Our actions in the field of tuberculosis

The Mérieux Foundation has made the fight against tuberculosis a priority by combining in its projects community-based intervention with vulnerable populations, with a mother-child approach, and the strengthening of health and laboratory systems, and of diagnostics with an operational research approach.


Research Mothers & children Access to diagnostics




In progress

Tuberculosis (TB) is the second leading cause of infectious death after COVID-19 and the leading cause of death among people living with HIV. In 2021, WHO estimates that 10.6 million people worldwide had TB and 1.6 million died from the disease. Resource-limited countries account for 98% of TB cases. The COVID-19 pandemic has significantly slowed the global fight against TB, with a significant decline in case notifications and an increase in mortality for the first time in a decade.

The global fight against TB poses many challenges. Advances in research and development are needed to improve TB prevention, diagnosis and treatment. To address these challenges, the Mérieux Foundation is developing and leading a TB program with partner members of the GABRIEL network and the International Network of Pasteur Institutes.

A collaborative approach to serving communities

Our strategy is focused on working with National TB control Programs (NTPs) in LMICs, alongside local institutions involved in the diagnosis and research of TB. This includes members of the GABRIEL network and the Institut Pasteur’s international network, field experts such as doctors, paediatricians and community health workers, as well as stakeholders and key opinion leaders worldwide. 

We work with partners to help them develop an efficient laboratory system in accordance with international frame of reference in order to provide vulnerable populations with universal access to quality health services. Laboratories have been built in partnership with NTPs to improve a global TB technical expertise, surveillance and epidemiology.

We also provide technical training on TB diagnostics, quality data management, and biobanking.

In partnership with health authorities and research institutions, we contribute to the development of operational research studies that help NTPs define an optimal screening and management strategy for people infected with TB. Prioritising community-based approaches underpin our overall ethos. This is especially important in the prevention, diagnosis, treatment and care of drug-sensitive and drug-resistant, and HIV-associated TB.

Finally, technology transfer programs are key to improving the diagnosis of childhood TB and developing tools for the evaluation and monitoring of treatment. We support research institutions and health authorities to develop these programs alongside clinical research studies, with the assistance of young researchers from the GABRIEL network.

Meeting the main TB-related challenges

Improving TB infection (TBI) prevention

According to WHO estimates, a quarter of the world’s population is infected asymptomatically by the tuberculosis bacillus. This is known as TB infection (TBI), formerly known as latent TB infection (or LTI).  About 5-10% of them will develop TB disease in their lifetime.  The large-scale deployment of a global strategy for the screening and management of LTI represents a major challenge for health authorities.

The Mérieux Foundation has been developing since 2019, in partnership with the Institut Pasteur of Madagascar and the Centre Pasteur of Cameroon and with the financial support of the Initiative, an operational research project that aims to support National TB Control Programs, in the definition of a cost-effective strategy for screening and management of TBI in Madagascar and Cameroon (APRECIT project). 

Developping new screening tests for better notification 

About a third of TB cases worldwide are reportedly under-reported. There are several reasons for this underdetection:

  • most TB diagnostic tests are based on the analysis of quality sputum, a difficult biological sample to obtain, especially in children (underdetection of pediatric TB cases);
  • the main tests for the detection of Mtb from sputum have poor analytical performance (sensitivity, specificity, predictive value, etc.);
  • the performance of these tests requires dedicated facilities, adapted equipment, a sometimes complex supply chain and qualified personnel. These facilities may be difficult to access for populations living in rural areas or far from large urban areas.

The development of tests for screening, triage and/or diagnostic confirmation of TB, not based on sputum analysis, is therefore a major priority for WHO, FIND and Stop-TB Partnership.

The Mérieux Foundation is also part of this strategy by ensuring technology transfer and evaluation of diagnostic innovations in their ability to better detect TB in children (DEDICATE project), or to better detect TB directly in the community through the use of an innovative, portable, rapid, cost-effective, non-invasive test that does not require energy resources (EBC-LAM project)

Improving therapeutic follow-up to limit treatment failures

Although TB is a curable disease, multidrug-resistant TB (MDR-TB) to first-line antibiotics remains difficult to treat. In the case of TB disease, a four-antibiotic-based curative treatment is administered over a period of 6 months. The efficacy of this treatment is higher than 90% in most countries.

In the case of MDR-TB, treatments are longer and associated with more side effects, which limit patients’ adherence to treatment, favour treatment failures and increase the number of patients lost to follow-up. To date, there is no laboratory test capable of helping clinicians to identify, at an early stage, patients who respond to anti-tuberculosis treatment and those whose disease is progressing. Since 2017, the Mérieux Foundation has been coordinating a multicenter evaluation of diagnostic solutions to improve the therapeutic follow-up of TB patients. This project has participated in strengthening the research capacities of the GABRIEL network member countries, through the training and supervision of PhD students, technology transfer and the evaluation of innovative diagnostic solutions.

Through this TB program, we wish to:

  • Create a synergy between different scientific and medical expertise represented in the Mérieux Foundation’s networks;
  • Propose and promote access to diagnostic innovations adapted to countries with limited resources and useful for the early detection and diagnosis of TB and the treatment of the most vulnerable.
  • Develop and strengthen, in partnership with health authorities, training and awareness-raising of the population on TB issues.

Our projects in the field of tuberculosis:

  • APRECIT: Evaluation of strategies to improve the screening and overall management of latent tuberculosis infection in Cameroon and Madagascar.
  • DEDICATE: Evaluation of the clinical performance of two innovative blood tests for the triage and diagnosis of paediatric and extra-pulmonary forms of tuberculosis in Bangladesh.
  • HINTT: HBHA immune-monitoring for following-up tuberculosis treatment and improving the success rate.
  • Labo2S: Reinforce the capacities of laboratories in charge of the diagnosis and biological monitoring of patients infected with HIV and/or tuberculosis in Niger.
  • EBC-LAM: Evaluation of a rapid and non-invasive breath test for TB screening in regions with limited resources
  • APRECIT-BIS: Support the National Tuberculosis Control Programs of Madagascar and Cameroon to improve screening for TB infection in populations at risk, and the identification of beneficiaries of TB preventive treatment.
  • Supporting the fight against tuberculosis in Lebanon: supporting Lebanon’s National Tuberculosis Control Program and the Rodolphe Mérieux Laboratory in Beirut, designated National Reference Laboratory for Tuberculosis since 2018, to guarantee access to diagnosis and treatment of active and latent tuberculosis.