Nearly 40 years ago, Dr. Charles Mérieux, chairman of the Mérieux Foundation, and Prof. Jacques Monod, director of the Institut Pasteur, decided to address the inaccessibility of vaccines in Africa. They asked Philippe Stoeckel, who had previously worked for Dr. Mérieux and was then a student at the Institut Pasteur, to develop a project to deal with the issue. That’s when Stoeckel came up with the idea for the nonprofit organization Agence de Médecine Préventive, or AMP.
With funding primarily from the Foundation Mérieux and the French Ministry of Cooperation, AMP set up shop in Bobo-Dioulasso, Upper Volta (now named Burkina Faso) in 1972. The objective was to create a regional office to facilitate work in the eight Francophone member countries of the Organisation de Coordination et de Cooperation pour la Lutte Contre les Grandes Endemies (OCCGE): Benin, Burkina Faso, Cote d’Ivoire, Mali, Mauritania, Niger, Senegal, and Togo.
Off to a Strong Start: Strengthening Immunization Systems and Strategies (1970s)
The early mission of AMP was to enhance vaccine delivery and the diagnosis of infectious diseases. Working in close collaboration with the OCCGE, AMP focused on improving sample collection for laboratory diagnosis of yellow fever, monkeypox, cholera, measles, and meningococcal meningitis.
Very quickly, the organization expanded its focus from surveillance to clinical trials and effectiveness studies. By the end of the 1970s, AMP was heavily involved in the development and testing of two vaccines in particular: meningococcal polysaccharide vaccine, groups A and C, and enhanced inactivated polio vaccine (eIPV). The development of the latter was done in collaboration with Dr. Jonas Salk, Dr. Charles Mérieux, and Dr. Hans Cohen. To facilitate their work, they created the Forum for the Advancement of Immunization Research (FAIR), for which AMP acted as Secretariat.
Partnering Up to Improve Vaccine Coverage and Health Services (1980s)
In the following decade, AMP worked with UNICEF, WHO, and other partners to develop the Universal Child Immunization (UCI) initiative (launched by UNICEF Executive Director James Grant) in West Africa, notably Burkina Faso.
At this time, the need to train local health workers in epidemiology became clear. AMP partnered with the U.S. Centers for Disease Control and Prevention (CDC) in 1983 to develop applied epidemiology in France and French-speaking Africa. This resulted in the creation of the Institute for the Development of Applied Epidemiology (IDEA), which offered training to both French and African health professionals.
Expanding Presence, Growing Impact (1990s)
The 1990s were a turning point for immunization and AMP. The 4th International Seminar on Immunization in Africa—organized by AMP in Yamoussoukro, Cote d’Ivoire in 1994—highlighted concerns about safety of injections, effectiveness of immunization, health economics, and sustainability of immunization. As a result, AMP expanded its activities to focus on these areas, creating, for example, the EPIGEPS training program in epidemiology and health management.
Near the end of the decade, AMP got involved with the William H. Gates Foundation, PATH, and other partners to establish a strategic sustainable alliance for immunization that would become the Global Alliance for Vaccines and Immunisation (Gavi, the Vaccine Alliance) in 2000.
2000s: New Opportunities in a Changing Global Context
The 2000s were marked by increased global attention to public health and immunization, creating new momentum for AMP and others to support Expanded Programs on Immunization (EPIs) worldwide. AMP continued to collaborate with a diverse range of industry actors, bridging the gap between the public and private sector.
In 2002, AMP developed the EPIVAC® on-the-job training program in applied vaccinology and health management. Targeted mainly at district medical officers in sub-Saharan Africa, the master’s degree program aims to improve immunization program performance in participating countries. Since 2007, graduates and program partners can stay in touch thanks to the EpiVac.net network, which promotes knowledge and experience sharing across sub-Saharan Africa.
The 2000s also marked the deployment of the first LaboMobil® in Burkina Faso in 2002. An all-terrain vehicle, the LaboMobil® is a complementary tool for national reference laboratories that provides support for microbiological analysis of epidemic and infectious diseases, especially acute bacterial meningitis.
In the late 2000s, AMP was awarded Bill & Melinda Gates Foundation grants in support of EPI goals, including: “SIVAC” to create or strengthen National Immunization Technical Advisory Groups (NITAGs) in Gavi-eligible and middle-income countries (except the Americas); “Africhol” to improve cholera surveillance and prevention in Africa; and “ADVIM” to enhance advocacy for immunization financing in Benin, Burkina Faso, and Côte d’Ivoire.
2010s: Strengthening Immunization and Health Systems
In the 2010s, AMP has continued to support countries to strengthen their health and immunization systems to deliver both routine EPI vaccines and various new vaccines entering the market.
With epidemiological research remaining a key activity, AMP has led multiple studies and authored peer-reviewed scientific articles on acute bacterial meningitis, pneumococcal and Hib pneumonia, yellow fever, pertussis, polio, influenza, cholera, and rotavirus, examining issues like burden, vaccine impact, vaccine costing and financing, surveillance, and adverse events following immunization.
A significant multi-year surveillance study is “PneumoTone,” launched in 2010 in collaboration with the Togolese government. Using data from the Tône district of northern Togo, it has provided the first population-based estimates of pneumonia burden in the African meningitis belt. Its second and current phase includes surveillance of pneumonia among adults and evaluation of PCV13 vaccine impact among children. Complementing this study is an evaluation of 13-valent pneumococcal conjugate vaccine immunogenicity among children in Burkina Faso conducted with GCP standards; results from this study will inform decisions on the best vaccine schedule for children in the meningitis belt.
AMP’s health logistics program played a key role in “LOGIVAC,” a joint AMP-WHO project launched in 2011. LOGIVAC has contributed to the development of the first-ever French-language bachelor’s degree in health logistics; the creation of a regional reference / resource center; the implementation of a logistics demonstration site in Comé, Benin; and there-design of Benin’s vaccine delivery system,now considered a model for the region.
As part of mission funding awarded by Gavi during 2013, AMP now works closely with five African countries – as well as WHO and UNICEF – to provide technical support for new vaccine introductions and immunization coverage improvement. Another recent project with Gavi is “Bobo-PREP” (Bobo-Dioulasso Pneumococcal Research and Evaluation Program), which aims to evaluate PCV13 impact in the region of Bobo-Dioulasso, Burkina Faso.
AMP’s Health Economics and Medical Anthropology program received a grant from the Meningitis Vaccine Project which it used to pioneer an assessment of individual household costs and the importance of vaccine for household finances, in this case use of MenAfriVacTM to prevent serogroup A meningococcal meningitis. Subsequently, AMP received funding from the Bill & Melinda Gates Foundation to assess the costs of meningitis surveillance (to help support MenAfriVacTM vaccine monitoring) and to evaluate immunization costing and financing in West Africa.