Health and research: Institut Pasteur and the Réseau Pasteur. A tradition for the Pasteur Network, a vision for the 21st century

Transcription

1 Health and research: Institut Pasteur and the Réseau Pasteur A tradition for the Pasteur Network, a vision for the 21st century 1

2 Institut Pasteur Vision: To improve human health and welfare through scientific discovery From patients and diseases biomedical research, teaching and training, and back to applications of research discoveries and patients

3 Three missions Biomedical research A key role in public health: monitoring of infectious disease status, expertise and field interventions Sharing knowledge: teaching and training

4 Inauguration of the Institut Pasteur, November 14, 1888 In the presence of President Sadi Carnot

5 Institut Pasteur: the successful outcome of an international fund raising project. «Our institute will be both a health center for treating rabies, a research center for infectious diseases and a learning center» Louis Pasteur The friendship with Brazil started at the very beginning. Don Pedro II corresponded regularly with Pasteur. He signed Votre confrère bien attaché (your devoted colleague).

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7 Institut Pasteur today A private non-profit foundation Workforce : 2600 persons of more than 60 different nationalities, in Paris

8 120 years of research for health 120 years of discoveries that saved millions lives Vaccines : rabies, BCG, yellow fever Discovery of the plague and malaria (Laveran Nobel 1907) Treatment of diphteria Discovery of the anti-infectious effect of sulfamides Discovery of HIV1 and HIV2 virus Initiated disciplines 10 scientists received the Nobel price Microbiology Immunology Molecular Biology Trained scientists all over the world F. Barré-Sinoussi, L. Montagnier, 2008 F. Jacob, J. Monod, A. Lwoff, 1965

9 Louis Pasteur Pasteur, the chemist who changed medecine

10 Jenner Jenner injecting vaccine (Gaston Melingue, 1879)

11 Louis Pasteur and rabies

12 The international network : a long history In 1891, Albert Calmette founded in Saïgon the first Institut Pasteur out of France to vaccinate populations against rabies and smallpox.

13 A long history The Institutes multiplied over the years: the founders were trained in the Pasteur school Calmette - Laboratoire de microbiologie de Saigon, I.P. Saigon in Yersin - Institut Pasteur de Nha-Trang (Vietnam) Marchoux - Laboratoire de microbiologie de St Louis (Sénégal), became I.P. Dakar in Thiroux - Laboratoire de microbiologie de Tananarive, became I.P. Madagascar in Martin G. - Institut Pasteur de Brazzaville (Congo) Kerandel- Laboratoire de microbiologie de Phnom-Penh, devenu I.P. du Cambodge Leboeuf - Institut G. Bourret à Nouméa, became I.P. de Nouméa in Leger M. - Laboratoire de microbiologie de Cayenne, became I.P. de Guyane in Gauducheau - Laboratoire de microbiologie d Hanoï, became I.P. Hanoi in Mesnard - Institut Pasteur de Téhéran (Iran) Fabre - Laboratoire de microbiologie de Pointe à Pitre, became I.P. de Guadeloupe in Raynal - Institut Pasteur de Shanghaï (Chine) Gamet - Institut Pasteur de Yaoundé (Cameroun) 1960-Chippaux A. - Institut Pasteur de Bangui (Rep. Centre Afrique) 1970-Chippaux A - Institut Pasteur de Côte d Ivoire. 13 Bureau du Conseil d Administration du 6/10/2009

14 Yersin, a life in Vietnam

15 Yellow fever, Dakar

16 The international network today

17 Institut Pasteur : research 10 Scientific departments: 130 research units Half is dedicated to infectious diseases Genomes and Genetics Developmental Biology Neuroscience Cell Biology and Infection Immunology Infection and Epidemiology Microbiology Parasitology and Mycology Structural Biology and Chemistry Virology Publications : 60% with international collaboration, 20% within Europe

18 Pasteur Network Global Health and principal infectious diseases Viral diseases AIDS, Flu, dengue, rabies, hepatitis, poliomyelitis, yellow fever, SARS, haemorrhagic fevers, Chikungunya Bacterial diseases Tuberculosis, enteric diseases, plague, whooping cough, meningitis, anthrax, Parasitic diseases Malaria, leishmaniasis, amibiasis, Chagas disease, sleeping sickness Fungal diseases Cryptococcosis, candidiasis, aspergillosis

19 Infectious diseases promote poverty Morbidity : over 2 billions people are infected Impairment of intellectual and physical development in children The economic impact is huge: - in developing countries : Reduced productive capacity/worker - in developed countries, (SARS or pandemic flu threat)

20 Millennium Development Goals 1. Eradicate extreme poverty and hunger. 2. Achieve universal primary education. 3. Promote gender equality and empower women. 4. Reduce child mortality. 5. Improve maternal health. 6. Combat HIV/AIDS, malaria and other diseases. 7. Ensure environmental sustainability. 8. Develop a global partnership for development.

21 A few examples of programs in the Réseau Pasteur 21

22 Health and Sustainable development A few examples of activities addressing global health challenges Avian flu and H1N1 flu diagnosis and surveillance (South east Asia, Africa..) Rapid diagnosis for plague, cholera, meningitis Malaria surveillance and drug resistance HIV/AIDS

23 HIV/Aids in the w orld

24 HIV/AIDS Since 1981, more than 25 millions people died of AIDS. 35 millions live with the infection Ongoing projects : co-infections, mother to child transmission, evaluation of treatments, vaccine research. Fundamental research : immunology, cell biology, multidisciplinary

25 CERMES in Niger, in the «Meningitis belt»

26 Rapid diagnostic test for bacterial meningitis in Niger Strips for fast meningitis diagnosis: from basic research to field intervention. New lab created in Niger. Will produce diagnosis for 5 years for country and region Centre of Health in Bokki, Niger New training center being built : to train health care workers of region

27 Capacity building Meningitis 4 serogroups, sustained production of diagnostic kits CERMES/IP, distribution heath centers. S Chanteau et al, Plos Medicine, New lab for meningitis New residence, training center Kits Partnerships MoH/ IP / Sanofi Aventis WHO support (local, regional, HQ)

28 Diagnosis and surveillance Developing high quality, simple and reliable new diagnostic tools and making them available is essential for vaccine programs, and also for proper disease treatments. Circulating infectious agents must be precisely known and followed to propose adapted actions. It is essential: to improve surveillance to predict epidemics to assess impact of interventions and to adapt Without proper diagnosis and surveillance, million dollars efforts may be inefficient

29 Of man, mosquito and virus Chikungunya epidemics in the Indian ocean : an emerging disease study 29

30 Emerging infectious diseases Infectious diseases really new in human species : AIDS, Ebola, SARS already existed, but have recently increased in incidence, geographic distribution: dengue, lyme disease, West Nile, chikungunya, Newly evolved strains of pathogens : multi-drug resistance tuberculosis, drug resistant malaria Diseases are emerging because of human activities : changes in life conditions, environment, international exchanges, conflicts, refugees movements..

31 Emerging infectious diseases and human activities : not new 1517 Arrival of Spanish people in Yucatan, bringing diseases that were unknown to local populations : small pox, measles

32 Global warming

33 Climate Change & Health Climate Change Impacts Direct impacts Physical systems (water, temperature ) Biological/ seasonal cycles Indirect impacts Human Health: Injuries/deaths Thermal stress Infectious diseases Malnutrition Mental stresses Injuries, drugs, etc. Economy, society migration, urbanisation

34 Regional impact of global change Europe Africa S.-Asia Latin-A SIS sea level sea level ? ? ? ? Based on: McMichael and Kovats, 2000

35 Number of emerging disease events per decade This decade : 60 % of human emerging diseases due to animal pathogens Majority of these due to wildlife (ex SARS) Vector borne (transmitted by mosquito), 25 %, increasing Drug resistance, 20 %, increasing Jones et al, Nature, 451, p990, 2008

36 Relative risk of an emerging disease event Pathogens from wild life Pathogens from non-wild life Drug resistant pathogens Vector-borne pathogens Jones et al, Nature, 451, p990, 2008

37 Ex: Emergence of dengue in the world before 1960 after millions cases each year severe cases, dead

38 Study of an emerging disease : Chikungunya. A major outbreak occured in La Reunion island in the indian ocean Brief history of the Chikungunya Transmitted by mosquitoes 1950s : several small local epidemics (Africa, Asia) Neglected tropical disease 2005: poorly known virus

39 A disease story : Chikungunya outbreak Mar-June 2005 Sept-Dec 2005 Jan-March 2006 Number of new cases per week

40 A mosquito story Aedes albopictus

41 A virus story : a mutation occurred in the virus 100 viral strains analyzed March March 2006 Mutation E1-226A E1-226V More rapid multiplication in the mosquito More efficient transmission to man Exceptional epidemic Mar.-Jun 2005 Sept.- Dec Jan.- Mar Rain Lack of immunity

42 To be better prepared for the future 42

43 What to do? In the future, the unpredictable risk of diseases could hold the international scene, notably in the field of infectious pathologies. For example : flu today It is thus essential: to develop alarm systems to detect the appearance of new epidemic phenomena very early on. Surveillance to promote the prevention of infectious diseases to spread out new diagnostic, therapeutic and vaccine strategies and to monitor intervention to reduce the risk of appearance of resistance to the antiinfectious agents.

44 The future of research in infectious diseases The need for research for sustainable development is huge. In countries, which are most affected, there is an urgent need for : - training - research - capacity building - development of biotechnology Required conditions for sustainability and success

45 Training in the International Network Avian Flu training in Cambodia for African Members of the International Network

46 Research : soon a new building dedicated to emerging diseases A multidisciplinary research center, developing cutting edge technologies, focused on emerging diseases. Building started in 2009.

47 What is necessary? What system? Scientists : senior, experienced, junior, beginners Technical tools A working environment well adapted and safe Personal perspectives which are stimulating Financial means: sufficient and sustainable Ways for the results to be presented and published A permanent administrative and political support International interactions and collaborations

48 Conclusion: what is needed for global health research Good scientists, well trained, who identify the right questions to solve the health problems in their context and environment and who develop the results of their research They need an environnement with institutions and proper administration, which allow them to conduct their research to success Political will and support is key to a sustainable success. International collaboration, sharing and political discussions in which the actors are involved

49 In conclusion To adapt the vision of our founding predecessors in a world of global health, with the ambition of making a real difference. To be actors in health diplomacy and have a visible impact for the benefit of health and of a better balanced world. «All for one and one for all» 49

50 Oswaldo Cruz

51 Einstein visit to Fiocruz, received by Chagas and colleagues (1925)

52 Oswaldo Cruz and the press Oswaldo Cruz receiving the gold medal in Berlin in 1907, at the international congress for hygiene and demography, for eradicating yellow fever in Rio

53 Oswaldo Cruz and the press Hygiene giving orders

54 Obrigado Merci Thank you

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