 Donc, on doit viser 17h30 pour la plume. Ok. Donc, on doit faire ça efficacement. On doit finir la session par 5h30. Parce que nous avons le château pour rentrer à la reception du matin. Si vous voulez prendre le château. La reception du matin est à 7 p.m. Mais le dernier château est à 6 p.m. Donc, on ne peut pas... Oui, on peut... Oui, bien sûr. Mais si vous voulez prendre le château, le dernier est à 6 p.m. Je vais vous débrouiller pour pouvoir le prendre. Donc, il y aura une présentation de Jean-François Gégant de l'Institut de Research & Development sur l'inflexion et l'inflexion. Et ensuite, nous allons avoir une présentation des posters. Ce que vous voulez partager, c'est de faire un poster de votre poste, mais deux minutes de poster. Donc, ça veut dire que c'est une minute de poster. Ok. Et ensuite, nous allons passer au poster et nous pouvons discuter dans le poster lobby. Ok, merci. Donc, bonsoir à tous. Avant de commencer cette présentation, je vais vous présenter moi-même. Je suis professeur de l'Institut de Research & Development sur l'inflexion. C'est-à-dire que j'ai passé, ou je l'ai utilisé pour passer mon temps dans les zones tropiques de l'Afrique, en Afrique, en Sao-Sisi et en États-Unis. Et je suis aussi professeur de l'Institut de Research & Development sur l'institut de Research & Development sur l'inflexion global. Donc, aujourd'hui, j'ai changé mon titre avec un sous-titre, en mettant le carton devant les portes. La translation en français n'est pas assez différente d'une façon ou d'une autre. Donc, je suis totalement d'accord avec des commentaires faits avant, notamment par Carla. C'est-à-dire qu'on doit définitivement développer, je veux dire, une recherche d'évidence sur l'institut de Research & Development, une des raisons de la disappearance d'un sujet dans l'Institut de Research & Development et notamment dans l'Institut de Research & Development. C'est-à-dire que so many stupid things have been said on climate change and health with any based evidence research that this topic has been withdrawn from UN resolutions during the past decade. Today it is becoming again but we do need to have more time series, more special series in order to develop an evidence based research. So, we go. So, I like this cartoon so I made a translation in English so two guys, there are two mosquitoes are living in a tube in the other ground in Paris and one, the first one is saying in Paris for a long time yes since the last AV summer eats, yes. And they will for sure transmit to you infectious disease like Zyka virus or Chikungunya virus. Is it definitely clear that they will transmit to you and give you tropical disease in temperate areas? Will we have more tropical disease in temperate areas due to climate change? This is the question. The main problem I am facing today it's not with researchers. This is with journalists Jean-François explains what will be the tropical disease that will appear in Paris within the next years. Due to climate change, I explain them we are not sure of that and the journalists are telling me are you sure of that because we read this in any newspaper today but the writings in newspapers are not supported by scientific evidence most of the time. So this is the style of picture you could read and you could look at in different newspapers, media newspapers, scientific papers 20 years ago, you know with this map distributional map of malaria disease all over the world and due to climate change. So we have strongly changed our point of view today but you can see from this picture that this is a dramatic point of view about climate change on Earth. Let's remember that during by the mid of the 20th century, not so far from today in Northern Italy and Mediom Italy and the south of France there were a lot of cases of malaria disease and not due to climate change. And even in London at the end of the 19th century as well. So there is a link between climate, climate variability climate change and infectious disease but other drivers can happen to make that the disease is able to sustain or not in a given region. So we already discuss about this book this book has been produced for COP 22 I guess yes, is it? So I will let the specimen here but you can download I mean the book from the website of my institute here so this is the URL the internet site and you can download for free a PDF file of it. So in this book several people present here have written or participated to the written of a chapter but with Isabella, Robert Baruchy on a we have been in charge to produce a review about climate change in the Mediterranean Basin. So there are not so few research work working on infectious disease in the Mediterranean Basin trying to link climate change to the development and spread of infectious disease. So I found several papers discussing on most reviews on review of paper. We very, very poor empirical data indeed. So you can have a look on this different scientific production. Anyway, so we already have seen this nice picture so I will concentrate on the impact of climate change on else and mainly on infectious disease because this is my field of expertise. Ok, so is this nice guy? The tiger mosquito present here in Italy today just due to climate change so I will directly go to the answer nothing to see with climate change much more to see with trade. The trade of secondary tie trade and it appeared two decades ago in Albania and it is spreading all over all over the south France and even Spain but I will show you all car traffic traffic and even train traffic has a strong importance in the spread of this mosquito responsible for causing Zika virus disease for instance so nothing to see with climate change indeed. So we already discussed about the impact of climate change direct impact indirect impacts on else so I will discuss most of the time about the indirect impacts on infectious disease. So in this book you will find this table so in two separate slides the first one you see the different disease that are still present in the Mediterranean basis yes or no most of them are present in the in the Mediterranean basin and you can see from this column that for most of these different infectious disease when you say no is that we have very very poor evidence demonstrating that climate change is responsible for their persistence within this region and even their spread producing outbreaks and epidemics you can see that most of the time this is no no no no except for some items ok you can go directly on to this table in this book ok so the second this is the same so this is the following sub table ok and you can see no no no no no except for some ones so we have very very poor data for the Mediterranean sea so this is a series of cases of dengue fever in the Mediterranean area with different cities and regions and you can see that the dengue fever was present for a while in the Mediterranean basin and again nothing to see with climate change so I mean the ship trade within the region the basin region has has got a strong importance in the spread of this infectious disease all over the region the Mediterranean region so anyway ok so I will concentrate on climate change for my talk today about infectious disease because I am an infectious disease epidemiologist and secondly I am also a numerical ecologist at heart so I have two different jobs to put together ok so I used to produce modeling as well so I was quite comfortable with the two previous talks as well so you can see from this slide that I mean this is for diarrhole disease that are due to different infectious disease agent it can be a bacterium it can be a protozoan it can be a bacterium and it can be other reasons that an infection as well that epidemics of diarrhole infection here I am not sure that the pointer is working anymore oops no ok so anyway you can see epidemics boom and burst of disease cases of diarrhole infection this is a Peru but not in the Mediterranean area because we have that such time series to show you today ok thank you so you can see this boom and burst that produce epidemics and that goes quite well and that correlated very well with the temperature in the sea because this bacteria and this viruses are located and are totally embedded into the aquatic marine environment and they produce this series of booms and burst so producing epidemics so depending on the sea surface temperature which they are on population dynamics so here I mean for this case disease they are strongly sensitive to climate conditions but here I am not discussing about climate change I am discussing about climate and climate variability during a year so I am discussing about the seasonality and the fluctuations of epidemics during a year ok so I will take two examples first I will go with bacteria living in the marine system and then I will show some illustration about the tiger mosquitoes which is responsible for transmitting I mean some infections to humans ok so we go with bacteria living in the marine systems like vibrio which are responsible for causing diarrhole disease and even for the dreadful killer which produce I mean cholera ok so you can see from this slide that cholera here this is cholera at Kolkata in India Matlab in Bangladesh that cholera at least for this one is depending on the season it depends as you can see here from the sea surface temperature as I already say to you but it also depends on the chlorophyll air concentration on other parameters just because its ecological niche depends on these conditions so sometimes during the year some conditions are good for the reproduction of the spread of the bacterium or the virus to duplicate huge epidemics into the population ok so we can have longer series the same region in India and Bangladesh so you can see that I think that cholera cases are in black they are totally correlated highly correlated with some I mean drivers of this disease emergence on epidemics in the population ok but this kind of data are very rare in epidemiology this is what we call I mean time series time series ok so you can see that the population dynamics of infections in humans strongly depend on the conditions in the environment that are highly favorable or not for the reproduction the spread and the spillover from the environment to human population when they are exposed the same so main idea and we absolutely need to develop and to get long time series of such data so we need to develop surveillance of these infections are notably in the Mediterranean sea basing because we have very very poor data indeed about infections and if we want to reply to the question is climate change or will climate change will have an impact on these infections in the Mediterranean basin we absolutely need to have this time series of course on even special series as well ok so if we go in deep in time now and we want to correlate this time series of cases with here this is the southern oscillation index in the in the ocean Indian Ocean so I cannot explain you why but anyway you can see that after the the 70's and 80's you can see that the SOI index and the cholera epidemics are strongly associated but what we call in counter phase so you can see that the when SOI is high in value you are with lower cases and the reverse conditions happens when you have the lowest cases of SOI you have the big epidemics so I cannot explain you in deep but something is happening with the SOI that a physicist are telling us that it is connected to the anzoo aninio aninio phenomenon that makes that during the aninio aninio phenomenon something is happening on the different epidemics for this disease but again I'm not speaking here about climate change I'm speaking about climate variability because the aninio aninio phenomenon is climate variability I'm not climate change Physicists can't explain furthermore if there is a link between aninio aninio phenomenon and climate change but I will not go in detail with this today ok? so the aninio aninio phenomenon on the planet today is producing many epidemics and the reason is why depending on the rainforest in a given region, more rainforest it gives it transform the habitats it gives more rainforest say for the mosquito to reproduce and if you have more mosquitoes you can have more infections in animals or in humans ok? so you see now the link between the aninio aninio phenomenon and epidemics so the same for here this is the Baltic sea this is what we observe today ok? but what is more important and I am trying to make the link with the second part of my talk which concerns the Aedes albopictus tiger mosquito this is about I mean storms heavy storms that can happen today notably in the south of France we call these the 7 old events that happens during the autumn period that produce heavy rainfalls in the regions of Marseille, Nîmes and Montpellier where I live but with this heavy rainfalls that with the waters flowing flowing to the lagoon so more fresh waters makes that you observe the salinity in the lagoon so having less salinity in the lagoon makes that it's good for some bacteria like this one colerae vibriovalificus paramoemoleticus that can explode an increase in population size and you can get them when eating up on oysters fruits for instance so with this heavy rainfalls into this region this makes that it has a strong impact on to the salinity decreasing the salinity so increasing the production of this bacteria into this system so you are at higher risk to contract gerular disease in this cases so we pass now to the Aedes albopictus so again for this type of mosquitoes that can transmit tropical infections this is like dengue fever zika virus fever shikongunya virus fever as well the insect is necessary for the transmission you need to be bitten bitten by a mosquito if the mosquito is infected you can contract the infection and develop a disease but the mosquito is a condition that is necessary but not sufficient other factors may or will help to explain the development of outbreaks and epidemics with a vectorial bone transmission of this type ok so this is the distribution of the tiger mosquito this was the distribution of the tiger mosquito 10 decades ago but this shows you that the mosquito was originating from Southeast Asia and it came in southern Europe again by the trade of secondary tire because there are huge trade of secondary tires all over the world and it came into Albania first and then entered into Italy and then spread all over the region, Europe, France et Spain but just due to the trade of secondary tires then it found the local conditions of course to develop or not ok so this is the current distribution of the Aedes albopictus today the tiger mosquito sorry so when it is red this is the distribution that has been observed ok then the tiger mosquito is able to transmit many viral infections like a dengue fever for instance but the presence of the mosquito doesn't say anything at all about human cases of course ok so these are the projection of the Aedes aegypti which is the tropical the tropical vectors of dengue for instance no no or the map here green but you can see that the Aedes albopictus can find the climatic suitability habitats for its spread totally independent from climate change I mean in many regions in the poor river valley for instance or in the Loire river valley are very mild soft and even during the winter conditions for having the mosquito this mosquito to sustain and spread and reproduce because the conditions are totally adequate for it to be present and develop and spread so most of the time and this is what you can read in many scientific publications according to transmission of infectious disease due to climate change most of the time this is the vector that is present to you and that is modeled onto a map this is not the infection this is not the infected case and again the mosquito is necessary for the transmission of the virus or any other infections of this category that you absolutely need virus to be present and most of the time the virus is not present because people here are totally confounding between the drivers that makes that the first cases of infections appear somewhere in the region and what makes and what are the reasons for big epidemics like in Africa to happen and the drivers for having big epidemics to happen are totally different from those that are responsible for the settlement of the mosquito which are due to climate other drivers for the development of epidemics are just due to poor conditions sanitary conditions nutrition status is very important as well nothing to see with climate change so there is a strong confusion here made between the settlement of the mosquito and the development of a big epidemics or due to other drivers and other fighters than climate and we do know in epidemiology that many tropical diseases settle in those countries just due to poor conditions sanitary conditions that are very bad etc etc etc so I will skip this so I mean people are doing some projections like this one we can have just a look on this so this is the distribution in 2015 of the Hades albopictus mosquito with the red areas that shows you where the mosquito is present and you can see the observation of climate here that are favorable during this period of time favorable for the development of the mosquito so what can you tell from this comparing these two pictures the modeling, this is the observation quite the same years of the period of time there is an over distribution of the presence of the mosquito here when compared to what we observe today because the climate projection are over calculating the distribution of the mosquito and again nothing to see with dange fever I'm just telling you and speaking about the vectors, not the infections ok so what we observe today is that for the dire mosquitoes here is that with the heavy rainfalls that we receive in France due to the 7 periods and events it produced heavy rainfalls in southern France in grey here so it produced and increased the heavy rainfalls it makes that produce jites or habitats for the mosquito to reproduce so without the heavy rainfalls during the autonal period nothing happens and the population of the mosquito tends to disappear from the region but with this heavy rainfalls it gives a second chance to the mosquito to reproduce ok and if you try to compare and superimpose with just superimpose the the chikungunya fever virus is not present in southern France at the moment anyway if you see this green line here this is the period of time during which the chikungunya fever virus could be able to be transmitted to you man ok, so it gives a second chance these heavy rainfalls here the save note period heavy rainfalls give a second chance to the mosquitoes to reproduce to increase the period during which the chikungunya virus could be transmitted if it existed it doesn't exist so many people are doing the confusion i.e. albopytus the tiger mosquito just putting it onto the map saying that we are at risk you have tropical diseases in Europe, in western or southern Europe we have the mosquitoes but we don't have the disease and for the zika you can put the equation as journalists used to do the microcephaly ok, so nice picture mosquito equals the disease which equals the microcephaly syndrome but this is very very complex indeed to go from the mosquito presence and distribution to the development of the disease and to the microcephaly cases that have happened dramatically ok, so we understand from this talk that you have the development of an outbreak epidemics and big epidemics of tropical infections in southern or western Europe as of course something to see with climate of course but other drivers are very important for this tropical infection to spread and most of the time the main drivers that are responsible for the development of this epidemics I have to see with what we call the bad of poverty I mean on nutrition as well I mean people are very sensitive to any infection if you are mal nourrished like in many countries of Africa for instance so you have just to increase the level of nutrition to get people being better and better protected against infections so this very recent work shows you that this is the red arrow here I will not go in deep into the statistics so this is what we call I mean GLM model this is statistical model they are using interactions and this interaction shows you that the hiatus albopictus is spreading not like recurrent waves northwards and westwards it just settle pockets of individuals that are totally unable to survive into these pockets this is what interactions can explain you to you today so it means and the simple explanation is that the mosquitoes enter into the back of your car and during the commutation it can settle here at your in Paris when you open the back of your car getting out from the car spreading around but just around with no infection this is what this statistical modeling is telling you so some people in my lab and Montpellier in collaboration with a team in Spain of trying to understand what could be the role in Spain of cars car traffic into the spread situation of these mosquitoes ok this is Spain Valencia et cetera so you can see these guys into the cars here collected into the cars and this gives you according to different regions of Spain the tiger mosquito traffic that exist today in Spain just due to car traffic ok ok so this gives you an ideal list for sure you are not able to read this list but you can you will be able to come back to this presentation later and this is the few evidence that we have about infectious disease that climate change is responsible for the settlement on spread so I am speaking about infectious disease here you can see that the list is not very huge so totally different with what you can read or opening a newspaper or opening your Italian tv to nag and saying so tiger mosquito is all over Italy due to climate change you know so I will skip this I will skip this also I am sorry about that but I try to respect the time I have to present this talk so I won't just so this is in French so there is an English an English cartoon of this but it was not of good quality this comes from the newspaper Le Monde Diplomatique ok and it gives you a good idea this is the reason why I decided to present this picture nice picture I have two or three slides it gives you an idea about the vulnerability of society so risk infectious is risk environmental risk environmental risk risk is the same a product between a hazard or multiple hazard the exposition of individuals and communities like workers for instance multiplied as well by what we call vulnerabilities can be individual it can be community vulnerabilities so you understand that people living in tropical Africa because they are sometimes for some of them malnourished they are much more vulnerable to any infection attack infectious disease attack of course because of this vulnerability so this gives you a map and a diagram with different colors we give use for the different states the vulnerability of the states ok according to their political decisions at the moment the political government that they have the average nutrition status etc etc number of hospitals etc etc ok and here it gives you a good idea about the preparedness of these different nations ok and you can produce this map which shows you shows you that Africa is still staying Africa and that most of African countries are not well prepared not only between infections but to any disasters ok and with very low very high vulnerability this is in orange and red ok so best solution in order to decrease the vulnerability of those system is first to prepare them to this risk like climate change risks of disasters in order to decrease their vulnerability to this system on this pass through of course education increasing the level of universities in Africa etc etc ok what is very interesting also this is the increase or the decrease of the human population size in the world during the the last decade and you can see that population is increasing in population size and this is good for French because French language will become the second language spoken in the world I hope so for the Italian people as well but anyway this is the story ok so with people and African people increasing in population size this is also good for infectious disease to settle because one of the main key parameter in infectious disease epidemiology this is population size population size means more susceptible to any infections ok so with an increase in population size for sure we will get more epidemics of this style notably in Africa ok to conclude this is another book produced by my institute I think that the way climatologist and physicist working on climate change I've seen climate change I've been in some ways responsible for this strange story for the topic I mean it was on the arena 10 ans ago then it totally disappeared and now it is becoming a top priority in research my explanation to that is that because climatologists have seen climate change to its impacts one of them being as consequences as impacts in an upstream downstream fashion or way of thinking 10 ans ago they totally changed their way ok I will be on time second period I mean you can see that climate change is the main driver responsible for causing impacts on human individuals on societies on the even ecosystems but it exist I mean feedbacks loops and I mean political decisions ok so it becomes much more complex but in this third scenarios this is the one we are today can you show me where is putting exactly climate change climate change is not here the upstream part of the cartoon it is somewhere inside the cartoon this is here ok and this draw much more complex view about the role of climate change with other global change that happened ok trade transportation of humans of beings of animals is very important in the transmission of the spread of infectious disease of course so all is mixed together climate change being one of the driver but not the only one than previously seen ok so three steps so we are here this period has produced this is the 80s to the middle of the 90s produced many things people in Europe will die from malaria, will die from dengue fever will die from and it's not true ok and we are here because other drivers may mix together with climate change like for infectious disease producing or not outbreaks and epidemics ok so I thank you for your attention and I'm ready to reply to some questions thank you very much so I will let a specimen but you can download a pdf5 for free from my institute so this is first the editors is my institute but this is a scientific production from many different institutes in France with some collaborators collaborators overseas as well so this is a multidisciplinary interstitial production ok François Isabella et c'est bon je respecte thank you Jean François coming back to your sea situation do you have any model that can predict what's going to happen if the mosquito is expanding its area its distribution area est capable to model whether or not there are risks for epidemics depending on populations on level of life and so on ok so again this is this is very complex to do so you understand that what is done 90 to 95 of the scientific production about vectorial disease is just met on the vector but the vector is the coach the coach can have some viruses or not but if you just model the distribution or of the coaches or the buses you will model only the distribution of the buses or so of the insects are not the virus that they can transmit so you need to consider many other parameters and we are not sure today that with an increase say of the temperature the increase of the temperature will be good for the virus to duplicate into the mosquito and then when being transmitted to a human individual it will be obliged to adapt to other conditions etc etc etc making that the duplication of the virus its infectious properties to invade the human systems are not well understood under that condition etc etc so you are multiplying probabilities multiplied by probabilities multiplied by probabilities and the final product is near zero Thank you may I may I just so I produce in French I'm sorry Isabella I produce in French a paper for the Ministry of Health ask me are the conditions today at Bamako, Mali that I know very well because I lived in Mali at Bamako during the 80's when I made my PhD thesis there are the conditions say in 50 years according to climate change good for the development of the malaria disease I can tell you no with the conditions that are estimated for climate change temperature and for values in Mali at Bamako for instance in 50 years the cycle of malaria disease will not be able to to work because the malaria protozones will suffer a lot from these new conditions maybe not the insect but the parasites will suffer a lot so making that with climate change so what I am explaining to you is totally the converse situation of what you have read in different papers and books the conditions will be totally different from the parasites to generate his life cycle and then produce infections in humans because the conditions will be so hard for the reproduction of the parasites this is a parasite so this is a protozone this is not a bacteria this is different but this is strange that I am explaining to you sometimes with climate change malaria disease will disappear not from all the continent but in some areas it will be so hard no water high temperature of course hot conditions of temperature but this will not be good for the disease life cycle as well so less malaria cases Isabella, I am sorry no problem, thank you it's very nice to listen to this very nice talk too I want to would like to have your point of view on what semenza is doing trying to define a vulnerability index he publishes some paper on that and in the case of infectious disease it's showing that people living in Sweden et cetera by 2035 2055 will be at risk of infectious disease because of climate change but also because of behavior mainly I think you had a very complicated scheme there obviously if we think about resilience et cetera some population could be at higher risk than others and in their projection for it will be better than now except Sicily so vulnerability is something very difficult to calculate so it depends on the parameter that you introduce to calculate vulnerabilities so it depends on the category of disease you are speaking about behaviors for sexual transmission behavior is of course important but it can be important for a vectorial bone disease as well so 10 years ago Dakar so what we observe in Senegal and in many cities of tropical tropical Africa today is that we have more and more malaria cases in suburban areas is it okay with you suburban areas I mean areas around the city center where people are developing agriculture and agronomy which is a big problem in terms of infectious diseases as well so we observe more and more malaria cases all over Africa today like in Dakar for instance and why there is the development of agriculture you need water to give water to the vegetable so you need to produce to generate channels so new habitats for the vectors to produce a spread infection okay so 10 years ago there were at least 150,000 cases of malaria in the sub areas peri areas of Dakar today there are only 1,500 on the big difference is the difference of magnets okay that people can use so if you decide at the United Nations decide to to sell the bed nets just for symbolic 1 euro people are using much more the bed nets if you give them for free to those population they do prefer to use them to fish to protect the vegetable against the pest this has a dramatic effect because the bed nets have some insecticides and repellents onto the net it can percolate onto the vegetable the carrots that you want to and then you have much more toxins into the vegetable that these people just because they use bed nets so vulnerabilities is something very difficult to estimate so it depends if it's chronic disease so I cannot answer it depends on its infectious disease but most of the time for tropical infectious disease the big difference I see between medicine and public health and international public health if you want to decrease the vulnerabilities of those population you need to increase the status the nutrition status this is what I would say for infectious disease in any case you are a good guy if you are a policy maker in doing so I don't vulnerabilities is something very different very very very complex indeed like exposure as well but yeah yeah your presentation has been very nice so I am from India and especially from Kolkata Kolkata yes so I could not resist myself to have some doubt clear recently we do not have cholera sir we have malaria or dengue or chicken gunia maybe in news in Kolkata of course cholera was there before 1970s so we had lot of deaths due to cholera recent past we do not have any epidemics on cholera secondly what is your explanation for the absence of cholera break at the moment we have now better sanitation good water quality supply I mean cholera is something related to water drinking water so that drinking water supply is very good nowadays and regarding malaria I would say so if I read the literature it was correlated with railway development so railway development in India and Bengal was synonymous to malaria or any kind of fever so malaria was known as a Bengal fever, Burdman fever Kalajar many types of fever was there and now it is dengue or chicken gunia or Japanese encephalitis like that so now problem is it is sometimes correlated with mining activity is another thing recently came another paper published from Tokyo University they have correlated the malaria with the labor concentration means the labor, most of the labor hard working labor are tribals tribals lives in rough terrain area forest regions so they carries malaria in their blood so a mosquito bites the labor and bites other people so they got infected so now I want to know how climate change or railway development or mining or deforestation how can we correlate all these things so this is my second topic I mean biodiversity deforestation on emerging infections but we can pursue the discussion later together thank you for the presentation my question was really related to last comment the point is relating to the fake news we heard this morning here in Italy mainly there was this huge debate about the risks that due to people immigration campos to health for example the spread of diseases that are not endemic for Italy or for Europe in relation to the first question what do you think you have thought about these double possibility the spread of the vector but the spread of the infection parasites not the infection, the parasite itself but people that move and bring the so this is an interesting question but we are sometimes at the limit of what we call the ontology and it takes speaking about that there are some national and European program on this at the moment because we have more infections for instance coming from the source in Turkey and Greece there are lots of works on this but most of the time you see you have people migrating how many people are infected so you decrease the number of people on the total number of people that are infected again this is always the same problem and you multiply so making that the risk there is a nice paper that has been published in the Lancet very recently a few months ago I organized a seminar on this at the ministry of health France in general there are many things that are not verified by I would say evidence so my main message again we can discuss further my main message is that in general in epidemiology so I used to be in Africa for instance this is always the others the foreign news that are responsible for introducing the disease on the other side of the river for instance so in epidemiology there are lots of traditional I would say fake news for instance if there were the disaster like typhoon tsunami for sure I mean billions of euros on to those programs and notably to studying else but there is a nice meta-analysis that has been done by a friend of mine on the 479 last different terraria terraria disasters during the past and only in few cases it generated epidemics only two on this total amount the two situations of epidemics have nothing to see with the disaster ok so in epidemiology to end this talk you see that sometimes to find the factors, the determinants of the drivers it's sometimes very difficult to disentangle between the different factors that are responsible for causing the disease on the outbreak so thank you very much I think that we have to end here and we may continue during the dinner we said that we will organize presentation teasing presentation, one minute teasing presentation of the poster so we have maybe quarter of an hour 20 minutes to do so if you can test it in that proposal please come over me I hand you the microphone and you can tease us who wants to do this first yeah I think you want you look like you want and then we go to the discussion yeah