In the fight against infectious diseases, the Mérieux Foundation has always worked as closely as possible with local partners in the field. From the first COVID-19 epidemic alerts, the foundation took action to provide aid adapted to the low-income countries where it works.
First reported on December 31, 2019 in Wuhan, China, the Coronavirus disease 2019 (COVID-19) rapidly reached global epidemic proportions and destabilized some of the world’s most robust health systems. True to its commitment to public health in developing countries, the Mérieux Foundation, with its partners, mobilized resources to respond to the crisis. The Foundation has made the fight against COVID-19 a priority, by massively dispatching diagnostic tests, launching or expanding projects and supporting local health authorities.
Strengthening local diagnostic capacities
24 diagnostic kits that are essential for identifying patients and implementing effective quarantine measures were sent to fourteen laboratories in thirteen countries as early as March 2020.
A program of training and technology transfer was set up to support local laboratories in performing these tests: transmission of operating procedures and WHO recommendations on biosafety, dispatch of protective equipment and disinfectants, and organization of training teleconferences with each laboratory.
To ensure sufficient volumes to meet demand, the foundation has provided two different detection kits: one developed by the Charité laboratory in Berlin, validated by the WHO, and the other developed by the Christophe Mérieux Laboratory in Beijing, validated by the Chinese CDC (test used for all COVID-19 screening in China).
Sars-Cov-2 detection kit – Charité laboratory, Germany
This test, validated by WHO, based on the sequences of SARS-CoV-2 coronaviruses and SARS-related viruses, consists of two RT-PCR (Real Time Reverse Transcription Polymerase Chain Reaction) per sample: the first-line screening test detects betacoronavirus SARS-related Cov (Severe Acute Respiratory Syndrome) and the confirmatory test specifically detects SARS-CoV-2.
The EVAg consortium (European Virus Archive, a European consortium funded by the H2020 programme) supports and provides the positive controls, proving that detection of the virus by this test is effective.
The kit developed by the Christophe Mérieux Laboratory in Beijing, founded jointly by the Mérieux Foundation and the Chinese Academy of Medical Sciences (CAMS), and validated by the Chinese CDC has also been shipped. The lab team developed a RT-PCR molecular test being used for all SARS-CoV-2 diagnostics in China. All COVID-19 diagnostics are currently made with this test in China.
The shipping of these tests and the support offered aim to overcome equipment and technology shortcomings and support quick and effective diagnosis of novel coronavirus cases.
Rodolphe Mérieux Laboratories at the heart of the fight against COVID-19
The Rodolphe Mérieux Laboratories teams, such as in Mali and Madagascar, mobilized in the fight against the COVID-19 outbreak since the earliest signs of alert in the countries.
The Rodolphe Mérieux Laboratory in Beirut was mandated by the Lebanese Ministry of Health to carry out COVID-19 screening alongside the Rafik Hariri University Hospital laboratory. Testing activities for COVID-19 began there on March 7, 2020 and the laboratory is now one of the five reference laboratories for the Ministry of Health. The compliance rate of the COVID-19 tests they perform has been evaluated at 100% by WHO, while the national average is 94%.
In Brazil, the Rodolphe Mérieux Laboratory in Rio Branco was the first facility in the State of Acre responsible for the COVID-19 testing (between March and October 2020, nearly 30,000 tests have been performed). It has been integrated into the State’s public health network. The laboratory receives test confirmations from all around the country but also from bordering Peruvian and Bolivian cities.
The Rodolphe Mérieux Laboratory in Cambodia has also been mandated by WHO and the Cambodian Ministry of Health to perform COVID-19 diagnostics.
In the Democratic Republic of the Congo, the Rodolphe Mérieux Laboratory of Goma holds a central role in the country’s fight against the COVID-19 epidemic. Teams analyze samples taken as part of the regional surveillance and perform tests for all domestic and international travelers. In total, more than 200 tests are performed daily.
Limiting nosocomial infections
While diagnosing COVID-19 is an urgent priority, it is equally important to identify and reduce transmission risk in hospitals. Evidence has shown that SARS-CoV-2, like SARS-CoV-1 in 2003, is characterized by a particularly high rate of nosocomial infections. In response, the Mérieux Foundation in collaboration with Prof. Philippe Vanhems, epidemiologist at the Hospices Civils de Lyon, has developed a research protocol to assess nosocomial transmission risk for SARS-CoV-2: the NOSO-COR project.
This is a prospective, non-interventional – observational, hospital-based study to describe and document cases of COVID-19 nosocomial transmission in hospitals, and to describe infection prevention and control practices and policies in hospitals.
The NOSO-COR project has two features:
- mapping available expertise in hospitals in order to identify what interventions are needed to limit nosocomial transmission;
- carrying out an epidemiological study to gain a better understanding of transmission chains, risk factors and impact of hospital-based prevention and infection control measures, in order to identify key infection risk factors.
This study is implemented in the following countries:
- Africa, in collaboration with Africa CDC and with the support of the Bill & Melina Gates Foundation:
- Ivory Coast (Institut National d’Hygiène Publique and Treichville University Hospital in Abidjan),
- Guinea (Institut national de Santé Publique and University Hospital in Conakry),
- Madagascar (Charles Mérieux Center for Infectious Disease of the University Ankatso in Antananarivo and the Befetalanana and Aniosala Hospitals in Antananarivo)
- Mali, (Charles Mérieux Center for Infectious Disease of Bamako and Point G University Hospital),
- Bangladesh (iccdr,b Dhaka Hospital) ;
- Brazil (Hospital das Clinicas) ;
- Middle-East :
- Lebanon (Rodolphe Mérieux Laboratory in Beirut and Saint Joseph Hospital)
The protocol has also been made available to eight teaching hospitals in France for subsequent results- and experience-sharing.
The Mérieux Foundation manages the implementation of the research protocol in the countries, particularly in the research laboratories that are members of the GABRIEL network, and the Hospices Civils de Lyon are responsible for the implementation in teaching hospitals. Professor Jianwey Wang, from the Christophe Mérieux Laboratory in Beijing, acts as scientific advisor.
The study has been registered on clinialtrials.gov website under the identifier NCT04290780. The project has been approved by the ethics committee in France and the national ethics committees of the partner countries.
Supporting health professionals
Throughout the crisis, the foundation’s experts have been in regular contact with healthcare decision-makers and professionals in the field, particularly through its laboratory networks.
By providing individualized support, in close connection with those working in the field, the foundation’s teams facilitated and guided the work of laboratory personnel. They provided advice both on tests to be used, handling of samples, transport protocols and on the screening strategies and response policies to be implemented at the national level.
The foundation has also been asked by the Laboratory Directorates to address issues related to diagnostic strategy and the development of public health interventions.
To promote knowledge and experience sharing between partner countries but also information dissemination to all first line health workers, the Mérieux Foundation took part in the organization of event focused on the COVID-19 outbreak: a COVID-19 ACDx webinar, bringing together nearly 400 participants was set up (add news link) to highlight good practices and feedback from countries on the four continents.
The Mérieux Foundation, in partnership with the Foundation for Innovative New Diagnostics (FIND), the African Society of Laboratory Medicine (ASLM) and the London School of Hygiene and Tropical Medicine (LSHTM), help developing a French MOOC on Diagnostics and Testing for COVID-19, for laboratory personnel. On the course learners were able to engage with high number of experts and educators, such as Prof. Kouriba, (Charles Merieux Center for Infectious Disease of Bamako, Mali) and Prof. Ouedraogo, (National Reference Laboratory on Antimicrobial resistance in Burkina Faso). The project was made possible with the support of the Agence Française de Développement (AFD) as part of the Initiative “COVID-19 – Health in Common” which supports in particular the RESAOLAB project,
Adapting current projects
Several projects already initiated have benefited from additional top-up payments or budget reallocation to respond to the COVID-19 emergency. This responsiveness and adaptability owe much to the mutual trust between the foundation and its funding partners – a strength of the foundation that made a tremendous difference in the context of the health crisis of Spring 2020.
This emergency funding included:
- L’AFD (Agence Française de Développement) has allocated an additional envelope to support the Laboratory Directorates of the seven member countries of the RESAOLAB program, and has allocated COVID-19 funding to the LABOGUI project in favor of 39 hospital laboratories in Guinea (protective equipment, reagents and disinfectants).
- AFD is also helping the GHESKIO Centers in Haiti, the Mérieux Foundation’s longstanding partner, to strengthen diagnostic capacities and provide technical assistance to the Public Health Laboratory.
- Expertise France provided additional funding to introduce a COVID-19 component to the APRECIT project in Madagascar and Cameroon. APRECIT, whose initial objective was to compare tuberculosis screening strategies, now integrates COVID-19 screening tests and will analyze the interactions between the two pathologies.
- Expertise France is funding a COVID-19 extension to the EVAMAD project in Madagascar which focuses on increasing the coverage of HIV viral load testing: prevention and initiation of a study on HIV/COVID-19 co-infection.