAMPLES IN LOWER-INCOME COUNTRIES Organized jointly by the Inserm Ethics Committee, GFBR and Fondation Mérieux (November 2015) SOCIAL INNOVATION IN HEALTH INITIATIVE SOCIAL INNOVATION IN HEALTH INITIATIVE (SIHI) (SIHI) DECEMBER 2-3, 2015 • LES PENSIÈRES Led by the WHO TDR (Special Programme for Research and 57 PARTICIPANTS Training in Tropical Diseases) (December 2015) What success factors and strategies * are needed to encourage innovative social initiatives for public health? n In partnership with Sanofi Pasteur This event, attended by representatives of the Ministries of Health of Uganda, Malawi and * Vaccination ecosystem health check (January 2015) Swaziland, featured presentations on * Off-target effects of vaccination (June 2015) community-based solutions, detailing their * Beyond Ef cacy: the full public health impact of vaccines impact on local healthcare systems. The (June 2015) meeting was organized by the WHO TDR, the * Demand side interventions to increase and sustain Bertha Centre for Social Entrepreneurship vaccination uptake (September 2015) and Innovation (University of Cape Town) and * Pertussis: biology, epidemiology and prevention the Skoll Centre for Social Entrepreneurship (November 2015) (University of Oxford).

40 2015 ANNUAL REPORT STRATEGIC AREAS OF ACTION

INTERNATIONAL FOCUS ON… CONFERENCES •

TH 5 CHARLES MÉRIEUX CONFERENCE ASIAN PACIFIC VACCINOLOGY HAITI • Organized in partnership with the GHESKIO Centers, MEETING the Jacques Cartier Center and the Francophone University Association (AUF) (February 2015) NOVEMBER 30TH – DECEMBER 3RD BANGKOK (THAILAND) 6TH GLOBAL LABORATORY INITIATIVE 152 PARTICIPANTS SWITZERLAND • Organized by the WHO Global TB Programme The second Asian Pacific Vaccinology and supported by Fondation Mérieux (April 2015) * Meeting included workshops on available vaccines, vaccines under development and national prevention strategies. MIDDLE EAST AND EASTERN EUROPE The participants confirmed the need to continue RABIES EXPERT BUREAU MEETING sharing information and exchanging best practices at the regional level, to ensure the FRANCE • Organized in partnership with the Global Alliance effectiveness of vaccination strategies. for Rabies Control (April 2015)

WORLD RABIES DAY LAOS • Organized by Laos’ Ministry of Health with the support of Fondation Mérieux (September 2015)

ASIAN PACIFIC VACCINOLOGY MEETING THAILAND • Organized in partnership with Sano Pasteur (December 2015)

41 2015 ANNUAL REPORT STRATEGIC AREAS OF ACTION

SUPPORT FOR INNOVATIVE PUBLIC HEALTH INITIATIVES

Fondation Mérieux supports global initiatives that offer innovative solutions to public health challenges. The Foundation continued its work with three multi- national partnership initiatives in 2015, focusing on dengue fever control, diseases of pandemic potential, and enteric diseases.

42 2015 ANNUAL REPORT STRATEGIC AREAS OF ACTION

PARTNERSHIP GLOBAL RESEARCH INITIATIVE FOR DENGUE CONTROL COLLABORATION GloPID-R AGAINST DIARRHEAL AND ENTERIC DISEASES The Partnership for Dengue Control GloPID-R (Global Research Collaboration (PDC) is an alliance that brings together for Infectious Disease Preparedness) is IN AFRICA AND ASIA international organizations, scientific the only alliance of its kind to bring experts and public health leaders. together research funding organizations The Initiative against Diarrheal and Enteric The PDC is hosted by Fondation Mérieux on a global scale to facilitate an effective, diseases in Africa and Asia (IDEA-Cholera) and seeks to contribute to the elimination rapid research response to a signi cant is a multidisciplinary, multinational and of dengue fever – a disease that affects outbreak of an infectious disease independent group of health professionals 400 million people each year in more with pandemic potential. GloPID-R involved in cholera and enteric disease than 120 countries in the subtropics. coordinates and shares information among control and prevention efforts. The In 2015, the PDC advised the Mexican funding organizations, thereby helping initiative draws on the expertise of government on the introduction of a new to avoid duplication of effort and professionals working on the ground, dengue vaccine and obtained a consensus resources and enabling a rapid response who come together at regional workshops. when a health emergency is declared. among international experts on the clinical Two workshops were held in 2015, in India de nition of severe forms of the disease, The GloPID-R Secretariat is funded by the and Benin respectively. Two declarations working with the NIH. European Union’s Horizon 2020 program were drafted at these workshops: the Fondation Mérieux also launched a and is coordinated by Fondation Mérieux “Delhi Declaration” and the “Cotonou new website to give the program greater and the University of Oxford. Its key Declaration” – advocacy documents visibility in 2015: achievements in 2015 included conducting aimed at opinion leaders, institutions www.controldengue.org. a study to identify and map research and local and national organizations. funding organizations and networks, The initiative is supported by the Bill & IDEA is hosted by Fondation Mérieux and to analyze existing capabilities and Melinda Gates Foundation, Sano Pasteur, and funded by Sano Pasteur, and was potential barriers to a rapid response. Takeda, bioMérieux and Bayer. of cially incorporated into the WHO GloPID-R has doubled the number of Global Task Force for Cholera Control in funding organizations involved since its 2015. creation, and it now has over 20 organiza- tions participating throughout the world.

AN INTEGRATED GloPID-R RESPONDS APPROACH TO THE ZIKA TO ELIMINATING OUTBREAK DENGUE FEVER • • In response to the Brazilian Ministry of The PDC adopts a holistic approach to Health’s official declaration of the Zika controlling the disease, incorporating virus as a public health emergency in all existing tools and methods (vaccines, November 2015, GloPID-R assembled an antiviral treatments, insecticides, new Outbreak Committee on December 1st. surveillance methods, and innovative GloPID-R members produced a report mosquito control strategies). identifying Zika virus capabilities and research activities, and detailing key issues requiring a research response.

43 BENIN BURKINA FASO GUINEA FONDATION MÉRIEUX MADAGASCAR WORLDWIDE *** MALI NIGER SENEGAL TOGO BRAZIL HAITI BANGLADESH CAMBODIA CHINA LAOS MYANMAR IRAQ IRAN LEBANON TAJIKISTAN ANNUAL REPORT 2015 ANNUAL REPORT FONDATION MÉRIEUX WORLDWIDE

AFRICA •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• BENIN BURKINA FASO

n Fondation Mérieux offi ce: 1 Burkinabe employee n RESAOLAB network member since 2009 * RESAOLAB PROGRAM ACHIEVEMENTS: • Construction of the Continuing Training Center and External Quality Control Unit in Ouagadougou, within the General Directorate of Pharmacy, Drugs and Laboratories, inaugurated in 2013 • Renovation and equipping of 3 other continuing training centers: Bobo-Dioulasso (DRS), Ouahigouya (Lazaret Medical Center) and Fada N’Gourma (Regional Hospital) • Renovation of the laboratory and practical workrooms of the Faculty of Pharmacy of Ouagadougou in 2014*

n Fondation Mérieux offi ce: 1 Beninese employee IN 2015 n RESAOLAB network member since 2013 SUPPORT FOR CLINICAL BIOLOGY LABORATORIES n Participation in the SOCIALAB study: historical and IN 2015 anthropological research in Senegal, Burkina Faso and Mali on the development and current status of medical RESAOLAB PROGRAM ACTIONS laboratory services in national health systems n Launch of the construction of the External Quality Control and Training Center on the grounds of the Ministry of RESAOLAB PROGRAM ACTIONS Health of Benin n Quality plan review for the 2015-2017 period n Implementation of the quality plan in laboratories: n External Quality Assessment Sessions for 101 laboratories: 200 laboratory technicians bene t from the quality assurance 74 laboratory workers from public and private structures training module have been oriented to quality management, bacteriology, n Scholarships: 2 applicants for the Bachelor of Science in parasitology and hematology Biological and Applied Medical Sciences (BAMS) in Mali n Scholarships: 5 technicians for the Bachelor of Science in and 2 students for the DES in Medical Biology (in year 2) Biological and Applied Medical Sciences (BAMS) in Mali n 5 training modules administered: quality assurance, and 2 students for the DES in Medical Biology biosecurity, inventory management, chronic diseases, n 4 modules broken down into workshops and practical data management training: quality management, antibiotic susceptibility n Launch of the renovation and equipping of the practical testing, laboratory data management and preparation and workrooms of the Ecole Polytechnique d’Abomey-Calavi management of culture media (EPAC) SUPPORT FOR LOCAL INITIATIVES TRAINING AND KNOWLEDGE-SHARING n Support for the NGO Djantoli for the extension of its n IDEA workshop on strategies to combat cholera in Cotonou programs for access to healthcare to 2 new outlying (October 5-9) neighborhoods of Ouagadougou

*With support from Fondation Christophe et Rodolphe Mérieux 45 2015 ANNUAL REPORT FONDATION MÉRIEUX WORLDWIDE

AFRICA •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• GUINEA MADAGASCAR

n First Fondation Mérieux mission in 2006 n Fondation Mérieux offi ce: 1 expatriate and 1 Malagasy employee n Charles Mérieux Infectiology Center with a Rodolphe Mérieux Laboratory* within the University of Antananarivo (2010) n One GABRIEL network member: University of Antananarivo n Renovation of 9 clinical biology laboratories since 2007

RODOLPHE MÉRIEUX LABORATORY n First Fondation Mérieux mission in 2010 RESEARCH FOCUS: n Fondation Mérieux offi ce: 2 expatriates n Leprosy n Neglected tropical diseases and 1 Guinean employee n Diarrheal diseases n Meningitis n RESAOLAB network member since 2013 IN 2015 IN 2015 SUPPORT FOR CLINICAL BIOLOGY LABORATORIES n New Fondation Mérieux of ce in Conakry n Renovation of 3 laboratories in 2015: Befelatanana microbiology laboratory, Sambava Hospital bacteriology SUPPORT FOR CLINICAL BIOLOGY LABORATORIES laboratory and Andapa Adventist Hospital laboratory n Launch of the LAB-NET project to begin surveillance of viral n Technical support for the establishment of a network of hemorrhagic fever syndromes in Guinea: 5 need assessment public hospital laboratories (RESOILAB) missions carried out n Deployment of a Laboratory Information Management n Support for the Coronthie Women and Children’s Health System and training in 9 laboratories Center in Conakry: supervision by Prof. Diallo of the n Implementation of HIV viral load testing at the Charles Charles Mérieux Infectiology Center in Mali Mérieux Infectiology Center n Support for the pharmaceutical studies program created RESAOLAB PROGRAM ACTIONS by Fondation Mérieux in 2006: training to strengthen the n Foundation stone laid for the Laboratory Directorate in Donka capacity of hospital pharmacies n Distribution of transport kits and personal protective equipment to laboratories and Ebola Treatment Centers in CURRENT RESEARCH PROJECTS Guinea n Molecular surveillance of resistance of Mycobacterium n Scholarships: 2 technicians for the Bachelor of Science in leprae to leprosy treatment Biological and Applied Medical Sciences (BAMS) in Mali n Epidemiology, mycological and molecular diagnosis of and 2 students for the DES in Medical Biology tropical mycoses: to assess the current incidence of n Training sessions for trainers in the RESAOLAB network at chromomycosis and sporotrichosis in Madagascar the Institut de Perfectionnement Professionnel en Santé (IPPS) n Surveillance of pediatric bacterial meningitis at the n Training sessions on modules on pre and post-analytical Tsaralalana Mothers & Children’s University Hospital testing phases and Ebola for 246 workers laboratory

46 2015 ANNUAL REPORT FONDATION MÉRIEUX WORLDWIDE

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n Development and validation of a molecular test for the n Development of diagnostic tools for pneumonia: Streptococcus diagnosis of bacterial meningitis: retrospective study in pneumoniae strain typing by real-time multiplex PCR collaboration with the Charles Mérieux Infectiology n Development of a molecular biology training module Center and the Tsaralalana Mothers & Children’s University made available in different versions aligned with local Hospital on 297 samples needs, adapted for Madagascar (15 participants) n Assessment of the endemicity rate for intestinal bilharzia by Schistosoma mansoni in the Haute Matsiatra region SUPPORT FOR LOCAL INITIATIVES n Access to hygiene for destitute people in Madagascar GABRIEL NETWORK MULTI-CENTER STUDIES: alongside the Akamasoa association: construction of n Proof-of-concept for the analysis of the microbiome of waste containers, latrines, urinals and a water tank hospitalized children with pneumonia in developing n Training in health education for the most vulnerable families, countries – Biodiversity project in partnership with school medical services and child protection associations

Fondation Mérieux mourns the loss of Dr. Bénédicte Contamin, its regional director for the Indian Ocean, based in Madagascar for close to a decade. She passed away Friday, August 21st after a battle with cancer.

All those who were fortunate to know For almost ten years, she contributed to tropical diseases, diarrheal disease in children Bénédicte appreciated her generosity, her clinical biology and access to healthcare for and meningitis. She also contributed to re- enthusiasm and her passion for access to the Malgasy population. search projects with an international scope, health for all. She devoted her life to the including the GABRIEL network’s multicenter Bénédicte launched Fondation Mérieux’s care of the most vulnerable, especially study on the pathogens responsible for fi rst mission in Madagascar in 2006 and children. severe pneumonia in children under 5 years oversaw the creation of the Charles Mérieux of age. Infectiology Center, built on the University of Antananarivo campus in 2010. Her fi rst Beyond the scientifi c domain, Bénédicte initiative was strengthening the capacities Contamin was instrumental in Fondation of the Ansirabé Hospital laboratory. The Mérieux’s support to local charitable Bénédicte was a physician, specialized in success of this project resulted in the organizations. These include Père Pedro’s internal medicine and infectious and tropical development of a model that could be Akamasoa (“good friends”) association for diseases. Before joining Fondation Mérieux applied to other sites and a close collaboration which, most recently, the Foundation in 2006, she was the Senior Registrar assistant with the Madagascar Ministry of Health. renovated a homeless shelter for families, in infectiology in Prof. Dominique Peyramond’s Five other laboratories have since been and the Vahatra association, for which it department at the Hospices Civils de Lyon renovated and their personnel and that of supported the creation of a health (Lyon Civil Hospitals) where she worked other health centers have been trained. insurance plan. closely with Dr. Christophe Mérieux. She Bénédicte brought her expertise to the Her death is a great loss, not only for then practiced medicine at the Pointe-à-Pitre research projects of the Rodolphe Mérieux Fondation Mérieux and the Charles Mérieux University Hospital in Guadeloupe and in Laboratory at the Infectiology Center. Her Infectiology Center, but also for the under- Réunion where she was appointed hospital work focused on diseases that are privileged populations she cared for with practitioner in 2002. prevalent in Madagascar: leprosy, neglected passion.

*With support from Fondation Christophe et Rodolphe Mérieux 47 2015 ANNUAL REPORT FONDATION MÉRIEUX WORLDWIDE

AFRICA •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• MALI

n First Fondation Mérieux mission in 2003 IN 2015 n Fondation Mérieux offi ce: 1 expatriate SUPPORT FOR CLINICAL BIOLOGY and 3 Malian employees LABORATORIES n Charles Mérieux Infectiology Center n Celebration of the 10th anniversary of the Charles Mérieux with a Rodolphe Mérieux Laboratory* in Bamako (2005) Infectiology Center on September 17th in the presence of n One GABRIEL network member: Mr. Alain Mérieux Charles Mérieux Infectiology Center n Development of the technical capacities of the Charles Mérieux n RESAOLAB network member since 2009 Infectiology Center: implementation of a BSL3 laboratory * RESAOLAB PROGRAM ACHIEVEMENTS: dedicated to diagnosis and research on tuberculosis and other Renovation and equipping of training sites (in 2010): dangerous viruses and technology transfer for measuring • Kayes and Mopti regional hospital laboratories hepatitis viral loads • The laboratory of the National Institute of Training in n Development of specialized biology activities and biological Health Sciences (INFSS) in Sikasso monitoring of viral hepatitis • Multimedia rooms at the INFSS in Kayes (with support n Continuation of the mobile laboratory project in partnership from the International Cooperation of the Principality with the German Program for Excellence in Biological and of Monaco) and in Sikasso Health Security, the Bundeswehr Institute of Microbiology • National Quality Control Unit (UNEEQ) at the National and the GIZ (German Federal Enterprise for International Institute of Research in Public Health (INRSP) Cooperation): rst successful deployment exercise and continuation of the technical training sessions RODOLPHE MÉRIEUX LABORATORY n Renovation of the laboratory of the Gabriel Touré Hospital RESEARCH FOCUS: maternity ward* n Tuberculosis n Hepatitis B n Support for the LABOMEDCAMP project, aimed at n Respiratory infections improving the quality of infectious disease diagnosis in front-line laboratories in Mali

48 2015 ANNUAL REPORT FONDATION MÉRIEUX WORLDWIDE

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CURRENT RESEARCH PROJECTS n Research partnership: 3 signing ceremonies as part of the establishment of a research cooperation agreement between the Chinese Academy of Medical Sciences (CAMS), the Charles Mérieux Infectiology Center of Mali and Fondation Mérieux

GABRIEL NETWORK MULTI-CENTER STUDIES: n Proof-of-concept for the analysis of the microbiome of hospitalized children with pneumonia in developing countries – Biodiversity project n Development of diagnostic tools for pneumonia: Streptococcus pneumoniae strain typing by real-time multiplex PCR n Quality initiative: Mali is one of 4 pilot sites for an initiative designed to help GABRIEL member laboratories meet the requirements for international ISO 15189 accreditation n Development of a general teaching module on molecular n Launch of DJOMI: a U.S. CDC-GHSA (Global Health immunology delivered at the Charles Mérieux Infectiology Security Agenda) project in consortium with Catholic Center in May (15 participants) Relief Services and Mali Health for the assessment of the national laboratory network and the strengthening of TRAINING AND biosecurity/biosafety capacities KNOWLEDGE-SHARING n Participation in the SOCIALAB study: historical and n Organization of the 3rd Vaccinology in Africa course at the anthropological research in Senegal, Burkina Faso and Mali Charles Mérieux Infectiology Center: rst edition in a French on the development and current status of medical laboratory speaking country (41 students of 12 different nationalities) services in national health systems n Integrated training program “Water-Hygiene-Sanitation n 9th class of the Bachelor of Science in Biological and Applied project manager” and “ Nutrition project manager” in Medical Sciences (BAMS): 25 students from 8 countries* partnership with the Bioforce Institute

RESAOLAB PROGRAM ISUPPORT ACTIONS FOR LOCAL INITIATIVES n Validation of the quality plan: an external quality assessment n Partnership with Samusocial international (Mali, Senegal, mission covered 80 laboratories Peru) which provides assistance to children living on the n Scholarships: 9 technicians for BAMS Mali streets* n Writing of a new training module on the production and n Science and health education pilot program in primary quality control of culture media and stains schools in Mali

*With support from Fondation Christophe et Rodolphe Mérieux 49 2015 ANNUAL REPORT FONDATION MÉRIEUX WORLDWIDE

AFRICA •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• NIGER SENEGAL

n First Fondation Mérieux mission in 2012 n First Fondation Mérieux mission in 2009 n Fondation Mérieux offi ce: 1 Nigerien employee n Fondation Mérieux offi ce: 1 expatriate n RESAOLAB network member since 2013 and 1 Senegalese employee n RESAOLAB network member since 2009 * IN 2015 RESAOLAB PROGRAM ACHIEVEMENTS: • Support for the creation of a National Laboratories RESAOLAB Directorate (2013) PROGRAM ACTIONS • Renovation of continuing training centers in Thies, n 3rd RESAOLAB International Steering Committee in Kaolack (2014) Niamey in November with the participation of 4 guest countries: Ghana, The Gambia, Guinea-Bissau and Nigeria IN 2015 n Foundation stone laid for the Health Laboratories Directorate in the presence of the Health Minister of Niger SUPPORT FOR CLINICAL BIOLOGY LABORATORIES and the Director-General of the West African Health n Start of the I-LAB project: development of a tool for the Organization (WAHO) in November 2015 automation of epidemiological data collection from n Renovation and equipping of the practical workrooms at laboratories, funded by the Skoll Foundation the National School of Public Health (Ecole Nationale de n SOCIALAB program whose aim is to understand the social, Santé Publique, ENSP) of Niamey cultural and historic factors limiting the support of n Implementation of training modules at the Centre de laboratory services during prenatal care: historical and Recherche Médicale et Sanitaire (CERMES) in Niamey anthropological research carried out in 2015 in Senegal, and at the Zinder hospital for 259 technicians: pre and Burkina Faso and Mali on the development and current post-analytical phases, inventory management, biosecurity, status of medical laboratory services in national health biological waste management and quality assurance systems n Training of trainers in the RESAOLAB network: n Launch of a project for strengthening the Laboratories 20 participants Directorate activities in consortium with PATH and nanced by the U.S. CDC-GHSA (Global Health Security Agenda)

50 2015 ANNUAL REPORT FONDATION MÉRIEUX WORLDWIDE

••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• TOGO

RESAOLAB n First Fondation Mérieux mission in 2012 PROGRAM ACTIONS n Fondation Mérieux offi ce: 1 Togolese employee n Supervision of 20 laboratories n RESAOLAB network member since 2013 n Inspection of 15 private laboratories and non-registered laboratories IN 2015 n Supervision sessions and collection of antimicrobial resistance data in 18 laboratories RESAOLAB n External Quality Assessment inspection for 40 laboratories PROGRAM ACTIONS specialized in bacteriology n Drafting and validation of the National Quality Plan n Scholarships: 5 technicians for BAMS Mali and 18 scholar- n Drafting of a training plan for clinical biology personnel ships for the DES in Medical Biology n Training of trainers in the RESAOLAB network n Training of trainers in the RESAOLAB network: 2 sessions n Scholarships: 1 student in the DES in Medical Biology on data management and quality systems (50 participants) n Training of laboratory technicians: 6 sessions on data CURRENT management (150 participants) and one session on quality RESEARCH PROJECTS systems (53 participants) n Drafting of a handbook on laboratory techniques by the n Second phase of the PneumoTone study on etiologic Laboratories Directorates agents responsible for pneumonia in a cohort of patients with respiratory diseases in the city of Dapaong SUPPORT FOR LOCAL INITIATIVES TRAINING AND n Partnership with Samusocial international (Mali, Senegal, KNOWLEDGE-SHARING Peru) which provides assistance to children living on the n IDEA: AFRICHOL consortium meeting in Lomé in June streets*

*With support from Fondation Christophe et Rodolphe Mérieux 51 2015 ANNUAL REPORT FONDATION MÉRIEUX WORLDWIDE

AMERICAS •••••••••••••••••••••••••••••••••••••••••••••••••••••••• BRAZIL HAITI

n First Fondation Mérieux mission in 2011 n 2 GABRIEL network members: the Oswaldo Cruz Foundation and the Laboratório Nacional de Computação Científi ca (National Laboratory of Scientifi c Computation) n Foundation stone laid and construction of the Charles Mérieux Infectiology Center with a Rodolphe Mérieux Laboratory in the Fundacre Hospital in Rio Branco (2015)

IN 2015 CURRENT RESEARCH PROJECTS n First Fondation Mérieux mission in 2002 n Study of active surveillance of severe in uenza cases in hospitalized patients carried out in partnership with n Rodolphe Mérieux Laboratory * within the Institute of Sano Pasteur at 3 clinical sites in Brazil - Fortaleza (Ceará Infectious Diseases and Reproductive Health (IMIS) part state), Rio de Janeiro and Porto Alegre (Rio Grande do Sul of the GHESKIO Centers (Haitian Group for the Study of state): 575 cases recruited Kaposi’s Sarcoma and Opportunistic Infections) in Port-au-Prince (2009) GABRIEL NETWORK MULTI-CENTER STUDIES: n One GABRIEL network member: the GHESKIO Centers n Proof-of-concept for the analysis of the microbiome of hospitalized children with pneumonia in developing RODOLPHE MÉRIEUX LABORATORY countries – Biodiversity project RESEARCH FOCUS: n Development of diagnostic tools for pneumonia: n Tuberculosis n HIV/AIDS Streptococcus pneumoniae strain typing by real-time n Bacterial resistance multiplex PCR

52 2015 ANNUAL REPORT FONDATION MÉRIEUX WORLDWIDE

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IN 2015 n Development of a molecular biology module made available in different versions aligned with local needs, adapted for SUPPORT FOR CLINICAL BIOLOGY LABORATORIES Haiti (30 participants) n Refurbishment of the Rodolphe Mérieux Laboratory’s BSL3 laboratory TRAINING AND KNOWLEDGE-SHARING n Establishment of bacteriology activities in the laboratory n 5th Charles Mérieux Conference, February 23rd in of the Institute of Infectious Diseases and Reproductive Port-au-Prince Health thanks to technical assistance in clinical biology n Launch of the SPHaïtiLAB project to strengthen the SUPPORT laboratory network in Haiti TO LOCAL INITIATIVES n 5 th BAMS Haiti class September 2015 - May 2016: th 20 students n 10 year of the micro-credit loan program for women living with HIV (8,900 loans received by 3,900 women since 2005)* CURRENT RESEARCH PROJECTS n Support for the children’s home in Leogane (Communauté de l’Incarnation): construction of buildings, sanitary facilities GABRIEL NETWORK MULTI-CENTER STUDIES: and development of an income-generating activity* n Proof-of-concept for the analysis of the microbiome of n Support for the children’s home in Cap Haitian (Our Lady hospitalized children with pneumonia in developing of the Miraculous Medal): medical support and food aid* countries – Biodiversity project n Support for the Klib Timoun Kè Kontan association for n Development of diagnostic tools for pneumonia: disadvantaged children: launch of an income-generating Streptococcus pneumoniae strain typing by real-time activity* multiplex PCR n Support for the French AAIP association ( re ghter’s n Quality initiative: Haiti is one of 4 pilot sites for an initiative international aid actions) for operating and tting out the designed to help GABRIEL member laboratories meet the Saline dispensary: development of an income-generating requirements for international ISO 15189 accreditation activity*

*With support from Fondation Christophe et Rodolphe Mérieux 53 2015 ANNUAL REPORT FONDATION MÉRIEUX WORLDWIDE

ASIA ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• BANGLADESH CAMBODIA

n First Fondation Mérieux mission in 2009 n Rodolphe Mérieux Laboratory* in Chittagong, within the Bangladesh Institute of Tropical and Infectious Diseases – BITID (2015) n 2 GABRIEL network members: the ICCDR,B (International Centre for Diarrhoeal Disease Research) and the ideSHi (Institute for Developing Science and Health Initiatives)

RODOLPHE MÉRIEUX LABORATORY RESEARCH FOCUS: n Tuberculosis n Typhoid

IN 2015 SUPPORT FOR CLINICAL BIOLOGY LABORATORIES n Launch of the activities of the Rodolphe Mérieux Laboratory in Chittagong, within the BITID, with the diagnosis of resistant tuberculosis strains in partnership with ideSHi n First Fondation Mérieux mission in 2001 n Support for the NGO Friendship: equipping a laboratory n Fondation Mérieux offi ce: 2 Cambodian employees (clinical diagnostics system) and training for technicians n Rodolphe Mérieux Laboratory* within the Faculty through a partnership with the NGO Biologie Sans of Pharmacy of Phnom Penh (2005) Frontières (BSF) n New regional platform for research on infectious diseases on the Institut Pasteur campus in Phnom Penh CURRENT RESEARCH PROJECTS in 2014 (part of Fondation Mérieux’s membership n Study of the transmission of tuberculosis in prisons in in the AVISEAN Sud scientifi c network) order to improve early detection and control of the epidemic n Reconstruction of the Faculty of Pharmacy in Bangladeshi prisons in Phnom Penh in partnership with n Automation of MIRU-VNTR marker typing of Mycobacterium the Pierre Fabre Foundation in 2003 tuberculosis on the QIAxcel system within the ICCDR,B n 9 clinical biology laboratories renovated since 2007 n Diagnosis of typhoid fever: assessment of a new molecular n test, developed thanks to clinical samples collected in One GABRIEL network member: different sites in Bangladesh with the support of the the University of Health Sciences in Phnom Penh Bill & Melinda Gates Foundation RODOLPHE MÉRIEUX LABORATORY ISUPPORT FOR LOCAL INITIATIVES RESEARCH FOCUS: n Support for the NGO AMD (Aide Médicale et n Respiratory infections Développement)*: purchase of an autoclave to strengthen n Relationship between pathogens the diagnostic capacities of the clinical biology laboratory and the environment of the Mother & Child Hospital of Chittagong

54 2015 ANNUAL REPORT FONDATION MÉRIEUX WORLDWIDE

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IN 2015 GABRIEL NETWORK MULTI-CENTER STUDIES: SUPPORT FOR CLINICAL BIOLOGY n ID-Bio International Research Group: molecular epidemio- LABORATORIES logy of tuberculosis in Southeast Asia n Strengthening the diagnostic capacity of the clinical biology n Proof-of-concept for the analysis of the microbiome of laboratory of the Takeo provincial hospital: installation of hospitalized children with pneumonia in developing a high-throughput biochemistry platform countries – Biodiversity project n Support for CamLab, Cambodia’s national clinical biology n Development of diagnostic tools for pneumonia: laboratory network: organization of the external quality Streptococcus pneumoniae strain typing by real-time control program, EQA 2015, for 32 public laboratories multiplex PCR n 9th class of the Diploma of Specialist Studies (DES) in Medical n Development of a molecular biology training module Biology, open to doctors and pharmacists (7 students) made available in different versions aligned with local needs, adapted for Cambodia (30 participants) CURRENT RESEARCH PROJECTS SUPPORT FOR LOCAL INITIATIVES n PCR technology as a detection tool for invasive pneumo- n Support for the NGO 1001 Fontaines for its research on coccal disease: study to determine the characteristics of pesticide levels in clean water production in Cambodia* invasive pneumococcal disease and the colonization in n Support for the NGO Magna - Children at Risk, for the Cambodian children before and after introduction of the treatment of orphans living with HIV and prevention of pneumococcal vaccine on a national scale (PCV13) mother-to-child transmission* n Hepatitis C mono-infection (HCV) and HIV-HCV co-infection n Launch of the hand hygiene promotion initiative with the in Cambodia: epidemiology, risk factors and burden of production and distribution of hydroalcoholic solution in disease the Siem Reap hospital n Support for the “Dr. Christophe Mérieux Center” children’s home in Phnom Penh*

*With support from Fondation Christophe et Rodolphe Mérieux 55 2015 ANNUAL REPORT FONDATION MÉRIEUX WORLDWIDE

ASIA ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• CHINA IN 2015 SUPPORT FOR CLINICAL BIOLOGY LABORATORIES n Construction and inauguration of a BSL4 laboratory in Wuhan within the framework of an intergovernmental agreement between China and France to ght against emerging infectious diseases n Continuation of the program to decentralize tuberculosis diagnosis* through a partnership between Fondation Mérieux and the Chinese Ministry of Health (around 15,000 patient consultations in screening centers in 2015)

CURRENT RESEARCH PROJECTS n Research partnerships: 3 signing ceremonies as part of the establishment of a research cooperation agreement between the Chinese Academy of Medical Sciences (CAMS), the Charles Mérieux Infectiology Center of Mali and Fondation Mérieux n Launch of the CARE project: signing ceremony with Fondation Mérieux and its partners, the First Af liated Hospital of Zhejiang University and the Zhejiang University International Hospital

GABRIEL NETWORK MULTI-CENTER STUDIES: n First Fondation Mérieux mission in 2006 n Proof-of-concept for the analysis of the microbiome of n Fondation Mérieux offi ce: 3 Chinese employees hospitalized children with pneumonia in developing countries – Biodiversity project n Christophe Mérieux Laboratory* within the Institute of Pathogen Biology at the Chinese Academy of Medical n Development of diagnostic tools for pneumonia: Sciences (CAMS) in Beijing (2008) Streptococcus pneumoniae strain typing by real-time multiplex PCR n One GABRIEL network member: the Institute of Pathogen Biology at the Chinese Academy of Medical Sciences TRAINING AND (CAMS) KNOWLEDGE-SHARING n 3rd international foundation to be offi cially recognized by the Chinese Ministry of Health in 2014 n Fondation Mérieux was a partner in the “Africa-China Partnership: Caring for an HIV-Free Generation” event in Johannesburg, on December 5th, organized by the CHRISTOPHE MÉRIEUX LABORATORY Organization of African First Ladies against HIV/AIDS RESEARCH FOCUS: (OAFLA) and the National Health and Family Planning n Pneumonia n Tuberculosis Commission (NHFPC) of China with the support of UNAIDS, WHO and the Bill & Melinda Gates Foundation

56 2015 ANNUAL REPORT FONDATION MÉRIEUX WORLDWIDE

••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• LAOS

n First Fondation Mérieux mission in 2005 n Fondation Mérieux offi ce: 2 expatriates n Christophe Mérieux Infectiology Center and Rodolphe Mérieux Laboratory* within the University of Health Sciences in Vientiane (2009) n 9 clinical biology laboratories renovated, including 8 in the Khammouane province in 2013 n One GABRIEL network member: the Ministry of Health

RODOLPHE MÉRIEUX LABORATORY RESEARCH FOCUS: n Respiratory infections and tuberculosis n HIV/AIDS and human papillomavirus (HPV) n Hepatitis

IN 2015 SUPPORT FOR CLINICAL BIOLOGY LABORATORIES n Extension of the Christophe Mérieux Infectiology Center n Foundation stone laid for the Food Safety Laboratory n Continuation of the project to improve diagnostic capacities of laboratories in the Khammouane province and increased training

CURRENT RESEARCH PROJECTS n ID-Bio International Research Group: molecular epidemio- logy of tuberculosis in Southeast Asia n LaCoRIS project: respiratory infections in cohorts in Vientiane n Lao PDR project: to determine the primary resistance to HIV treatment ITRAINING AND KNOWLEDGE-SHARING n LaoCol-VP project* (cost-effectiveness study of techniques n Antibioguide: the guide on the proper use of antibiotics to detect cervical cancer): presentation of the results to published for Laotian doctors is now available in French Laotian partners and English n Quality initiative: Laos is one of 4 pilot sites for an initiative n World Rabies Day organized in Vientiane designed to help GABRIEL member laboratories meet the n Organization of the first regional symposium on viral requirements for international ISO 15189 accreditation hepatitis at the Christophe Mérieux Infectiology Center

*With support from Fondation Christophe et Rodolphe Mérieux 57 2015 ANNUAL REPORT FONDATION MÉRIEUX WORLDWIDE

ASIA ••••••••••••••••••••••••••• MIDDLE EAST••••••••••••••••• MYANMAR IRAQ

n First Fondation Mérieux mission in 2010 n First Fondation Mérieux mission in 2014 n Renovation of 3 units within the Public Health Laboratory between 2011 and 2014* (the molecular biology, IN 2015 bacteriology and virology laboratories) SUPPORT FOR CLINICAL BIOLOGY LABORATORIES

IN 2015 n Equipping the laboratory of a health center at the Bardarash refugee camp, where 11,000 Shabaks are living SUPPORT FOR CLINICAL BIOLOGY LABORATORIES n Implementation of tests for HIV viral load measurement SUPPORT FOR LOCAL INITIATIVES on 2 sites in 2015 (Yangon and Dawei) and completion of n Completion of the construction and equipping of training programs: after Mandalay in 2011, a total of 250 homes* for the war-displaced of the Nineveh plains, in 3 platforms for viral load testing in Myanmar partnership with Fondation Saint-Irénée, Fondation Raoul n Support to maintain the quality of testing at laboratories Follereau, the Auvergne-Rhône-Alpes Region, Grand Lyon, performing HIV viral load testing and early diagnosis in and the City of Lyon newborns in the Mandalay region* n Construction of the Saint-Irénée school* for displaced n Continuation of the support for the development of micro- children in Erbil, in partnership with Fondation Saint-Irénée, biology in the National Health Laboratory in Mandalay Fondation Raoul Follereau, Fondation AnBer, and the Auvergne-Rhône-Alpes Region n Assessment mission for the construction of a medical center equipped with a medical analysis laboratory for the displaced

58 2015 ANNUAL REPORT FONDATION MÉRIEUX WORLDWIDE

••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• IRAN TAJIKISTAN

n First Fondation Mérieux mission in 2015 n First Fondation Mérieux mission in 2009 n National Public Health Reference Laboratory (NPHRL) IN 2015 in Dushanbe designed and equipped by the Foundation in 2013 SUPPORT FOR CLINICAL BIOLOGY LABORATORIES NPHRL RESEARCH n Signature of 2 partnership agreements with the Institut FOCUS: Pasteur of Iran for: n Tuberculosis • the construction of a BSL3 laboratory in Tehran • the construction of a training center and BSL2 laboratory in Zahedan IN 2015 SUPPORT FOR CLINICAL BIOLOGY LABORATORIES LEBANON n Follow-up on the maintenance of the laboratory through the WHO n First Fondation Mérieux mission in 2008 n Rodolphe Mérieux Laboratory* within the Technology Center of the Saint Joseph University in Beirut (2011) n One GABRIEL network member: Saint-Joseph University

RODOLPHE MÉRIEUX LABORATORY RESEARCH FOCUS: n Bacterial resistance

IN 2015 SUPPORT FOR CLINICAL BIOLOGY LABORATORIES n Continuation of specialized testing activities (HIV, HBV, and HCV viral load, HCV genotyping, tuberculosis strain typing) n Theoretical training on BSL3 laboratory safety regulations for 11 scientists

CURRENT RESEARCH PROJECTS n Study on the etiology of respiratory infections in Syrian refugees in Lebanon in order to improve patient care

*With support from Fondation Christophe et Rodolphe Mérieux 59 2015 ANNUAL REPORT GOVERNANCE

GOVERNANCE •

BOARD MANAGEMENT SCIENTIFIC FONDATION OF DIRECTORS COMMITTEE COMMITTEE MÉRIEUX USA

REPRESENTATIVES Benoît MIRIBEL Prof. Albert OSTERHAUS BOARD OF DIRECTORS OF THE FOUNDING Director General Chairman Prof. David L. HEYMANN Université Erasmus MEMBERS Emmanuel DE GUIBERT President de Rotterdam (The Netherlands) Alain MÉRIEUX Secretary General Public Health England Prof. Antoine ANDREMONT(1) (United Kingdom) President Dr. François-Xavier BABIN Hôpital Bichat-Claude Bernard Claudine FRIEH International Development Dr. Jon ANDRUS (France) Karine MEHLER Director Sabin Vaccine Institute Alexandre MÉRIEUX Prof. Françoise BARRÉ-SINOUSSI (United States) Prof. Hubert ENDTZ Sophie MÉRIEUX Institut Pasteur (France) Scienti c Director Stéphane BANCEL Prof. Christian BRÉCHOT Moderna (United States) Dr. Christophe LONGUET QUALIFIED PERSONS Institut Pasteur (France) Medical Director Didier CHERPITEL Didier CHERPITEL Prof. Abdullah BROOKS (1) Fondation Mérieux Board Koren WOLMAN-TARDY Prof. François GROS International Centre for Diarrhoeal of Directors (France) Communication Director Prof. David L. HEYMANN Disease Research, Bangladesh Dr. Kevin DE COCK Dominique PELLA (Bangladesh) Center for Global Health, U.S. Prof. Dominique PEYRAMOND Prof. Stewart COLE Centers for Disease Control and (1) Prof. Didier RAOULT École Polytechnique Fédérale Prevention (United States) Dr. Robert SEBBAG de Lausanne (Switzerland) Dr. Warren JOHNSON Prof. Xavier de LAMBALLERIE Center for Global Health, GOVERNMENT Faculté de Médecine de Marseille Weill Cornell Medical College REPRESENTATIVE (France) (United States) The Prefect of Prof. Ogobara DOUMBO Karine MEHLER the Auvergne-Rhône-Alpes Malaria Research and Training Fondation Mérieux Board Region Center Bamako (Mali) of Directors (France) Prof. David L. HEYMANN Dr. Stanley PLOTKIN (2) Public Health England Vaxconsult (United States) (United Kingdom) Prof. Johan NEYTS TEAM Faculté de Médecine Dr. Louise GRESHAM de l’Université de Louvain CEO (Belgium) Emily PENROSE (1) Prof. Jean-William PAPE Program Manager Centres GHESKIO (Haiti) Prof. Fabien ZOULIM Inserm - Lyon (France)

60 (1) Since December 2015, replacing Prof. Pierre-Marie GIRARD, Dr. Kai Man KAM and Prof. Arnold S. MONTO n (2) Until March 2015 2015 ANNUAL REPORT PARTNERS

MAIN PARTNERS •

Fondation Mérieux is grateful GOVERNMENTAL INTERNATIONAL Institut de recherche to its many partners for biomédicale des armées (IRBA) their continuing trust and INSTITUTIONS ORGANIZATIONS & NGOS commitment. Institut de Recherche pour Agence Française de Global Fund to Fight AIDS, le Développement (IRD) In 2015, thanks to their Développement (AFD) Tuberculosis and Malaria London School of Hygiene and contribution, numerous Armed Forces Health Handicap International Tropical Medicine (LSHTM) capacity-building and research Surveillance Center Indian Ocean Commission Serum Institute of India projects were initiated and (AFHSC/GEIS) (IOC) Université Claude Bernard enhanced to help local stake- Auvergne-Rhône-Alpes Islamic Development Bank (IDB) Lyon 1 holders in their fight against Region Œuvres Pontificales University of Geneva infectious diseases. Centers for Disease Control Missionnaires de Lyon University of Oxford and Prevention (CDC)* Red Cross City of Lyon Special Programme for Deutsche Gesellschaft Research and Training in für Internationale Tropical Diseases (TDR) - INDUSTRY Zusammenarbeit (GIZ) UNICEF, UNDP, WHO, Direction de la Coopération the World Bank Bayer Internationale (DCI) de World Bank - through Biocentric la Principauté de Monaco the West African Health European Union Organisation (WAHO) bioMérieux th Cepheid FOUNDATIONS (7 Framework Program, World Health Organization ACP Science and Technology (WHO) European Diagnostic Programme, H2020, through Manufacturers Association Bill & Melinda Gates Research and Innovation (EDMA) Foundation (RTD) and the International Fast-track Diagnostics Bioaster Cooperation and GlaxoSmithKline Biologicals CDC Foundation Development (DEVCO)) UNIVERSITIES Image 7 Fondation AnBer Grand Lyon & RESEARCH INSTITUTES Ipharmex* Fondation Bullukian Hospices Civils de Lyon Janssen Research & Fondation Christophe et Ministère des Affaires Centre International Development Rodolphe Mérieux étrangères et de Recherche en Infectiologie Luminex du Développement Fondation de France Conférence Internationale international (MAEDI) – Merck des Ordres de Pharmaciens Fondation La main à la pâte through Expertise France, Mérieux Nutrisciences Francophones (CIOPF) Fondation Raoul Follereau Global Fund 5% Novartis Vaccines Institut national de la santé Fondation Saint-Irénée Ministère de la Santé et de la recherche médicale Pfizer Publique de Madagascar Fonds pour eux* (Inserm) Qiagen Naval Health Research Skoll Foundation Institut National du Cancer Sanofi Pasteur Center (NAMRU-2) Stavros Niarchos Foundation (INCa) Sanofi Pasteur MSD Wellcome Trust Institut Pasteur Takeda

* Since 2016 61 2015 ANNUAL REPORT 2015 ACCOUNTS & KEY FIGURES

2015 ACCOUNTS & KEY FIGURES •

BALANCE SHEET

ASSETS NET NET (K€) DEC. 31, 2015 DEC. 31, 2014 FIXED ASSETS Intangible xed assets 9 10 Property, plant and equipment 1,832 2,023 Investments and other nancial assets 26,199 24,582 TOTAL 28,040 26,615 CURRENT ASSETS Inventories 4 4 Payments on account 21 34 Accounts receivable 1,203 885 Other receivables 12,275 13,045 Marketable securities 58,126 53,177 Cash and cash equivalents 3,781 4,945 Prepaid expenses 1,835 599 Unrealized exchange losses 8 2 TOTAL 77,254 72,692 TOTAL ASSETS 105,294 99,307

LIABILITIES AND FUND BALANCE (K€) DEC. 31, 2015 DEC. 31, 2014 FUND BALANCE True endowment 64,916 64,916 Reserves 884 884 Retained earnings 12,815 17,749 Net income / loss for the period 5,648 (4,934) TOTAL 84,263 78,616 QUASI ENDOWMENT Allowances for contigencies 105 2 Funds reserved for future engagements 2,783 2,035 TOTAL 2,888 2,037 LIABILITIES Loans 5 3 Accounts payable 2,340 2,941 Investment payable 702 750 Other payable 2,888 1,822 Deferred income 11,940 13,001 Unrealized exchange gains 267 137 TOTAL 18,142 18,654 TOTAL LIABILITIES AND FUND BALANCE 105,294 99,307

62 2015 ANNUAL REPORT 2015 ACCOUNTS & KEY FIGURES

INCOME STATEMENT (K€) ACTUAL 2015 ACTUAL 2014 INCOME Services revenue 311 233 Grants 26 28 Reverse on operating allowances 14,121 10,235 Expenses refund 665 545 Other operating income 326 119 TOTAL INCOME 15,447 11,161 EXPENSES External purchases and expenses 9,201 5,364 Taxes and duties 1,176 822 Salaries and social contributions 3,662 3,177 Depreciations 313 579 Donations and subsidies received 7,125 6,472 Grants awarded - - Net book value of sold assets - - Other operating income 8 13 TOTAL EXPENSES 21,485 16,426 CURRENT INCOME -6,038 -5,265

FINANCIAL INCOME Dividends 1,044 904 Other nancial income 1,088 1,618 Reverse on nancial allowances 205 213 Net income from marketable securities 12,008 1,122 TOTAL FINANCIAL INCOME 14,345 3,856 FINANCIAL EXPENSES Financial allowances 943 520 Other nancial expenses 857 1,272 TOTAL FINANCIAL EXPENSES 1,800 1,792 FINANCIAL RESULT 12,546 2,064

EXCEPTIONAL INCOME Exceptional income - 2 Exceptional reverse on allowances - - TOTAL EXCEPTIONAL INCOME - 2 EXCEPTIONAL COSTS Exceptional expenses - 115 Exceptional allowances for contingencies 112 - TOTAL EXCEPTIONAL COSTS 112 115 EXCEPTIONAL RESULT -112 -113 Income tax - - TOTAL INCOME 29,793 15,019 TOTAL EXPENSES 23,397 18,333

INTERMEDIATE BALANCE 6,396 -3,314 Prior funds carried forward 2,035 415 Funds reserved for future engagements 2,783 2,035 NET INCOME / LOSS FOR THE PERIOD 5,648 -4,934

63 2015 ANNUAL REPORT 2015 ACCOUNTS & KEY FIGURES

USE OF FUNDS STATEMENT EXPENSES (USES) (€) ACTUAL 2015 INCOME (FUNDS) (€) ACTUAL 2015 MISSIONS 16,746,601 DONATIONS AND LEGACIES 324,670 Clinical biology laboratories 2,625,059 Donations 25,871 Collaborative research programs 3,696,487 Legacies 298,799 Training and knowledge-sharing 5,544,852 OTHER PRIVATE FUNDS 10,787,668 Support for local initiatives 2,099,503 Sponsorship / Patronage 2,286,800 Support for Mérieux Laboratories Grants from 4,609,524 350,686 and Centers Fondation Christophe et Rodolphe Mérieux International expertise (including Quality) 1,014,692 Other grants 3,891,343 Development of innovative public health 1,415,321 GRANTS AND OTHER PUBLIC FUNDING 3,333,118 initiatives OTHER INCOME 15,142,060 Services revenues 310,508 FUND-RAISING EXPENSES 1,186,449 Refund of expenses 664,516 Other nancial income 13,114,333 OPERATING EXPENSES 4,111,324 Dividends 1,052,703

TOTAL EXPENSES FOR THE PERIOD 22,044,373 TOTAL INCOME FOR THE PERIOD 29,587,516

ALLOWANCES 1,039,243 REVERSE ON ALLOWANCES 205,163

DEPRECIATION 313,387

FUNDS RESERVED FOR FUTURE ENGAGEMENTS 2,783,340 PRIOR FUNDS CARRIED FORWARD 2,035,233

ACCOUNTING RESULTS (PROFIT) 5,647,569 ACCOUNTING RESULTS (DEFICIT) -

GRAND TOTAL 31,827,912 GRAND TOTAL 31,827,912 Evaluation of in-kind patronage 12,953 Evaluation of in-kind patronage 12,953

64 2015 ANNUAL REPORT 2015 ACCOUNTS & KEY FIGURES

65 EUROPE

2015 ANNUAL REPORT 2015 ACCOUNTS & KEY FIGURES ASIE

EUROPE AFRIQUE

ASIE OCEAN INDIEN BREAKDOWN BREAKDOWN OF 2015 OF 2015 EXPENSES EXPENSES (Excluding provisions and exceptional BY ACTIVITY expenses) (Excluding provisions and exceptional expenses) AFRIQUE CARAIBES Missions 81% Training and knowledge-sharing 33% Administration 13% Collaborative research programs 22% Fundraising expenses 6% Clinical biology laboratories 15% Support for local initiatives 12% OCEAN INDIEN Development of innovative public health initiatives 8% International expertise 7% Support for local structures and Mérieux Centers 2%

GEOGRAPHICAL BREAKDOWN CARAIBES SEGMENTATION OF 2015 INCOME OF ACTIVITIES (Excluding dedicated funds, EUROPE provisions and non-recurring items) (Excluding funds carried forward to 2016)

Europe (1) 38% Endowment income & investment 26% Africa 21% Fondation Christophe et Rodolphe Mérieux 23% Asia 17% Sano Pasteur sponsorship and partnership 15% ASIE South America 10% Private partnerships 15% Middle East 5% Public partnerships 11% The Caribbean 5% Real estate income 5% Indian Ocean 4% Other sponsorships 2% Donations and Legacies 2% (1) Mostly activities in developing countries managed from France Other income 1% AFRIQUE

66

OCEAN INDIEN

CARAIBES 2015 ANNUAL REPORT 2015 ACCOUNTS & KEY FIGURES

GEOGRAPHICAL SEGMENTATION OF EMPLOYEES* AS AT DECEMBER 31ST 92 employees worldwide **

92 83 70

2013 2014 2015

** Full-time equivalents ** Excluding interns, temporary employees and local research and training center staff

7,728 EVOLUTION OF EXPENSES BY FIELD OF ACTIVITY 5,574 5,150 (In K€) 4,513

3,681 3,299

2,554 2,101 1,953 1,730 1,559 1,414 1,412 1,304

50

CLINICAL BIOLOGY COLLABORATIVE TRAINING SUPPORT DEVELOPMENT LABORATORIES RESEARCH AND FOR LOCAL OF INNOVATIVE PROGRAMS KNOWLEDGE-SHARING INITIATIVES PUBLIC HEALTH n 2014 n 2015 n 2016 Estimate

67 2015 ANNUAL REPORT

PHOTOS Khelil Aïtout AntasH E. Bergoend Antonin Bouvier Alexis Chezière Moustapha Diallo Dubray Photographie Hubert Endtz Fondation Mérieux Fotolia Friendship GettyImages WRITING Martin Grosjean iStock Fondation Mérieux JB Mercier&Studio K www.fondation-merieux.org Felix Leclerc Sophie Poisard-Storz Christophe Longuet www.solutions-editoriales.com Melon Rouge ©mrcproduction.fr CREATIVE CONCEPT, Didier Plowy-Institut de France Micka Perier DESIGN, PRODUCTION Pixelle Photography théra Adrien Rignol www.theraconseil.com Bernard Seytre RCS Lyon B 396 160 242 Régis Sodoyer Pascal Tournaire Verse Image PRINTING Imprimerie Daniel Faurite COPYRIGHT www.faurite.fr careHPV and QIAxcel Printed in France on PEFC paper are the property of from sustainably managed forests QIAGEN JUNE 2016

68 ANNUAL REPORT C 100 M 72 J 0 N 32 Pantone : 281 C

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