CSA reflections paper

Onchocerciasis Control Programme in the Volta River Basin area Programme de Lutte contre l'OnchocErcose dans la R6gion du Bassin de la Volta JOINT PROGRA,MME COMIvIITTEE Office of the Chairman JPC. CCP COMITE CONJOINT DU PROGRAMME Bureau du Pr6sident JPC6.t2 ORIGINAL: ENGLISH Novenber 1985 JOINT PROGRAMME COMMITTEE Sixth Session Geneva L0 - 13 December 1985 Prov;lstonal agenda item 5 CSA REFLECTIONS PAPER Ladles and Gentlemen, It is a great pleasure for me to follow, what by now has become an establlshed tradltlon, and to share wlth you some of the observatlons and reflectlons of the Committee of Sponsorlng Agencies, whl.ch has been lnvolvedln the preparation for Ehe upconing third phase of the Programme. As prevlous speakers have already eloquently lndicated, we flnd ourselves presently at something of a watershed ln the Programme. More than a decade has passed in whlch a very successful control prograrme to stop rlver bllndness has been bullt up. The control programue ln lts size and organizatlon - comPrlslng several countries and organlzed as an lndependent lnternatlonally supported control organizatlon - ls unlque ln the world. The results of the control programtre are equally remarkable. The disease has been halted for a nelr generatlon of Afrlcans ln those seven countries conprlslng the current progranme area, and areas previously abandoned out of fear of onchocerclasis have been opened up for cult.lvatlon. Ihe basic control strategy set ln \974 by the PAG misslon has been unchanged. But duilng Phase II (1980-85) tactics of control strategy have been adJusted to cope wlth problems that arose, such as reinvaslon of blackflles and resistance to pestlcides. Equlpnent, such as hellcopters andflxed-rlng alrcraft have been upgraded and technologies adapted. More recently the Progranme area has been redeflned, and boundarles redrawn lnpreparatlon for Phase III (1986-91). But one of the great challenges of the Progranme, "how to oalntain lts results and how to brlng lt to a successful concluslon wlth the problems of reLnvaslon and reslstance", was stlll open and subject to considerable dlscussion. You w111 recall the varlous attenpts whlch have been undertakento find definite answers to these questions the report of the Independent Commlsslon and the Senegambia proposal ln 1981 to naDe only two of then. A11 these studies have been very useful and tinely as they conflrmed both the success of the control programme in reduclng rlver bllndness and the need to extend the Prograrme beyond its present boundaries, partlcularly to the west -ln order to malntain lts good results. JPC Pa8 6.1?. e2 Now wlth two key documents before the members today, (1) the Plan of Operatlons, which outllnes in detall operatlonal approaches, methods and costs oi control ln the third phase, and (ti) the Legal Agreement, both of which are based on the pollcy framework set out by the Long-Terro Strat.egy accepted by the prevlous JPC in Nlamey, the directions for the future have been comprehenslvely and firnly outllned. I would llke to draw your attention to the fact that the Plan of Operations has been prepared by the Prograume ltself. The staff has crltically revlewed experience, has been rethlnklng establlshed procedures and has been questlonlng some accepted aasunPtions. The effort, carrled out durlng the past year, has been very worthwhile and not only have we, the Qemmlttee of Sponsorlng Agencles, the Partlclpating Countries and the donor communlty, greatly beneflted from a clearer look lnto the future, but also OCP has learned fron lts experlence and ls better prepared now for new challenges. It ls against this background of review and analysis that the Cogmlttee of Sponsortng Agencles strongly and lrholeheartedly endorses the Plan of Operatlons as the guldlng docuoent for the thlrd flnancial phase. In looking ahead to face the challenges of the future, the CSA has asked itself nrhat are the lngredlents to success ln the Programme. Why has lt lrorked, what needs to be maintained to ensure that the Programme is functloning with the same efflclency? There are four factors which come to olnd, all of whlch are equally lnportant. Flrst, the contlnulty of flnancial support has been an essenEial precondltlon for success. The fundlng of Che Programme ls an example of lnternatlonal cooperatlon and commltment and the willlngness of the donors to provide contlnulng support for a tlne sllce of about tlrenty years ls a polnt whlch ls hard to over-emphaslze, partlcularly for developnent in sub-Saharan Afrlca. A second factor is the clear, ltnlted and well-defined objective of che Programme rrlth lts effectLve organlzatlonal structure set up for attalnlng 1t. The Programe |s geared to implenent a speclfic control technology. It has essential controL over its resources, both human and flnanclal, and It has an organlzatlonal structure which ls not only effectlve in addresslng thls obJectlve, but ls also flexlble and capable of adjustment. The Programme hasr to support change, a focused operatlonal research capacltyr whlch provldee for learning and experloentatlon. Most lmportantlyr lt has a dedlcated, flrst rate staff. A thlrd factor of fundanental lnportance for OCP, has been ln the Past and w111 conttnue to be for Ehe future, the support from the Partlcipatlng Countrles, partlcularly the complete freedom of movement wlthln and among the countrles. It ls worth ernphaslzlng that the Programme has enJoyed fu1l collaboratlon from all the countrles concerned and that its operatLons have not been affected ln any way by any polltlcal change. Fourthly, we feel that the Progranrme has beneflted fron coordlnating and statutory bodles which have been approprtate and balanced ln thelr approach.I am referring to the Jolnt Prograome Cormittee, the Conrmittee of Sponsorlng Agencles, the Expert Advlsory Committee, the Ecological Group and the Natlonal Onchocerclasis Corunlttees. These entltles have provided for the necessary policy or technlcal dlrectlves, and have ensured cost-effecttve oPeratlons and accountabllLty. Even so they have never becone admlnlstratively "over-polrerlng" and have left OCP to address its nandate, to control river bllndnes s. JPC6.12 Page 3 The operational challenges for the future are clear and not to be underestimated. The Programne is belng expanded, practlcally doubllng lts area, into geographical areas whlch are substantially different ln terns of terrain and infrastructure from the present Prograrnne area. It needs also to prepare for maintainlng the results after the Programne itself has come to a successful conclusion. The process, which is outllned In the paper on devolution is belng clarlfied for the present Progranrme area, but requires further research and experlnentatlon ln the years to cone to be adapted to the extension areas. [rle have drawn your attentlon to the new challenge and the factors for success because we feel strongly that lt ls essentlal to understand then to face the years to come. I would lIke to highllght here one of the factors in Partlcular, whlch the CSA considers essentlal to nalntaln success ln thefuture. It ls the need to preserve the Programmers present well-defined and clear objectlve and organizatlonal structure focuslng only on controlling onchocerciasis. This inplies guarding agalnst burdening the Progranme with additlonal responsibllltles ln such other fields as prlmary health care and socioeconomlc developnent, and reslsting the tenptation to bureaucratlze the Programmets execution, the latter by requlrlng more studies and reports. We ralse this concern because in the past years there has been the tenptatlon to use - the efflcient Programme structure to puraue development objectlves whlch are closely related to onchocerciasls control, partlcularly the develoPtrent of health servlces and socloecononic developnent or settlenent activlties in the present control area. Llhlle the Conroittee feels that these activlties are essential ln a national developoent context, and that OCP couldlegitinately be asked to help, we nevertheless are convlnced that OCPrs role thereln should be llntted to that of a support agency. The Prograrnme has prepared a preltninary report on the status of socloeconomic developoent ln the present OCP area. There are lnterestlng questlons to be answered relatlng to the extent of resettlement in the Programrne area, the response of the governuents ln deallng wlth the nelr opportunltles, the effect of settlenents on the Sahelian envlronnent, the needfor agrlcultural or rural development support nechanisns etc. To revlew the data and to develop a strategy for rural development of the onchocerclasls controlled areas ls a challenge for the beneflclary countries. It ls also a challenge for the donor conmunity. The CSA has looked at what night be approprlate assistance nechanlsns and responslbillties for our agencles and what steps are requlred no!, to respond to thls challenge. The agencles will flrstly support ocP to flnallze the ongolng study documenting the changes ln the area, an endeavour ln whlch, Particularly, FAO w111 be closely involved. Secondly, the Bank has offered to undertake a follow-up study on development opportunitles ln the oncho-controlled areas, lf merlted. Finally, we are consultlng with the beneflclary countrles on how best existlng mechanlsns could be used to identify and follow-up on development opportunitles; the roundtable and consultative group nechanlsms of UNDP and the Bank respectlvely are showlng good potential. We w111 address some of the socloecononic lopact lssues when we reach that polnt on the agenda. I would like to conclude the CSArs reflectioas at thls point by returning for a moment to the Programrets two, immediate goals. Blackfly control operations remain the heart of thls Prograrnme. Therefore the flrst and nost JPC6.72 Page 4 lnportant goal is to extend the Programme successfully and efficlently westward and southward. A fornldable challenge indeed. Second, there must be progressive development of the concept of naintenance and devolutlon wlth a clear deternination of what activities w111 need to be carried on after the operatlons end ln the countries and identificatLon of resources required to ensure adequate maintenance and so prevent a recrudescence of the di.sease. I would like to thank you for your attentlon.