A decades-long partnership between Limoges, France, and the African Republic of Benin has contributed to neuroepidemiological advances in both regions.
By Dieu donné Gnonlonfoun, Jérémy Jost, Dismand Houinato, Pierre-Marie Preux
From left to right: Prof. Dismand Houinato, MD, PhD, previous director of the LEMACEN Unit in Cotonou, Benin; Prof. Jeremy Jost, MD, PhD, future director of the EpiMaCT Unit in Limoges, France; Prof. Dieu donné Gnonlonfoun, MD, PhD, current director of the LEMACEN Unit in Cotonou, Bénin; Prof. Pierre-Marie Preux, MD, PhD, current director of the EpiMaCT Unit in Limoges, France.
The academic cooperation between Limoges, France, and the Republic of Benin in neuroepidemiology and public health is the result of more than four decades of scientific, pedagogical, and human relationships.
It began in the early 1980s, around tropical neurology and epidemiology, and progressively developed into a structured partnership involving the entities from both countries. In Limoges, these included the University of Limoges, the Institute of Epidemiology and Tropical Neurology (IENT) — later renamed the Institute of Epidemiology and Global Health–Michel Dumas (IESM-MD) — and the successive Limoges research units that preceded the Epidemiology of Chronic Diseases in Tropical Zone unit (EpiMaCT). Partner entities in Benin included the University of Abomey-Calavi, the Laboratory of Epidemiology of Chronic and Neurological Diseases (LEMACEN), and, for specific training projects, the University of Parakou.
The Limoges-Benin Partnership
From the outset, this cooperation was closely linked to the development of tropical neurology as an academic field. Prof. Michel Dumas and the Limoges team played a central role in building scientific and teaching links with Benin, notably through neurological teaching and support for the training of Beninese physicians and academics.
The IENT was created in 1982 as a structure dedicated to training, research, and international cooperation in tropical neurology and epidemiology. This early orientation explains why the Limoges-Benin partnership was first rooted in neurology before progressively expanding to neuroepidemiology, chronic diseases, and broader public health.
A key feature of this cooperation has been the long-term training of Beninese academic leaders. This point is essential because the partnership wasn’t only built through institutional agreements; it was also built through individuals who trained partly in Limoges and later took major responsibilities in Benin.
LEMACEN founder Prof. Dismand Houinato is a neurologist and professor of neurology at the University of Abomey-Calavi. He was trained in public health and epidemiology in Limoges, including through doctoral and HDR-level pathways, and became one of the major figures structuring chronic disease and neurological epidemiology in Benin.
The new director of LEMACEN, Prof. Dieu donné Gnonlonfoun, is a professor of neurology at the University of Abomey-Calavi. He followed part of his academic training in Limoges, including master’s and doctoral training in epidemiology. This continuity between successive generations of Beninese neurologists trained in part through the Limoges partnership is one of the strongest indicators of the depth and durability of the cooperation.
Formalizing a New Agreement
In 2003, the partnership entered a new phase with the formalization of a framework agreement between the University of Abomey-Calavi and the University of Limoges. This agreement provided the institutional foundation for long-term scientific and educational cooperation. It was aimed at strengthening academic ties, fostering collaborative teaching and research initiatives, and supporting the advancement of Francophonie academic cooperation. The agreement encompassed a wide range of activities, including staff exchanges and teaching assignments, the mobility of students and academics, the sharing of scientific and pedagogical expertise and resources, and broader measures to reinforce institutional capacities within both universities.
A renewed interuniversity partnership agreement was signed in 2020. It confirmed the same strategic orientations. These included:
- collaboration in teaching
- research and development
- expertise
- staff exchanges
- student exchanges
- exchanges of university documentation
- cultural and intellectual activities
This renewal was important because it gave a contemporary institutional framework to a cooperation that had already become dense, productive, and multidimensional.
EpiMaCT
The Limoges research structures also evolved at the same time. Before EpiMaCT, the research team worked under earlier names, including NETEC (Tropical and Compared Neuroepidemiology) and NET (Tropical Neuroepidemiology). EpiMaCT was created in 2022 and now embodies the continuation and broadening of this scientific trajectory. Its focus is the epidemiology of chronic diseases in tropical settings, including neurological disorders, cardiovascular and metabolic diseases, mental and cognitive health, and cancers.
This evolution mirrors the trajectory of the cooperation with Benin: from tropical neurology to neuroepidemiology, and then to the broader epidemiology of chronic diseases and global health.
The institutional transformation of the Limoges institute also reflects this broadening scope. The IENT became the Institute of Epidemiology and Global Health-Michel Dumas (IESM-MD) in September 2025, following an administrative decision in August 2025. This change of name preserved the historical legacy of the IENT and Prof. Dumas, while making explicit the wider global health dimension that had progressively become central to its activities.
On the Beninese side, the creation of LEMACEN in 2014 was a major turning point. The Laboratory of Epidemiology of Chronic and Neurological Diseases, hosted by the faculty of health sciences at the University of Abomey-Calavi, provided a strong local institutional base for the partnership.
The Benin Connection
LEMACEN made it possible to consolidate a Beninese research environment dedicated to chronic and neurological diseases. It did so with missions in research, training, supervision of master’s and doctoral students, scientific support, research project implementation, seminars, and expert activities. Its creation did not initiate the cooperation, which was already several decades old, but it gave it a more stable and visible scientific anchor in Benin.
Since 2014, the partnership has expanded considerably. Joint research has been conducted in both population- and hospital-based settings covering epilepsy, dementia, stroke, and other neurological disorders. Research has also covered cancers, mental health, alcohol-related disorders, and other chronic diseases.
The thematic extension from neuroepidemiology to chronic disease epidemiology has been progressive and coherent, because many of these conditions share common methodological, health, and public health challenges. These include case identification, access to diagnosis, treatment gaps, long-term follow-up, stigma, disability, and integration into primary care and public health policy.
Training has been one of the most visible and durable outputs of the cooperation. Between 2010 and 2025, the available institutional figures report more than 20 jointly supervised master’s students, 16 doctoral theses, eight ongoing university theses in cotutelle, and more than 60 joint Medline-indexed publications. Selected examples can be found in the References section.1,2,3,4,5
These figures show the scale and regularity of the partnership. The cooperation has not been limited to occasional exchanges; it has generated a continuous pipeline of trained students, doctoral candidates, researchers, and academic leaders.
The second edition of Appui au Développement de l’Enseignement Supérieur Français en Afrique (ADESFA), a fund from the French Ministry of Foreign Affairs for the development of French higher education in Southern and Eastern Africa, was launched in 2020. It represented a major step in structuring training. It supported the development of a joint public health master’s program in neuroepidemiology involving the universities of Limoges, Cotonou, and Parakou.
The inclusion of the University of Parakou is important, because it shows that the partnership was not limited to the University of Abomey-Calavi and was already opening toward a broader Beninese academic network. ADESFA II helped strengthen local training capacities, harmonize curricula, and build a license-master-doctorate continuum in public health in Benin. It also contributed to the emergence of a new pool of students and young researchers able to work on epidemiology, neuroepidemiology, and chronic diseases.
INSPIRE-UAC
This dynamic is now continuing with the Innovation Santé Publique Internationale Recherche Enseignement à l’Université d’Abomey-Calavi (INSPIRE-UAC) project from the French Development Agency and the French National Research Agency. This is a larger structuring project devoted to international public health innovation, research, and education at the University of Abomey-Calavi.
INSPIRE-UAC aims to strengthen public health training offerings, including neuroepidemiology across the university system, from bachelor’s to doctoral level. It is also designed to reinforce the coherence of public health pathways. Although UAC is the central Beninese institution in the project, the University of Parakou is also expected to cooperate in this new phase, in continuity with its involvement in ADESFA. This is important because the long-term objective is not only to reinforce one program, but to contribute to the structuring of a national and regional training ecosystem in public health.
INSPIRE-UAC also represents a change in scale. It is no longer only a matter of individual mobility, co-supervision, or short teaching missions. The project includes curriculum structuring, professionalizing training pathways, doctoral training, digital teaching infrastructure, and pedagogical engineering. The development of a shared Moodle learning management system (LMS), pedagogical support from Limoges, and training of teachers in the use of digital tools all illustrate the movement from a bilateral academic exchange toward a more integrated educational partnership.
Capacity-building activities have also continued through international courses and targeted training. In 2025, international courses were organized in Benin on subjects including:
- epidemiology
- neuroepidemiology and vascular neurology
- epidemiology and occupational and environmental risk assessment
These activities aimed to strengthen practical skills in data collection, analysis, interpretation, and application of epidemiological methods. They also brought together neurologists, cardiologists, internists, psychiatrists, public health doctoral students, epidemiologists, and other health professionals, thereby reinforcing the multidisciplinary character of the cooperation.
The partnership has also gained institutional and political visibility. Visits to LEMACEN by French senators in 2024 and French deputies in 2025 should be seen as milestones in the recognition of the cooperation. They illustrate that the partnership is no longer only an academic or scientific relationship, but also part of a wider framework of university diplomacy, Francophone cooperation, and international development.
Similarly, the planned Fête de la Science in Cotonou in September 2026 will extend the cooperation toward public engagement, science communication, gender equity in science, career orientation and links with socioeconomic partners.
Several research projects have contributed to this progressive consolidation. They were funded by diverse sources, including the French National Research Agency, the Nouvelle-Aquitaine Region, Sanofi Global Health Unit, and IRD (the French Institute for Research and Development). Together, they show that the partnership has been supported by a succession of national, regional, private and international funding mechanisms.
EMPOWER
The most recent large-scale development is EMPOWER, funded by the European Union’s Horizon Europe research and innovation program, coordinated by the University of Limoges through EpiMaCT and involving LEMACEN. The EMPOWER project focuses on people living with noncommunicable diseases (including neurological diseases), frontline health workers, and digital health tools in sub-Saharan Africa.
EMPOWER includes the University of Abomey-Calavi as a full partner, alongside institutions from Togo, Italy, Switzerland, Luxembourg, and the Université Numérique Francophone Mondiale (UNFM). This project marks another change of scale: The Limoges-Benin cooperation has become part of a wider international implementation-research consortium addressing chronic diseases and health system strengthening in West Africa.
The cooperation has grown through successive stages, from early links in tropical neurology and individual training to a structured institutional partnership. It then expanded through joint master’s and doctoral training, shared research, and co-authored publications. More recently, larger projects helped structure public health training in Benin.
The partnership is now entering a new phase through major international projects. The central strength of the cooperation lies in its continuity. It has survived institutional changes, changes in research unit names, evolving scientific priorities, and successive generations of academic leaders. Its continuity is also embodied by the fact that both the founder and the current director of LEMACEN are professors of neurology who followed part of their academic training in Limoges. This creates a rare form of partnership, where institutional history, scientific trust, and human trajectories reinforce each other.
Over more than four decades, the Limoges-Benin cooperation has moved from pioneering academic exchange in tropical neurology to a comprehensive partnership in neuroepidemiology, chronic disease epidemiology, and public health. It has contributed to training, research capacity, doctoral supervision, scientific production, curriculum development, digital education, international projects, and public engagement.
The current goal of the Limoges-Benin cooperation is to support a center of excellence in public health and chronic disease epidemiology in Benin. This will be rooted in neuroepidemiology but open to the broader challenges of noncommunicable diseases and global health. •
Dieu donné Gnonlonfoun is a professor of neurology and director of the Laboratory of Epidemiology of Chronic and Neurological Diseases at the University of Abomey-Calavi in Cotonou, Benin. Jérémy Jost is a professor of clinical pharmacy at the University of Limoges and is affiliated with the Institute of Epidemiology and Global Health-Michel Dumas. Dismand Houinato is a professor and honorary director of the Doctoral School in Health Sciences at the University of Abomey-Calavi. Pierre-Marie Preux is a professor of epidemiology and head of the epidemiology department at the University of Limoges.
References:
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Houinato D, Yemadje LP, Glitho G, Adjien C, Avode G, Druet-Cabanac M, Preux PM. Epidemiology of epilepsy in rural Benin: prevalence, incidence, mortality, and follow-up. Epilepsia. 2013 Apr;54(4):757-763. doi:10.1111/epi.12082.
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Cossi MJ, Gobron C, Preux PM, Niama D, Chabriat H, Houinato D. Stroke: prevalence and disability in Cotonou, Benin. Cerebrovasc Dis. 2012;33(2):166-172. doi:10.1159/000334195.
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Paraïso MN, Guerchet M, Saizonou J, Cowppli-Bony P, Mouanga AM, Nubukpo P, Preux PM, Houinato DS. Prevalence of dementia among elderly people living in Cotonou, an urban area of Benin (West Africa). Neuroepidemiology. 2011;36(4):245-251. doi:10.1159/000328255.
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Houehanou YC, Lacroix P, Mizehoun GC, Preux PM, Marin B, Houinato DS. Magnitude of cardiovascular risk factors in rural and urban areas in Benin: findings from a nationwide STEPS survey. PLoS One. 2015 May 6;10(5):e0126441. doi:10.1371/journal.pone.0126441.
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Wachinou AP, Houehanou C, Ade S, Totah T, Berger M, Solelhac G, Amidou S, Fiogbe AA, Alovokpinhou F, Lacroix P, Preux PM, Marques-Vidal P, Agodokpessi G, Houinato D, Heinzer R. Prevalence of sleep-disordered breathing in an African general population: The Benin Society and Sleep (BeSAS) study. Lancet Respir Med. 2022 Sep;10(9):831-839. doi:10.1016/S2213-2600(22)00046-7.
