Coronavirus: "Without a diagnosis, medicine is blind"

Text by: Bruno Faure Follow

Alain Mérieux chairs the Mérieux Foundation, which specializes in the diagnosis of infectious diseases in developing countries, present in 18 countries, particularly in Africa. Engaged against the Ebola virus in Africa, the French pharmaceutical manufacturer is also speaking on the response to the new coronavirus.

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RFI: What do you think are the countries where your actions have led to concrete successes?

Alain Mérieux : "Success", the term is strong. We have been very happy and efficient in a country for twenty years, in Haiti. We have a laboratory, orphanages, microcredit and it works very well in a country ravaged today by insecurity and violence. It is a country that I love very much and where my son Rodolphe, who died in a plane crash in 1996, worked. We have done well in Mali. In Bamako, we have a very nice laboratory: we have installed a P3 to work on tuberculosis diagnostics.

Mali, a troubled country, particularly at this time ...

The context is difficult at the moment, but we have created two maternity hospitals in Bamako. We are working with [Xavier] Emmanuelli on social Samu for street children in Bamako. So there we do what we can. We know very well that we cannot replace the State but if there had not been the French intervention, I make this parenthesis, Mali would be Somalia today, that is to say that there would be no more state. So I think what France and President Hollande did at the time was an act of great courage and vision.

With a context of anti-French sentiment ...

We must not exaggerate, because we are fortunate to work in a profession which is that of public health, the fight against infectious diseases where there has never been either a geographical barrier or a barrier between the different religions. It is the chance of our trade: to cross all that and to sublimate a little the problems, which does not prevent from being concretely confronted with them. And it is true that these are countries where I went very quiet ten years ago and where I can no longer wander. I go there with close protection, because these are countries that have become very dangerous.

For the past few months, you have been working in particular against the Ebola virus in Africa. What are your latest initiatives ?

For Ebola, we work with what we know how to do, that is to say, the diagnosis. And it turns out that each year we give the Institut de France a grand prize named after Christophe, who died in 2006, given to a scientist from developing countries. And we gave it in 2015 to Professor [Jean-Jacques] Muyembe Tamfum, who is the man who was charged by the President of the Democratic Republic of the Congo to fight against the Ebola virus which is rampant in Kivu. Professor Muyembe asked for our help and we sent him, with an Antonov, three containers, including a fridge, a P2 and a P3 to be able to work on Ebola. We sent him to Kigali, he landed in Rwanda and then there, he went by the mountain road to Kivu, in Goma. The installation takes more time than expected, but it is a laboratory that will be secure not only from a biological point of view, but also from a physical security point of view.

When is it possible to fight against these epidemics which are so difficult to fight in certain areas ?

When a country is structured in public health, as is the case of China today. People criticize it a lot, but China is doing everything it can and everything it needs transparently to fight the new coronavirus . But several countries, like African countries, have absolutely no Chinese capacity to cope. So the big danger is that this epidemic or other epidemics hit countries that are not prepared. And that is why it is necessary to have Sentinel laboratories on site, as in time for the Pasteur Institute. They make it possible to make diagnoses of both the plague, which has returned to Madagascar, like Ebola, like chikungunya, like Zika, like HIV, tuberculosis which is coming back in force, malaria ... When we have the diagnosis, we have already taken a big step forward. Then you have to deal with it. When possible, vaccinate preventively. But without diagnosis in these countries, medicine is blind.

Do you think that there should be an international reflection at the level of leaders to precisely better fund the diagnosis, better organize it ?

Yes. But I must admit that today things have changed a little. We work, for example, very strongly with the French Development Agency which helped us a lot to work in Mali, to expand on what are called the 7 neighboring countries Resaolab, the West African Network biological analysis laboratories. We set up laboratories, we worked with local health ministries. There is always a partnership. All our collaborators, who are in the field, are either Africans, Lebanese or Haitians. We always work in perfect symbiosis and collaboration with the local health authorities. For example in Goma, we worked with Usaid, the United States Agency for International Development. In Asia, we work with Australians. We work with the Fleming Fund (Fleming Fund UK) and with many international organizations. We understood that alone, we could do nothing and that we have to work in a network, motivated by public health problems. I am optimistic, because there is a strong global awareness.

Do you think this virus from China can contribute to this global awareness ?

Any crisis has dramatic effects, but also positive effects. As we have seen with Ebola, there has been considerable mobilization. For example, the Japanese donated two P3 laboratories which are currently in Kinshasa. We offer [a laboratory] with Usaid in Goma. It's a completely global approach. I would say that we have learned from Ebola, that we are learning from the coronavirus, and that we will learn from other epidemics. Each time, it is a speed race between the reservoir of virus or pathogens which is always within the animal, before passing to mammals and then to humans. It's still the classic way. So, it is a chain which today requires a “One Health” approach - one that involves not only medicine, diagnosis, but also physical security, housing, food, and especially education. So, this is a global battle which is fought on a planetary level and which can only be waged with a long-term vision, a vision of sharing and generosity.

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