Fondation Merieux

A family foundation dedicated to fighting infectious diseases

Improving health and training in developing countries

3 January 2008, Lyon (France)

Which priorities, in terms of health policies, to improve access to reliable health products?

Which priorities, in terms of health policies, to improve access to reliable health products?

Which training to meet the needs of local skills reinforcement? How to improve the health staff framework and to limit 'brain drain'?

How to develop initiative results focused on women's health so that the whole population can profit from progress in public health?

All these great questions were largely discussed at the conference entitled 'Health and Training: which stakes for developing countries?'

Organized on 3 December 2007 in Lyon by Fondation Mérieux in the honour of the centenary of it's founder, this day was based on a key sentence of Doctor Charles Mérieux: 'Health and training are the essential foundations for all individual and collective development'.

Coming for some from developing countries, more than three hundred people attended the conference. Personalities such as Philippe Couillard (Minister of Health and Social services of Quebec), Jean-Michel Sévérino (General manager of the French Association of Development), Michele Boccoz (Director of International Finances Facility for Immunization Company), Jean William Pape (Founder of the GHESKIO Centre in Haiti), and Jean-Baptist Richardier (Founder of Handicap International), brought their accounts and took part in the debates with the public.

The conference offered three workshops with the following topics: 'Access to diagnostic and reliable drugs: which stakes for the developing countries?', 'Which training for health staff to achieve the goals of the Millenium?' and 'Role of Women in the development and health: assessment and prospects'.

Access to diagnostic and reliable drugs: which stakes for the developing countries?

Improving access to care, drugs and quality diagnosis is possible. The proof is in the two projects carried out in Haiti by GHESKIO centre and in Mali by Fondation Mérieux.

Professor Jean William Pope, founder of GHESKIO, described the creation of a campaign against HIV in Haiti with the setting up of training programmes for medical staff and the population, mobile medical teams, the development of a fast and cheap detection test, and access to anti-retroviral treatments for 7 000 patients.

Youssouf Issabré, Director of Fondation Mérieux Mali, explained the creation of the centre Charles Mérieux in Bamako, a centre with multiple medical analyses activities, training of biologists and the setting up of a network of laboratories in the country. These accounts were the starting point for the exploration of several leads to improve the access to quality health products in countries where, according to WHO, nearly 25% of drugs are counterfeit. It proves that it is essential to continue to develop international partnerships to assist these countries and encourage governments to give more resources for their health programmes or to reinforce the systems of quality control. Another way for improvement would be to encourage drug and generic drug production in developing countries which would then be less expensive.

This workshop highlighted the importance of reinforcing diagnosis capacities in developing countries, parallel to all initiatives in favour of drugs access.

Which training for health staff to achieve the goals of the Millenium?

As a prelude to this workshop, Professor André Capron, a member of the Sciences Academy, pointed out the weaknesses of health training carried out in developing countries: lack of durability, integration, appropriation, evaluation and follow-up.

Professor Stoeckel, President of the Association of Preventive medicine, recounted the action of Doctor Charles Mérieux in the creation of a practical course of epidemiology, as Doctor Charles Mérieux knew that to produce and distribute vaccines was not enough, it was necessary to be able to have reliable results in order to judge the relevant effects of vaccination.

Mrs Lardy, President of Bioforce Development, also gave an account of the creation of the Institute, which she headed, in order to offer to the developing countries a reference training centre for the workers in 'support operations'.

Professor Sidiki Cissé, Health Minister of Mali, explained how, in his country, a special effort is made to run continuous training by skills, to bridge the existing gap between what the health staff have learned in theorectical training and the reality of pratical experience.

At the end of the debates of this workshop, the following main ideas were summarized: It is necessary to think about, at the time of their conception, the creation of diversified, complementary and pragmatic training programmes (faithful to the economic, social and cultural limits). It is also important to follow up the initial training with further training that would allow the updating of practices and knowledge with practical experience. Also, in order to prevent loss of trained professionals, it is indispensable to give them the means to carry out their work in adequate conditions.

Role of Women in the development and health: Assessment and prospects

The health of women is about their well-being as individuals as well as their families, and is linked to their role as citizens, playing an essential role in their contribution to the human and economic development: that is what Professor Hélène Delisle, Director of Transnut (Departement of Research on Nutritional Transition and Developement) explained in her introduction of this workshop.

Despite these important roles, inequalities persist in level of health between men and women, inequalities currently accentuated by the nutritional transition that exist with women in developing countries, affected by the food deficiencies and also now by problems of obesity. This double burden has repercussions for the entire population: maternal malnutrition results in children having chronic illnesses.

Why do these inequalities persist? For Mrs Bilkis Vissandgee of the Montreal « Faculté des sciences infirmières »: principally because it is extremely difficult to underline, in a quantitative and qualitative way, the importance of the work, notably domestic, of women in health improvement and development.

The Director for the Centre International Studies and Cooperation (CECI), Michel Chaurette, followed by explaining that, in the course of different projects already implemented, how by the improvement of the position of women, a whole population developes and has access to a better state of health.

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