ASSOCIATION FRANCAISE ASSOCIATION FRANCAISE RAOUL FOLLEREAURAOUL FOLLEREAU

Support from the Association Support from the Association FranFranççaise Raoul Follereau aise Raoul Follereau

for Buruli ulcer controlfor Buruli ulcer control20052005--20062006

JehanJehan--Michel RONDOTMichel RONDOTDirector, Support and ProgrammesDirector, Support and Programmes

AFRF 1995AFRF 1995--2006 a 122006 a 12--year year partnership with Buruli ulcer controlpartnership with Buruli ulcer control

Since 1995 RaoulSince 1995 Raoul--Follereau has taken up a new challengeFollereau has taken up a new challenge

A bold, yet simple and pragmatic strategy, in keeping with A bold, yet simple and pragmatic strategy, in keeping with the recommendations of the WHO Advisory Group on the recommendations of the WHO Advisory Group on Buruli ulcer, and then of the TAGBuruli ulcer, and then of the TAG

Responding to requests from countries through partnershipResponding to requests from countries through partnership

A strategy that hinges on three A strategy that hinges on three complementary lines of action complementary lines of action

AA-- Improving patient case managementImproving patient case management

BB-- Support for researchSupport for research

CC-- Spreading knowledge and awareness Spreading knowledge and awareness

AFRF 2005AFRF 2005--20062006««you don't change a winning you don't change a winning

strategystrategy…… »»Considerable progress has been made in the last 5 Considerable progress has been made in the last 5 yearsyears

Even so, much remains to be done, as Even so, much remains to be done, as MMycobacterium ulceransycobacterium ulcerans has certainly not has certainly not revealed all its revealed all its ««secretssecrets»»

The immediate task is to consolidate what has The immediate task is to consolidate what has been achieved and to give priority to meeting been achieved and to give priority to meeting patients' needspatients' needs

AA-- Support for case managementSupport for case management

Our efforts are mainly focused on two Our efforts are mainly focused on two countries where the disease is endemic, countries where the disease is endemic, Côte Côte dd’’IvoireIvoire and and BeninBenin, which have for many , which have for many years been partners in our leprosy control years been partners in our leprosy control efforts.efforts.

Since 2005, AFRF has also been active in Since 2005, AFRF has also been active in the Republic of the Congo in support of the the Republic of the Congo in support of the work of the new PNLUBwork of the new PNLUB

In Côte d'Ivoire: In Côte d'Ivoire: continuingcontinuing ourourworkwork in in uncertainuncertain circumstancescircumstances

The The Raoul FollereauRaoul Follereau Institute in Institute in AdzopAdzopéé (IRF) (IRF)

Our support was exclusively earmarked for the IRF in Our support was exclusively earmarked for the IRF in AdzopAdzopéé, a hospital run by the Ministry of Health, a hospital run by the Ministry of Health

In 1999, AFRF signed an agreement with the Ministry of In 1999, AFRF signed an agreement with the Ministry of Health to finance Health to finance ««case managementcase management»» of 200 Bu patients at of 200 Bu patients at the IRF Adzopthe IRF Adzopéé Manikro.Manikro.

Since that date, it has provided drugs, reagents and Since that date, it has provided drugs, reagents and consumables worth 115 000 euros each year.consumables worth 115 000 euros each year.

Today, the grave crisis besetting Côte dToday, the grave crisis besetting Côte d’’Ivoire is having a Ivoire is having a dramatic impact on health programmes. Nevertheless, in dramatic impact on health programmes. Nevertheless, in very these trying circumstances, IRF has managed to keep very these trying circumstances, IRF has managed to keep its services running: in 2005, AFRF dispatched the its services running: in 2005, AFRF dispatched the required drugs and consumables.required drugs and consumables.

The Centre Demi Emile in The Centre Demi Emile in AngrAngréé, Abidjan, Abidjan

Since 2005 we have been providing Since 2005 we have been providing assistance in the form of drugs for this assistance in the form of drugs for this centre which is run by Father Marcocentre which is run by Father Marco

The Centre, which has been The Centre, which has been ««relocatedrelocated»» on on account of the division that has split Côte account of the division that has split Côte d'Ivoire, continues to provide case d'Ivoire, continues to provide case management for patients from all over the management for patients from all over the country in the southcountry in the south

In Congo along with leprosy, Buruli ulcerIn Congo along with leprosy, Buruli ulcer

2005 saw the beginning of a new form of 2005 saw the beginning of a new form of cooperation between the Congolese Ministry of cooperation between the Congolese Ministry of Health's recently established PNLUB and AFRF, Health's recently established PNLUB and AFRF, which was invited to become a partner. which was invited to become a partner.

Our support, which is both financial and material, Our support, which is both financial and material, is used to build up the capacity of the national is used to build up the capacity of the national PNLUB coordinating office.PNLUB coordinating office.

It is also used to provide case management for BU It is also used to provide case management for BU patients in the region of Pointe Noire, where the patients in the region of Pointe Noire, where the disease is endemic and which has been assigned disease is endemic and which has been assigned priority.priority.

In order more precisely to determine the In order more precisely to determine the terms of our collaboration, Dr Augustin terms of our collaboration, Dr Augustin GuGuééddéénon, the Association's Medical non, the Association's Medical Adviser, made an evaluation mission to Adviser, made an evaluation mission to Brazzaville. After this, the national Brazzaville. After this, the national coordinator in Congo made a study mission coordinator in Congo made a study mission to Cotonou to benefit from the experience to Cotonou to benefit from the experience garnered in Benin (a fine example of garnered in Benin (a fine example of south/south synergy and cooperation)south/south synergy and cooperation)

In Benin, AFRF In Benin, AFRF –– a partner of a partner of MoH and of PNLUBMoH and of PNLUB

Help in running the PNLUB coordinating officeHelp in running the PNLUB coordinating office

CapacityCapacity--building for the benefit of the National building for the benefit of the National Mycobacterial Reference Laboratory LNRMMycobacterial Reference Laboratory LNRM

Support for the CDTUB, which lie at the heart of Support for the CDTUB, which lie at the heart of the national system.the national system.

CDTUB PobCDTUB Pobèè

The The ««Raoul et Madeleine FollereauRaoul et Madeleine Follereau»» Centre for Detection Centre for Detection and Treatment of Buruli Ulcer was officially inaugurated and Treatment of Buruli Ulcer was officially inaugurated in April 2004in April 2004

The PobThe Pobèè Centre, which is an integral part of PNLUB, Centre, which is an integral part of PNLUB, represents AFRF's response to a request by the represents AFRF's response to a request by the Government of Benin, and is designed to complete the Government of Benin, and is designed to complete the national network so that it offers nationwide coverage.national network so that it offers nationwide coverage.

The Centre has: 4 wards (26 beds) , an outpatient The Centre has: 4 wards (26 beds) , an outpatient consulting room, an operating theatre and a laboratoryconsulting room, an operating theatre and a laboratory

After having built and equipped the centre, RaoulAfter having built and equipped the centre, Raoul--Follereau bears the full operating costs.Follereau bears the full operating costs.

Dr Annick Chauty is responsible for running the centre; Dr Annick Chauty is responsible for running the centre; both administrative and medical management are in the both administrative and medical management are in the hands of Dr Chauty and her team.hands of Dr Chauty and her team.

In 2005, 284 cases of Buruli ulcer were treated at the In 2005, 284 cases of Buruli ulcer were treated at the centrecentre

In line with the recommendations of WHO, prevention of In line with the recommendations of WHO, prevention of disabilities has been integrated into the centre's activities; disabilities has been integrated into the centre's activities; the first step was the recruitment of a physiotherapist and the first step was the recruitment of a physiotherapist and provision of the first items of equipment; the initial results provision of the first items of equipment; the initial results are already very encouraging. are already very encouraging.

GbGbéémontin Centremontin Centre

The The GbGbéémontin montin Centre at Zagnanado in ZouCentre at Zagnanado in Zou

Run by sister Julia, it was the first centre in Benin and the Run by sister Julia, it was the first centre in Benin and the forerunner of the commitment we have made. forerunner of the commitment we have made.

The centre's activities are diverse, although case The centre's activities are diverse, although case management of Buruli ulcer patients is still very important. management of Buruli ulcer patients is still very important.

For 12 years AFRF has been making a regular contribution For 12 years AFRF has been making a regular contribution to the operation of the centre, in the form of drugs and to the operation of the centre, in the form of drugs and medical consumables. medical consumables.

In 2005, the centre treated some 300 BU patients.In 2005, the centre treated some 300 BU patients.

Lalo CDTUBLalo CDTUB

At the request of Benin's Ministry of Public At the request of Benin's Ministry of Public Health, since 1 January 2005 we have been Health, since 1 January 2005 we have been helping to the run this centre. helping to the run this centre.

Lalo Lalo CDTUB is located in Mono Couffo CDTUB is located in Mono Couffo

it has 40 beds for patients it has 40 beds for patients

150 BU patients were treated there in 2005150 BU patients were treated there in 2005

BB-- Support for research Support for research programmesprogrammes

Since 1995, AFRF has been funding research programmes Since 1995, AFRF has been funding research programmes whose aim, through a better understanding of MU, is to whose aim, through a better understanding of MU, is to prevent and treat the disease.prevent and treat the disease.

The programmes include The programmes include ««studies of studies of MuMu ecologyecology»» and and ««therapeutic trial of aminosidetherapeutic trial of aminoside--rifampicin association to rifampicin association to treat clinical lesions caused by treat clinical lesions caused by MuMu infections infections »», carried out , carried out by by Pr Carbonnelle and Laurent Marsollier at Angers Pr Carbonnelle and Laurent Marsollier at Angers Medical Faculty. (2002Medical Faculty. (2002--2003)2003)

««GenomeGenome analysisanalysis»» by Pr Stewart Cole Institut Pasteur, by Pr Stewart Cole Institut Pasteur, Paris Paris

..

This research has opened up new paths, and This research has opened up new paths, and AFRF has continued to support researchers AFRF has continued to support researchers over the years, as it has high hopes of both over the years, as it has high hopes of both simplifying treatment and improving simplifying treatment and improving diagnosis and even prevention.diagnosis and even prevention.

In 2005, In 2005, €€229 000 were spent on research 229 000 were spent on research programmes on programmes on Mycobacterium ulceransMycobacterium ulcerans..

CC-- Disseminating information Disseminating information and raising awarenessand raising awareness

In conjunction with WHO, AFRF has paid for the French In conjunction with WHO, AFRF has paid for the French language versions of BU documentation at a total cost of language versions of BU documentation at a total cost of 60 000 euros. 60 000 euros.

In 2005, it paid for the French version of the documentary In 2005, it paid for the French version of the documentary ««Buruli ulcer: Education is the keyBuruli ulcer: Education is the key»» at a cost of $5000at a cost of $5000

The manual on Prevention of Disability in Buruli Ulcer, at The manual on Prevention of Disability in Buruli Ulcer, at a cost of $10 000a cost of $10 000

It is keeping up its effort to inform and educate the French It is keeping up its effort to inform and educate the French public about this poorly known disease. Its publications public about this poorly known disease. Its publications and annual meetings are used as an opportunity to put out and annual meetings are used as an opportunity to put out messages which catch the attention of the media.messages which catch the attention of the media.

It covers part of the cost of publishing an printing It covers part of the cost of publishing an printing the the «« Bulletin de lBulletin de l’’ALLFALLF »» many of whose pages many of whose pages are dedicated to the effort to control are dedicated to the effort to control Mycobacterium ulceransMycobacterium ulcerans infectioninfection

There is no doubt that these efforts as a whole, There is no doubt that these efforts as a whole, together with those of each one of us, have led to together with those of each one of us, have led to the development of a genuine awareness at the the development of a genuine awareness at the national and international levels. Nowadays, the national and international levels. Nowadays, the disease is something less of a disease is something less of a «« mysterymystery »» and and somewhat less somewhat less ««neglectedneglected»»..

Overview and prospects : Overview and prospects :

Major progress has been made in only a short Major progress has been made in only a short period; the studies under way are promising, period; the studies under way are promising, although there are still many uncertainties about although there are still many uncertainties about Mycobacterium ulceransMycobacterium ulcerans..

This makes it all the more important for us to This makes it all the more important for us to consolidate our achievements and to press ahead consolidate our achievements and to press ahead with research. with research.

Better case management and control Better case management and control of Buruli ulcerof Buruli ulcer

one of the primary objectives is to simplify one of the primary objectives is to simplify medical treatment. medical treatment.

investigations also have to be continued in investigations also have to be continued in order to make diagnosis easier.order to make diagnosis easier.

Consolidation of our achievements is the Consolidation of our achievements is the responsibility of the national programme responsibility of the national programme directors, who are responsible for directors, who are responsible for implementing the strategies adopted.implementing the strategies adopted.

The Association The Association FranFranççaiseaise RaoulRaoulFollereauFollereau can assure them of its can assure them of its willingness to help and its commitment willingness to help and its commitment to fostering the necessary coordination of to fostering the necessary coordination of their their programme's programme's partners at the national partners at the national level.level.