Opinion column: "Infectious diseases and epidemics: science and health threatened by US isolation"

News emerging from the United States is causing growing concern within the international scientific and medical community. After the withdrawal of the United States from the World Health Organization (WHO), the freezing of the budgets of the major US public health and research institutions, the suspension of USAID (United States Agency for International Development) development aid programs, and the restrictions imposed on the PEPFAR (President’s Emergency Plan for AIDS Relief), cooperation between researchers and scientific progress are under serious threat. Additionally, censorship affecting fundamental principles of equity, diversity, and inclusion, and crucial topics such as climate change is now evident in official U.S. documents.

In this context, the scientific community of the ANRS Emerging Infectious Diseases (French national agency for research on AIDS and emerging infectious diseases – ANRS MIE), an Inserm agency and key institution in the fight against endemic and emerging infectious diseases, stands in solidarity with its American counterparts and with all the researchers concerned. It also expresses its grave concern about the potential consequences of this unprecedented situation on global health.

Peter Agre (Nobel Prize in Chemistry, 2003) has noted that international collaboration is essential not only for scientific progress but for the future of humanity. No country, no matter how powerful, can address today’s global challenges alone. These collaborations have led to considerable results both in the acquisition of new knowledge and in the improvement of public health, in the richest countries as well as in those with low or intermediate resources, particularly in the field of HIV/AIDS and communicable diseases.

The United States is a major funder of scientific research (the NIH – a US government institution responsible for biomedical research – allocated $3.3 billion USD for HIV/AIDS research alone in 2023) and is one of France’s key partners. By joining forces, American researchers and French teams from the ANRS MIE have made major advances, such as demonstrating the effectiveness of antiretroviral prevention of mother-to-child transmission of HIV, anti-tuberculosis treatments, particularly for patients living with HIV, and, recently, pre-exposure prophylaxis (PrEP) to prevent HIV infection. Thanks to these breakthroughs, the prevention of mother-to-child transmission of HIV has become the international standard, WHO recommendations for the treatment of tuberculosis have been adapted, and many countries have now integrated PrEP into their prevention strategies. Collaboration between the NIH and Inserm has also demonstrated the effectiveness of vaccines against Ebola virus disease in West Africa in the midst of a health emergency.

Recent epidemic crises, like Covid-19, remind us that science, innovation and cooperation are our best assets for saving lives. Today, close partnerships between American, French, and other international scientists contribute to pandemic preparedness and response. Recent US policy decisions jeopardize these essential scientific links precisely when global cooperation is most needed to combat emerging infectious diseases, including those threatening the US. Current risks include pathogens like the H5N1 virus, which causes the flu epidemic in the United States, mpox and Ebola; they require rigorous surveillance and total transparency to anticipate their potential international spread.

The health challenges, particularly pandemics, that the world will face require a coordinated global response, with the United States playing a crucial role. Scientific research is a common good that transcends political boundaries. The interruption of exchanges between researchers, restrictions on funding, and the exclusion of certain scientific communities and civil society representatives will undoubtedly have profound consequences for global public health.

Beyond the shock caused by the U.S. government’s decisions, it is imperative to rethink the framework of international cooperation in global health. This crisis highlights the reliance of low- and middle-income countries on the United States. Strengthening their autonomy is now a critical priority. Europe has an essential role to play, by fully committing itself to ensure its leadership and forge the necessary intercontinental alliances.

Signatories:

Read Le Monde’s opinion column here.

Find below the complete list of signatories of the opinion column published in Le Monde:

• Francoise Barré Sinoussi, Nobel Prize in Medicine 2008
• Didier Samuel, Inserm Chairman and Chief Executive Officer
• Yasmine Belkaid, President of Institut Pasteur Paris
• Isabelle Richard, Chair of the Board of Directors of ANRS MIE*
• Valerie Verdier, Chairman and Chief Executive Officer of French Institut de Recherche et développement (IRD)
• Yazdan Yazdanpanah, Director of ANRS MIE
• Francois Dabis, former Director of ANRS
• Jean Francois Delfraissy, former Director of ANRS
• Michel Kazatchkine, former Director of ANRS
• Nathalie Bajos, President of French National AIDS Council
• Nathalie Arhel, CNRS (Centre national de la recherche scientifique)
• Maryline Bonnet, IRD
• Éric Delaporte, IRD
• Alpha Diallo, ANRS MIE/Inserm
• Eric Dortenzio, ANRS MIE/Inserm
• Karine Lacombe, Saint Antoine University Hospital, Paris
• Vincent Leclercq, General Director of Coalition Plus
• Jean-Michel Molina, Paris-Cité University
• Michaela Muller Trutwin, Institut Pasteur
• Ventzislava Petrov Sanchez, ANRS MIE/Inserm
• Hervé Raoul, ANRS MIE/Inserm
• Yves Souteyrand, ANRS MIE/Inserm
• Camille Spire, President of AIDES
• Florence Thune, General Manager of Sidaction