ACTING TO REDUCE HEALTH INEQUALITIES

GIL CORRE

PRESS KIT

SUMMARY SANOFI ESPOIR FOUNDATION: ACTING TO REDUCE HEALTH INEQUALITIES #1

Christopher A.Viehbacher Chief Executive Officer of Sanofi

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Jean-François Dehecq President of the Sanofi Espoir Foundation

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Caty Forget Managing Director of the Sanofi Espoir Foundation

LONG-TERM PARTNERSHIPS TO IMPROVE THE HEALTH OF VULNERABLE COMMUNITIES #7

My Child Matters: improving survival rates for children with cancer in low-resource countries Cary Adams, Chief Executive Officer of the Union for International Cancer Control (UICC)

#11 Stand up for African Mothers: reducing maternal mortality in Africa Muriel Gavila, Managing Director of the African Medical and Research Foundation (AMREF)

#15 ENFAMS: Favoring access to health for homeless children and families

AMREF

Aline Delettrez, Resource Development and Communication Director of Samusocial de Paris

GIL CORRE

MEURA / MEDECIN S DU MONDE

SANOFI ESPOIR FOUNDATION: ACTING TO REDUCE HEALTH INEQUALITIES

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Promote access to health We have always had a comprehensive access to medicines programme but where the Foundation and Sanofi differ from others is that we realized a long time ago that the real challenge is access to healthcare itself. We work with our partners to find out what is really needed and develop programmes that will have a real impact on the health of those in most need. Vaccines and medicines are part of the approach, but equally education & awareness, training or finance to build capacity form an integral part of our initiatives. As a healthcare partner, we have the expertise and resources to make a real difference.

Christopher A. Viehbacher Chief Executive Officer of Sanofi

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SANOFI ESPOIR FOUNDATION: ACTING TO REDUCE HEALTH INEQUALITIES

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Medications alone cannot improve health in the most impoverished of countries. The creation of the Sanofi Espoir Foundation is the expression of our enduring commitment to improve access to healthcare for the world’s most in-need populations. For decades now, the various entities of the Sanofi Group have been supporting humanitarian actions by way of financial support, by making medicines and vaccines available to impoverished populations for free or at very low prices, or by providing emergency donations to catastrophe victims. With the Foundation, we are going further with this commitment by creating long-term partnerships focused on three priority areas of action: fighting childhood cancers in developing countries, reducing maternal and neonatal mortality, and improving access to care for the most vulnerable communities. We thus hope to ease access to care for the world’s poorest populations and contribute to the development of the countries where we act.

Jean-François Dehecq President of the Sanofi Espoir Foundation

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SANOFI ESPOIR FOUNDATION: ACTING TO REDUCE HEALTH INEQUALITIES

Questions for… »

Caty Forget Managing Director of the Sanofi Espoir Foundation

What principles guide the actions of the Foundation? We take action on issues that are being neglected and to which we can bring real, long-term benefits. In particular we seek to reduce maternal and infant mortality and improve access to health for the most impoverished populations. These commitments fall within the United Nations’ Millennium Development Goals and provide a framework for a collective, public-private dynamic. With our partners we seek to give impetus to this dynamic. We work hand-in-hand with our 43 main partners to accompany countries and regions in the creation and deployment of programs to improve access to healthcare. There are currently close to 60 programs underway.

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How are your actions translated on the ground? Our actions fall within a logic of multi-year engagements, as participative as possible, carried out in partnerships with NGOs, communities, health professionals and health authorities A program is considered a success when it genuinely improves access to health for the most impoverished populations, strengthens all levels of the care system, and, in the long-term, positively influences health policy.

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How do you measure the effectiveness of a program? This question is present from the beginning. When the program is still on the drawing boards, we define the objectives of the project with our partners, the actions to be implemented to attain the objectives, and the health indicators, social or economic, that will measure benefits for the concerned populations, healthcare stakeholders and ultimately healthcare policy. These indicators are also vital for establishing an exit strategy that will allow the action to carry on as long as possible. Evaluations are requested systematically when the project includes public partners such as the Agence Française de Développement or the European Union. We monitor impact criteria for all of the Foundation’s programs.

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SANOFI ESPOIR FOUNDATION: ACTING TO REDUCE HEALTH INEQUALITIES

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Today, what concrete results have your programs provided? My Child Matters, our program for fighting childhood cancers in low-income countries, increased two-year survival rates for leukemia from 16% to 68% at the Philippines Children’s Medical Center. Also thanks to My Child Matters, treatments for the poorest populations are now covered by the national healthcare system. In Africa, we currently have 7 programs underway to decrease maternal and infant mortality. Since 2010 these programs have resulted in the training of 1,350 midwives, nurses and physicians. One midwife can provide care to 500 women per year and indeed we will be intensifying the support for midwife training in the coming years. And finally for the third axis of the Foundation, access to care for the poorest populations, we are ocusing our attention not only on innovative reimbursement systems in developing countries but also on access to health in France, through, for example, our unprecedented survey on the

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AMREF

ASHIC FOUN DATION

TH RULL ELISABE

ONDE INS DU M / MEDEC

challenges faced by homeless families.

SANOFI ESPOIR FOUNDATION: ACTING TO REDUCE HEALTH INEQUALITIES

The Foundation in numbers (2012) » Established in 2010; five-year budget of €33.7 million.

Health policy support programs to accompany development:

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60 programs at end-of-year 2012, including 20 to fight childhood cancers in Asia, Africa and Latin America, 11 to reduce maternal and infant mortality, and 7 to strengthen structures and systems for access to healthcare by impoverished populations.

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43 main partners, including pediatric oncology units in southern countries, international organizations such as the Union for International Cancer Control (UICC) and UNICEF, and organizations and NGOs such as the African Medical and Research Foundation (AMREF), Care, the French Red Cross, Médecins du Monde, Samusocial, etc.

»

40 beneficiary countries.

Urgences humanitaires

»

8 countries (Haiti, Syria and Sahel countries: Chad, Niger, Mali, Cameroon, Senegal, Burkina Faso).

Donations of medicines and vaccines:

» »

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212,000 boxes of medications - 645,000 vaccine doses – value of €12 million 2.2 million beneficiaries in 31 countries

SANOFI ESPOIR FOUNDATION: ACTING TO REDUCE HEALTH INEQUALITIES

Board of Directors »

The Sanofi Espoir Foundation is led by a Board of Directors chaired by Sanofi Honorary President Jean-François Dehecq. The Board counts 15 members and meets twice a year to define major orientations, validate strategic projects over €200,000, and attest to the sound management of the Foundation.

» The College of the Founder’s Representatives Serge Weinberg, Chairman of the Board of Directors of Sanofi Christopher A. Viehbacher, CEO of Sanofi Jérôme Contamine, Executive Vice President, CFO Hanspeter Spek, President, Global Operations Gilles Lhernould, Senior Vice President, Corporate Social Responsibility Laure Thibaud, Senior Vice President, Communication Robert Sebbag, Vice President, Access to Medicines Caty Forget, Managing Director of the Sanofi Espoir Foundation

» The College of Staff Representatives Françoise Pierre, Project Manager - Foresight & Strategic Initiatives Division - Secretary

of the Group’s European work Cristina Moscardi, Director of Corporate Social Responsibility for the Latin America region

» The College of Qualified Individuals Jean-François Dehecq, President of the Foundation Alice Dautry, Managing Director of the Institut Pasteur Jean-Michel Severino, Chief State Auditor, Member of the Academy of Technology,

President of the French Water Partnership (PEE) Safiatou Thiam, Medical Doctor in Public Health, Former Minister of Health Juan Antonio de Castro de Arespacochaga, Professor and Director of the Development

Policy Group (GPD) at the University Complutense in Madrid (Spain)

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LONG-TERM PARTNERSHIPS TO IMPROVE THE HEALTH OF VULNERABLE COMMUNITIES Three priority areas:

» Battling childhood cancers » Reducing maternal and infant mortality » Improving access to care for vulnerable communities

» My Child Matters

Improving survival rates for children with cancer in low-resource countries My Child Matters was born of a shocking fact: the five-year survival rate for children with cancers is 80%1 in developed countries, but only 30%1 in low-income countries. Every year, more than 175,0002 children are diagnosed with cancer and 90,0002 of them will die from the disease.

“Early experience with My Child Matters sites has given us insights into the nuances that contribute to this devastating statistic”, explains Cary Adams, Chief Executive Officer of the Union for International Cancer Control (UICC): “The common symptoms of cancer are not

recognized; it’s diagnosed too late; cancer management infrastructures are non-existent; or treatments, when they are initiated, are quickly abandoned.”

An exemplary public/private partnership The My Child Matters program was conceived by the Sanofi Espoir Foundation and deployed in partnership with the UICC. It fuses financial support, the expertise of cancer specialists from the world over and effective networking to improve all aspects of the healthcare chain: information and awareness campaigns for authorities and the public; health personnel training; early diagnosis; access to care, including the underdeveloped fields of pain management and palliative care; and psychological support for children with cancer, their families and their care providers. “Since its launch in 2005, My Child Matters has become one of UICC’s strongest and

most emblematic partnerships,” continues Cary Adams. “It’s an example of effective cooperation between an NGO and a business foundation, with highly involved partners, a long-term engagement, positive results and durable effects. The Sanofi Espoir Foundation has provided €5.2 million since the start of the program, which represents a major contribution in this field.”

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1UICC

SIOP (February 2013)

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LONG-TERM PARTNERSHIPS TO IMPROVE THE HEALTH OF VULNERABLE COMMUNITIES After seven years of action, childhood cancers receive focus More than 40 projects in 26 countries have received support. “First, My Child Matters has had a

significant impact in raising awareness for pediatric cancers in these countries and the region beyond” summarizes Cary Adams. “This has led to the development of local capacities for early diagnosis and treatment and second, this investment has generated vital evidence on how to reduce the divide in survival rates between high and low resource countries, evidence which will drive our advocacy call to focus on childhood cancer at the highest levels, in front of the World Health Organization and the United Nations.” A new, three-year action plan has been established and focused on three priorities: 1) evaluation and strengthened accompaniment for 15 current projects in Asia, Africa and Latin America; 2) support for interregional networks; 3) deployment of petitioning actions in partnership with the UICC to insure that childhood cancers become a public health priority in the future.

UICC is a membership organisation that exists to help the global health community accelerate the fight against cancer. Founded in 1933 and based in Geneva, UICC’s growing membership of over 770 organisations across 156 countries, features the world’s major cancer societies, ministries of health, research institutes and patient groups. Together with its members, key partners, the World Health Organization, World Economic Forum and others, UICC is tackling the growing cancer crisis on a global scale.

The partnership As of 2013, twenty projects were underway in 16 countries (Africa: Burkina Faso, Cameroon, Cote d’Ivoire, Mali, Mozambique, Senegal, Tanzania; Asia: Pakistan, Philippines, Thailand; Latin America: Bolivia, Colombia, Equator, Honduras, Panama, Paraguay). » Direct beneficiaries: 38,700 children treated and 9,700 healthcare professionals trained since 2006.

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GUILLERMO SAMUD IO

GIL CORRE

» Fields: cancer registries, family information, healthcare professional training, access to healthcare, psycho-social support, palliative care.

LONG-TERM PARTNERSHIPS TO IMPROVE THE HEALTH OF VULNERABLE COMMUNITIES Programs in Asia, Africa and Latin America: concrete

»

The Philippines Since 2006, the program has

»

Sénégal The Dakar Unité d’Oncologie

results

»

Paraguay In Paraguay, 80%3 of the

enabled the creation of a

Pédiatrique (UOP; pediatric

population lives in rural zones.

network of 31 establishments

oncology

The project resulted in the

assuring

Groupe

pediatric

cancer

unit)

and

the

Franco-Africain

of

four

regional

d’Oncologie

capital city of Manila and

(GFAOP;

thus closer to the children’s

pediatric oncology group)

the other two in 2011, to

homes, a vital aspect for

were footholds for the launch

decentralize

a

of My Child Matters in 2006. In

cancer management. The

the six years that followed,

department

the program equipped and

oncology at the Asunción

improved the organization of

Hospital became the national

the UOP, improved capacities

reference center in 2012.

for

country

composed

of

thousands of islands. The

number

of

pediatric

oncology-hematology specialists has grown from 20 at the start of the program to 56 today. Medicines, available originally through donations, are now better managed by the country’s health insurance program. A particular focus is

Pédiatrique

creation

management outside of the

French-African

clinics, two of which were accredited

in

2009

and

childhood of

pediatric

and

Since the start of the project,

launched the development

close to 13,800 chemothe-

of

in

rapy treatments have been

regional hospitals to support

administered, of which 350

early

diagnosis,

pediatric

oncology

financially stressed families

were in the regional clinics.

and allow them to continue

The number of consultations

receiving care, thus reducing

has risen to 24,450, of which

the number of “drop outs”.

989 were in the clinics. The

My Child Matters initiatives

treatment abandonment rate

also led to the development

fell from 13% before the

The program has succeeded

of

support

project to 0% in 20114. A total

in reversing the statistics:

programs for sick children,

of 620 healthcare professionals

today, 70% of cancers are

their families and the care

were trained in pediatric

detected while still in early

providers, as well as the

oncology

stages, versus 30%3 in 2006.

organization of palliative care

childhood cancer network

Treatment abandonment rates

for children at the end of their

was

were reduced from 80% to

lives and those in therapeutic

interest by the president of

failure.

Paraguay, and the national

being placed on leukemia, the most frequent childhood cancer.

3

10% . At the Philippine Children’s

psychological

in

declared

2012. of

The

public

Medical Center, now the

reference center’s budget

national reference center, the

was considerably increased.

two-year survival rate for leukemias climbed from 16% in 2010 to 68%3 in 2011.

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3Ribeiro RC, Steliarova-Foucher E, Magrath I, et al. Baseline status of paediatric oncology care in ten low-income or mid-income countries receiving My Child Matters support: a descriptive study. Lancet Oncology, 2008, 9:721-729. My Child Matters Philippine Report, unpublished data from collated reports of network collaborating hospital, 2011 4ReNACI database.

LONG-TERM PARTNERSHIPS TO IMPROVE THE HEALTH OF VULNERABLE COMMUNITIES

Focus on… 2 interregional networks in Africa

»

Improving the early diagnosis and management of retinoblastoma

in a nation’s capital, and diagnostic means

The Foundation also supports a retinoblastoma

trained and competent personnel,” empha-

program piloted by Prof. Pierre Bey for the

sizes Pierre Bey.“Material aspects are necessary

Alliance Mondiale Contre le Cancer (AMCC;

but not sufficient; before all else, competent

such as CT scanners and other imagery equipment. The other essential element is “to have

world cancer alliance). Retinoblastomas can

medical personnel must be available in all

develop in one or both retinas and lead to

contributing specialties: a pediatrician with

blindness or death if they are not rapidly

oncology training, several surgeons with

diagnosed and treated. If a diseased eye must

different specialties, a radiation therapy

be removed an ocular prosthesis may be

specialist, etc. This is one of the major aspects

implanted under the supervision of the reference

that makes cancer treatment different from

center. If both eyes are involved, conservative

other specialties such as infectious diseases

treatment may be considered at least for one

where only one type of specialist is needed.”

eye if the cancer was discovered early. “This

Dr. Bey’s project is active in Mali and being

laser-based treatment is more complicated,

launched in the Democratic Republic of the

but thanks to the Foundation’s support, an

Congo. Four other sub-Saharan countries are

ophthalmologist in Bamako has been trained

also slated for inclusion.

by the Institut Curie,” explains Pierre Bey. “We are going to buy a laser as soon as the situation in Mali gets back to normal and extend the program to other cities.” The program is currently focused on 250 children in sub-Saharan Africa, 30 of who have already underwent surgery in Mali. However, throughout Africa 2,000 new cases are diagnosed each year.“The program extends from early diagnosis

to rehabilitation; it also includes public awareness actions

and

training

for

medical

and

paramedical personnel, so that the cancer, which occurs most frequently in very young children, can be detected and treated early,” continues Prof. Pierre Bey. “However, it is then

vital that disease management be facilitated; without that, early diagnosis is useless.”

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Strengthening training for healthcare personnel in French-speaking African countries The Sanofi Espoir Foundation is providing support for the Ecole d’Oncologie Pédiatrique (pediatric oncology school), which is already providing training for 12 member-countries of GFAOP. The objective of the program is to propose a progressive training curriculum that addresses the needs of the diverse actors in pediatric oncology care provision, as these are similar across nations. Although the main objective is to train care providers so that they can

provide

pertinent

management

of

childhood cancers, the school can also act as

The program is aiming to double the current

a starting hub for an international network and,

survival rate of 40%.

if the curriculum is accredited, a building block for the professional development of healthcare

In terms of means and infrastructures, there should be at least one pediatric oncology unit

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stakeholders.

LONG-TERM PARTNERSHIPS TO IMPROVE THE HEALTH OF VULNERABLE COMMUNITIES

» Stand up for African Mothers Reducing maternal mortality in Africa

Somewhere in the world, a woman dies every 2 minutes from pregnancy or labor complications that could have been managed, and 99%5 of these deaths occur in low-income countries. Each year, in sub-Saharan Africa, this issue results in the deaths of 162,0005 women (56%5 of worldwide deaths) and in turn nearly a million orphaned children. The majority of African women—nearly all in South Sudan (92%5)—give birth alone, with no qualified professional present. On average, 40%5 of African women still do not have access to healthcare during pregnancy or childbirth. To compare, women in high-income countries run a 1 in 3,800 risk of death during pregnancy or labor vs a 1 in 39 risk for women in low income countries—a one hundred fold increase. And yet, progress has been made: “Maternal mortality has been reduced by 50% over the last

few years, attaining thus two-thirds of the Millennium Development Goal of 75%,” explains Muriel Gavila, Managing Director the African Medical and Research Foundation (AMREF) in France.

“To achieve the remaining 25% and ensure stronger and durable progress, we need to train midwives in rural areas, there where the majority of the population lives. More than 80% of deaths are due to complications that could have been successfully managed in a health center with basic emergency and obstetrics services. The women who are the most at risk are those from poor and isolated communities, particularly very young women or girls. Indeed, in numerous communities, girls continue to be married very young and family planning is poor or nonexistent. The most serious pregnancy-related complications occur in teenage mothers.”

One trained midwife can provide care for up to 500 mothers per year Training midwives is at the heart of Stand Up for African Mothers, a program supported by the Sanofi Espoir Foundation. Indeed, its goal is to train 15,000 midwives in around 15 African countries before 2015 and heighten public and governmental awareness of health issues in pregnancy and childbirth. Candidates benefit from an initial 3 to 4 year training period and/or CME programs for personnel in rural zones who often fall behind in medical knowledge.“Using a large amount of E-learning,

we bring their knowledge up to the standards of the World Health Organization and the International Confederation of Midwives,” explains Muriel Gavila. These new technologies have resulted in the training of midwives in Uganda, Kenya and Tanzania and will be implemented in French-speaking African countries. By guaranteeing the necessary hours of theoretical and practical training, the tools also provide motivation for the care providers to set up practice in isolated rural areas.

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Trends in Maternal Mortality 1990-2010 WHO, UNICEF, UNFPA and the World Bank 2012

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LONG-TERM PARTNERSHIPS TO IMPROVE THE HEALTH OF VULNERABLE COMMUNITIES

The partnership with the Sanofi Espoir Foundation permitted not only the funding of the pilot program in Uganda but also all needed evaluations to start reproducing the program in western Africa.

Training African midwives to improve the health of women, and thus that of their communities In addition to giving life, African women also provide education, water, food, and indeed care to ill members of their families or communities. And yet their own health is often secondary, if not forgotten. With 80% of medical acts in Africa performed within the home and within the community, it is clear that women play a vital role in the system, and must therefore be considered as front-line partners and beneficiaries of community and public healthcare programs. Midwives also have an important role in educating women and the community, assuring women’s reproductive rights and providing family planning activities. “In the AMREF-led programs, messages

get through better when the commune benefits from the presence of a community health agent, a volunteer who works alongside the midwife. Certain practices are declining,” summarizes Muriel Gavila. Former experiences provide compelling results: Ethiopia, South Sudan and Kenya were the first countries to benefit from in-class or e-learning midwife training implemented by AMREF and the programs were very successful. Going forward the plan is to enlarge them for deployment across all of Africa.

A candidate for the 2015 Nobel Peace Prize in the name of all African midwives Stand up for African Mothers soutient également la candidature d’Esther Madudu, sage-femme africaine formée par l’AMREF, au Prix Nobel de la Paix 2015, comme représentante de toutes les sages-femmes africaines dont l’engagement est déterminant pour l’avenir de l’Afrique. L’AMREF veut ainsi montrer combien les femmes sont importantes pour la communauté.

S DE LES ENFANT

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L’AÏR

LONG-TERM PARTNERSHIPS TO IMPROVE THE HEALTH OF VULNERABLE COMMUNITIES

The Sanofi Espoir Foundation: recognized expertise The Sanofi Espoir Foundation “provided very strong momentum to this pan-African program by

supporting the pilot e-learning program in Uganda as well as studies for its deployment in western Africa”, explains Muriel Gavila.“The foundation also supported the launch of the program in Europe. For us, Sanofi Espoir is an essential partner because it provides top-level expertise in the field and understands the issues perfectly.

“We recently created a coalition with several United Nations agencies to accelerate the movement and extend it to more countries. We wish to continue the dynamic beyond 2015 and we are sure that the Sanofi Espoir Foundation will have an important role to play,” concludes Muriel Gavila.”

AMREF Flying Doctors is the leading NGO in Africa. It was created in 1957 to bring aid to isolated African communities. For over 55 years, AMREF has developed programs focused on healthcare provision and proficiency

development

for

African

healthcare

professionals.

The association is currently leading 150 programs per year in 30 African countries, thus improving health for 7 million people.

The Stand Up for African Mothers program was launched during the 2011 Women’s Forum and is supported by an international group of influential women, with Graca Machel Mandela as the

AMREF

global campaign patron.

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LONG-TERM PARTNERSHIPS TO IMPROVE THE HEALTH OF VULNERABLE COMMUNITIES

Maternal and infant mortality other programs supported by the Sanofi Espoir Foundation

» Assuring the promotion of early screening in Algeria

and municipality of Tanout, the regional directorate

of

health

and

the

regional

hospital of Kankan, and the NGOs AGaji, In Algeria a project is underway to train healthcare

Kosimankan, Fassodemin and Chirurgie Solidaire.

professionals for disorder screening in newborns

The program seeks to network the various

and to create a multidisciplinary mother-child

healthcare actors and provide training to those

healthcare network. The project is led by the

on the front-line, in particular village matrons

NGO Santé Sud, the Algerian Federation for

and midwives.

Handicapped Persons, the chiefs of services for pediatrics and obstetrics & gynecology and the Health Department. Ultimately the program will enable propositions to the Algerian Health Ministry for the creation of pilot services in the management of disorders of newborns, a first for Algeria.

» Strengthening obstetric and neonatal

care in poor and isolated populations in the Adamawa Region and northern Cameroon In Cameroon, a program developed with Unicef

» Improving

maternal and neonatal health in Nouakchott, Mauritania

is focused on providing essential urgent obstetric and neonatal care in the country’s north where maternal and infant mortality is much

In Mauritania’s capital, a project is underway

too high. For example, the under-5 mortality

with Santé Sud, the National Hospital Center,

rate in this region is 42% higher than in the rest

the Sebkha Health Center and the Association

of the country.

Mauritanienne pour la Santé de la Mère et de l’Enfant (Mauritanian Association for Mother and Child Health). As part of the country’s national strategy for reproductive health, the project’s main objective is to reduce maternal mortality by 10% and neonatal mortality by 40% in three years.

» Battling maternal mortality in Benin Thirty-five villages in one of Benin’s poorest regions are the subject of an innovative program launched with the humanitarian organization CARE. The program is built upon strong community participation and the use of

» Strengthening capacities to reduce

the causes of maternal and neonatal mortality in Niger and the Republic of Guinea The partners and stakeholders for this project include

the

humanitarian

association

Les Enfantsde l’Aïr, Unicef Niger, the hospital

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cellular communication technologies for preventative education and obstetric emergency management. The program is also deploying cooperative funds and health mutuals to improve healthcare quality and reimbursement.

LONG-TERM PARTNERSHIPS TO IMPROVE THE HEALTH OF VULNERABLE COMMUNITIES

» ENFAMS

Favoring access to health for homeless children and families Over the last ten years the number of people comprising homeless families has been multiplied by 6, i.e., at least 25,000 people in Greater Paris. Beyond these numbers, the situation is all the more troubling due to the increasing time spent by families in emergency hotel-based housing: from an average of 12 nights in 1999 to several years currently. Paris’ social emergency care service, the Samusocial, intervenes for nearly half of these homeless families. The Samusocial reports that in 2010 the number of homeless families, especially single-mother families, has passed the number of isolated homeless persons. The only hope of a roof for these families is the already-saturated emergency housing programs. Adding to this precariousness, the families often encounter a language and cultural barrier, which prevents them from contacting the social services responsible for relaying the Samusocial. Although hard on all members of the family, it is the health of the children, including their psychological health, that suffers the most.

A survey unprecedented in France to learn more about homeless families To provide more pertinent assistance to these families, the Observatory of the Paris Samusocial is looking to gather information on their lives via the “ENFAMS”1 survey. This unprecedented research activity will not only shed light on the characteristics of this population and its difficulties but also permit actions for their medical, psychological and social well-being via the mobilization of associations and institutions on the issue of homeless families. The survey, available in over ten languages, includes in particular a health section that will gather information by way of questions for the parents, anthropometry data and psycho-cognitive tests for the children, and blood (finger prick to study iron and vitamin deficiencies) and hair (lead and mercury analyses) samples. Findings may result in immediate management solutions within a network of partners created for the survey. The ENFAMS survey will continue through 2014 and contribute to attaining the Millennium Development Goals for improving access to health for impoverished populations. The partnership with the Sanofi Espoir Foundation covers the three action levels of the Paris Samusocial: working with the homeless families, getting healthcare professionals on-board and soliciting public stakeholders. Of particular interest is making sure that the actions of collectivities do not fall by the wayside.

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LONG-TERM PARTNERSHIPS TO IMPROVE THE HEALTH OF VULNERABLE COMMUNITIES The Sanofi Espoir Foundation and Samusocial: a 12-year and counting partnership The Sanofi Espoir Foundation is a long-standing partner of the Paris Samusocial. “Sanofi, who is

with us for this survey, has been a partner for years now; the company helped us deploy the first-ever mobile tuberculosis team in 2000,” emphasizes Aline Delettrez, Resource Development and Communication Director. “They then stayed by our side over the next ten years until the

project financing was taken over by the regional health agency. It’s wonderful to have a partner who stays with the project up to its institutionalization.” The Paris Samusocial was created by Dr. Xavier Emmanuelli in 1993 and is currently directed by Eric Molinié. It promotes and develops a professionalized approach for reducing exclusion. Since 2000 with the Samusocial, Sanofi has accompanied the creation and deployment of a mobile tuberculosis team and other mobile assistance teams, supported the Maison des Femmes (Women’s Home), donated medicines and vaccines, and provided its support for international actions (Russia, Romania, Peru, Egypt, Burkina Faso) as well as for training and inter-country capitalization programs representing €2.5 million.

Future actions with the Samusocial An upcoming program involving the Solipam (solidarity Paris moms) will focus on pregnant women within the homeless population. Here again, the support of the Sanofi Espoir Foundation will enable the training of midwives and social workers so that they can in turn provide assistance to homeless pregnant women. Also, the Foundation participates in the Paris Samusocial consensus conference, uniting all stakeholders in the fight against exclusion. There, the discussions focus on establishing gold standards for policies on reducing exclusion and

BENOIT TELLIER

ZERY DIDIER PA

managing the health, social and psychological needs of these populations.

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LONG-TERM PARTNERSHIPS TO IMPROVE THE HEALTH OF VULNERABLE COMMUNITIES

Access to care for vulnerable communities other programs supported by the Sanofi Espoir Foundation

»

Access to care for vulnerable populations in France: a program deployed with the French Red Cross, partner since 2004 This project aims at reducing health inequalities by easing access to care for people and families without resources wherever they may be in France. The Red Cross in France counts 600 offices and branches, including those in France’s overseas departments and territories. Homeless people and families, immigrants, students, prisoners, the working poor and many others are exposed to major health threats. The life expectancy of France’s poorest populations is 45 years. The project is built around ten APASMs6, managed by volunteers and located in areas with large immigrant or homeless populations. The partnership with the Sanofi Espoir Foundation provides €600,000 of financial support over three years to improve the existing APASMs and create others.

»

Paris. The partnership with Sanofi Espoir comprises €600,000 of financial support over three years, which strengthens the support provided over the past ten years for the NGO’s actions in France and in the world.

»

Easing the creation of health insurance mutuals: programs in Benin, Mali, Nepal and India to reduce inequalities in healthcare access. When health insurance systems are not available to all, an accident, a serious illness or complications during pregnancy can quickly become dramatic for a family with non-formalized revenue. To break the vicious circle of poverty and

difficulty

accessing

healthcare,

The Sanofi Espoir Foundation is supporting several innovative programs in Benin, Mali, Nepal and India that bring together healthcare services and micro-financing and/or microinsurance. Since 2007 the Foundation has been

Improving access to care and the orientation of those in very precarious situations in social centers in 4 major French cities.

providing support in India for a program in partnership with the NGO Inter Aide and five local associations to improve access to health for poor families living in the shantytowns of Pune and Bombay. Joining the mutual gives

This Medecins du Monde project is aimed at

them access to quality health services at

intensifying its own action for people living in

affordable prices negotiated by partner health

the most difficult of conditions, in particular for

structures. Any hospitalization is reimbursed and

women (40% of the people admitted to the 21

information on health and hygiene is provided

7

program CASOs ) and children (12%). The four

for the families. At end-of-year 2012, more than

CASOs concerned by the project orient close

151,000 people had joined the mutual, which

CAto 8,000 people per year for 16,665 pas-

costs €2 per person per year.

sages. The medical teams working at these facilities provide more than 13,500 consultations per year, approximately half of which are in

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in

Antennes de Premier Accueil Social Médicalisé (medicalized urgent social support branch) Centres d’Accueil, de Soins et d’Orientation (shelter, health and orientation centers)

6 7

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Frédéric Lemonde-San Media Relations Tél. + (33) 01 53 77 91 55