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Presented by Institut Pasteur du Cambodge & the CNRS at the Asian Development Bank last 12 July 2013 during the Health Community of Practice Brownbag Seminar.
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Asian Development Bank Manilla July 12
A vision of an ASEAN at the forefront of anticipation, containment and control of
zoonoses and emerging infectious diseases
1
Disclaimer: The views expressed in this paper/presentation do not necessarily reflect the views or policies of the Asian Development Bank (ADB), or its Board of Governors, or the governments they represent. ADB does not guarantee the accuracy of the data included in this paper and accepts no responsibility for any consequence of their use. Terminology used may not necessarily be consistent with ADB official terms.
PRESENTATION
« One Health » paradigm to confront EID in SEA Institut Pasteur International Network at the forefront of EID Institut Pasteur in Cambodia : missions and flagship projects to APSED Presentation of CNRS activities CNRS in SEA: networking on biodiversity and ecosystems towards EID Vision of CNRS-IPC on « One Health » approach to APSED
Creation of a regional platform for research on communicable infectious diseases and emerging pathogens in Southeast Asia
Conclusion/discussion
Intermediate hosts/Reservoirs/
Vectors
A multitude of major factors of
emergence
Environment
Susceptibility: Genetics,
Immune status Behavior
Cultural performances
Virulence Recombinaison
Mutations Drug resistance
More than half of emerging epidemics are caused by pathogens
which originated in animals
« One Health » Paradigm
Southeast Asia
Southeast Asia: a region endemic for emerging pathogens
A multitude of major factors of emergence
• Poverty: Regions with low incomes • Increasing human population • Frequent contacts with domestic
and wild animals • Migrating population • Tourism
• Important pig and poultry production • Bats and rodents reservoirs of diseases • Numerous hematophagous insects infected • Illegal animal trade
• Deforestation • Climatic disasters • New intensive agriculture (manioc, hevea…)
IPIN: A global Network with 32 Institutes worldwide
In countries with high Incidence and endemic infectious diseases
The IPIN (Asia-Pacific) & focus on the Mekong Region
4 Mekong countries
What we have in common Scientific culture
Pathogens
Populations
Environment
What differs Cambodia : French + national
Vietnam, Laos: national PHL
China: national academies
Various levels of development
6
• Participate to the national and regional surveillance activities for a better prevention, outbreak management and response under IHR
• Strive for innovative and competitive research projects that are adapted to local needs in an international context
• Contribute to sustainable local and regional capacity and capability building, and partnerships to control emergence and spread of emerging infectious diseases under APSED requirements
Missions of IPIN in SEA
Public Health Research Training
The Institut Pasteur in Cambodia
The Institut Pasteur in Cambodia is a for-not- profit private foundation of public utility .
The missions of IPC are excellence in research for public health application and training
By its history (60 years in Cambodia) and its missions, it has a vital role to play in the fight against infectious diseases and emerging pathogens as well as in the support to public health in Cambodia and in Southeast Asia.
8
• 171 staff:
- 150 Cambodians
- 9 French Expats
- 12 students/fellows
• 3 NRC
• 4 Research Units
• Technical platforms
• BSL-3/ASL-3
Flagship projects in IPC (major collaborations)
• Seasonal and Avian Flu (WHO/FAO/NaVRI/DHHS/CIRAD)
• Dengue and other arboviroses (EU/IPIN)
• Impact of the Environment on EID (AFD/CNRS/IPIN)
• Infectious Encephalitis (IRD/CIRAD/INSERM/IPIN)
• Zoonoses and Pathogen Discovery (WCS/CNRS/CIRAD)
• Malaria drug resistance (WHO/GF/NIH/NAMRU2/ITMA/IPIN…)
• Tuberculosis and HIV (ANRS)
• Rabies (IPIN)
• Antimicrobial Drug Resistance (WHO, FAO) 9
(In close partnership with MoH and WHO; Large participation of hospitals and communities)
Network building on emerging diseases
Main sponsors
CNRS, brief institutional presentation of activities in ASIA
12
● I CNRS operates under the French Ministry of Education and Research
● I The largest fundamental research organization in Europe, CNRS directs over 1100 research teams , regrouped in 10 domains :
I mathematics I computer sciences I physics I nuclear and particle physics I chemistry I ecology and the environment I biology I earth sciences and astronomy I systems & engineering sciences I human and social sciences
● I Almost 34,000 people including 11,400 researchers and 14,200 engineers, technicians and administrative staff
● I 90% of CNRS research is performed within joint research units, partnerships with universities, or international research institutes or companies
● I 25,500 publications each year in high-caliber international magazines
● I Founded in 1939, CNRS hosted 18 Nobel and 11 Fields Medal laureates
CNRS, an essential contributor of scientific research
CNRS institutional activities
13
Beij
ing
8 joint research units (UMI) in ASIA ( 30 worldwide ) 4 representative offices in Asia ( 11 worldwide )
New Delhi China
Mongolia
Japan
India
Taiwan
Korea
Indonesia
Malaysia
Nepal Pakistan
Myanmar
Bangladesh Vietnam
Laos
Thailand
Cambodia
Brunei
Singapore
Philippines
JAPAN : 3 UMI :
Tokyo
UMI LIMMS Laboratory of
Integrated Micro-Mechatromic
Systems, Tokyo-U
UMI JFLI Jp-Fce Laboratory in Informatics Paris6., Keio-U., Tokyo-U., NII.
UMI JRL Japanese Robotics
Laboratory,
UMI E2P2L : Eco-Efficient
Products & Processes Laboratory
RHODIA
CHINA : 1 UMI :
INDIA : 1 UMI :
UMI IFCAM : Indo French
Center for Applied Mathematics
DST
SINGAPORE : 2 UMI :
UMI IPAL : Image & Pervasive
Access Laboratory
I2R (A*STAR), NUS
UMI CINTRA : CNRS
International THALES NTU
Research Alliance
Hanoi
UMI MICA : Multimedia
Information Communication and
Applications Gr-INP, H.U.S.T.
VIETNAM : 1 UMI :
AIST
14
33 LIA ( virtual labs )
LIA CPN Center for Photonics
and Nanostructures
KOREA: 2 LIA :
LIA FK-PPL France Korea
Particle Physics Laboratory
TAIWAN : 1 GDRI
LIA ADEPT : Active deformation
& environt’l hazard assessment
VIETNAM : 6 LIA
LIA VIIC Petrochemical research
LIA PhytoChemistry
LIA FV-PPL
LIA CSA-CSAE
LIA ForMATH
LIA Corrosion
INDIA : 5 LIA
LIA Immunology n Genetics
LIA Nuclear Sciences
LIA IF Formal Methods Lab.
LIA CATalysis for
Sustainable … chemistry
LIA Solid State Chemistry
JAPAN : 6 LIA
LIA ElytLAB
LIA CASSH
LIA ReaDiLab
LIA FJPPL
LIA FJ-NSP
LIA FJ-MFL
LIA ORIGINS
CHINA : 11 LIA
LIA BioMNSL
LIA FC-PPL
LIA 2MCIS
LIA LAS2M
LIA LFCC
LIA LSE
LIA FOM
LIA XiamENS NanoBioChem
LIA PMC
LIA LMTM
SINGAPORE : 2 LIA
LIA FSQL : Quantun physics LIA CAFS : MechanoBiology
INSHS
INP
INC
INSIS
IN2P3
INS2I
INEE
INSMI
INSU
INSB
Southeast Asia
Environmental diversity Biological diversity Cultural diversity Historical diversity Socio-economic diversity
Southeast Asia: a region of high diversity
Southeast Asia: a hotspot of biodiversity at threat with an increasing number of ID outbreaks’ events
(Wilcove et al., 2013)
(Morand et al., 2013)
(Schipper et al., 2008)
Threatened mammals
Higher number of zoonotic outbreaks is linked with increasing biodiversity at threat
Higher number of vector-borne disease outbreaks is linked with low forest cover
Southeast Asia: ID outbreaks are related to biodiversity loss
(Morand et al., 2013)
2008
1999
1988
7 HR Land covers developed Rodents & RoBo acquired
7 HR Land covers in development Rodents & RoBo acquired
6 HR Land covers to develop Rodents & RoBo acquired in early 2014
Temporal change
Spatial change
Remote Sensing and Geographic Information Systems : reconstructing land use changes to infer risks
Administrative boundaries
Conceptual maps
Land covers
Epidemiological maps
Landscape genetics
Towards mapping of ecosystem services
Representing landscapes as a tool for community-based management and planning
Capacity building and research expert network in biodiversity and ecosystem services
• French teams
– CNRS-IRD-ISEM PathoDivSEA (AFD-CNRS)
– CIRAD-AGIRs GREASE-CIRAD (network)
– INRA-CBGP PathoID-INRA (metaprogram)
– IRD-BIOMECO PPR SELTA-IRD (network)
– IRD-CIRAD-InterTryp Platform BioZoonoSEA
– Institut Pasteur Cambodia One Health (FP7-EU)
• SE Asian teams
– Mahidol University, Dpt Medecine, TropMed, Bangkok
– Kasesart University, Dpt Veterinary, Bangkok
– Thammasat University, Dpt Anthropology, Bangkok
– Chulalongkorn University, Dpt Biology Bangkok
– AFRIMS (US Army), Bangkok
– Maha Sarakham University
– NAFRI, Agricuture & Forestry, Vientiane
– National Institute of Health, Vientiane
– Centre Christophe Mérieux, Vientiane
– University of Health Sciences, Phnom Penh
– IP Cambodia
– OUCRU, Ho Chi Minh City
– Veterinary University, Ipoh, Malaysia
– National University of Singapore
Network building
Vision of CNRS-IPC on Ecohealth approach
The One Health paradigm aims to strengthen human and animal health by acting at the Animal-Human-Ecosystems interface
Building capacity by implementing an Ecohealth approach:
1) To understand the patterns/processes of emerging diseases (from syndrome, transmission to ecology) and the interactions between environment and human health
2) To take into account the cultural/traditional/scientific knowledge in order to develop a scientifically and acceptable Ecosystem Services for Diseases Regulation
3) To develop risk maps and map scenarios based on Geographic Information Systems as a tool for science/decision interface (surveillance, land planning, etc.)
See more at www.ceropath.org
Rodents and rodent-borne diseases : - Biodiversity changes - Rodent-borne diseases - Agricultural pests - Local perception: hunting, health, environment
Project CERoPath 2008-2012 - Tools (barcoding), database, maps - Trainings - Research network in SE Asia Project BiodivHealthSEA 2012-2015
www.biodivhealthsea.org
Interdisciplinary research & stakeholder involvement - hospitals, departments Agriculture, Health, Livestock
Vision of CNRS-IPC on « One Health » approach
Mobilize and coordinate forces present in ASEAN to :
– develop our knowledge, particularly in the anticipation, early detection, containment and control of zoonoses, and in emerging diseases;
– understand the causes and the mechanisms behind emergences, resistance to antimicrobials, and the crossing of the inter-species barrier;
– analyze the consequences of the emergences on the ecological, social, political and economic outcomes.
New viruses identified in rats in SEA causing SARI in humans (IPC-CNRS)
Creation of a regional platform for research on communicable infectious diseases and emerging
pathogens in Southeast Asia
PROJECT OF INFRASTRUCTURE IMPLEMENTED IN
INSTITUT PASTEUR IN CAMBODIA
PR-ASIA
11 March 2013
Completed: end 2013
• To develop a competitive technical platform for the surveillance of emerging infectious diseases in Cambodia and in the SEA region
• To develop an integrated approach of new problematics in human and animal health within the « One Health » paradigm
• To increase the competitivity, efficacy, and innovation by fostering a multidisciplinary research (microbiology, clinic, ecology, environment, socio-economic, epidemiology) with external partners, and by offering an attracting scientific environment
• To develop the training capacity in all domains of infectious diseases
Missions of the PR-ASIA
• Laboratoires (including a BSL-2) for molecular biology, cell biology, immunology, microbiology for more than 40 researchers and technicians
• A biobank equiped with freezers and liquid nitrogen
Laboratory modules connected to IPC facilities
• Offices for researches in silico, modelization, anthropology, social and environmental sciences, data analysis
• Additional rooms in IPC (epidemiology Unit, Virology, Immunology)
420 m2, evolutionary
• Access to platforms of IPC (BSL-3, Animal facility, insectarium…)
A regional initiative on a major public health issue
SOUTHEAST ASIA ENCEPHALITIS PROJECT
A multidisciplinary and inter-organizational project
Encephalitis in Asia:
• Among the most frequent and severe causes of pediatric hospitalization
• Significant biodiversity hotspot particularly at risk for pathogen emergence (high interaction between humans and animals)
29 • SouthEast Asia encephalitis project BAD, July 2013
First pilot sites: Subsequently expanded to:
• Cambodia • Thailand • Laos • Indonesia • Vietnam • Other sites (China, Myanmar…)
Main and specific objectives
Improve clinical/microbiological diagnosis and medical care of children suffering from acute encephalitis syndrome
Identify unknown pathogens responsible for encephalitis cases
Document and analyze risk factors related to clusters of encephalitis cases through the “One Health” approach (human, animal and environment health)
Promote increased preparedness for emerging diseases by providing information to clinicians and public health stakeholders
The SEAe project aims to reduce
the morbidity and mortality associated to
infectious encephalitis in Southeast Asia
by improving diagnosis and medical care
for children
SOUTHEAST ASIA ENCEPHALITIS PROJECT
30 • SouthEast Asia encephalitis project BAD, July 2013
Conclusion/Discussion
Structure a cross-sectoral and multidisciplinary academic and applied research on zoonoses and EID to foster a regional strategic framework to build sustainable local and regional capacities and expertise to ensure public health security through surveillance, risk assessment, early detection and rapid response in SEA
Networking with local health, agriculture and environment authorities and international organizations in a coordinated fashion
Collaborate with clinical, institutional and academic partners
Offer a scientific and technological platform for hosting and connecting researchers and developing innovative, competitive and expert task force in the region
Complement existing networks on surveillance of, and response to EID (Focal IHR, WHOCC, GOARN etc.)