C 100 M 72 J 0 N 32 45Pantone : 281 C 19672012 years In tribute to Marcel Mérieux... 1967Creation of Fondation Mérieux annual report n 2012

Infectious diseases cause 13 million deaths

each year around the world, predominantly

in developing countries. “ “ For 45 years, Fondation Mérieux has been taking action to help ensure that every child, woman and man has fairer access to essential healthcare.

1967Creation of Fondation Mérieux 2 contents

C 100 M 72 J 0 N 32 Pantone : 281 C 45 1972 Creation of the AMP 19672012 years (Agency for Preventive Medicine) 2012 annual report n CONTENTS 3

P.4 President’s Message 2 IN THE FIELD:

Director General’s Fighting Infectious P.26 The Caribbean P.6 P.8 Editorial Diseases

P.28 Africa P.10 Enhancing Research Capabilities

P.32 Indian Ocean

P.16 Increasing Access to Diagnostics

P.34 Asia

Encouraging P.20 Knowledge-Sharing and P.42 Governance Training P.43 Main Financial Partners

2012 Accounts & P.44 Key Figures

1974 Bamako (Mali) 4

2 President’s Message

Doctor Charles Mérieux created Gradually, at the impetus of Dr. Christophe Fondation Mérieux in 1967. By initiating Mérieux, we redirected our efforts a dialogue between North and South, towards the field, at the heart of disease his aim was to combat the infectious outbreaks, in an area where we are diseases that afflict developing countries, recognized for our expertise: biological ignoring borders between continents diagnostics. Without diagnostics, medi- and boundaries between human and cine is blind. We therefore decided to en- veterinary medicine. hance diagnostic capabilities in developing countries, by creating laboratories of This led to an epic adventure in vacci- excellence in infectious disease - the nology and preventive medicine, punc- Rodolphe Mérieux Laboratories - tuated by major advances in public equipping them with high-performance Alain Mérieux n President health, such as the 1974 vaccination tools, training healthcare personnel, campaign in Brazil and the creation of and offering support through applied Bioforce to provide logistical training research programs. In addition to these for the coordinators of humanitarian central laboratories, we also renovate initiatives. The Fondation later became clinical laboratories within regional hos- involved in research into emerging pitals to give local populations access pathogens with, in particular, the to improved diagnostic accuracy for construction of the P4 Jean Mérieux better patient outcomes. Laboratory.

C 100 M 72 J 0 N 32 45Pantone : 281 C 19672012 years 1974 Bamako (Mali) 2012 annual report n President’s Message 5

45 years of dedication… “For medicine that is innovative, plentiful and available throughout the world”

We now have a presence in Mali, the same long-term vision of an integrated Louis Pasteur, and then carried on by Madagascar, Haiti, Cambodia, Laos, approach to healthcare, combining Drs. Charles and Christophe Mérieux. Myanmar, Lebanon and Tajikistan, and medicine, nutrition, water quality and We have developed this idea over the will soon be in Brazil and Bangladesh. education. years to give it greater momentum, moving towards medicine that is inno- We have been able to foster such a In 2012, we celebrated 45 years of action vative, plentiful, available throughout network through close collaboration in the fight against infectious diseases. the world and accessible to the most with local healthcare leaders. Today, the This action was made possible thanks underprivileged populations. GABRIEL and RESAOLAB networks to the outstanding mobilization of parti- bring together biologists and healthcare cipants hailing from very diverse back- It is an idea that we must take even professionals, working in our areas of grounds and the unwavering support of further, as there is still a very long way focus. our partners, such as Sanofi Pasteur, to go. who have worked with us for many We are making progress, shoulder to years. I pay tribute to them all. shoulder, with the researchers, doctors, biologists, universities, public healthcare We all believe in one grand idea. That organizations and government institu- idea was born in 1897 and nurtured by tions who work in the field. We all share Marcel Mérieux, who studied under

1974 Meningitis vaccination campaign (Brazil) 6

2 PROGRESS THROUGH PARTNERSHIP

How could we have created Rodolphe Mérieux Laboratories on 5 continents without the engagement of local partners, dedicated to public health?...

Benoît Miribel n Director General

C 100 M 72 J 0 N 32 Pantone : 281 C 45 1983 Creation of Bioforce 19672012 years Développement 2012 annual report n Director General’s Editorial 7

2 PROGRESS THROUGH PARTNERSHIP

How could we have designed the recently in developing innovative initia- Together, we want to strengthen local GABRIEL network or the RESAOLAB tives to address infectious disease capacity and encourage the adoption program in West Africa without our challenges in developing countries. of research and training programs to partners to determine with us how expand the means that are available to New partnerships in 2012 took us to confront the challenges posed by fight infectious diseases, which are a to new territories such as Amazonia, infectious disease? concern to us all. Tajikistan and Bangladesh. They Since its creation in 1967, Fondation reinforce our integrated approach to Mérieux approaches its mission through healthcare, without boundaries between partnerships, bringing together public human and veterinarian medicine, in and private stakeholders, across borders, close alliance with local stakeholders. united around a common mission and Through the growing involvement of drawing on synergies of expertise and our partners, and backed by the resources to provide fairer access to confidence of the Mérieux family, the healthcare for vulnerable populations. Fondation’s teams strengthen, year by From the very beginning, this partnership year, the impact of the projects we approach has been in the Fondation’s conduct locally in infectious hotbeds to “genes”. We have reaffirmed it more help vulnerable populations.

1983 Les Pensières conference center 8

2 Fighting Infectious Diseases AN ORIGINAL MODEL FOR ACTION

Fondation Mérieux offers an original 70% of medical decisions are based Access to improved model for action, based on an integrated on diagnostics, making them an approach to addressing public health essential part of healthcare at both diagnostic accuracy for issues and a long-standing expertise in individual and collective levels. By better patient outcomes is clinical biology. providing relevant and reliable results, biological diagnostics make it possible one of Fondation Mérieux’s 2 Its mission is to enhance to identify pathogens, prescribe the right local capacities in developing treatment for each patient, and monitor top priorities. To achieve its effects. countries to reduce the impact this, Fondation Mérieux of infectious diseases on On a wider scale, diagnostics are indis- vulnerable populations. pensable for epidemiological surveillance works closely with Fondation and establishing appropriate public health policies and prevention initiatives. Christophe et Rodolphe However, developing countries very Mérieux, an independent often lack facilities for clinical analyses, high-quality diagnostic tools, qualified family foundation under personnel and effective research the auspices of the Institut resources. de France, for which it operates in the field.

C 100 M 72 J 0 N 32 Pantone : 281 C 45 1986 First “Cents Gardes” 19672012 years symposium on AIDS at Les Pensières 2012 annual report n Fighting Infectious Diseases 9

2 Fighting FOCUSED ON RESOURCES Infectious Diseases 3 OBJECTIVES TO TAKE ACTION n 100 people working in more than ten 1. Enhancing local countries around the world research capabilities n An international network of 13 training and through collaborative programs research centers NETWORKING on the pathologies specific to underprivileged countries, providing n Several hundred infectious disease experts TO TAKE ACTION training for researchers, and develo- involved in training and public health programs ping diagnostic tools for improved n Several thousand healthcare professionals To fulfill its mission in public health, the identification of infectious diseases. trained locally to provide better care for Fondation builds international networks vulnerable populations and actively develops partnerships n Integrated research teams bringing spanning all relevant disciplines. It works 2. Increasing vulnerable closely with developing countries’ together some 15 researchers at the Emerging populations’ access to health authorities, public and private Pathogens Laboratory in Lyon and

academic research bodies, international diagnostics the Christophe Mérieux Laboratory in Beijing organizations, governments, develop- by strengthening clinical biology n The GABRIEL* network federating ment banks, foundations, NGOs and capacities in regional public health 15 research units in different countries the healthcare industry. centers. n An annual budget of close to n15 million n A family foundation based in Lyon with 3. Encouraging a presence in the USA, China and dialogue and close to a dozen developing countries knowledge-sharing within the public health community to contribute to the dissemination and development of expertise and * Global Approach for Biological Research on Infectious innovative projects. Epidemics in Low-income countries

1999 Creation of the P4 Jean Mérieux Laboratory 10

1. Enhancing Research Capabilities

Today, this applied research capability Fondation Mérieux has its own is structured around two units: research teams, which are a key asset • the Emerging Pathogens Laboratory, part of the International Center for in fulfilling its mission and a foundation Infectiology Research at Gerland in for its expertise. Lyon (France), • the Christophe Mérieux Laboratory in Beijing (China), part of the Institute of Pathogen Biology at the Chinese Academy of Medical Sciences (CAMS).

C 100 M 72 J 0 N 32 Pantone : 281 C 45 2000 First ADVAC 19672012 years vaccinology course at Les Pensières 2012 annual report n Enhancing Research Capabilities 11

Researchers benefit from preferential In partnership with local healthcare network serves as a catalyst. Its goal is to access to the P4 Jean Mérieux Labora- authorities and stakeholders, the foster the sharing of skills and knowledge, tory, a BSL4 maximum-security unit Fondation sets up laboratories of to facilitate the implementation of applied dedicated exclusively to emerging excellence, the Rodolphe Mérieux research programs and epidemiological pathogen research, belonging to the Laboratories, which have two objectives: studies with the goal of improving the Fondation and managed by Inserm, the applied research in infectious disease, diagnosis, prevention and treatment of French national institute for health and and training. Since 2005, six Rodolphe infectious diseases. medical research. The Fondation Mérieux Laboratories have been created research teams also have access to the and contribute to building capacities in This collaborative international scientific CAMS technical platforms in Beijing. applied research, training and biological network was created by the Fondation analysis in their surrounding regions. and is supported by the Lyon and Beijing The Fondation’s teams are working Two new projects, in Brazil and Bangla- research laboratories. It brings together on the development and validation of desh, are underway. a variety of members, including the molecular diagnostic tools for use in Rodolphe Mérieux Laboratories, local infectious disease surveillance in the laboratories of excellence, academic GABRIEL network laboratories, located research centers, hospitals, private in developing and emerging countries. companies, etc. In collaboration with its partners, GABRIEL: Fondation Mérieux is contributing to GABRIEL has met with considerable building reliable epidemiological data- A NETWORK IN ACTION success and now connects members bases that will help to develop appro- from 15 countries: Brazil, Cambodia, priate public health policies. It also The Fondation takes a collaborative Cameroon, Canada, China, France, runs research programs to identify and and multi-partner approach to research, Georgia, Haiti, Laos, Lebanon, Luxem- characterize new pathogens, biomar- in which the GABRIEL (Global Approach bourg, Madagascar, Mali, Mongolia kers associated with certain diseases, for Biological Research on Infectious and Paraguay. A Ukrainian university is and resistance to antibiotics. Epidemics in Low-income countries) due to join GABRIEL in 2013. Partnerships

2001 Creation of Fondation Rodolphe Mérieux 12

have also been established with Institut Pasteur, Inserm and the World Health Organization (WHO).

GABRIEL HAS 2 THREE OBJECTIVES:

n enhancing and harmonizing research capabilities in developing countries in the areas of pathogen detection, identification and surveillance, n running multi-center studies on infectious diseases with significant impact on public health, n harmonizing applied research methodologies by transferring techno- logy and implementing quality assurance procedures.

STRUCTURING APPLIED RESEARCH WITH AFRICARAMI

The multi-center AFRICARAMI* project, AFRICARAMI facilitates the creation of SOLID PROGRESS: launched in 2009, is an example of independent and sustainable research the collaborative approach developed programs aiming to: n 63 participating institutions by the Fondation to structure applied n establish effective regional and national research in developing countries. n 3 research protocols accepted partnerships to enhance coordination by ethics committees The AFRICARAMI scientific and technical and the exchange of research between n 8 protocols on tuberculosis network aims to reinforce research laboratories, and pneumonia underway capabilities in four countries: Cameroon n foster research policies aligned with n (Biotechnology Center at the University local priorities, 450 scientists trained on of Yaoundé), Mali (Charles Mérieux seven training modules n improve researchers’ scientific skills Infectiology Center in Bamako), n through joint-training courses with each 12 scientific presentations at Madagascar (Charles Mérieux Center partner, international conferences of Infectiology in Antananarivo) and Haiti n 2 seminars organized (GHESKIO Centers in Port-au-Prince). n increase the dissemination of results to The project will receive 1 million in funding improve the visibility of research activities over three years from the ACP Science within the scientific community. and Technology Programme and the European Commission.

* African and Caribbean network to support the fight against infectious diseases

C 100 M 72 J 0 N 32 Pantone : 281 C 45 2003 Inauguration of 19672012 years the Faculty of Pharmacy in Phnom Penh (Cambodia) 2012 annual report n Enhancing Research Capabilities 13

Tuberculosis is responsible for 1.7 million deaths each year. Due to difficulties in diagnosis and the development of multi- drug-resistant strains, only Pneumonia is currently the 60% of cases are identified, #1 cause of death in children making this disease a major under 5. public health issue. Every minute, 4 children are lost to this disease. FIGHTING RESPIRATORY INFECTIONS AND MULTIDRUG-RESISTANT TUBERCULOSIS

With its teams in Lyon and Beijing, as It is also working on other particularly well as its GABRIEL network partners, severe infectious diseases and im- Fondation Mérieux is coordinating plementing local initiatives on issues collaborative applied research pro- specific to certain areas: diarrheal grams in two priority areas: respira- diseases, typhoid fever, malaria, tory infections and multidrug-resistant fevers of unknown origin, neglected tuberculosis. tropical diseases, HIV and hepatitis.

“With respect to malaria, there is hope. sible number of people, and also when In addition to the anticipated vaccine, the most underprivileged populations strategies have been developed that, have the access they need. (…) The applied on a large scale, could significantly challenge for the future of global health reduce the number of deaths caused is to develop the capacities within our by malaria and meet the objectives set countries to enable communities to by the Millennium Development Goals. think and find solutions for themselves. (…) Today, this goal is within reach. I have seen it for real during the GABRIEL Today, infectious diseases - and indeed network’s working days, whereby Prof. Ogobara DOUMBO non-infectious diseases - know no borders. 20 countries work together in the field Director of the Malaria Research (…) and Training Center, Mali of infectious diseases. A network is a The true solution to these problems horizontal organization where each hub is solidarity and sharing. It is through contributes something extra. solidarity and sharing that we will be able to harness the solutions made In Mali, we are part of a hub conducting possible by technology and techniques. research on malaria, thus making our True democratization of healthcare contribution to the fight against this - global health - is when public health- disease. This is what global health is all care strategies include the largest pos- about.”

2005 Inauguration of the Rodolphe Mérieux Laboratory in Bamako (Mali) 14

UNDERSTANDING IDENTIFYING THE SEVERE RESPIRATORY CAUSES OF PNEUMONIA INFECTIONS IN CHILDREN

WITH ISARIC A multi-center epidemiological pilot trial involving 2,200 children is underway to In 2012, the GABRIEL network joined identify the viral or bacterial agents that ISARIC (International Severe Acute cause severe pneumonia in children Respiratory Infection Consortium), under five years of age. The study is initiated by the Wellcome Trust and being conducted by members of the backed by the Medical Research GABRIEL network in ten countries and Council, the Bill & Melinda Gates the molecular tests being used were Foundation and Inserm. Based on developed by the Emerging Pathogens multi-regional collaboration between Laboratory in Lyon. Thanks to the sup- research networks, ISARIC’s objective port of Sanofi Pasteur, the trial was is to run international clinical research extended to include two sites in India. activities during the intervals between flu pandemics. It provides a collaborative The study, which is currently underway platform enabling clinical trials to be set up in China, Cambodia, Madagascar, Mali, quickly in response to the emergence Brazil, Paraguay, Lebanon, Haiti and of a new respiratory pathogen or the Mongolia, was the subject of an initial advent of a new infectious epidemic. scientific publication in 2012 and is due PREVENTING for completion in 2013. The data obtained is analyzed in collaboration with the RESISTANCE TO Epidemiology and Public Health Group, UMR CNRS 5558, University Lyon I and ANTIBIOTICS: GENOMIC Edouard Herriot Hospital. SEQUENCING

As part of the fight against multidrug- resistant tuberculosis, Fondation Mérieux is coordinating a project aiming to iden- tify the genomic markers for resistance IDENTIFYING to antibiotics. The methodology is based on sequencing the complete bacterial THE VIRAL AGENTS genome on a high-throughput platform using isolates chosen for the resistance BEHIND A FLU-LIKE of their phenotype. This collaborative project is founded upon a number of SYNDROME partnerships: the isolates analyzed in 2012 originated from Georgia (National In 2012, staff at the Christophe Mérieux Center for Tuberculosis and Lung Laboratory documented the role and Diseases) and Haiti (GHESKIO Centers), diversity of pathogens causing cases of sequencing is carried out using the flu-like syndrome observed in hospitals genomic platform at the University of in Beijing. In order to improve patient Lyon (ProfileXpert), and secondary care and determine the most appro- and tertiary analysis is carried out in priate treatment, it is important to iden- partnership with Genostar. A database tify the virus responsible for the of clinical, biological and genomic infor- infection. As a result of this research, mation is currently being compiled. the laboratory has published nine scientific papers on the flu virus, respi- ratory syncytial virus, metapneumovi- rus, bocavirus, enteroviruses and adenoviruses.

C 100 M 72 J 0 N 32 Pantone : 281 C 45 2005 Inauguration of 19672012 years the Rodolphe Mérieux Laboratory in Bamako (Mali) 2012 annual report n Enhancing Research Capabilities 15

CHRISTOPHE MÉRIEUX PRIZE 12 SCIENTIFIC AWARDED TO DR. FIRDAUSI QADRI, PUBLICATIONS MEDICAL RESEARCH DOCTOR IN BANGLADESH IN 2012

In 2012, Fondation Mérieux research teams submitted 12 papers that were published in scientific journals.

n Potential implication of new torque teno mini viruses in parapneumonic empyema in children. Eur Respir J. n Influenza A/H1N1 2009 pandemic and res- piratory virus infections, Beijing, 2009-2010. PLoS One. n Viral and atypical bacterial etiology of acute respiratory infections in children under 5 years old living in a rural tropical area of Madagascar. PLoS One. n Differential seroprevalence of human boca- virus species 1-4 in Beijing, China. PLoS One. n Coxsackievirus A21, enterovirus 68, and acute respiratory tract infection, China. Emerg Infect Dis. n Evolutionary dynamics analysis of human The sixth Christophe Mérieux Prize enterica. The challenge is to improve metapneumovirus subtype A2: genetic evi- was awarded to Dr. Firdausi Qadri, prevention and speed up the detection dence for its dominant epidemic. PLoS One. Director of the Centre for Vaccine of these diseases. The results obtained n Genetic diversity of human adenovirus in Sciences at the International highlight the need for an integrated hospitalized children with severe acute lower Centre for Diarrhoeal Disease and approach to preventing these infec- respiratory infections in Paraguay. J Clin Virol. tions, taking into account a number of Research in Dhaka, Bangladesh, n Nonstructural protein NS1 immunodomi- factors including immunity, nutrition, nant epitope detected specifically in dengue for her remarkable research work environment and water quality, and into infectious enteric diseases virus infected material by a SELDI-TOF/MS education. based assay. J Med Virol. which have a devastating impact in developing countries. Today, research objectives focus on new n Crimean-Congo hemorrhagic fever virus- antigens that could stimulate protection, infected hepatocytes induce ER-stress and as well as new immunization strategies. apoptosis crosstalk. PLoS One. This area of research is essential to n Prevalence of human metapneumovirus in This e500,000 prize is conferred by the public health in developing countries, adults with acute respiratory tract infection in Beijing, China. J Infect. Institut de France on behalf of Fondation where 200,000 to 300,000 children die Christophe et Rodolphe Mérieux to as a result of ETEC and 100,000 from n A toolbox for tuberculosis diagnosis: an Indian support research into infectious diseases cholera each year. multicentric study (2006-2008): microbiological in developing countries and to reward results. PLoS One. teams working in the field. * Enterotoxinogenic Escherichia coli n Multidrug-resistant tuberculosis in Port-au- Prince, Haiti. Rev Panam Salud Publica. 2012 Dr. Qadri studies the immune responses Mar;31(3):221-4. triggered by various vaccines against enteric diseases, with a particular Since the launch of the GABRIEL emphasis on three types of illness: network in 2008, its members have V. cholerae, ETEC* and Salmonella published more than 170 scientific papers.

2007First Christophe Mérieux Trends in Virology Conference at Les Pensières 16

2. Increasing Access to Diagnostics

Fondation Mérieux possesses world-renowned expertise in the creation and renovation of clinical laboratories dedicated to infectious disease diagnostics.

C 100 M 72 J 0 N 32 Pantone : 281 C 45 2007 First Christophe Mérieux Prize 19672012 years awarded by the Institut de France to Professor Ogabara Doumbo (Mali) 2012 annual report n Increasing Access to Diagnostics 17

Around the Rodolphe Mérieux In the last ten years, 15 hospital Laboratories, Fondation Mérieux laboratories have been renovated in Diagnostics creates and renovates clinical this way, bringing access to diagnostics and Mobile Telephony laboratories within regional hospitals to remote areas that are often poorly and healthcare organizations to give equipped in terms of healthcare facilities. The most recent information and local populations access to accurate The direct consequences for patients communication technologies are diagnoses and thus improve patient include less travel and an often crucial harnessed to improve diagnostic care. The Fondation helps these reduction in the time before receiving capabilities. In addition, Fondation laboratories to get started by providing treatment or being monitored for certain Mérieux participates in innovative all the necessary equipment (laboratory diseases. In addition, the Fondation has projects using mobile telephony, such benches, microscopes, diagnostic tools, initiated training courses leading to a as VOICES*, to provide care for isolated etc.), in compliance with international diploma: in Haiti and Mali, there is the populations and collect epidemiological quality and biosafety standards. In BAMS* course for senior laboratory data. Computer networks are being parallel, the Fondation offers training for technicians and, in Cambodia, the D.E.S. developed to enable biologists to work laboratory staff in techniques appro- (diploma of specialist studies) in Medical together and improve their working priate for the diseases prevalent in Biology for doctors and pharmacists. practices. developing countries. It fosters national (see page 22). and international laboratory networks *Bachelor of Science in Biological and Applied * VOIce-based Community-cEntric mobile Services to promote the sharing of experience Medical Sciences for social development (see page 31) and harmonization of practices, thus strengthening the healthcare systems of these countries.

2008 Launch of RESAOLAB 18

France Emerging Pathogens Laboratory in Lyon P4 Jean Mérieux Laboratory in Lyon

LeBANon HAiTI Rodolphe Mérieux Laboratory Rodolphe Mérieux Laboratory in Beirut in Port-au-Prince Laboratory of the State University Hospital MALI Rodolphe Mérieux Laboratory in Bamako resaolab Laboratories SeNeGAL BrAZil resaolab Laboratories Rodolphe Mérieux Laboratory in Rio Branco (ongoing) BURKINA FASO resaolab Laboratories

Fondation Mérieux’s 2 AN INTERNATIONAL NETWORK international presence

Working through multi- The first phase ofRE SAOLAB, initiated RESAOLAB is part of a movement in disciplinary networks is in 2009 in West Africa thanks to co- participating countries to strengthen funding from the Agence Française de their laboratory systems. In particular, it a common thread throughout Développement (French development has led to the creation of the National all Fondation Mérieux activities agency), will come to a close in 2013. Laboratory Department in Senegal, promoted the drafting of a national and is a major factor in the Its goal is to reinforce the quality of laboratories policy in Mali, and provided long-term success and clinical laboratory services and systems support to the Laboratory Department in Burkina Faso, Mali and Senegal sustainability of its projects. in Burkina Faso. through a regional and multi-disciplinary Programs such as RESAOLAB approach. exemplify this approach. Three years after its launch, RESAOLAB has made it possible to run major conti- nuing training programs, to equip training and quality assurance laboratories, to implement epidemiological surveillance programs and to create a particularly active network that should, during a second phase, RESAOLAB+, be extended to other countries in Africa. (see page 29)

C 100 M 72 J 0 N 32 Pantone : 281 C 45 2008 Inauguration of 19672012 years the Emerging Pathogens Laboratory (France) 2012 annual report n Increasing Access to Diagnostics 19

TAJIKISTAN National Public Health Reference Laboratory in Dushanbe BANGLADESH Rodolphe Mérieux Laboratory in Chittagong (ongoing) ChinA Christophe Mérieux Laboratory in Beijing Myanmar Public Health Laboratory of Mandalay LAOS Rodolphe Mérieux Laboratory in Vientiane Thakhek Hospital’s laboratory Mahosot Hospital’s laboratory CAMBODia Rodolphe Mérieux Laboratory in Phnom Penh MADAGASCAR Battambang’s laboratory Rodolphe Mérieux Laboratory Khmer-Soviet Friendship Hospital’s laboratory in Antananarivo Kossamack Hospital’s laboratory Fianarantsao Hospital’s laboratory Svay Rieng’s laboratory (ongoing) Fort-Dauphin Hospital’s laboratory Takeo Regional Hospital’s laboratory Antsirabe Hospital’s laboratory

“Regarding Fondation Mérieux’s The Islamic Development Bank’s partnership with the IDB, two examples operations intersect with Fondation illustrate the relevance of the Fondation’s Mérieux’s priorities in the fight against strategy. disease in two areas of healthcare: strengthening healthcare systems and Even today, some samples are sent alternative funding for health insurance.” abroad in order to confirm a diagnosis. Through its laboratory network, the Fondation helps countries to eliminate this need and become self-sufficient. Dr. Daouda MALLE Director, Human Development Department, Secondly, in many African countries Islamic Development Bank (IDB) and not that long ago, patients arriving at a healthcare center with a fever were treated with quinine and typhomycin, on the basis that “if it’s not malaria, it might be typhoid fever”. This situation can be avoided today thanks to the laboratories. (…)

2008 Inauguration of the Antsirabe Hospital laboratory (Madagascar) 20

3. Encouraging Knowledge-Sharing and Training SPREADING SCIENTIFIC INNOVATION WORLDWIDE: Les Pensières Conference Center is Les Pensières was created with an 2 LES PENSIÈRES a venue for meetings and North- initial focus on vaccinology, but now South and South-South dialogue, extends its activities to diagnostics dedicated to scientific discussion and other issues with an impact on and disseminating innovation. For public health, such as nutrition, food more than 40 years, it has welcomed safety and access to safe water healthcare professionals (researchers, Through Les Pensières, the Fondation clinicians, biologists, pharmacists, is able to share scientific expertise veterinarians, representatives of internationally and enhance knowledge healthcare and regulatory authorities, in the fight against infectious diseases. etc.) across disciplines and countries, It is at the origin of an outstanding to attend high-level conferences and multi-disciplinary network of specialists institutional training courses. that is poised to advance public health on a global scale.

C 100 M 72 J 0 N 32 Pantone : 281 C 45 2008 Inauguration of 19672012 years the Christophe Mérieux Laboratory in Beijing (China) 2012 annual report n Encouraging Knowledge-Sharing and Training 21

In 2012, 85 conferences and training courses were held at Les Pensières, with internationally renowned speakers and over 3,500 participants from around the world.

THE CONFERENCE PROGRAM Fondation Mérieux also organizes or supports scientific conferences in INCLUDED: various countries around the world. n BETTER FOOD FOR BETTER HEALTH: in 2012 INTERNATIONAL the field of nutrition and health, CONFERENCES INCLUDED: n LES CENTS GARDES: an international conference on HIV/AIDS vaccine n INTERNATIONAL VACCINOLOGY WORKSHOP research, TOKYO (Japan): fifth edition of the vacci- n MATERNAL IMMUNIZATION: a conference nology workshop on the future of addressing challenges and opportunities immunization, n for vaccination during pregnancy, MOVING FORWARD: organized in colla- n SOUTH AMERICA VACCINOLOGY WORKSHOP boration with the London School of n ENTERIC INFECTIONS: on the issue of (Brazil): eighth edition, reviewing the Hygiene and Tropical Medicine, to acute and chronic diarrheal diseases, latest knowledge and sharing recent consider the latest needs and solutions experience on the subject of epidemiology n GLOBAL LABORATORY INITIATIVE in the diagnosis of infectious diseases and vaccination campaigns, MEETING: organized in partnership with in resource-limited countries. WHO and Stop TB, dedicated to the n AGING AND IMMUNITY (Italy): organized in challenges of diagnosing tuberculosis collaboration with vaccine manufacturers as part of efforts to control the disease and dedicated to issues specific to in developing countries, aging in the field of infectious disease.

2008 Christophe Mérieux Prize awarded by the Institut de France to Professor François Nosten (Thailand) 22

TRAINING HEALTHCARE PROFESSIONALS RAISING AWARENESS

There is little point in strengthening The Fondation places emphasis on AMONG OPINION clinical testing structures in developing training in the field so that students are countries unless this is underpinned working in their own countries and LEADERS by initiatives to train local healthcare encouraged to remain there to become professionals, both laboratory technicians the healthcare professionals of tomorrow. Institutional training courses are offered and the leading doctors and scientists at Les Pensières conference center for These local training courses are delivered of the future. The Fondation has honed members of the public health community in Charles and Christophe Mérieux its expertise in this area, establishing links in developing countries. The aim is that Infectiology Centers such as those in with universities and training organizations doctors, biologists and the representatives Bamako and Vientiane. such as the ESTBB*, the University of of regulatory bodies and health authorities Geneva and the London School of A Bachelor of Science in Biological and from these countries subsequently pass Hygiene and Tropical Medicine. In this Applied Medical Sciences (BAMS) has on these skills and improve practices at way, it has implemented a number been established in Haiti, with the support a local level. of training and knowledge-sharing of the French AnBer Foundation, and in programs intended to reinforce biological Mali, thanks to funding from the Islamic IN 2012, THESE TRAINING expertise in the field and to raise aware- Development Bank. Since its launch in ness among opinion leaders regarding 2007, about one hundred laboratory COURSES INCLUDED: major public health issues (including technicians have completed the program, n ADVANCED VACCINOLOGY COURSE vaccinology, diagnostics, emerging delivered in partnership with the ESTBB. (ADVAC): thirteenth edition of this vacci- pathogens and neglected diseases). Other training courses leading to quali- nology training course, organized with It also contributes to building teaching fications have also been set up, including the University of Geneva, curriculums in pharmacy and biology a diploma of specialist studies in medical n ADVANCED COURSE ON DIAGNOSTICS at the university level. The Universities biology at the University of Health (ACDx): third edition of a training course of Health Sciences in Phnom Penh Sciences in Cambodia. organized in partnership with the London and Antananarivo are examples of this School of Hygiene and Tropical Medicine, commitment. * School of Biology, Biochemistry and dedicated to the diagnosis of infectious Biotechnology at the Catholic University of Lyon disease.

C 100 M 72 J 0 N 32 Pantone : 281 C 45 2008 Launch of 19672012 years the GABRIEL network 2012 annual report n Encouraging Knowledge-Sharing and Training 23

“It is clear that we must improve patient care in developing countries and create GLOBE networks of healthcare facilities. This applies for HIV/AIDS and for other diseases. This implies not only the need REMOTE TRAINING to strengthen infrastructure to establish efficient reference healthcare centers, WITH GLOBE but also to reinforce training capabilities for all healthcare workers: from caregivers Prof. Françoise BARRÉ-SINOUSSI to doctors, they all have an important GLOBE (Global Link for Online Bio- Ph.D, Nobel Laureate for Medicine or Physiology medical Expertise) is an online network Professor, Institut Pasteur role to play. for healthcare professionals and scientists and Research Director, INSERM President, International AIDS Society (IAS) This training aspect is essential. We in developing countries. This electronic must train the instructors who will train, portal is intended to strengthen expertise step by step, the teams staffing the and knowledge-sharing about infectious healthcare centers in these networks. diseases, by making a range of tools, information and training modules available We must also educate the local com- to members. Four years after its launch, munities, so that they can be relied GLOBE has approximately 20,000 visitors upon for the crucial first step, diagnosis, per year and more than 700 members and also to work with them to gain easier originating from 179 countries. access to the population.”

2009 Inauguration of the Thakhek Hospital laboratory (Laos) 2...IN THE FIELD

C 100 M 72 J 0 N 32 Pantone : 281 C 45 2009 Christophe Mérieux Prize 19672012 years awarded by the Institut de France to Doctor Eric Leroy (Gabon) 2012 annual report n IN THE FIELD... 25

2...IN THE FIELD THE CARibBEan 2 P.26 AFRIca 2 P.28 INDIaN OCeAN 2 P.32 ASIa 2 P.34 Haiti Burkina Faso Madagascar Bangladesh ethiopia Cambodia Mali China Senegal Laos Myanmar Tajikistan Lebanon

2009 Inauguration of the Rodolphe Mérieux Laboratory in Vientiane (Laos) 26

HAiTI Rodolphe Mérieux Laboratory in Port-au-Prince Laboratory of the State University Hospital IN THE FIELD...

PARTNERSHIP WITH 2 HAiTI GHESKIO In 2012, the Fondation intensified its support for its long-standing partner, Engaged in Haiti since 2002, GHESKIO (Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Fondation Mérieux’s commitment is unwavering, Infections), taking action to strengthen Haiti’s medical diagnostic capabilities, with the Rodolphe Mérieux Laboratory in the particularly through technical support to the microbiology laboratory. Today, GHESKIO Centers, the BAMS degree course, 70 people work at the Rodolphe Mérieux Laboratory, created by the Fondation as and several projects aimed at helping part of GHESKIO’s Institute of Infectious Diseases and Reproductive Health (IMIS). the country’s women and children. Every day, this team works to diagnose multi-resistant tuberculosis, cholera and HIV, playing a key role in the fight against infectious diseases and the prevention of epidemics.

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BAMS TRAINING

Building on the success of the training course established in Mali in 2007, Fondation Mérieux has implemented a Bachelor of Science in Biological and Applied Medical Sciences (BAMS) in Haiti. The course, which leads to a qua- lification, is organized in collaboration with the ESTBB (School of Biology, SUPPORTING Biochemistry and Biotechnology) at the Catholic University of Lyon, the National ASSOCIATIONS AND Public Health Laboratory in Port-au- Prince, and Haiti’s Ministry of Public HUMANITARIAN Health and Population. Its aim is to improve laboratory technicians’ bio- INITIATIVES IN 2012 medical analysis skills and knowledge of quality assurance regulations. n Support for the French AAIP association (firefighters’ international The second BAMS class, comprising aid actions) 18 new trainees, started the course in Construction of three “Kayïti” houses September 2012. for a dispensary in Jacmel.

n A new children’s center for the Communauté de l’Incarnation SUPPORTING Fondation Mérieux, the religious com- munity, Communauté de l’Incarnation HAITIAN WOMEN LIVING (led by Brother Franklin Armand), the WITH HIV French association Kayïti, and the CROSE (association for the coordination of Prof. Jean-William PAPE regional organizations in Southeast Founder and Director of the GHESKIO Centers The program of micro-credit loans for women living with HIV was continued Haiti) work together to implement this throughout 2012, in partnership with project. “For us, global health is built upon a the ACME (Haitian cooperative asso- It has resulted in the construction of 15 number of pillars: healthcare of course, ciation for micro-enterprises) and the “Kayïti” houses and two multi-purpose and education (…), but also the possi- GHESKIO Centers. The women partici- halls. The site is being equipped to bility of access to employment. (…) pating in this project, who all live in accommodate around 60 children and ten supervisors as of summer 2013. This is the first time that we have Port-au-Prince, receive training in setting up a profit-making activity, managing a received help from a foundation that n Extending the Our Lady of loan and running their micro-enterprise. asks for nothing in return, other than the Miraculous Medal children’s that we look after our patients. (…) In 2012, more than 500 women were home in Cap-Haïtien granted micro-credit loans through this This assistance is extremely important During 2012, Fondation Mérieux program. to us, not only for our patients, but also continued works to increase the capacity in terms of diagnostics. We have a high- Despite the difficulties that Haiti has and improve living conditions in this performance laboratory and, at present, encountered since the earthquake of institution, which is managed by Sister we are able to diagnose HIV and tuber- January 2010, this program is an on- Godelive. 500 children attend the culosis using all the molecular biology going success, achieving a reimburse- renovated school and the orphanage is techniques available, here in Haiti. (...) ment rate of nearly 85% in 2012 and home to nearly 100. In 2012, five new We are perhaps one of few centers in the reintegration of a number of women. “Kayïti” houses were built to accommodate the world where a patient can come for This social initiative has a significant the members of the religious community, an HIV test and also be screened for impact on living conditions and continues freeing up additional premises for the tuberculosis. If we diagnose tuberculosis, to be necessary for a population that is children. the patient is treated that very same still facing great difficulties: more than day. That is the great benefit of these 2,800 people have benefited from this laboratories.” program since its launch in 2005.

2009 Inauguration of the Rodolphe Mérieux Laboratory in Port-au-Prince (Haiti) 28

MALI Rodolphe Mérieux Laboratory in Bamako resaolab Laboratories SeNeGAL resaolab Laboratories BURKINA FASO resaolab Laboratories IN THE FIELD... 2 AFRIca 2 resaolab WEST AFRICAN LABORATORY NETWORK

Created through close collaboration Fondation Mérieux is leading this project, RESAOLAB’s activities are based on between the Fondation and the ministries which began in 2009. Its first phase is three priority areas: of health in Burkina Faso, Mali and scheduled to come to an end in 2013. n continuing training of laboratory staff, Senegal, the RESAOLAB project aims RESAOLAB is co-financed by Agence n quality management for the tests to improve the health of populations by Française de Développement (AFD). carried out in the laboratories, strengthening the clinical laboratory The International Cooperation of Monaco, n epidemiological surveillance. system and harmonizing diagnostic The French Ministry of Foreign Affairs, practices in the three countries. WHO, and the West African Health Organisation (OOAS) also collaborate.

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FIGHTING NEGLECTED TROPICAL DISEASES IN AFRICA

Since 2008, Fondation Mérieux has taken part in the European Foundation Initiative for African Research into Neglected Tropical Diseases. To date, this initiative, which brings together five European foundations (Cariplo, Gulbenkian, Nuffield, Volkswagen and Mérieux) has made it possible to train 25 young African researchers, thanks to postdoctoral grants. These foundations also organize additional training for the researchers, as well as conferences fostering active South-South and North-South networks. Thus far, the resulting research projects have given rise to 15 publications in internationally recognized journals.

Achievements 2 BURKINA since 2009 FASO n 53 instructors trained n 111 training sessions given to EXTENDING A NEW CENTER 2,500 participants in the three countries THE PROJECT: FOR TRAINING AND n A distance learning platform developed (http://www.globe-network.org/) RESAOLAB+ QUALITY n 12 decentralized training and quality At the request of Benin, Guinea-Conakry, As part of the RESAOLAB project, control centers renovated and equipped Niger and Togo, the RESAOLAB project Fondation Mérieux backed the will be extended. construction of a Continuing Training n A Laboratory Information Management Center and External Quality Control The aim of the RESAOLAB+ project is software system developed and Unit within the General Directorate of to develop the current network to include 21 instructors trained Pharmacy, Drugs and Laboratories at these four new countries, thus extending the Burkina Faso Ministry of Health. n 15 laboratories in each country the scope of the project to seven West provided with equipment to facilitate African countries. The new center will make it possible to electronic data transmission for provide training for laboratory technicians RESAOLAB+ should be launched during communicable disease surveillance and improve the quality of medical ana- 2013.

2010 Christophe Mérieux Prize awarded by the Institut de France to Professor Jean-William Pape (Haiti) 30 2 MALI lyses. The center has facilities for around 30 people, including a microscopy room, a computer lab for distance learning ses- sions, and the External Quality Control SIXTH Unit, which monitors the activities and car- ries out quality control for all the laborato- BAMS CLASS ries in the country. Managed by the Charles Mérieux Infec- Three other training centers have un- tiology Center in Bamako, the Bachelor dergone renovations, at the regional of Science in Biological and Applied health departments in Bobo-Dioulasso Medical Sciences (BAMS) has been and Ouahigouya, as well as at Fada offered since 2007, in partnership with N’gourma Regional Hospital. the Faculty of Medicine and Pharmacy of Bamako and the ESTBB (School of Biology, Biochemistry and Biotechno- logy at the Catholic University of Lyon). This 9-month course results in a formal qualification and is intended to reinforce senior laboratory technicians’ biomedi- cal analysis skills and compliance with laboratory quality assurance regula- tions. In October 2012, Mali’s sixth class, comprising 27 new participants, began 2 eTHIOPIa its training. SUPPORTING IMPROVING SAMUSOCIAL TUBERCULOSIS Since 2005, Fondation Mérieux has REINTEGRATING been working with the Samusocial as- DIAGNOSIS sociation in Mali to provide care for HIV+ WOMEN street children. Funding and logistical support are provided for the medical A program to fight tuberculosis has been testing of young people monitored on a implemented by the Inter Aide association This program, managed in partnership daily basis. with the support of Fondation Mérieux with AFAS (women’s association to and the European Union. It has three support AIDS widows and orphans), Samusocial provides: objectives: raising awareness of infection, aims to achieve socio-economic reinte- n treatment in the streets during night- facilitating access to high-quality gration for women living with HIV in time patrols, Mali, by developing their ability to ma- diagnostics and mobilizing healthcare n medical monitoring of children in nage a profitable commercial activity. professionals in the fight against this order to provide appropriate treatment disease. Launched in 2010, the project entails and refer them to specialized facilities, Several laboratories have been equipped the bulk purchase of bales of fabric in n health education initiatives to raise in the Wolayta and Dawro regions in Burkina Faso, for subsequent distribu- awareness of issues such as daily hy- southern Ethiopia, with the primary tion in batches to women living with giene, prevention and vaccination. objective of substantially increasing the HIV. The women sell the fabric at mar- The Fondation also supports Samuso- number of cases detected. In parallel, kets, reimburse the project for the cial in Senegal. training was provided for health center batch, and then keep the profits. In staff. 2012, this initiative enabled 50 women to increase their revenue to support themselves and their families.

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2 SeNeGAL

VOICES and “mobile health”

Effectively sharing information between national structures and regional labora- tories is a major challenge for infectious disease surveillance. A “mobile health” experiment in Dakar since 2011 aims to improve epidemiological surveillance and continuing training for laboratory professionals, through the use of voice technology via mobile phones. The VOICES (VOIce-based Community- cEntric mobile Services for social development) project is funded by the European Commission. It brings to- Jérôme Froissart gether Senegal’s National Network of Director, Department of International Cooperation of Monaco* Laboratories, the Multinational Higher School of Telecommunications (ESMT) “The partnership between the Interna- CHARLES MÉRIEUX in Dakar, the telecommunications tional Cooperation of Monaco and group, Orange, the Dutch Organization Fondation Mérieux goes back a long INFECTIOLOGY for Applied Scientific Research (TNO), the way as we have been working together South African Council for Scientific and now for five years. We collaborated for CENTER Industrial Research, the Worldwide Web the first time on the RESAOLAB project Foundation, and Fondation Mérieux. and, more specifically, the International Despite the difficult political context in The VOICES project in Senegal enables Cooperation of Monaco is involved in Mali during 2012, the Charles Mérieux information on infectious epidemics to setting up laboratories at the community Infectiology Center maintained its usual be shared more quickly and reliably, via level in Mali, so that local populations level of activity. The medical biology three mechanisms: have direct access to healthcare ser- laboratory continued to receive students n the collection of epidemiological vices. Through this partnership, we will for practical training courses and the information from regional laboratories, create nine laboratories in rural areas. center maintained its involvement in n continuing training for laboratory staff, We value our collaboration with Fondation international partnerships. Mérieux very highly. (…) n a web-based interface to display and monitor epidemiological data and for We appreciate this approach based on educational applications. strengthening human capital (through the GABRIEL network) and fostering This preliminary trial in the field, during partnerships (through the creation of which daily reports are generated for networks like RESAOLAB), bringing three diseases (cholera, shigellosis and together public institutions, national meningitis) has shown very encouraging centers and financial backers. It is a real initial results. opportunity.” The VOICES project is now ready to be deployed in other regions. * As of April 2013, Secretary General of the World Association of Children’s Friends (AMADE)

2010 First ACDx course at Les Pensières 32

MADAGASCAR Rodolphe Mérieux Laboratory in Antananarivo Fianarantsao Hospital’s laboratory Fort-Dauphin Hospital’s laboratory Antsirabe Hospital’s laboratory IN THE FIELD... 2 MADAGASCAR Fondation Mérieux has reaffirmed its commitment to enhancing clinical biology capabilities in Madagascar, through Charles Mérieux Infectiology Center initiatives launched in 2011 and the continuation of several projects run by the Rodolphe Mérieux Laboratory.

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The initial results obtained confirm that TRAINING MARKERS TO malaria is endemic in this region, as half of the fevers observed in young children PHARMACY STUDENTS DIFFERENTIATE are attributable to the disease. These results, which need to be confirmed, Since 2006, Fondation Mérieux has PNEUMONIA enable the speed at which pathogens worked to improve the training received spread through the region to be tracked. by pharmacy students at the University AND MALARIA IN of Antananarivo, in partnership with the Pierre Fabre Foundation, the French FEVERISH CHILDREN International Cooperation department and the schools of pharmacy at the The aim of this study, which was SOUTH-SOUTH universities of Grenoble and Toulouse. launched in 2011, is to identify host markers of diagnostic significance that Rooms for teaching and practical COOPERATION TO could be used to differentiate between work have been renovated, following malaria and pneumonia in children aged the introduction of hospital pharmacy TRAIN TECHNICIANS 2 to 59 months with a fever over 38°C. courses and practical training programs. At the request of the Madagascan The project is funded by the National The Faculty of Pharmacy’s second class Ministry of Health, Fondation Mérieux Institutes of Health (NIH) and Institut of students graduated in 2012. organized a training course for laboratory Mérieux. It is run in partnership with the technicians. The training was part of an Ampasimanjeva Medical Foundation on initiative to create an infectious disease the east coast of Madagascar, near surveillance network comprising seven Manakara. The markers will be identified regional hospital laboratories. The course by the Canadian biotechnology company, was implemented in collaboration with Caprion, based on samples taken from the Ministry of Health and delivered by Madagascan patients. Malian instructors, who are familiar with A rapid diagnostic test for malaria is constraints similar to those in Mada- carried out in order to distinguish lower gascar. respiratory tract infections from malaria.

2011 Inauguration of the Rodolphe Mérieux Laboratory in Beirut (Lebanon) 34

LeBANon Rodolphe Mérieux Laboratory in Beirut TAJIKISTAN National Public Health Reference Laboratory in Dushanbe BANGLADESH Rodolphe Mérieux Laboratory in Chittagong (ongoing) ChinA Christophe Mérieux Laboratory in Beijing Myanmar Public Health Laboratory of Mandalay LAOS Rodolphe Mérieux Laboratory in Vientiane Thakhek Hospital’s laboratory Mahosot Hospital’s laboratory CAMBODia Rodolphe Mérieux Laboratory in Phnom Penh Battambang’s laboratory Khmer-Soviet Friendship Hospital’s laboratory Kossamack Hospital’s laboratory Svay Rieng’s laboratory (ongoing) Takeo Regional Hospital’s laboratory IN THE FIELD...

2 ASIa 2 BANGLADESH

In the spring of 2012, a Memorandum A NEW of Understanding (MOU) was signed for the construction of the future Rodolphe RODOLPHE MÉRIEUX Mérieux Laboratory at the Bangladesh Institute of Tropical and Infectious LABORATORY Diseases (BITID) in Chittagong. Fondation Mérieux is responsible for building and IN CHITTAGONG equipping the laboratory and training the staff. This laboratory of excellence, which should be operational by the end of 2013, will be dedicated to training biologists and applied research on the specific pathologies prevalent in Bangladesh, where the threat of infection is particularly high.

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DETECTING SALMONELLA STRAINS THAT CAUSE TYPHOID

20 countries, including Bangladesh and An applied research program is currently Dr. Firdausi QADRI Haiti, and about 150,000 people, children being run by Fondation Mérieux to Director of the Centre for Vaccine Sciences and adults alike, die from the disease develop a sensitive molecular diagnostic at the International Centre for Diarrhoeal every year. However, thanks to the efforts test to detect the salmonella strains Disease Research, Bangladesh of foundations such as Fondation Mérieux, responsible for typhoid fever. people are beginning to talk about the “Diarrheal diseases are extremely WHO currently estimates that between disease and to make use of the vaccines widespread, but not widely discussed. 17 and 22 million people suffer from available. (…) They continue to cause deaths around typhoid fever each year, with up to the world, in children and adults alike. Bangladesh is a poor country, but its 600,000 fatalities. The disease is trans- I would like to mention one particularly people are receptive. When you come to mitted in contaminated water or food. severe example, namely cholera. Many their aid with diagnostic tools, treatments Current diagnostic techniques lack people have forgotten the devastating and vaccines, they place their belief in sensitivity and are not well-suited to the effects of this disease. It is a disease the support being offered and embrace conditions encountered in the field. that we have neglected and whose it. We can make this happen around The program is funded by the Bill & impact is immeasurable. Thanks to the world. (…) Melinda Gates Foundation and involves various efforts throughout the world, it If we work together on global health, five partners: the Pasteur Institute, the is now possible to treat and prevent we can achieve great things.” West Scotland Specialist Virology Center, cholera. Approximately 3 million people Fast-track Diagnostics, Kemri-CDC, are infected with cholera in over and the Child Health Foundation in Bangladesh.

2012 Creation of the Dr. Christophe Mérieux Center in Phnom Penh with French association Les Enfants du Mékong (Cambodia) 36

2 RENOVATING TRAINING CAMBODia THE SVAY RIENG AND RESEARCH HOSPITAL LABORATORY IN PHNOM PENH

Fondation Mérieux funded the renovation In 2012, training and research programs of a 175 m² medical biology laboratory at the Rodolphe Mérieux Laboratory and the installation of a microbiology were focused on three major projects, unit at the hospital in the city of Svay each with an international partner: Rieng, located in the province of the n Clinical pharmacology, with a study same name. Also involved in the project on the metabolism of therapeutic mole- were the Cambodian Ministry of Health, cules among Cambodian populations, the World Health Organization for n Descriptive epidemiology, focusing equipment, and the Diagnostic Micro- on children with severe respiratory in- biology Development Program (DMDP), fections and acute diarrhea requiring an American NGO specializing in prac- hospitalization, tical microbiology training. n Interaction between pathogens This successful renovation has led to and the environment, monitoring the the implementation of a high-quality presence of human pathogens in the laboratory network in Cambodia, with a environment (primarily water and view to enhancing the effectiveness rodents). and quality of monitoring of infectious diseases.

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10th ANNIVERSARY OF THE D.E.S. IN MEDICAL BIOLOGY PHARMACOLOGY: Supported by the Fondation since STUDYING 2003, the Diploma of Specialist Studies (D.E.S.) in Medical Biology is a doctorate- ANTIRETROVIRAL AND level postgraduate degree awarded by ANTIMALARIAL DRUGS Cambodia’s University of Health Sciences, open to doctors and pharmacists. The Rodolphe Mérieux Laboratory has This three-year course combines theo- an analytic platform, in particular for retical classes, practical work, hospital denaturating high-performance liquid placements and research at Cambodia’s chromatography (dHPLC), which is Rodolphe Mérieux Laboratory. Its aim is used to measure plasmatic drug to provide medical biologists with concentrations of antiretroviral and anti- training enabling them to carry out quality tuberculosis drugs. Following the work assurance of medical analyses, super- carried out by Prof. Monidarin Chou for vise the activities of a medical biology his thesis on pharmacogenetics in laboratory, and establish operational 2012, this platform was opened up for links between clinical departments and measuring the concentration of other the laboratory. Teaching covers a wide molecules present in antimalarial drugs range of subjects relating to biological (Mefloquine). diagnostics in humans, including bio- The platform, which is the only one of chemistry, hematology, parasitology, its kind in Cambodia, makes it possible immunology, virology and bacteriology. to accelerate the country’s progress In 2012, ten Cambodian professors towards self-sufficiency in the fight were nominated to coordinate each against malaria. training module, in collaboration with professors from the French universities participating in the course. “Aviesan is the French National Alliance for Life Sciences and Health, created three years ago to bring together the main research bodies in this field. Fondation Mérieux is a very important DIARRHEAL DISEASE RESEARCH IN TAKEO partner of the Aviesan-South group, both through the GABRIEL network and In developing countries, diarrhea-related hospital, by developing a well-adapted its participation in designing research diseases remain the second most molecular diagnostic system and making projects. frequent cause of death in children optimal use of the tools available at the A research project looking at encephalitis under five. The infectious agents that Rodolphe Mérieux Laboratory. cause diarrhea may be bacterial in South-East Asia and a regional Until April 2012, 400 samples were (for example, Salmonella spp, Vibrio platform for transmissible diseases in taken, included in the protocol and cholera, Escherichia coli, Enterobacteria, Asia are examples of the initiatives tested using kits developed by Fast- Shigella spp), viral (hepatitis A, norovirus, implemented. Both involve significant track Diagnostics to identify the bacteria rotavirus and enterovirus) or parasitic commitment in terms of training and and viruses. A PCR test developed by (Giardia, Taenia saginata). enhancement of capabilities. The aim is DSO was also used to identify Vibrio to pool the resources of the various A research program was launched in cholera. Parasites were identified by organizations present at each site.” March 2010 by the Rodolphe Mérieux microscopy. Laboratory in Cambodia, jointly funded This research will be continued in 2013 Dr. Bernadette MURGUE by Singapore’s national laboratories and the results will be published in the Deputy Director of IMMI/Aviesan (DSO) and Fondation Mérieux. The scientific literature. primary objective is to monitor the pathogens responsible for acute diarrhea in the children admitted to the Takeo 38

2 CHINa MONITORING DECENTRALIZING RESPIRATORY INFECTIONS RESISTANT TUBERCULOSIS DIAGNOSIS IN BEIJING

Since 2009, Fondation Mérieux has (Zhe Jiang province); eight tuberculosis A new agreement was signed in 2012 worked with the Chinese Ministry of treatment centers in the cantons of with the Chinese Academy of Medical Health and the National Tuberculosis these two provinces; Sciences (CAMS) in Beijing, extending Reference Laboratory at the Center for n Training for 132 laboratory profes- the activities of the Christophe Mérieux Disease Control (CDC) to increase sionals at national, provincial and local Laboratory for a further five years. This diagnostic capabilities in the Zhe Jiang levels; unit is dedicated to assessing and and Heilong Jiang provinces for pa- developing new diagnostic techniques n Assessment of new tools to diagnose tients whose tuberculosis treatment is and biomarkers, as well as identifying pulmonary tuberculosis and detect not proving effective. and characterizing new pathogens. resistance to antituberculosis drugs, among 1,400 people thought to be in- As part of measures to monitor respiratory The first phase of this partnership was fected. infections in Beijing and the surrounding completed in 2012 and demonstrated area, the Christophe Mérieux Laboratory the importance of decentralizing re- continued, throughout 2012, to docu- sources to detect tuberculosis and re- ment the role and variety of pathogens sistance to treatment in China: responsible for respiratory infections n Equipment provided for the National observed in three of the city’s main Tuberculosis Reference Laboratory in hospitals. Beijing; two tuberculosis reference cen- ters for the Chinese CDC in Harbin (Heilong Jiang province) and Hangzhou

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2 LAOS

MONITORING HIV PATIENTS’ TREATMENT CoPanFlu STUDY ON INFLUENZA A

In 2009, the Christophe Mérieux Infec- This epidemiological study, which was in developed countries. The study, tiology Center of Laos (CICML) introduced carried out between February 2010 and which took place between February viral load measurement to monitor May 2012, was launched following the 2010 and May 2012, may result in a treatment for patients living with HIV, in advent of the H1N1 flu virus in March second scientific publication in 2013. order to improve their care. 2009. The aim of the study was to Following on from this protocol, an quantify the incidence of flu infection By the end of 2012, more than 2,300 additional study (Lalris) was launched and to identify the sociological and patients, of whom 48% were women, with a view to determining the pathogens epidemiological factors determining the had had their viral load measured at the involved in the symptomatic cases risk of infection. Center. identified during recruitment for CoPanFlu, This research was coordinated by the with no relation to the H1N1 virus. The In addition, in May 2010, the Christophe CICML, the EHESP (French School of data already available in this context Mérieux Infectiology Center of Laos Public Health) and Fondation Mérieux. shows a strong Streptococcus pneu- implemented an HBV and HCV viral The project involved a prospective moniae prevalence. Also thanks to this load quantification technique to assess cohort of more than 800 households, project, the Fast-track Diagnostics test the efficacy of treatments administered. i.e. approximately 4,000 people in a has been introduced at the CICML for district of Vientiane, for serological and respiratory diseases, with the support virological monitoring. The determining of the GABRIEL network. “INFECTIOLOGY factors and age distribution for sero- conversion in a vaccine-naive population AND LABORATORY were shown to be similar to those found DAYS” In October 2012, the second edition of the “Infectiology and Laboratory Days” took place at Thakhek Hospital, organized EPIDEMIOLOGY OF in partnership with the Rhône-Alpes regional council, Hospices Civils de Lyon, MULTI-RESISTANT TUBERCULOSIS STRAINS and Claude Bernard University Lyon 1. Some 50 participants convened at Since opening in 2009, the Christophe based on MIRU*-typing, thanks to a this event, focused on issues relating to Mérieux Infectiology Center of Vientiane transfer of technology from the Fonda- infectiology training for clinicians, the in Laos (a national organization under tion’s Emerging Pathogens Laboratory role and use of medical biology labora- the Ministry of Health) has carried out in France. This study will be conducted tories, and the importance of laboratory various research projects on the diagno- using the cohort compiled from the networking. sis of tuberculosis and detection of re- 2012 national prevalence study, as part sistance. The Center’s role is to analyze of the agreement between the National resistance to antituberculosis drugs Tuberculosis Control Program Center SUPPORTING using molecular tests to identify strains and the Christophe Mérieux Infectiology ASSOCIATIONS other than Mycobacterium tuberculo- Center of Laos. sis, as well as resistance to first-line * Mycobacterial Interspersed Repetitive Units In 2012, Fondation Mérieux provided antituberculosis drugs. The results of support for LaoPHA (Lao Positive this study, which was completed in Health Association), which offers assis- early 2012, have been published. tance to people living with HIV/AIDS, organizes preventive initiatives, and In 2013, Fondation Mérieux will launch provides treatment and care for com- a new study on the molecular epide- munities in the nine provinces of Laos. miology of the strains found in Laos, 40

2 MYANMAR 2 TAJIKISTAN NEW MOLECULAR MONITORING NEW NATIONAL BIOLOGY PLATFORM IN ANTIRETROVIRAL REFERENCE LABORATORY

MANDALAY TREATMENT Construction of the national reference laboratory for public health, located in In 2011, Fondation Mérieux began Following the renovation of the molecular Dushanbe, was completed in the fall of renovation work at the Mandalay Public platform, a technology transfer and mul- 2012, in partnership with the United Health Laboratory (PHL) in Myanmar. tiple-stage training course were carried Nations Development Program and The new molecular biology technical out in preparation for the launch of viral the Tajik Ministry of Health. The new platform has been operational since the load monitoring at the Public Health laboratory, with a total surface area spring of 2012. Laboratory in Mandalay. Staff received of 425 m², comprises two BSL2 and training at the Christophe Mérieux BSL3 units. This new structure should Infectiology Center of Laos, followed by bring about improvements in the on-site training and external quality diagnosis of tuberculosis, which is control prior to deploying testing on a particularly rife in this country, due to a large scale. number of multi-resistant strains, as well This test is now available for the 15,000 as other pathogens such as hepatitis, patients monitored by the NGO, The hemorrhagic fevers and respiratory Union Against Tuberculosis, with support infections. from the Global Fund. Financed by the Global Fund to Fight Given the increasing number of patients AIDS, Tuberculosis and Malaria, the receiving treatment, the challenge is to laboratory is the property of the Ministry limit the number of cases where the of Health. Its inauguration is scheduled virus “escapes” treatment and thus limit for the summer of 2013. the number of patients under second- line treatments.

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2 TAJIKISTAN 2 EQUIPPING LeBANon THE RODOLPHE MÉRIEUX LABORATORY IN BEIRUT

The Rodolphe Mérieux Laboratory, which was inaugurated in 2011, is located within the technology and health center at Saint-Joseph University in Beirut. Prof. Dolla Karam Sarkis The installation of the laboratory and Dean of the Faculty of Pharmacy and enhancement of the technical platform Director of the EPL, Saint-Joseph University, continued into 2012. Beirut

“We have a brand new Rodolphe Mérieux SUPPORTING Laboratory, built at the heart of the technology and health center at the ASSOCIATIONS University. This laboratory is one-of-a- kind, and to see it become part of the Fondation Mérieux supported the P’tits GABRIEL network represents a great Soleils association, which helps under- opportunity for the entire Middle East. privileged children living in Lebanon, We are currently working on all the regardless of their nationality or ethnic infections studied by the network, origins. P’tits Soleils covers the costs of including respiratory infections, emerging medical care (hospitalization, paraclinical viruses, tuberculosis and AIDS, and on examinations and specialized medical most of the diseases that afflict today’s consultations) and also provides medi- society.” cations, prostheses and vaccines. 42

2 BOARD OF DIRECTORS

Representatives of the Founding Members Alain Mérieux - President Claudine Frieh Karine Mehler Alexandre Mérieux Sophie Mérieux

Qualified persons Prof. Christian BRÉCHOT Didier CHERPITEL Prof. François GROS Prof. David Heymann 2 ScientifiC COMMITTEE Dominique PELLA Prof. Dominique PEYRAMOND Dr. Robert SEBBAG Prof. Françoise BARRÉ-SINOUSSI Institut Pasteur (France) Government representative Prof. Christian BRÉCHOT The Prefect of the Rhône-Alpes Region Institut Mérieux (France) Prof. Stewart Cole École Polytechnique Fédérale de Lausanne (Switzerland) Prof. Ogobara Doumbo 2 MANAGEMENT COMMITTEE Malaria Research and Training Center Bamako (Mali) Prof. Pierre-Marie Girard Institut de Médecine et d’Épidémiologie Appliquée - Hôpital Bichat, Paris (France) Benoît MIRIBEL Director General Prof. David Heymann Health Protection Agency (United Kingdom) Philippe LACOSTE Secretary General Dr. Kai Man Kam Laboratoire de Référence sur la Tuberculose du Ministère de la Santé Guy VERNET* Hong Kong (China) Scientific Director Prof. Arnold S. Monto Dr. Christophe LONGUET University of Michigan (USA) Medical Director Prof. Johan Neyts Dr. François-Xavier BABIN Faculté de Médecine de l’Université de Louvain (Belgium) International Development Director Prof. Albert Osterhaus ERASMUS MC, University of Rotterdam (The Netherlands) Prof. Fabien Zoulim Inserm - Lyon (France) * Position held by Prof. Christian TRÉPO ad interim February-September 2013, then permanently by Prof. Hubert ENDTZ

2 GOVERNANCE 2012 annual report n Main financial partners 43

2 Abbott 2 European Diagnostic 2 Ministère des Affaires étrangères / Manufacturers Association (EDMA) France Expertise Internationale (FEI) 2 AdvaMed 2 European Society for Paediatrics 2 National Foundation for Infectious 2 Agence Française de Infectious Diseases (ESPID) Diseases (NFID) Développement (AFD) 2 European Union 2 National Institute of Allergy 2 Agence de Médecine Préventive and Infectious Diseases (NIAID) / (AMP) 2 Fogarty International Center National Institutes of Health (NIH)

2 Agence Universitaire de 2 Fondation AnBer 2 National Vaccine Program Office la Francophonie (AUF) (NVPO) 2 Fondation Calouste Gulbenkian 2 American Society for 2 Novartis Vaccines Microbiology (ASM) 2 Fondation Cariplo 2 Nuffield Foundation 2 Agence nationale de la recherche 2 Fondation Christophe et (ANR) Rodolphe Mérieux 2 Pfizer

2 Bill & Melinda Gates Foundation 2 Fundação de Amparo 2 Qiagen à Pesquisa do Estado 2 Biokit do Rio de Janeiro (FAPERJ) 2 Région Rhône-Alpes

2 bioMérieux 2 Genostar 2 Sanofi Pasteur

2 Centre national de recherche 2 GlaxoSmithKline Biologicals 2 Sanofi Pasteur MSD scientifique (CNRS) 2 Global Fund to Fight 2 Serum Institute of India 2 Centers for Disease Control and AIDS, Tuberculosis and Malaria Prevention (CDC) 2 Stavros Niarchos Foundation 2 IMACCESS 2 CDC Foundation 2 United Nations Development 2 Institut Mérieux Programme (UNDP) 2 Crucell 2 Institut Pasteur 2 Université de Genève 2 Direction de la Coopération Internationale (DCI) de la Principauté 2 Institut de recherche biomédicale 2 VolkswagenStiftung de Monaco des armées (IRBA) 2 Wellcome Trust 2 European Centre for Disease 2 Islamic Development Bank (IDB) Prevention and Control (ECDC) 2 World Health Organization (WHO) 2 Johns Hopkins Bloomberg School of Public Health

2 London School of Hygiene and Tropical Medicine (LSHTM)

2 Merck

2 Main financial partners 44

2 balance sheet

ASSETS Net Net (Ke) dec. 31, 2012 dec. 31, 2011 Fixed assets Intangible fixed assets 20 14 Property, plant and equipment 3,182 3,693 Investments and other financial assets 17,521 17,507 Total 20,723 21,213 Current assets Inventories 6 7 Payments on account 103 104 Accounts receivable 1,117 1,005 Other receivables 3,000 2,662 Marketable securities 61,838 68,753 Cash and cash equivalents 7,656 3,073 Prepaid expenses 658 415 Unrealized exchange losses 0 2 Total 74,378 76,021 TOTAL ASSETS 95,100 97,234

LIABILITIES AND FUND BALANCE (Ke) dec. 31, 2012 dec. 31, 2011 Fund balance Dotation 64,916 64,916 Reserves 884 884 Retained earnings 24,433 28,099 Net income / loss for the period (824) (3,665) Total 89,410 90,234 Allowances for contingencies 241 243 Funds reserved for future engagements 1,396 1,403 Liabilities Loans 84 72 Accounts payable 1,284 1,819 Investment payable 0 0 Other payable 1,479 955 Deferred income 1,204 2,470 Unrealized exchange gains 2 38 Total 4,053 5,355 TOTAL LIABILITIES AND FUND BALANCE 95,100 97,234

2 2012 accounts & key figures 2012 annual report n 2012 accounts & key figures 45

2 INCOME STATEMENT

(Ke) ACTUAL 2012 ACTUAL 2011 INCOME Services revenue 280 277 Grants 118 672 Reverse on operating allowances 7,522 7,210 Expenses refund 436 238 Other operating income 27 17 Total income 8,383 8,414 EXPENSES External purchases and expenses 5,680 5,223 Taxes and duties 874 674 Salaries 2,112 1,909 Social contributions 982 892 Depreciations 634 626 Donations and subsidies received 4,666 3,921 Grants awarded 19 35 Net book value of sold assets - - Other operating expenses 7 - Total expenses 14,973 13,280 CURRENT INCOME -6,589 -4,866

FINANCIAL INCOME Dividends 1,097 814 Other financial income 1,342 25 Reverse on financial allowances 399 63 Net income from marketable securities 4,281 1,554 Total financial income 7,119 2,456 FINANCIAL EXPENSES Financial allowances 299 913 Other financial expenses 1,071 23 Total of financial expenses 1,370 935 FINANCIAL RESULT 5,749 1,520

EXCEPTIONAL INCOME Exceptional income 9 2 Exceptional reverse on allowances - - Total exceptional income 9 2 EXCEPTIONAL COSTS Exceptional expenses - 57 Exceptional allowances for contingencies - - Total exceptional expenses - 57 EXCEPTIONAL RESULT - -55 Income tax -1 -2 TOTAL INCOME 15,512 10,871 TOTAL EXPENSES 16,342 14,271

INTERMEDIATE BALANCE -831 -3,400 Prior funds carried forward 1,403 1,137 Funds reserved for future engagements 1,396 1,403 NET INCOME / LOSS FOR THE PERIOD -824 -3,665 46

2 USE OF FUNDS STATEMENT

EXPENSES (USES) (e) ACTUal 2012 INCOME (FUNDS) (e) ACTUal 2012 MISSIONS 11,102,330 Donations and legacies 128,657 Clinical biology laboratories 1,048,387 Donations 117,772 Collaborative research programmes 3,799,348 Legacies 10,885 Training and knowledge sharing 4,331,443 Other private funds 6,546,339 Support for local initiatives 866,721 Sponsorship/ Patronage 2,911,800 Support for local structures 229,079 Grants from Fondation Christophe et 1,325,000 International offices 810,755 Rodolphe Mérieux Specific projects and exploratory missions 16,596 Other grants 2,309,539 Fund-raising expenses 1,357,577 Grants and other public funding 984,903 Operating expenses 1,923,863 Other income 6,426,874 Services revenues 280,389 Refund of expenses 435,912 Other financial income 4,599,972 Dividends 1,110,601

TOTAL EXPENSES FOR THE PERIOD 14,383,770 TOTAL INCOME FOR THE PERIOD 14,086,773

ALLOWANCES 309,215 REVERSE ON ALLOWANCES 398,982 DEPRECIATION 623,286

FUNDS RESERVED 1,395,984 PRIOR FUNDS CARRIED FORWARD 1,402,815 FOR FUTURE ENGAGEMENTS

Accounting results (profit) - Accounting results (deficit) 823,684

GRAND TOTAL 16,712,254 GRAND TOTAL 16,712,254

Evaluation of in-kind patronage 11,107 Evaluation of in-kind patronage 11,107

2 2012 accounts & key figures 2012 annual report n 2012 accounts & key figures 47 48

2 BREAKDOWN OF 2012 INCOME (excluding provisions and non-recurring items)

ENDOWMENT INCOME & INVESTMENT ...... 35% SANOFI PASTEUR SPONSORSHIP AND PARTNERSHIP ...... 16% PRIVATE PARTNERSHIPS ...... 15% Fondation Christophe et Rodolphe Mérieux ...... 10% EUROPE PUBLIC PARTNERSHIPS ...... 9% REAL ESTATE INCOME ...... 8% OTHER SPONSORSHIPS ...... 4% OTHER INCOME ...... 2% DONATIONS AND LEGACIES ...... 1%

2 BREAKDOWN OF 2012 EXPENSES ASIE (excluding provisions and exceptional expenses)

MISSIONS ...... 78% ADMINISTRATION ...... 12% Fundraising expenses ...... 10%

AFRIQUE

2 BREAKDOWN OF EXPENSES BY ACTIVITY 5 500 000

(excluding provisions and exceptional expenses) 5 000 000

4 500 000 OCEAN INDIEN ...... TRAINING AND KNOWLEDGE-SHARING 39% 4 000 000 Collaborative research programs ...... 34% 3 500 000 Clinical biology laboratories ...... 10% 3 000 000 2 500 000 Support for local initiatives ...... 8% 2 000 000 INTERNATIONAL expertS ...... 7% 1 500 000 ...... Support for local structures 2% 1 000 000

500 000 0 CARAIBES

2 2012 accounts & key figures 2012 annual report n 2012 accounts & key figures

2 Geographical segmentation of activities

EUROPE ...... 40% (excluding scientific and medical coordination, and international development)

AFRICA ...... 22% ASIA ...... 21% EUROPE THE CARIBBEAN ...... 8% INDIAN OCEAN ...... 6% south america ...... 3%

2 GEOGRAPHICAL SEGMENTATION OF EMPLOYEES ASIE 120 employees worldwide

EUROPE ...... 44% AFRICA ...... 24% ASIA ...... 18% INDIAN OCEAN ...... 8% THE CARIBBEAN ...... 6% AFRIQUE

2 EVOLUTIONS5 500 000 IN EXPENSES BY FIELD OF ACTIVITy

(in K() 5 000 000 4,241 4,301 4 500 000 3,975 OCEAN INDIEN 3,703 3,844 4 000 000

3 500 000 2,695 3 000 000

2 500 000

2 000 000 1,253 n 2011 1,043 1,112 1 500 000 842 866 n 2012 706 1 000 000 n 2013 estimate 500 000

0 Clinical Collaborative TRAINING Support CARAIBES biology research AND for local laboratories programs KNOWLEDGE-SHARING initiatives C 100 M 72 J 0 N 32 Pantone : 281 C

17, rue Bourgelat 69002 Lyon • France Tel: +33 (0)4 72 40 79 79 Fax: +33 (0)4 72 40 79 50 [email protected] www.fondation-merieux.org 07-13 - Printed in France on recycled paper Credit photo: AntasH, Christelle Becam / Lyon Reportage, E. Bergoend, A. Chezière , Ligne de Front, Melon Rouge, B. Mercier & Studio K, Prezzo, Pixelle Photography, D. Plowy (Institut France), P. Tou rnaire THERA Conseil RCS B 396 160 242