Scientific and Technical Advisory Committee: report of the third meeting,Geneva, 3-4 March 1976

r-t octfsrrcfto.t ONCHOCERCIASIS CONTROL PROGRAMME IN THE VOLTA RIVER BASIN AREA SCIENTI FIC AI{D .TECHNICAL AD'fTSORY COMMITTEE Report of the )Third Meetils Geneva. 3-4 March 1975 I -2- CONTENTS List of participants A. Opening of the meeting B. Election of Chairman C. Adopcion of the agenda D. Report by STAC members on Eheir visits to Ehe Progranune area E. Progress report, on epidemiological activiEies . . F. Report on epidemiological and chemoEherapeucic research and proposed programne for 1976 G. Ways and means of promoting Ehe development of new drugs H. Progress report on entomological actlvities . . I. Report on entmrotogica1 research and proposed progranune for L97 6 Vector ecology Veccor control Environmental protection J. DaEa analysls . K. other maEeers . L. Date of the next meeEing M. Adopcion of the reporE N. Closure of the meeting ANNEX I. Agenda Af.lNEX II. ReporE of the Joine Meeting of the Ecological Panel and che Sciencific and Technical Advisory CommicEee . . Paragraph 24 35 37 45 51 63 65 70 7I 72 73 Page 3 4 4 4 4 5 9 10 11 11 L2 L2 L2 L2 13 t4 I1 2 3 4 20 6 8 8 I3 LIST OF PARTICIPAI{TS Members of Ehe CoflrniEtee Dr Colvin Gibson, AssisEanE Eo the Direccor for Conurissioned Officers, National InsEiEute of HealEh, BeEhesda, Maryland, United Staces of America. Dr PeEer Haskell, Director, CenEre for Overseas PesE Research, @!g, Uniced Kingdom ofGreat Britain and NorEhern Ireland. Dr Hermann KnuEtgen, DirecEor, InsEituEe of Tropical Medicine, University of Tiiblngen, Tilbingen, Federal Republic of Germany. Dr Friedrich Kuhlow, (Director, Department of Entomology, Bernhard-Nocht InstituEe, Hamburg), DirecEor, Liberia Research Unit, cfo Aong Mining Company, P.O. Box 538, @.!g, Liberia. Dr Marshall Laird, Director, Research Unit on Vector Pathology, Memorlal Universicy of Newfoundland, St. Johqrs , Newfoundland, Canada. Dr Christiaan Lucasse, Chief, Yellow Fever Research and ProducEion Unit, Institute of Tropical Hygiene, Department of Microbiology, Aneterdam, Netherlands. Dr James Miles, Chief, Pestlcides Branch, VecEor Blology and ConErol Division, Bureau of Tropical Diseases, CenEer for Disease Controlr 1[l@, Georgia 30333, United States ofAmerica. Dr Jean Mouchet, Inspecteur g6n6ra1 de Recherche, Office de la Recherche scienEifique et technique outre-mer, Dlrecteur des Services scientiflques cenEraux, 70-74, rouce drAulnay, 93140 Bondv, France. Dr George S. Nelson, Director, Department of Medical Helminthology, London School of Hygiene and Tropical Medicine, London, United Kingdoa of GreaE BriEain and Northern Ireland. Dr Letitia E. obeng, DirecEor, rnstituEe of Aquatic Biology, Achlmota, Ghana. Dr F61ix Serie, Directeur g6n6ral de la Sant6 publique, MinlscEre de la Sant6 publ ique, Cocodv- Abidian COte drlvolre. WHO Secretariat Dr A. Bellerive, Director-ConsultanE, Onchocerciasis Control Progranrme, MIO Headquarters,(Secretary). Dr H. Ramamonjy-Ratrimo, Regional Adviser, PrevenElon and ConErol of Diseases, World Health organizaEion, Regional Office for Africa, Brazzaville, Peoplers Republic of che Congo. Mr J. Duppenthaler, SLaEistician, Onchocerciasis Concrol Prograurne, t{HO Headquarters. Dr P. Kramer, MedicaL Of.tLcerfEpidemiologlst, Chlef, Epidemlologlcal EvaluaEion Unir,Onchocerciasis Control Prograrmre, Ouagadougou, Upper Volta. Dr R. Le Berre, Scientist/Entomologist, Chief, Vector Control unit, onchocerciasis ConErol Progranune, Ouagadougou, Upper Volta. Mr J. D. M. Marrr Entomologist/Oiotogist, Onchocerciasis Cont,rol progrnrnme, WHO Headquarc,ers. Dr E. onori, Medical officer/Epidemiologist, onchocerciasis control programne, wHo HeadquarEers. Mr G. Quelennec, EnEomologist/chemisc, onchocerciasis Control progranrrne, pIIo HeadquarEers. Mr F. trlalsh, EnEomolo8lst, onchocerciasis Control Progranune, Ouagadougou, Upper Vo1ta. -4- A. OPENING OF TTIE MEETING 1. Following Ehe joinr meecing L,irh Ehe Ecological panel (Ep) opened by Dr L.(Annex II) the Ehird meeEing of the Scientific and Technical Advisory Committeeplace on 3 and 4 March 1976 in WIIO Headquarters, Geneva. Bernard,(SrlC) rook B. ELECTION OF CHAIRMAN 2. Dr G. Nelson, who had been elected Chairman of the joinE meecing, conEinued in Ehe chair. ADOPTION OF THE AGEI{DA The agenda adopted by the Committee is appended as Annex I. REPORT BY STAC MEMBERS ON NMIR \NSITS TO THE PROGRAI4ME AREA 4. Dr G. S. Nelson and Drs C. L. Gibson and L. Obeng reported on their visiEs to the Progranune area in October 1975 and January 1976 respecElvely. It was stressed thac the overall performance of staff and the progress of che Progranune were impressive, and the colEoencs of che Co'rEoittee members should be considered ln this context. 5. It was generally felt chac, in order Eo ensure conEinuiEy in the staffing of the Progranme, greaEer opporEuniEies should exist for technical staff Eo participate in research $rithouE jeopardizlng essential routine work. STAC suggested thar field sEaff should rake Part in discussions on research needs with WIIO sEaff in Geneva, and wiEh STAC members. 6. MIO acknowledged Ehe need for motivation of personnel and pointed out EhaE chere qrere, in fact, E$ro caEegories of sEaff working in the field: those whose career was advanced and who considered themselves Ehe "engineerstt of such programnes and the younger research workers for whom opportunicies for involvemenc in research would be created. It was also explained that Ehe research progranrne was jointly prepared by the Programne scaff in Geneva and Ouagadougou and Ehat good cooperatlon and exchange of lnformaEion exisEed at all levels. 7. t{hi1e appreciaEing Ehe difficulEies encount,ered by WIIO in recruiEing a second ophthal- mologisc, STAC wa6 concerned that, aE presenE, only one ophchalmologist was employed full time by Ehe Programme. The need for locaI counterparEs for key personnel was highlighted, and it was suggesEed that provision be made Eo Erain addicional staff in specific fields in order to relieve the specialized staff of some of the rouEine work. 8. WHO reninded STAC thaE, so far, OCP had arranged for the training aE che Insticut de Recherche sur lronchocercose, Bouak6, (Ivory CoasE) ot L2 enEomologisEs and 25 enromological technicians for Ehe Programme. 9. In che field of entomology the members noEed that, as reconmended by STAC at it,s first meeElng, emphasis had been laid on locating and monitoring breeding siEes and sEeps were being Eaken to invesEigate Ehe reinvasion problem. MenEion was made of the apparent. variability in the handling of flies for dissecEion, and reservaEions were expressed regarding the technique used for examining the flies for infection. WIIO informed the ComitEee that a consEanc effort was being made Eo ensure the standardization of methods t,hroughouc Ehe Programme. l-O. IE $ras felt that the research acEiviEies conducted by OCCGE and ORSTOM in Bouak6, were being carried ouE wiEh lmagination and enthusiasm, and were beginning Eo produce results of signlficance for the Progranune. tlith regard to aquaEic moniEoring, which might be considered as an operaEional raEher Ehan a research activity, iE was suggested Ehat greater coordinaEion was required between the differenE groups engaged in this work and Prograrme personnel. t c 3 D -5- t 11. WHO informed rhe Committee chat che hydrobiological Eeams regularly received the insecticide Ereatment schedules in cheir areas, and a radio was being installed ln Bouak6 on 4 March Eo improve coaununicaElon and coordination wlth Lhe Vector ConErol UniE. L2. In rhe field of epideniology ic had been not.ed thac the clinical examinaEions had greatly improved slnce the visits of the STAC merrbers in Ehe early part of 1975. However, Eechnlques for deEecc,ion of ltght infecEions required greater refinement. Ic was felt that rhe activltiee of the soclologisEs were somewhat limited in relation Eo Eheir abilities, although greacer exploit.aEion of Eheir experEise would result. from Ehe establishment of che Economic Development Unit. 13. The appointmenE of a staEisEiclan to handle Ehe epidemiological, entomological and aquaEic monitoring data, in line wich the STAC recorunendation for the development of a data proceasing system, rras noted with satisfaction. L4. The STAC meobers felt that a closer associaEion between che ulttO/UNOP Trypanosoolasis Research proJect and the WIIO Onchocerclasis Control Progranme would be desirable, parEicularly ln view of thetr cloEe relationshlp in Eerms of ecology and resettlement, and Ehe hazard presented for migrating populat.ions and Progragme staff. 15. OCP, fully arrare of the cr)rpanosonlasis rlsk co local pfpulations moving lnto the riverlne valleys, was Ealntaintng close contacE wich the $II|O/UNDP Trypanosomiasts Project. Arrangements had already been oade for the regular nedical survellLance of Programre personnel 16. Concern rras expreased at Ehe postponement of the consEruction of a cenEral Prograrme headquartera in Ouagadougou, wtrlch was considered of vital importance co facilicaEe cosmuni- cations and coordlnaEion. It rras also felt chat a central laboratory was required for both the parasltological and entomological work. L7. WIIO explained Ehat the decieion to posEpone the construcEion of a Progremnq trs4dquarters had been necessary for budgetary reasons, buE that iE was planned to present the maEcer to the third seesion of the Joint Coordinat{ng Comlttee. In the meantime the poseibility of renEing a building to house most of the Programe Unite was being explored. 18. The Cmlttee strongly reco*ended that inEerdisciplinary meeclngs of senior Programme personnel ghould take place ac regular intervals to discuss both che research and control accivitles. Meobers also urged that efforts be made to sEimulate the National Onchocerclasls C@iEtees Eo play a treater role in Programne acEivlcles. 19. Inasouch as baseline data do not now exieE regarding the disEribution and prevalence of Siuuliuo in the Phase III area during the rainy season and che dry season, STAC reconrmended Ehbt insecticide applicatton should not 6EarE in this area unEil a full yearrs collection of entoEologlcaL data had been ngde. However, in vien of the qi-gnff_i-C.+!r! 9p-efg-t-!ona1 and paliqy_ p_lgllems which would resulE from suctr 1 dgqtgiqL l_c_11eg_iqreed that STAC would soneider ti-ii-isaua-ln ildtail at its next meecing in November 1976. E. PROGRESS REPORT ON EPIDE}fiOIPGICAL ACTIVITIES 20. The epideniol.ogical evaluation activtties carried ouE during Ehe past year were deacribed by WIIO. Ttre oethodology which had been ortginally applied in the field surveys had been sltghtly oodtfied: (a) a thorough search for head nodules ln simple evaluation surveys had been carrled out since January 1976 and skin snips from the correspondtng outer canthus had been Eaken whenever nodules were found; (b) all ekin snips found negatlve with the standard method were rechecked by keeping speclmens in physiological saline in a micro- tieration plate f.or 24 hours for later examlnaElon (positlvity lncrease by 5.2% but preliminary results indicated that Ehe sensitlvlty rras more pronounced amongsE adult than young children and higher in hyperendemic chan hypoendemlc areas); after a period of crlaL the Snellen E-tesc had been replaced by che Sj6gren hand-test; (d) a 3-scep scale Eo EesE visual aculEy was being used ln simple surveys whereas the g-slep scale concinued to be used in detailed evalua- tion surveysl (e) a guideline for the colleceion of sociological daca had been recently finalized and was now being used in routine evaluaEion work. -6- 2I- The results of the activities carried out in Upper Volta, Mali, Ivory coast and Ghana were presented. Durlng che year over 26 OO0 people had been examined, more c,han double thefigure foreseen ln the PAG Mieslon report for the first year of acEiviEies. Thls was due EobetEer geographlcal coverage, at Ehe expense, perhaps, of inadequate randomization in che aelectlon of vl1Iages. 22. In reviewing Ehe epidemiological activities carried out in the progranme area STACfelt that the poseibillty of transplacental infection ehould not be overlooked as this nayhave an imPortant bearlng on Ehe assessment of the incidence of the disease. In this regardthe Coutrtrittee recomnended that the oCP Epidemiological Evaluation UniE pay parcicular atgen6ionro the youngest age cohorts, using Lhe most accuraEe diagnostic meEhod, in order Eo reduce, as much as poasible, false negatlve resulEs among those age-groups. 23. on the basis of the epidemiologlcal survey resulEs obtained to daEe, it qras reconunended chat a ner{ estimate be made of the total ntrmber of persons bIlnd as a result of onchocerciasie wlthln the Progranrne area. Efforts should also be made to determlne whether or not there isgenerally a htgher nortaltty anong blind persons and, particularly, among thoge blind fron onchocerciasts. F. REPORT ON EPIDEMIOIPGICAL AT.ID CHEMOTHERAPEUTIC RESEARCH AIID PROPOSED PROGRAUME EOR 1976 24. WHo reported on the epidemiologtcal, paraeltological, imuunologicaL and chemoEherapeutie research activities carried out in 1975 and the progranme for research on the eame subjectsfor L976 wae briefly reviewed by Ehe Cqmitree. 25- rn the field of epidemiology, STAC was informed Ehar agreements had been established with the Medical Reeearch Councll in London, UK, and the Tropenmedizlnisches Instltur of theUniversity of lllblngen, Federal Republic of Germany, for the study of the dynaaics of Erans- mission in the savanna area of northernCameroon. In addition, the aame team would continue studies initiaEed in previous years on che pathogenesis and chemotherapy of onchocerciasis. 26. An agreeoent had been establiehed with Ehe IsEiEuto di Iscologia e Anatqria patologica, Rome, rtaly, where hietologlcal examlnations of skin biopsles from fatients examined uy itre IProgrannne parasitologists would be carried out and the results courpared with photog..piri. material obtained from the same Patienta in the Programme area. In thie way lt was hopedLo achieve better identification, classification and recording of skin leslons due t.o onchocerciasis. 27. t'IiEh regard to paraslcology, scudies were in progress in Ehe prograrnme area co improve and evaluate the diagnostic methods. Plans had been made Eo compare th. i.p."t of physio-logical saline and Hanks balanced ealE solutions on the emergence of mlcrofilariae from skin snlps 28. An inveetigation on the disEribution of D SETED Eocerca and other filariasis was I initiated in northern Ghana by the Progranme teams in d and it was planned that euch studies be carried ouE sysEematicallyifferent geographical areas of the programne. 29. In relation Eo imunology, the CormnitEee rcas informed thag a research training grant, awarded by IIIHO ln 1975 to a worker at the Minerva InstituEe for Medical Research, Helsinki,Finland, had been extended for another year wiEh OCP funds in view of Ehe very promising resulEs obtalned in the isolatlon of a purified and speclfic onchocerca votv,rius antigei.The Centre for Disease Control, AtlanEa, uSA was collaboragi"lTllf,-ffi in rhe assessmenr ofa fluorescenE antibody cesE which uttlizes o. volvulus adult $rorm aecgions as antigens and serum sampres Eaken in che Programme area. e...IilEf,fDeparrmenr of clinlcal Tropical Medicine,London School of Hygiene and Tropical Medicine, (U.K.) would visit the progranrme area inthe coming month6 to test, in collaboration with the field personnel, the enzyne-linked irununo- sorbent assay method. In reviewing the chemotherapeucic acEivities, mention was made of che resuLcs obEained in field trtals wlth suramin and diethylcarbamazine by the Mobile ophthal- mologlcal Team, Ministry of Health, upper volta, and the Royal Commonwlalth Society ior theBlindrs ceam, sEationed at Bolgatanga, northern Ghana. Ihe Conunittee $ras also informed -7- that an agreement had recenEly been established wich the OCCGE for chemoEherapeucic crials wiEh levamisole, diechylcarbamazine plus levamisole, and nifurEimox Eo be carried ouE by Ehe Parasitological SecEion of CenEre Muraz, Bobo-Dioulasso, Upper Volta. 30. The progress made in the establishment of a chemocheraPeuEic research cenEre in the Programme area was reported. The Ghana GovernmenE had made available part of the premises of a newly built hospiEal and annexed laboracory facilicies aE Tamale, norEhern Ghana, where a naEional medical support uniE would assist when required. WIIO was experiencing difficulties in the recruitmenE of two WHO consultanEs Eo be actached Eo Ehis cencre. 31. With regard to oEher research activities, iE waa reported that (a) scudies on the distribution of animal onchocerciasis and identificaEion of infective fllarial larvae in S. damnosum had not yeE starEed as it had not been possible to find insEituEions or investigators in Ehe Programme area to underEake them. fhe possibility of using well-equipped laboraEories oucside che Programme area for che identification of infecEive filarial larvae had been explored buc difficulties were being encounEered in the colleccion and preservation of che maLerial; (b) an agreement had been established very recenEly wiEh Ehe Centre for Disease Control, Atlanta, Georgia, USA under which aEtempEs would be made co infecE jiirds(Meriones unguiculat,us) with O. cervicalis. C. variipennis, wtrich had already been successfully colonized and proven Eo be a vecEor of O. cervlcalis would be used as a source of infective macerial; (c) an agreemenE had also been escablished with Ehe Johns Hopkins University, USA for the improvement of the technique which had been successfully uEitized for the in viEro culLure of mlcrofilariae. The would be used for the in vitro culEure. West African savanna sErain of O. volvulus 32. The Comittee realized che difficulEiea encountered so far in finding suitable insEiEutions in the Prograutre area Eo undertake sEudies on Ehe distribution of animal onchocerclasie and on the identificatlon of infect.lve filarial larvae in S. damnosun. Considering, however, the imporEance of Ehese sEudies ln the assessmenE of transmission PoEentials, the Couraittee recounended thac efforts continue to be aade (a) to scudy thedistributlon in Ehe Prograurme area of Onchocerca species in domesEic and wtld animals and Cheir vectors and (b) to idenEify Ehe infective filarial larvae in S. um. 33. A proposal was made chat a mobile clinic be set up on an experimental baets inthe Programne area for the treaEmenE of eye diseases. In Lhis respecE STAC considered that the cooperation and assistance of Ehe NaEional Onchocerciasis Comittees and the InternaEional Agency for the Prevention of Bllndness should be sought. Such a clinic might offer Ereatnentfor trachoma, enEroPion, xerophthalmla, glaucoma, senile cataract, toxoplasmosis and a variety of acuEe eye condiEions (conjuncEivitis, corneal ulcers, iriLis, foreign bodies, eEc.). Ag regards onchocerciasis, the clinic, in collaboraEion wlEh Ehe Programre Epldemiological Evaluation UniE, could undercake the detecEion and removal of head nodulesl and assess thebeneflts of thie procedure on Ehe development of eye lesione. Using Ehe criceria listed in che Report of che tlllo Experc CommlEtee on the Epidemiology of Onchocerciasis (1976) the clinic could also screen the population for persons who are especiallyttat riskrtof becoming blind. 34. Such a mobile eye clinic would also provide an additional opportunity for rraining medical and paramedical personnel in Ehe ocular aspects of onchocerciasis and in other comnontroplcal eye diseases. The Conrnittee suggested that arrangements be made wichln Ehe Progranune area for already exisEing naEional centres to be utilized for treatment of selected Patients wiEh DEC and suramin under medical supervision. IE was pointed out Ehat t,he GovernmenE.s would require clearly defined proEocoLs. n -8- G. WAYS AND MEANS OF PROMOTING THE DEVELOPMENT OF NEW DRUGS 35. The Committee $ras informed t.hat at the last Steering Comnitt,ee sessionWHO asked che World Bank whether funds could be made available co subsldize a few selected pharmaceuEical companies for conducting preliminary sEudies on the developmenE of new filaricidal drugs. The Bank suggested that hftIO should encourage such companies to presenE cost and cime estimatesfor research on products suitable for mass campaigns againsc onchocerciasis. proposals would be considered by a [J]IO technical group and, on the basis of the groupts reconmendaEion, the Steering CommitEee would consider ways of financing che research. The acElon Eaken in recenc years by WIIO in an atEempt Eo stimulate the pharmasqu6ical indusEry co develop new drugs against the most imporEant parasitic diseases was described. 36. Recognizing the urgent need for a drug suiEable for mass adminisEration again6t onchocerciasis, STAC recornmended that trlIIO convene, at an early date, a meeEing of representa- Eives of appropriaEe academic centres and pharmaceutical companies in order co encourage the companies, where appropriate, to release substances already available for the necessary screening prograrme and to stimulaEe Ehem to synthesize new compounds. H. PROGRESS REPORT ON ENTOMOIOGICAL ACTIVITIES 37. WIIO reviewed the entomological accivltiee since the beginning of 1975. IE was reported thaE, following the suspension of operations due Eo the aircraft crashes, insecEicide treatment had been resumed on 10 February 1975 and had contlnued uninEerrupted in Phase I. In January 1975 treatmenE had been extended inEo Phase II. Ihe control of the inunaEure stages of S. damnosum had been generally saEisfaccory and, recently, iE had been possible co suspend the appllcation of insecticlde for two months along certain sEretches of the Black Volca and the Como6-L6raba. In the latter area studiea erere being undertaken Eo determine whether the rrbille[ cytotype had been effectively ellminated. On the lower Como6, Ereatment had been stopped for five weeks, but recormrenced when one sice wa6 found to be relnfected. AE the present. tlme, Phase I operations had become rouEine, while Phase II EreaEment. qras restricted to the t'lhiEe Volta ln Ghana where hydrological conditions warranced it. Surveillance of breedlng 6iEe6 in the Phase III areas was under way prior to the opening of the sectors and sub-sectora in May 1976, and the conunencement of treatment in earLy L977. 38. Ihe reinvasion which had caken place in the lower periphery of the control area wa6 described. This reinvasion starEed ln May 1975 and conElnued throughout the rainy season. The fLies were confined to the river valleys, and zero catches were recorded only a few kilometres away. The flies caught were almost 1OO7. parous and in some the numbers of infeccive 0. volvulus larvae were more comparable to the forest than the savanna zone. 39. On the assumption that the phenomenon would recur in 1976, in the same zone or elsewhere, an tnEensive seven-poinE research progranune had been planned. This involved (a) testing the vector poeential of the invading fqrale S. damnosum s.1. wiEh regard to the local O. vo lvulus parasites; (b) deeermining the cyEotaxonomic status of che flies; (c) idencifying the flies by electrophoretlc means; (d) 'rfingerprintingrr che site sources by X-Ray fluorescence- spectroscopy of flies; (e) carrying ouE climatological studies; (f) extending surveys Eo rhe south of the OCP area; and (g) experimental Ereatment of breeding siEes ouEside Ehe control area if necessary. 40. The Commictee considered the reinvasion problem aE lengch and agreed EhaE thorough investigation was required. Some members felc Ehat reinvasion was normal in prograrunes aimed at conErolling migraEory insecEs and thac, accordingly, a flexible approach should be maintained. The mechanisms whereby flies enter the area should be invesEigated. The meteorology of the area should certainly be studled, as, Eo date, lt appeared that several Eypes of weather systems coul-d be involved; this should be coupled with some basic work on flight behaviour and flight performance. The possibilicy of extending the currenE Prograruue area was raised and, while MIO was not against such expansion, STAC considered that it was preferable Eo waiE until further studies on Ehe reinvasion decermined its importance or other!,rise Eo Ehe conErol prograflrme before a policy decision of this magniEude was taken. I -9- 41. WllO reported thac many ccuntries throughout Africa out.side the present Programtre area, where onchocerciasis was endenric, had requesced cont.rol measures buE the training of local scaff and che collecc.ion of base line data was necessary prior to Ehe implementation of such operacions. 42. The CoumitEee was informed of work done in differenc parts of West Africa on the marking, release and recapcure of flies. A method which had noc proved very sat,isfactory in Parts of the oCP area had been used to great effect in the Cameroon foresE area where iE had shown thac S. damnosum adults were moving along Ehe river valleys in considerable numbers uP to 79 km from their source. AIso, Ehere was evidence thaE parous flies tended to remain in close Proximity Eo, and move along, Ehe rivers, while nulltparous flies dlspersed away from the rtvers. As che flies along the Bandama rcere almosc 1Oo7. parous, Lhis might also indicate an accive movement upstream. t{indborne invasions may be Ehe means whereby cheflies reached the lotrer river valleys iniEially and ic was sEressed EhaE Ehe E$ro mechanisms srere not muEually exclusive; both aspecEs, cherefore, need to be studied. It was agreed chat ln 1976 much relevant information could be collecced from the proposed research, inparticular by controlling downstream slEe8 outside Ehe control area suspected of producing the flies. 43. tlith regard co the meteorological studies, WHO poinEed out Ehe difficulties and cost of increaeing the surveillance activitles co permit daily catching in more points. I,he research Progrrrrrme, ouclined above, intended to make use of Che nec,work of catching points and regular schedules with more inEenslve study being undertaken aE a few poinEs only. Altmlted number of extra personnel would be called in to assisE wich the study. 44. Ihe CmitEee, accepElng Lhe vari.ous consEraints, felt chat the research progragle should be long-term and not necessarily resEricted to one particular river. FLy marking and recapture should be undercaken. Emphasizlng thaE all flight is purposeful and norpaseive, STAC recomended the trial of different trapping devices, rnhich may indicate fly movenent ineide and outside the boundary layer. An enlarged research projecg could be envieaged Eo clartfy whether a long, windborne migration from outside the progranrme area oaa taking place; this was considered of paramount imporEance due to the concern of the Participating Councries. I. REPORT ON ENTO,TOIOGICAL RESEARCH AT,ID PROPOSED PROGRAMME FOR 1976 45. Vector ecology: Following a Scientific Advisory Panel (Sap) Working Group rphich meCln Geneva in Occober 1975 to consider che rea,ring of single generaEions and che development a research entomologisL had been recruited toof a eelf-perpetuating colony of S. damnosum establish a rearing laboratory. A consulEanE, (Dr J. Grunewald of the Instituce of Tropical Medicine, Tllbingen, Federal Republic of Germany) naa been recruited to analyze the !ilarerquality at Potential locations and esEablish baseline data fron slEes where different species of the S. damnosum complex were found. Ihe Corrurlttee was inforned that Ehe rearing laboratory would be situated in cloee proximity Eo the OCP area and an alrport where the wacer quality wae satlsfactory. Contracts had been established wich two laboratories in the USA and Germany to PromoEe work in progress on the establishment of seLf-perpeEuating colonies.Difficultlea lrere being encountered in transporEing llve marerial from West Afriea and this would be inveetigated by the research enromologist. 46. SEudies on Ehe S. dannosum complex were being continued by che cyEoEaxonomist of the Prograrmre and, under an agreement wlth occcE, by another scientist at Bouak6: larvae from sites throughout che Prograrune area were being identified and the distribution of thedifferent species of the complex plotted. contracrs had been established with Ehe LiverpoolSchool of Tropical Medlcine, United Kingdom, and the UniversiEy of Gtrana for the development of an electroPhoreEic technique co identify the different species wiEh particular emphasis on adulcs; recenE resulEs indicated Ehe possibilicy of idenrifying the adulcs of three species by chis method. ClassicaL Eaxonomic studies of che eggs, larvae, pupae and adults of che different species would be undertaken by the Biosyscematics Research UniE, OEtahra,Canada. Material for Ehese collaborating laborarories would be provided by Ehe research enEomologisC. 10- 47. STAC was informed that Ehe research on S. damnostmr was currencly confined to WestAfrica where, under an agreement with the Insti,t"i aE Recherches sur lronchocercose, Bouak6,two entomologisEs lrere engaged in developing techniques for sampling larvae and adulcs. Some progress had been reported on trials using plastic strips as larval aEtachmenEs on whichlarvae had been reported uP to 1.3 m below Ehe water eurface. The Committee feIE Ehac this would not Present a problem as striaEion in Ehe krater of the insectlcide currently in use didnot occur. 48- After trying many differenE kinds of trapping devices, success had been reported using a simple attracElon trap made of aluminium foil at Dakarango on Ehe Marou6. The CounitEee was informed that furt,her trials were taking place at the Gr6chan site (rvory coaer). Thepoesibility of finding pheromones and other atiractlve substances was being investigaEed.These could be tested in a wlnd tunnel when a suitable colony of S. daonosum had become avai 1ab le. 49. As recorded in c,he enEomological acElvities, the cooperation of biogeographers fronthe Centre for Overseas Pest Reeearch (UK) was anticipaEed in the srudy of the possible wind movernent of s. damnosum during the period of the invasion. 50. The Cmittee felt that iE qras esaenEial to deveLop an integrated research progrnnrme on Ehe moveoent and dlstribuElon of adult Simulium, whtch would include work on crappingtechniquesr flight performance and behaviour and other relevanE areaa. STAC st.orrgty - recotttmended, Eherefore, Ehat the Prograune convene a SAP Worklng Group aa goon ae possible, co clarify research prioriEies in fields directly related Eo the soluEion of rhe reinvasionprobleo. 51. Vgctor control: The need for a satisfactory field merhod for cesting susceptibility of Simulium larvae in Afrlca had been apparenE for some time and a consultant (Dr J. Mouchet,Directeur des Services scientifiques cenEraux de lIOF*STOM Bondy, France) recently completedtests lrith a method derived from that of Quelennec and oEhers which appeared saciefaclory.This involved exposing the larvae to the different concentraEions of insecticides in sEill water mainEained aE a conscant temperaEure in wet sand for Ehree hours. 52. Dr Mouchet, reporting on his mlssion, stated that his primary objective was to develop a satisfactory suscePtibllity Eestlng method which would be simple and usable in Ehe field bya techniclan. This he had eucceeded in doing and having obtained reproducible resulcs, hefelt the method had a strong posslbility of being adopted. Not only had he esrablished regular regression Lines for Abate but he had been able co demonstraEe that, outside the Prograrmre area, some S. dqqrnosum larvae, rrere suspected of resiscance to DDT. If this wae confirmed one could "i@E ose resisrance with merhoxychlor. 53. The CormnitEeer exPressing satisfact.ion at the development of a new susceptibili6ytesting meEhod, considered that. further sEudies on its applicability ehould be undertaken. 54. The facEors lioiEing the choice of inseccictdes for Simutium control were recalledby WIIO and it was pointed out thaE at present only a teu, i.,".cti.iae6 qrere in use in differenc Parts of the world including AbaEe, mechoxychlor and fenithrothion. The limitaEions of Ehelast two insecticides hrere ment.ioned. The present insecticide evaluation programme concerningfenithroEhion, methoxychlor, Altosid, Dimilin, I.mO 1825 and Reldan micro-encapsulaEed formu-latlon of methyldursban, was described. 55. Ihe extended trials being undertaken wirh Chlorphoxim were reporced. IniEial resulEs appeared to indicate a mortality of non-Earget organisms greaEer than that experienced with Abate. 56. Dr J. Miles described the research undertaken with chlorphoxim in Ehe Centre for DiseaseControl, Atlanta, USA and reported EhaE a mechod had been developed for determinaEion of resldues in fish and water. He reported that che raEe of decomposiEion of chlorphoxim was much higher than that of Abate. For example, the half-life of chlorphoxim in water aE pH 7 is 1.5 days, whereas that of Abate is approximately eighr vreeks under similar conditions. 11 - 57. The necessicy of a better understanding of che physical state of the inseccicide aE the mornent of its absorption by Simulium larvae was emphasized. This physical sEaEe, which was closely linked to Ehe formulation, appeared to determine the efficacicy and specificity of rhe inseccicide. The CommitEeers assistance in identifying an institucion able Eo undertake a sEudy on the behaviour of emulsions in waEer was strongly requested. 58. Following Ehe concern expressed at the last STAC meeEing regarding the potentiating effect of Abate and Metrifonate, WHO had established a contract with the InscicuEe for Medical Research, Zagreb, Yugoslavia for studies on Ehis subjecc. 59. Wich regard to the development of equipmenc, Ehe possibility of modifying Ehe rapld- release sysEem Eo achieve beEter discribution of small quantiEies of inseccicide was being invescigated. As Ehe Programme was relying on only one method of applicaElon, alternative methods were being developed. Ihe Commictee suggested thaE a link-up be escablished with the WIIO/UMP Trypanosomiasis Project in che testing of alEernative methodologies for applying insecticide. 60. In view of che need co accuraEely decermine the discharge of Ehe rivers at many points, assessment trials were belng considered wiEh a NASA-developed apparaEus. The availability of depth gauges equipped wich a VltF radio transmiEEer, for installation aE certain keypoints, was being invescigated. 61. In the field of biological concrol, close liaison was being malnEained with Ehe SIIIO Division of Vect,or Biology and ConEroI which was promoEing scudies of blackfly parasiEes aE a number of insEitutions. 62. Following a consultanErs recomendations on envi.ronmental manipulation, iE was lntended Eo modify, initially, an important breeding sice on Ehe Black Volta and exarnine the effecr.If satisfacEory, other similar siEes on the White Volta would be considered for modificaEion. 63. Environmental protecEion: The acute effecEs of a range of candidace insecticides on non-targeE organisms were belng evaluaced in Bouak6. Scudies on short and long-tern effect,s of insecticldes were being carried ouE in the CenEer for Disease ConErol, AclanEa, Georgia, USA and a proposal was under consideration for cooperaEion in decailed scudies of the effect of Abate and other insecticides on fish in Ghana. 64. fhe aquatic moniEoring programre sras belng carried out under contracE by inscituEions and specialists in Ghana, Ivory CoasE and Upper Volta. Following che establishnent of the revised Protocol in June 1975 and the finalizaEion of coded recording forms, data from Ehe eelected sampling siEes qras now being received on a regular basis for compucer sEorage andlaEer analysis. A consultanE recently collected baseline daca from a number of uncreaced rivers in Phases rr and rrr areas prior to the cor@encemenE of control. J. DATA ANALYSIS 65. It lras reported that the epidemiological data thus far collected and senE Eo Genevahad been entered into the computer and aE present a sysEem of data management was beingdevlsed and implernented Eo allow the long-term analysis necessary as ,.i1 "" to providl rapidfeedback of results fron each batch of data as it is received from Ehe progr:nrme area. 66. rE luas agreed that iE would be useful for the Prograrune sEatiscician Eo visit theLondon School of Hygiene and Tropical Medicine Eo become familiar with the analysis of theCameroon study carried out in London, in order to capitalize on similarit.ies between the cwo PrograrEnes and to PromoEe the comparabillty of resulEs. It was strongly recounended chac channels of conununicacion becween Ehe t,qro sEat,isticians be opened and maincained to facilicate such collaboration. 67. The conEinuing question of which data regularly collected in Ehe programme area by the vector conErol unit (with Ehe excepEion of fly caEching and dissecrion data, upon which allagree) should be sent Eo Geneva for documentation anafir compuEerizaEion was again discussed. 12- IE was explained EhaE a Breat deal of extra work was involved in the preparaEion of the treatment data for Eransmission Eo Geneva and it was sEressed that some of these daEa were useful only in the Vector Control Unitrs week Eo week operaEions and played no further role in the analysis of epidemiological data. 68. The following addiEional reasons for keeping an hisLorical record of these Vector Control UniE data were mentioned: (a) In the event of a breakdown or gradual deterioration of conErol efficacy, an analysis of such an historical documentation would be lnvaluable. (b) In the event of a rapid change of personnel (either for i11-health or mishap) Ehe existenee of such an historical documenEaEion could be a decerminant factor in the future success of the Programme. (c) In such a large scale, long-term Prograuroe as this, Ehere exist economic and political obligat.ions co maintain adequaEe document,aEion to respond t.o any fuLure queries. 69. As agreement had noE yeE been reached the advice of STAC in this maEter was requested. The CormltEee felt that che various units of the Programre, such as Ehe Epidemiological Evaluation Unit and the VecEor ConErol UniE, should be involved in the formulaEion of^aaaftian-affyporne56on wh-ic-h--Eo-5aEE the coLlection and anaifrii'of aata. lru.q-q9-F.11g constraints che Chairman.p-o-1tp9^qed furEher {-!{gu.s.sio'q -rlnti!.e.bejq9:(-q--me_e3Ts of the Comdltcee,by'-whlch iimJfOff 'reports could be submitted and studled. K. OTHER I.{ATTERS 70. Dr C. L. Gibson requested thaE naoes of individual consultants and research workers be included ln progress and other reports. L. DATE OF IHE NEXT MEETING 7L. It was agreed EhaE Ehe fourth meeting of the Scientific and Technical Advisory Committee would take pLace during the first week of November 1976 inrnediaEely following the proposed Working Group. M. ADOPTION OF THE REPORT 72. The CortmiEtee reviewed and adopted the draft repore with certain modifications. N. CLOSURE OF THE MEETING 73. In closing che meeting the Chairman thanked all participants and Ehe SecreEariat for the assistance he had received in carrying out his functions. Noting chat this rilas t.he last meeEing at which Dr Bellerive qrould be present, the Chairman took the opporEunity to convey to him the ConrmitEeers appreciaEion of his wisdom and guidance and iEs besE wishes for a long and happy reEiremenE. ACKNOWLEDGtr{ENTS The CommiEtee acknohrledged the special contribuEions made by the following WHO staff members: Dr J. Hamon, Director, Division of Vector Biology and Control; Dr T. Lepes, Director, Division of Malaria and Other Parasitic Diseases; Dr D. A. T. Baldry, Scientiet/EnE@rologist, Division of Vector Biology and ConErol; Dr A. A. Buck, Senior Medical Offlcer, Division of Malaria and Ocher ParasiEic Diseases; Dr B. O. L. Duke, Senior Medical Officer, Dlvision of Malaria and Other Parasitic Diseases; Dr E. de Maar, Medical Officer, Special Progranune for Research and Training in Tropical Diseases; Dr H. Nakajima, Senior ScientisE, Division of ProphylacEic, DiagnosEic and TherapeuEic SubsEances; Dr D. S. Rowe, Medical Officer, Special Progranrne for Research and Training in Tropical Diseases. - 13- AIINEX I I 2 3 4 5 6 Onchocerciasis ConErol Prograuune in the Volta Rlver Basin area SCIENTIFIC AITD IECHNICAL ADVTSORY COMMITTEE (STAC) Third ting 3 and 4 March 1976 AGEI.IDA Openlng of the meeting Elecclon of Chairman Adoption of the agenda Report of STAC uenbers on Eheir visits Eo the Prograrrnre area Progrese raF^rt on epideolological activitles Report on epidemiological and cheootherapeutical reeearch and proposed prograrme for L976 t{ays and means of proooting the development of ne!, drugs Progress report on entomotoglcaL activitieg Report on entmological research and propoeed programme for 1976 Other oatters Date of next rneetlng Adoption of the report Closure of the meeElng 7. 8. 9. 10. 11. L2. 13. -L4- Report of che Joinc l"teeting of the ECOLOGICAL PAI{EL and the SCIEMIFIC A}ID TECITNICAI ADVISORY @MMITTEE AITNEX II Geneva 2 March 1976 The Joint Meeting of the Scientlfic and Technical Advlsory C@oitree (STAC) and the EcologicaL Panel (gp) wae opened on 2 March L976 by Dr L. Bernard, Aaeletant DlrecEor- General of the World llealth Organlzation. Dr Bernard emphaaized that lrHO attached great lmportance to the viewe obtained from the different Co@ittees and Panels connected wieh the Onchocerciasis Control Progranme. Thie jolnt neeEing had been convened becauee, at the laet meeting of the EP the Chairoan of the STAC, Dr Janesens, had highllghted rhe rlek of duplicaEion between certaln functions of the Panel and the STAC. The Panel had proposed to the Joint Coordlnatlng CmnlEtee (JCC), through the Steering Couaittee, that either the two bodies should Eerge or Eheir roles be more clearly defined. At the JCC lt had been unanimously agreed that boch the STAC and EP ehould oaintain rhelr individuality. Ttre PurPose of this joint meeting was primsrlly to enabLe each group to clarify lte functlon,if poeeible wlthin its Ceroa of reference. Profeseor Neleon was elected Chalrman of the Joint meetlng. IE was recalLed that, by consEltution, Ehe Ecological Panel reported directly to the Steerlng ColtrtriEtee whereae the STAC rdaa an advisory body, in the firs.t inetance, to UHO. The Panel coneidered lts role to be the evaluation of the ecological/sociological effecEe and coneequences of the control operations wtrereas the role of STAC is concerned wlth the ecientiflc and technical aspects of the Progranrne. Ttreir functlone were seen to be cmplementary and lE wae proposed thac a Jolnt meetlng of STAC and EP should be held wtrenever the accumulation of itens of mutual lntereeE made this necesaary. It was also suggested that at leaet once a year the Eeetings of EP and STAC be held eimllraneouely at the eame location. IE was agreed that the reports of both bodies should be circulated to all members. It rras felt that although wlthin certaln fields, e.g. envlronmental. eurveilLance, there may be an overlap of lntereeE betlreen Ehe two bodies, thl.e would noc neceaaartly reault ln a duplication of effort. IE appeared thaE there would be a greater riek of duplication between EP and the Economic Developoent Advisory Panel (EDAP), in particular with regard to e oc loeconooic developoent . Greater cooPeratlon amongst the different advisory groups was conaidered of prime lmportance and lt was felc that ways and means of achleving this ahould be considered before EDAP ie foroed. Members emphasized the need for a conmon exchange of views and information between the various SrouPs and the host countrles on speclftc economtc developoent progrrnrnes. With regard to the formation of EDAP, the meeting qras informed that it sould be composed of specialisEs 1n the dieciplinee of animal husbandry, economy, agrlculture/agronomy, sociology, hydroLogy and general administratlon and the first meeting would be convened in June 1976. The Chairman of EDAP had indicated that tnvitations to partlcipate ln the panelrs work would be extended to members of other advlsory bodiee and to coneulEants in otherdisciplines, where aPProPriate. STAC and EP welcomed this indication and suggested that EDAP, STAC and EP designate liaison members to meeE with each of the other two groups. The neeting was also inforaed Ehat che OCP economist had recently taken up his posc; he would mainEain close lialson wiEh Ehe National Cosmittees for Onchocerciasls (see Operational AgreemenE, page 9). The lniEial funcEions of the Economic Development Unit are: (a) To colLect and collate baseline data frqr all sources inside and outside Ehe Programte area, relating Eo Ehe zones to be cleared of onchocerciasis. This will be a continuing role throughout the life of the proiecr. -15- Annex II (b) To maintain an up-to-date record of all development actions planned at. national and regional level within the Progranrme area. (c) To aeslst in arrangements for visiclng mlssions and in the preparation of background data. (d) To maintain close contacE with Ehe UNDP ResidenE Representatives, wiEh Ehe rePresentaElves of the United Nations agencies within the seven countries, and with the representaEives of banks and Eechnical aeststance miseions working in the Programne area. The Scientific and Technical Advieory Co@trittee revlewed its terms of reference and discussione focused on the duration and Ehe renewal of the mandaEe of members, and represen- taEion of different disciplines in the Cormlttee. WIIO explained that according to Ehe Memorandum of Understanding, STAC membera rdere appolnted for two years wichout preJudice to reappoinEment. The conposltion of the Comlttee and the appointment of members were Prerogatives of the DlrecEor-General of WHO. Pointing out Ehat che firsc year of Ehe mandate $ras sPent in becomlng aquainted wtEh the Progr4rnnie boch in terns of operational and technical problems, STAC members indicated the need for prolongacion of the Eerm of service on che Coumictee. In considering the purpose and the funcLlons of the Comitpee, members expressed Eheir viewe regarding the amount and frequency of lnformation received concerning Ehe operational and reeearch acLlvlties of the Progreme. GeneralLy, members were satisfied with the lnformation recelved perlodicalLy. It wae scressed that meobers interested in specific subjecte of research ehould conaider themselves free to request additional infonnat,ion from WIIO when necessary. On Ehe other hand, as set ouc ln the Cmitteers tenns of reference, WIIO would welcome information from members regarding the latesc knowLedge in their field of speciallzation. With regard to the reaearch activities reporEing syst€m, the Cmittee rdasinformed thaE su@arles of quarterly reports would be provlded in due course in addition tothe infornation already circu.Lated. Reeearch workers would be encouraged to publish results of thetr flndings in Ehe MIO/Oncho or WttO/WC series. The Chairman reminded the Comittee members thaE questione concerning administrativepolicies lrere not Ehe concerrr of the STAC. In this connexlon WIto indicated that the organizational structure of the PrograEme lras open to cornnenE, wtrile rtratters related EopereonneL rrere the concern of the Executive Agency. -16- Mesrbers of the Sclentific and Technlcal sory CommitEee Dr Colvin Gibeon, Assistant to Ehe Director for Cmtssloned Officers, National InsEiEute of Health, }1!@!g, Maryland, Unlted Srates of America. Dr Pecer HaskeLl, Director, Centre for Overseas Pest Research, London, Unlted Kingdom of Great Britaln and Northern lreland. Dr Pieter G. Janssens, Director, irince Leopold Institute of Tropical Medtcine, Natlonalestraat 155, B - 2000 Antwerpen , Betglum Dr Hermann Knuttgen, Director, In8tltute of TroptcaL Mediclne, University of 1llbingen, s!3g., Federal Repubtic of Geraany. Dr Friedrich Kuhlow, (Director, Depar.Enent of Entmology, Bernhard-Nocht Institute Hamburg),Director, Liberia Research Unit, e/o long Mlning Cmpany, P. O. Box 538, Monrovia, Liberia. Dr Marshall Laird, Director, Research Unlt on Vector Pathology, Memorial UnlversiEy of Newfoundland, St Johnrs, Newfoundland , Canada. Dr Chrietiaan Lucaese, Chief, Yellow Fever Reeearch and Production Unit, Institute of Tropical Hygiene, Department of Microblology, Ameterdam, Netherlands. Dr James Mi1es, Chlef, Pesticldes Branch, Vector Biology and Control Divleion, Bureau of Tropical Diseasee, Center for Disease Control, Atlanta, Georgia 30333, United StaEes of America. Dr Jean Mouchet, Inepecteur g6n€ra1 de Recherche, Office de la Recherche sclentifique eE technique outre-mer, Directeur dee Servtces scientifiques centraux, 70-74, rouce drAulnay, 9314O Bondv, France. Dr George S. Nelson, Direccor, Department of Medical Helntnthology, London School of llygiene and Troplcal Medicine, @!g, United Kingdoo of Great Brltain and Northern IreLand. Dr Letitia E. Obeng, Director, Instltute of Aquatic Biology, Achimota, Ghana. Dr F61ix Serie, Directeur g6n6raL de la Sant6 publlque, MinistEre de 1a Sant6 publique, Cocody-Abidjan, COce drlvoire. Menbere of the Ecological Panel Dr J. A. Lee, Director, Offlce of Environmental Affaire, and Development, International Development AssociaEion, D,C. 20433, Unlted States of America, (Convener). InEernaEional Bank for Reconstruction 1818 H. Street N. W., Washington, Dr A. D. Hese, A-LO2 Microbiology CSU, Port Col1ine, Colorado 80523, United Staces of America. Dr PieEer G. Janssens, Director, Prince Leopold InsEitute of Tropical Medicine, NaEionale- straat. 155, B - 2OOO Antwer DE n Belgiuo Professor T. Scudder, Division of Hunanities and Soclal Sciences, California InstituEe of Technology, Sasadena, Callfornla 91109, Unlted States of America. Dr R. SmiEh, Food and Agrlculture Organlzation, UNDP Office, P. O. Box 551, Sanara, Arab Republic of Yemen. Dr E. B. WorEhington) International BioLoglcal Programre, PublicaElons CommitEee, The Linnean SocleEy, Burlingcon House, London, W.1., United Klngdom of Great Britain and Northern Ireland. -L7- TER$TS OF REFERENCE OF ECOLOGICAL PANEL (a) The panel will undertake on behalf of the SEeering CosrniEeee a review of the exisEing environment-related data wiEh regard to the Onchocerciasis Control Progranune as well as the resulEs of earlier aad/or similar programnes for che control of the blackfly (Simulium damnosrrn) in order Eo evaluate and consulL on the ecological considerations involved and, further, to suggest whaE precautionary steps should be raken to prevent or minimize seriously adverse consequences; and, to indicate che nature and scope of a prograurne of monitoring and surveillance, if any, required to detect and otherwise measure changes in Ehe envlronment and its biota att.ribuEable to the control Progranune. (b) The panel will revieril at an apgropriate Eime the nature and magnitude of development being proposed for the area destined to be rendered free of onchocerciasis wlth a view Eo identifying the envlronmental and human ecologic impticattons of such development, both as regards problems and opportunities 1ikely Lo accrue under alternative approaches, if such Present thesrseLves; Eo suggest such steps as fluly be practicable and feasible in the development process for preventing andr/or mitigaEtng seriously adverse environmentat ana/or human ecologlc consequences, and for the enhancemenE of environmental and/or hunan ecologic valuee. The panel wiLl. have under conttnuing revlew the plans for development, includlng land use and rrater management, in order that thelr implicaElons for the envlronmenE and h"-an welfare can be betEer undersEood. (c) In accomplishlng the tasks set forth in (a) and (b) above, the panel may visit the Programe area to gatn flret hand knowledge of the nature and extent of the ecosysteflrs Eo be affected and with the logistics of the control effort. (Steering Comittee for Onchocerciasis ConErol ln the Volta River Basin area Fourth Session Report, Annex 4, May 1973). -18- TERMS OF REFERENCE OF II{E TECHNICAL ADTASORY CO},I}NTTEE 1 Introduction The Governments of Dahomey, Ghana, Ivory Coast, Mali, Niger, Togo and Upper Volta concluded, on 1 November 1973, an Agremrent $riEh the World Health Organization for ttre implemencation of the Ewenty-year onchocerciasis control Progranme in the volca River basin area, and agreed to the OrganizaEion serving as Executing Agency. It was agreed Ehat theOrganizaEion would be a66isEed in thac endeavour by a specially establtshed Scientific Advisory Pane1 (SAP). Twelve members of the Panel, speciallzed in Ehe maln scienEific and technical fields concerned by the Prograruue activities, will be appoinEed by the Organization to form theOnchocerciasis Control Programne Technical Advisory ComnicEee (OCP/TAC). The Onchocerciasis Concrol Programne Technical Advisory CommiEtee is esEablished to asslst the Organization in the Permanent scientific and cechnical evaluation of the plans and oPerations of the Progranrne and its associated training and research activities. The menbers of the ocP/TAc are epecialists who undertake to contribute wiEhout r€oumera-tlon, each in hie own fieId, co the evaluacion of the prograrure. Purpose and Functions of the Technical Advleory Cfiunittee Ihe purpoee and functlone of the C@lltEee shall be: to revlew the latesE knowledge and eclentiflc information available in all fields rel.aced Eo the Onchocerciasis Control Progranme and to srake it available to the Organization; Eo analyse and conunent on Ehe technical and ecientiflc reports of the prograrme and plans of accion; - Eo make recomnendaElons designed Eo improve Ehe planning of the prograrme and the implemenEaEion of iEs activiEies. The Conmittee shalL noE adviee the Organization on questions of adminlscrative policy andits concLusions and recorutendationa on Eechnical and scientiftc Eatters shal1 noE co@nit the0rganization. Select ion. lntment and Term of Office of Members The members of the Comrittee shall be selected by the Director-General from anong the members of the ccr/sm on Ehe baeis of rheir ability and experience. rn view of the Sreac flexibility required ln the planning and operaEions of Ehe prograoure, members of the comtrlttee shal1 be appointed for a perlod of two years wiEhouE prejudice to reappointmenE. A11 members of the Committee shal1 be convened in consultation wlth the Chairman of che TAC to aEtend che periodic meetings which will be held at least Ewice a year. Ihe OrganizaEion may organlze addltional meetings. The Organization will make arrangemenEs for mernbers of the TAC to visit Ehe Prograrmre area if necessary. I - During its first meeEing rhe ConrmitEee suggeseed adopting Ehe title of Sciencific and Technical Advisory Conrmittee. This ticle was approved by the Joint Coordinating Conunittee during iEs first session in February L975. a-19- I In accordance with the admlnlsEraEive regulaEions of the Organizationr a mernber of the OCPfTAC aEEending the periodic meeEings of the CornmicEee, or any working group session of the OCP/SAP to which he may have been convened, shalL be entiEled to a refund of rravelling exPen8{ls necessitated by their aEtendance and also Eo a daily living allowance during such meeEings and sesslons. InEernaEional Status of Members In the exercise of their functions Ehe members of Ehe OCPfTAC shalI act as inEernationaL exPerts serving the Progranure exclusively; in that capacicy they may not requesE or receiveinscrucEions from any governmenEs or oEher authority. They shall enjoy the privileges and iruuunities envisaged in Arcicle 67 (b) of rheConstitution of the Organization and set forth in the Convention on Ehe privileges and rmnuniEies of the Specialized Agencies and in Annex ry'rr thereof. Commi Etee Sessions. SecreEariatshio and Reports The OCP Support Untt at the Organlzatlon Headquarters shall provide the Secretariat atall CoruritEee meetings and shall arrange the cime and place of each session and shaLl conveneEhe members. At each seesion the Comnittee shaI1 elect a Chalrman froo its members Eo direcE itsdebates, and one (or two) rapporteur(s). The chainran may be reappoinEed. The working Languages of che ocpfTilc shaII be English and French. At each session the comlittee shal1 draw up a report setting forth lts flndings, observations and reconmendations. Such reports shall be forwarled by WHo, wlEh its conmenEsEhereon, to the Steering cos@ltEee. The Steerlng co@ittee shaIl transmic the reports, withits observations, co Ehe Joint Coordlnating Co@itcee (JCC)1 not tess than thirEy i.y" beforeEhe JoinE Coordinating CoEmicteerB annual oeeting. 1 Part ic Ihe Joint Coordinating Corunittee is composed of represenEatives of the sevenipating Governments of all contributing Parties and of the four sponsoring Agencles. a