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La lutte antivectorielle en France

 | 
Didier Fontenille
, 
Christophe Lagneau
, 
Sylvie Lecollinet
, 
et al.

Tools for risk management and anticipation

Regional and international cooperation1

Texte intégral

  • 1 In this chapter, references to the CD-ROM concern question 11: “What regional and international co (...)

1Vectors, like pathogens, live or survive in biogeographical zones that make light of national borders. Species or populations with a particular phenotype (such as resistance to insecticide) are most often introduced from a neighbouring country. Vector surveillance and their control must therefore imperatively be organized at regional scale. Attempts to eradicate a vector in one country would be all in vain if the same vector infests a nearby country without hindrance.

2Similarly, early warning systems would be much more efficient if they were based on information collected at the scale of the whole region threatened by a particular risk. Regional and international cooperation gives the opportunity to share experience, even pool means in both logistics and training.

3In France, vector control is organized around four large regions: Antilles-French Guiana, Indian Ocean, the Pacific and the European continental.

COOPERATION IN THE ANTILLES-FRENCH GUIANA REGION

4The départements and local authorities concerned are Guadeloupe, Martinique, French Guiana, Saint-Martin and Saint-Barthelemy. Most of the vector control efforts are concentrated on Aedes aegypti and Culex (Culex quinquefasciatus). Surveillance mechanisms are also in place aiming at Anopheles, potential Plasmodium vectors, and the possible introduction of Aedes albopictus. However, the Phlebotominae, sandflies, and Triatominae, blood-sucking bugs, are not covered by any organized control service in French Guiana, although they are disease vectors. Control actions are sometimes conducted against ticks that feed off livestock.

Five départements and local authorities

5There is currently no formally organized collaboration between these départements and local authorities, either for surveillance, training, operational research or regular exchange of experience. Arrangements amount just to informal, although numerous, exchanges and some research projects (see CD-ROM). The recent setting-up of a surveillance plan PSAGE for dengue in each département is helping to improve things, depending on the level of seriousness of the epidemiological situation, but each département still keeps its independence. The problems encountered and the gaps observed in the French Départements of America (FDAs) have already been abundantly described in the literature (see the IRD expert group report “La dengue dans les départements français d’Amérique. Comment optimiser la lutte contre cette maladie?”, 2003.

6Some avenues would be worthwhile exploring for the future. Part of the training for managerial staff could, for example, be done through the Antilles-Guyane University on an interregional basis. In addition, the Interregional Epidemiology Unit (CIRE-AG) and the Health Watch Units of the DSDS (Department of Health and Social Development) take an active part in entomo-epidemiological surveillance, and in examining ways to ensure a better response to any incidence of dengue and to communicate information.

The neighbouring countries

7No real officially formalized relations with the neighbouring countries were observed either, whether it be with Brazil or Surinam for French Guiana, or with the other Caribbean islands for the FDAs. The dengue epidemic of 2005 nevertheless acted as a warning, but the recommendations made at the time have not been turned into concrete measures. Currently, cooperation schemes started with Brazil mainly concern epidemiological aspects. And nothing has yet been put in place with Surinam on dengue. However, data are exchanged on the surveillance of malaria cases and Surinam is in favour of homogenizing the anti-malaria strategy (for further details on the context of this joint effort, see the CD-ROM).

8The Mosquito Destruction Centre in Martinique engaged in a cooperation scheme some years ago on “the entomological aspects of dengue in the Caribbean”. This action was financed by the Regional Cooperation Fund (FCR) and aimed to produce a map of the typology of the main breeding grounds of Aedes aegypti and of the levels of resistance to insecticides used by the different national control teams. The Pasteur Institute of French Guiana and the Martinique Mosquito Destruction Centre occasionally run exchange activities with Haiti (mainly concerning malaria).

9Whatever the case may be, a real demand exists for exchange schemes on vector control among all the technicians involved in the Caribbean (including Cuba).

The veterinary field

10Various joint actions are run in the veterinary sphere to arrive at better collaboration between the different actors involved in entomological surveillance. One example from the Caribbean is the CaribVET network (Caribbean Animal Health Network). This jointly involves institutions and professionals whose aim is to improve animal health and the quality and safety of animal-derived products. It brings together veterinary laboratories, government agencies, research institutes, farmers’ associations, non governmental organizations (NGOs) and universities, mostly Caribbean, but also from North, Central and South America.

International institutions

11International institutions have also the mission to conduct operations in the Caribbean area, in both the public health sector and the veterinary field. This is the case of the Caribbean Community (CARICOM, a group of about 15 member-States plus five associate members), the Pan American Health Organization (PAHO, the WHO office for the American countries), the OIE, FAO, the French aid organization Coopération française (through the Agence Française de Développement – AFD – and the FCR), the European Union (the Interreg cross-border cooperation programme), the American aid programme (by way of USAID, the United States Agency for International Development) and the Canadian aid programme.

12These networks are not yet mobilized for vector control actions, but the situation could develop, particularly in te framework of the new IHRs.

COOPERATION IN THE SOUTH-WEST INDIAN OCEAN

13The French département of Reunion Island and local authority of Mayotte belong to the same region. In Reunion, most of the vector control effort is aimed at Aedes albopictus and Anopheles arabiensis, along with Culex quinquefasciatus as a subsidiary target. In the strictly veterinary sector, livestock ticks are not dealt with by any organized control actions. Sometimes control actions are conducted against the haematophage fly Stomoxys calcitrans. In Mayotte vector control is oriented against Aedes albopictus, Aedes aegypti, Anopheles gambiae and Anopheles funestus, and possibly against Culex quinquefasciatus. As in Reunion Island, nothing is done in the veterinary field.

14This zone of the Indian ocean includes Madagascar, the Islamic Republic of Comoros, Mauritius, the Seychelles and, in East Africa, Mozambique, Tanzania and Kenya. At present there is no network or formalized cooperation activity involving vector control. However, WHO has insisted several times on the need to set up a regional epidemic surveillance and response strategy, including vector surveillance and control. In 2006 the organization set up jointly with the Indian Ocean Commission (IOC) an epidemiological surveillance network on infectious diseases taking in five countries (Madagascar, Comoros Islands, Seychelles, Mauritius, France). Both WHO and IOC wish to develop this approach further.

15The information report on the chikungunya epidemic in Reunion Island and Mayotte, for its part, (the French National Assembly Committee for Cultural, Family and Social Affairs, July 2006) recommended continuation of the “strong political commitment towards the setting-up of a warning and surveillance system at the scale of the Indian Ocean”.

16One of the responses to this demand was the creation of the Centre for Research and Intelligence of Emerging Diseases in the Indian Ocean (CRVOI) which has been in operation since 2007. One of its first projects included the compilation of an inventory of the capacities, competence and centres of expertise in the countries of the south-west Indian Ocean, including such resources in medical entomology. Networks of expertise, training, for exchange of experiences could arise from this initiative, even given that it is aimed more at research than on operational aspects.

17There is practically no cooperation activity between Reunion and Mayotte (apart from some technical support missions in 2008). There are two main reasons for this: the control services in these two islands are very young; and the priorities decided at regional level are concentrated more on epidemiological surveillance than on vector control (for further details, see CD-ROM).

COOPERATION IN THE PACIFIC REGION

18In Wallis and Futuna the important vectors are Aedes aegypti and Aedes polynesiensis. The Wallis and Futuna Health Agency and the Territorial Environment Service carry out vector control.

19Most of the interrelations in the region are organized with French Polynesia and New Caledonia. Formal relations also exist with other communities of the Pacific, but they do not directly concern vector control. These links are manifest in two public health networks: Public Health Surveillance & Communicable Disease Control (PHS&CDC) and the Pacific Public Health Surveillance Network (PPHSN).

COOPERATION IN EUROPE

20The cooperation actions in Europe are organized through associations and professional societies rather than in common operational networks. The operators meet regularly during annual conferences of these associations or societies.

France

21France is a pioneer in mosquito eradication since the setting-up in the late 1950s of public organizations such as the EIDs. Three of these were created (EID Méditerranée, EID Atlantique and EID Rhône-Alpes), each gaining the benefit of acquired experience while developing its own expertise. The establishment of these organizations in turn helped generate the Agence Nationale pour la Démoustication et la Gestion des Espaces Naturels Démoustiqués, or “National Agency for Mosquito Destruction and Management of Natural Mosquito-controlled Areas” (ADEGE, see Box).

The ADEGE in brief
The ADEGE groups together the three EIDs plus other public entities: the SIVU, “Single-purpose intermunicipal body”, of Lauterbourg (Alsace), the Martinique Mosquito Destruction Centre and the Mosquito Eradication services of Corsedu-Sud.
The Association also maintains strong links with its Spanish, Catalan and especially Italian, partners. It offers a forum for consultation and working together on strategies, techniques, methods and tools suitable for mosquito destruction or vector control and the management of environments where mosquitoes have been eradicated. It is also a platform for those wishing to join in transverse projects. ADEGE is also the ideal relay organization for passing requests and proposals coming from elected representatives.
In parallel, it organizes jointly with the Centre National de la Fonction Publique Territoriale (CNFPT), “National Civil Service Centre”, regular or occasional training sessions for operational staff of the public mosquito destruction services. Discussions on technical aspects, or even lectures on relevant topics, also take place at different times. Field demonstrations or trials are sometimes organized, bringing together technicians from the EIDs to select the appropriate machines or equipment for treatment, and decide on spreading techniques and insecticides. The EID administrative staff meet now and again to discuss experiences and receive training on administrative regulations.

22It was ADEGE that was assigned by the Department of Health in April 1998 to set up a surveillance operation against the introduction of Aedes albopictus in metropolitan France. The agency also initiated, in May 1999, the association Emerging Diseases in a changing European Environment (EDEN), whose objectives and functioning are comparable. EDEN was highly active when the European directive 98/8/CE was brought into application, but has been mobilized little since then.

The veterinary field

23In this field, the MedReoNet network should be useful for improving the surveillance of disease transmitted by Culicoids (such as bluetongue disease, African horse sickness, haemorrhagic fever in deer). This concerted action, financed by the European Union, promotes the sharing and exchange of data, skills and knowledge, experience and information. Regular meetings are held to maintain and improve surveillance systems in Europe and thus bring the possibility of anticipating the risk of transmission. The partners are research institutes, veterinary services or national agencies involved in the surveillance and diagnosis of Culicoids-borne diseases.

Cooperation activities

24European and international scientific cooperation activities hinge on various aspects of vector control.

25Through these, spatial remote sensing tools have begun to find applications in this field. The CNES, the French government space agency, has for example set up bilateral cooperation schemes or other arrangements with international organizations (see the chapter “Research: a key to successful vector control”).

26The IRD, for its part, is engaged in a wide range of joint ventures on projects of operational research (on impregnated materials, repellents, genetic control and so on) with operations in South America (Argentina, Bolivia, Brazil) and in Africa (Benin, Burkina Faso, Cameroon, Togo).

27At European level, a call for proposals was issued in 2008 by the European Centre for Disease Prevention and Control (ECDC) for a review on the surveillance and control of vectors at the scale of the whole continent. Also worthy of note, as well as the EDEN association, is the European Mosquito Control Association (EMCA), set up on 28 march 2000 and bringing together 170 members from 19 European countries and 5 countries from outside Europe to work on the common scientific and technical objectives concerning vector control. As well as this, the scientific and technological actors who in common work on vector control meet every two years at the conference of the European branch of the Society of vector Ecology (SOVE), alternating with EMCA.

28Finally, joint operations are run with WHO, occasionally or at the time of epidemics, involving the organization’s European office. Also the French Department of Health is involved in an international network as French contact for the implementation of the IHRs, in force since June 2007.

RECOMMANDATIONS
Develop regional cooperation schemes (French-based but also with neighbouring countries) with the aim of improving vector surveillance and information exchange, but also to encourage and develop training.
Support the creation of regional centres of expertise and training (Indian Ocean, Caribbean, Europe) linked to a national centre (similar to a Vectopôle specialist vector centre).
Reinforce means of exchange between professional associations and set up interactive interfaces for information (forums on dedicated Internet sites, virtual documentation centres), on related topics: operational activities, distribution of potential vectors and so on.

Notes

1 In this chapter, references to the CD-ROM concern question 11: “What regional and international cooperation can be envisaged for vector control?”.

© IRD Éditions, 2009

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