2023-09-07 08:15:25
In 2022, infectious diseases remained center stage. To better prevent and combat these pathologies, Inserm – through the thematic institute Inflammation, immunology, infectiology and microbiology and the ANRS | Emerging infectious diseases – has made many efforts in France, both in terms of understanding pathologies and treatments as well as diagnostics.
An article to be found in Inserm’s 2022 activity report
If the Covid has started to “normalize”, with a gradual lifting of health restrictions in 2022, at Inserm, research on this infection and other emerging and re-emerging infectious diseases has not slowed down… Remember that a disease is said to be “emerging” if it has never been reported by a health authority or if it is due to the evolution of a pathogenic agent already referenced. A re-emerging pathology corresponds to an identified disease which experiences a sharp increase in its prevalence or which occurs in a new region. Over the past 50 years, the rate of appearance of epidemics linked to these diseases has greatly accelerated.
At Inserm, research on these pathologies is coordinated by its dedicated agency: the ANRS | Emerging infectious diseases (ANRS | MIE). Created on January 1, 2021, it was born from the merger of two structures: the National Agency for Research on AIDS and Viral Hepatitis (ANRS) – which piloted research in these fields for 32 years, then also on other sexually transmitted infections and tuberculosis – and the consortium of multidisciplinary teams and laboratories REACTing – which since 2013 has been coordinating French research on emerging infectious diseases (Ebola, Zika, Covid-19, etc.). Installed since February 2022 at the ParisSanté Campus, “ the ANRS | MIE’s mission is to coordinate, lead and finance research on infectious diseases targeted until now by the ANRS and REACTing », says Yazdan Yazdanpanah, director of the agency.
A new dynamic of support for research on emergences
In practice, the ANRS | MIE works closely with several other public agencies involved in the field of emerging infectious diseases, including Public Health France, responsible for carrying out health monitoring at the national level. All this in conjunction with the Health Risk Monitoring and Anticipation Committee (Covars), successor to the Covid Scientific Council formed in March 2020 to deal with the pandemic. Set up in September 2022 and directed by Brigitte Autran, Emeritus Researcher in an Inserm unit in Paris, “ Covars is a health monitoring and alert structure that not only monitors Covid, but also all major health risks, linked to infectious agents, environmental and food pollutants, or climate change (pesticides, floods …) », develops Rémy Slama, director of the public health thematic institute of Inserm and member of Covars, alongside 18 other scientists, more than half of whom work in Inserm laboratories.
To carry out its missions, the ANRS | MIE benefited in 2022 from an envelope of 73 million euros, once morest 40 million for the former ANRS. ” It was important to increase our overall budget to cover actions relating to emerging infectious diseases without drawing on the funds historically allocated solely to infections targeted by the former ANRS (HIV, hepatitis, etc.). insists Yazdan Yazdanpanah. To meet this challenge, the ANRS | MIE was able to count on a new, very ambitious funding mechanism: one of the Priority Research Programs and Equipment, centered on emerging infectious diseases (MIE PEPPER) and endowed with 80 million euros for three to five years. Coordinated by Inserm through the agency, ” this program is part of a national acceleration strategy designed to help France prepare for and respond quickly to potential major health crises to come. It finances research intended to increase knowledge of emerging infectious agents and the mechanisms by which they affect health, to identify new therapeutic targets likely to lead to new drugs, or to develop vaccines and diagnostic tools. », explains Hervé Raoul, deputy director of the ANRS | MIE.
Covid, still a priority for Inserm research
In 2022, Inserm and ANRS | MIE have carried out various such works, targeting several specific diseases. Foremost among these: the Covid. Because if the pandemic has weakened, “ we are not immune to the appearance of new variants which might prove to be more dangerous than Omicron », points out Claire Madelaine, head of the Structuring support for research department, at the ANRS | MIE. One of the major challenges here is to maintain surveillance and research concerning the circulation and genetic evolution of the virus responsible for Covid, SARS-CoV-2, through sequencing. This is to detect the emergence and spatiotemporal distribution of variants, but also to better characterize them and their impact on public health. It is the purpose ofemerge. Launched in January 2021 and coordinated by Public Health France and ANRS | MY, “ this consortium was very active in 2022 observes Claire Madelaine. In close coordination with its surveillance activities, Emergen also develops and supports research projects. ” These are aimed in particular at estimating the transmissibility of the new variants detected as well as their pathogenicity, in particular their capacity to induce severe forms of the disease, and at evaluating the efficacy of treatments and vaccines as well as the possible appearance of resistance “says Claire Madelaine.
Another battle front for research Inserm and the ANRS | MIE, the long Covid remains a poorly understood disease, characterized by the persistence or appearance of symptoms more than three months following infection, compared to normally two to three weeks maximum. ” Thanks to a call for projects in two phases, launched in November 2021 then in February 2022, the ANRS | MIE has selected and then funded 27 research projects on this disease, for a total of nearly 10 million eurosrejoices Claire Madelaine. Many of them aim to better understand the epidemiology, the physiopathological mechanisms or even the social dimension of long Covid. Some aim to test interventions in order to improve patient care. »
Monkeypox, the other threat that has mobilized
But in 2022, another emerging infectious disease caused concern in France: monkey pox, or mpox, due to the monkeypox virus. Lethal in around 3 cases out of 10,000 in 2022 according to the Pasteur Institute, this infection known since 1970 was until then mainly limited to West Africa and Central Africa. But from May 2022, it affected several thousand people in Europe and America. To respond quickly to this new threat, the ANRS | MIE has activated an emergency search program. ” In a few days, we brought together a group of experts to define the scientific priorities. And from June 2022, we launched a call for projects, which made it possible to support ten projects », explains Éric D’Ortenzio, Head of the Strategy and Partnerships Department of the ANRS | MIE. Among them: the Mosaic study planned in ten European countries, including France. Initiated in just a few weeks, it aims to collect data on symptoms and responses to treatment from patients treated by participating hospitals. With two major goals: to better understand this disease and better treat patients. In the meantime, there is an effective pre- and post-exposure vaccine, recommended for people at risk, and symptomatic treatments.
Finally, another major event in research once morest emerging infectious diseases at Inserm marked 2022: the selection of the Acceleration and Transfer Consortium for the Response to Emerging Infections and Threats (Catriem), following a call for projects from the France 2030 plan, which aims to catch up with France’s industrial backwardness. Supported among others by Inserm Transfert, the Institute’s subsidiary in charge of technology transfer and innovation, ” Catriem intends to boost high-potential innovation projects resulting from public research and move them towards industrial transfer, to enable their transformation into technologies at the service of society. “says Claire Madelaine.
So in 2022, far from weakening, the response to emerging infectious diseases at Inserm and ANRS | MIE remained very active. At the height of the hopes that carry it: better manage and anticipate the crises that might arise in the future.
Many international initiatives
Research on emerging infectious diseases does not stop at the borders of France! ” As the majority of emergences occur in Africa and Asia, it is essential to carry out actions internationally », insists Éric D’Ortenzio, head of the Strategy and Partnerships department at the ANRS | Emerging infectious diseases. Through its agency dedicated to these pathologies, Inserm is involved in several collaborations of this type. This is the case of Prevac-up, launched in 2017 and which published promising results end of 2022. Co-funded by Inserm, ANRS | MIE and the European Commission, it is evaluating the long-term safety and efficacy of two vaccines once morest Ebola, an infection fatal in 25 to 90% of cases, which has long been rife mainly in Central Africa before also affecting Africa West since 2013.
Still concerning Africa, the signing of a multi-party agreement involving, among others, Inserm and the ANRS | MIE, in May 2022 in Conakry, Guinea, acted the creation of an international research platform in global health (Prisme) devoted in particular to emerging infectious diseases. Its objectives: to develop research projects on these pathologies, to improve training in clinical research and to strengthen human, technical and scientific capacities in Guinea.
Another important example is the Integrate trial, which aims to assess for the first time on a large scale the safety and efficacy of different drugs once morest Lassa fever, a real scourge in the west of the African continent, which kills 15 20% of hospitalized patients. ” Planned on 200 patients for each of the treatments evaluated, the trial will begin in Nigeria at the beginning of 2024, before being extended to Liberia, Guinea and Benin. », specifies Éric D’Ortenzio.
On a European scale this time, the project Be Ready launched in September 2022 aims to create a partnership to improve the capacity of Member States to prepare for and respond to emerging infectious threats. Coordinated by ANRS | MIE and Inserm, ” Be Ready should make it possible to develop a response strategy to epidemics, at European level and not just at national level », indicates Hervé Raoul, deputy director of the agency. Enough to allow the European Union to better coordinate its efforts in the event of a new health crisis.
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