In addition to Covid, which has already killed 15 million patients worldwide, what threats should we prepare for the health of the future? This is the main point of the Covid World Summit organized this Thursday, May 12, two years after the outbreak of the pandemic caused by the coronavirus that appeared in Wuhan, China. World health authorities will try to measure how well we are or are not prepared for pandemics. ” The topexplain the organizing countries under the aegis of the United States, we will redouble our collective efforts to end the acute phase of the Covid-19 epidemic and prepare for future health threats “.
What has the coronavirus taught us and, above all, what could the next health threats be? As the United States, Germany and Senegal, who co-chaired this summit, point out: ” We know that we must prepare now to build, stabilize and finance the global capacity we need, not only in the face of Covid-19 variants but also in the face of other health crises. “. The networks created to monitor emerging diseases and new viruses have already been reactivated. But the questions remain. Why was this new virus not isolated and how did it spread for more than a month? Without a doubt, the alert would have been faster if CoV-2 had emerged in a country concerned about informing its neighbors about the health risks. Despite a new atypical pneumonia in December 2019, the disease was not contained quickly enough in Wuhan. This led the United States to question the China’s influence on the World Health Organization, which was slow to raise the alert among the first cases in December and to publish its January 2020 statement. Do you guarantee that the WHO will be more independent from the states that finance it and more reactive next time? The issue will not be left unaddressed during this new summit.
What are the next health risks?
Participants will also discuss the health risks we may face in the coming years. After carefully ignoring the warnings of epidemiologists for twenty years, Western states have come to understand the importance of preparing for the next microbial attack. The most classic risks are known: a bad bird flu passing from birds to humans (as has just been detected in China) or perhaps a future variant of Covid more unpleasant than those of the Omicron line. Less publicized, multi-resistant bacteria to antibiotics and arboviruses carried by exotic mosquitoes are also part of the major health problems.
The End of the Antibiotic Miracle
On resistant bacteria, the latest figures published in the medical journal The Lancet are frightening. According to several researchers gathered on the subject around scientists at the University of Washington, five million people died from bacterial infections of this type in 2019… deaths per year. Ten years ago, the emergence of bacteria resistant to the main antibiotics sounded the alarm. These microbes that have found ways to evade our defensive weapons are linked in particular to the misuse of antibiotics.
” In some countries, it is prescribed at the slightest symptom, without guaranteeing by an antibiogram that it is a bacterial infection, confirms Évelyne Jouvin-Marche, research director at Inserm. We also suffer from the overuse of antibiotics on farms. France, which was not virtuous, reduced this consumption with plans ecoantibio 1 and 2. But some are more advanced, such as northern European countries and Great Britain, which reversed the progression curve of antibiotic resistance. Today, we need to carry out studies to fully understand the mechanisms of resistance and their causes.. »
In 2020, the French Ministry of Health has set a goal of reducing the consumption of antibiotics by 25% by 2024. The State has established a priority program for research on antibiotic resistance coordinated by Évelyne Jouvin-Walk.
Of course, the solution seems to be creating new, unknown antibiotics for resistant bacteria. But the laboratories have reduced their investments in these products. ” When a new antibiotic is placed on the market, it is first reserved for the hospital setting for the most affected patients. As often noted, bacteria will eventually adapt to these new molecules and become resistant. Between the prices charged and the duration of patents, the production of new antibiotics has become unprofitable for the pharmaceutical industry.. »
In France, Toulouse Antabio’s biotechnology is leading an antibiotic resistance research consortium to create a new antibiotic, two diagnostic software and suitable economic models. This Arpege project brings together bioMérieux, the Hospices Civils de Lyon and the Toulouse School of Economics (University of Toulouse). It received 9 million euros from the Investments for the Future Programme. In the UK, the government is innovating to pressure big pharma to relaunch antibiotic development. He is negotiating an agreement with the Pfizer laboratory and Japan’s Shionogi to guarantee the supply of antibiotics to the country.
Another alternative: phage therapy, which consists of using viruses that are safe for humans but deadly for resistant bacteria: phages. This way of treating viral infections has long been despised in France, all too happy with the miracle of antibiotics. Today, he returns to the front of the stage while generating very little resistance. French biotechnology specializing in phage therapy Pherecydes Pharma works particularly on the multiple resistances of the E. Coli bacterium. In Lyon, a team from the CRIOac infection reference center is also developing this alternative as part of the PHAGEinLYON project.
Arboviruses from Ecuador to the West
At the top of the health hazards list: arboviruses. These mosquito-borne yellow fever or dengue viruses can develop here under the effect of global warming. According to experts, a real pandemic in the world is unlikely. In addition to dengue, arboviruses need what are called “reservoir animals” to grow, which are monkeys for this type of virus. That said, we already have a mosquito that serves as a taxi for these viruses in Europe, explains Anna-Bella Failloux, head of the Arbovirus and Insect Vectors unit at the Institut Pasteur. ” The tiger mosquito is competent to transmit yellow fever, dengue, Zika or chikungunya viruses. He arrived in Albania in 1979 and moved to Italy in 1990 before settling in France in 2004. But in Europe, this type of infection always comes from imported viruses. A tourist returning from a trip or coming to France after being infected may be bitten by a tiger mosquito. The insect collects the virus that it will pass on to the next person it bites. Since establishing itself in Europe, arboviruses have circulated a little in the south of France, but contamination remains very limited.»
Regarding the danger, dengue and yellow fever can be fatal, while zika seriously damages the brain of infected newborns. Chikungunya leaves sufferers with joint pain for quite a while. For these diseases, the dengue vaccine offers little protection with annoying side effects, and the yellow fever vaccine is very complicated to produce. Currently, Valneva biotechnology is the most advanced in the development of a vaccine against chikungunya. If Sanofi had stopped the Zika vaccine in 2017 in the face of a drop in US Army funding, Moderna announces that it is embarking on the development of an RNA vaccine against this virus.
Finally, although the origin of the coronavirus-19 is not yet clearly defined, there remains another danger. ” The big risk that no one talks about is that of a pandemic from a laboratory accidentsays epidemiologist Renaud Piarroux. The more viruses that are manipulated and modified, the greater the risk of a pandemic emerging. These manipulations are risky activities and their oversight remains fallible. In 2004, an institute responsible for monitoring the quality of laboratory work made a mistake by sending an H2N2 virus that had not circulated since 1968 for diagnosis in place of a much less dangerous one. A mishandling could have put it back in circulation. This type of accident can happen with these pathogens with pandemic potential, known as PPPs. Dealing with them is not as safe as nuclear activities, although they can be just as dangerous as…“Today, the transfer of infectious material is better supervised, especially in France. But viruses playing with borders, it is difficult to guarantee zero risk beyond.