Progress report of the World Health Organization for 1978

,//-&N, woRLD HEALTH oRGANrzATroN W oRcANIsArIoN M.NDIALE DE LA seNrE ow/Yxfta.+ ORIGINAL: ENGLISE ONCHOCERCIAS IS VOLTA CONTROL PROGRAMME IN THE RIVER BASIN AREA PROGRESS REPORT OF TI{E WORI.D HEALTTI ORGANIZATION FOR 1978 CONTMTTS ST'MMARY VECTOR CONTROL EPIDEMIOLOG ICAL EVALUATION Page 2 3 5 6 7 8 8 10 ECONOUIC DEVEIOPMENT APPLIED RESEARCH ENVIRONMNTAL PROTECTION TRAINING LIAISON ACTIVITIES With the I,lirh the wirh the general public participating countries 10 10 10 L2 statutory organisms MANAGEMENT AND COSTS The issue of this document does not constrtute formal pubhcation. lt should not be revrewed. abstracted or quoted wrthout the agreement of the World Health Organrzatron, Authors alone are responstble for vtews expressed rn srgned artCleS. Ce document ne constltue pas une pubhcatron. ll ne dort farre I'objet d'aucun compte rendu ou r6sumC nr d'aucune cttatton sans l'autorrsatton de I'Organrsatron Mondrale de la Sant6. Les oprnions exprim6es dans les artlcles srgn6s n'engagent que leurs auteurs. ocP/R.f78.4 Page 2 SIIMI,IARY (i) The peak of the dry season was reached in Ltrarch when the aerial fleet was reduced from eight to six nachines. On the other hand, the rains started six weeks early and as rivers started to flow treatment recormenced over the whole Programme area. By July most of the rivers were being treated together with the Marahoud and Sassandra complex to the south. A11 eight helicopters and the two fixed-wing aircraft were fully utilized. (ii) The epiderniological evaluation t.eams started their second passage in the Phase I z one. (ili) In close cooperation with the National Onchocerciasi.s Comittees (NOCs), the Econmic Development Unit prepared its report on some aspects of the socioeconomic developnent of the zone. (iv) In research, there was important activity in many fields including helminthology, E.ransnission of onchocerciasis, testing of larvicides, the identification of the different species of the S. damnosum cmplex and their vectorial potential. (v) In environmental protection, a group of hydrobiologists engaged in the aquatic : monitori.ng activities roet in Ouagadougou in January. (vi) As to trai-ning, considerable progress has been made and more than 25 candidates have been awarded fellorships during the year. (vil) Very close contact has continued to be maintained with the participating countrieg, mainly through the annual meeting of the National Onchocerciasis Comittees whi.ch was heldthis year in Benin, with the statutory organisms, through various meetings and also with thepublic at large through an increased effort in the field of general inforroation. (viii) Another major activity has been the preparation of the report evaluating the firstfive years of operations and outlining the Plan of Action and Budget for the next phase 1980-1985. The draft report was reviewed initially by a sx0a11 group of Scientific and Technlcal Advisory Committee (STAC) members who met in Ouagadougou in early May, and subsequently by representatives of National Onchocerciasis Comittees (NOC) and the Steering Cornmittee in June, and the fu1l STAC at its August meeEing in Brazzaville. (ix) Expenditure for 1978 is expected to be in the order of g 12 1oo oOo, reflecting a saving of about $ I 7OO OOO i.n relation to the budget approved in December L977. INFRASTRUCTURE DEVELOPMENT, INSECTICIDE CONSUMPTION, FLIGHT HOURS AND EPIDEMIOI0GICAL EVALUATIONS: L974-t977 L97 4 L97s L976 L97 7 Tota 1 No. sectors No. subsectors L itres/insect ic ide Helicopter hours Fixed-wing hours No. villages examined (EEU) No. persons examined (EEU) 3 : I 6 90 000 2 783 s4L 74 L9 6?3 J 10 130 000 4 265 6t4 L29 30 960 155 6 15 5 3s8 I O25 111 25 98L 7 24 615 623 639 240 94L 37s 9 t 56 io ocP/PR/Is.4 Page 3 VECTOR CONTROL 1. For the firsc four months of 1978, the helicopter requirement of the aerial fleet was reduced from eight to six machines and the two fixed-wing aircraft were converted from treatment to passenger configuration. 2. With the onset of the dry season, which reached its peak at the end of March, riversgradually dried up. The fixed-wing and helicopter hours flown, and quanrities of Abate dispensed during the first six monEhs of the year, reflect this patEern: Helicopter Fixed-wing Abate January February March April May June Ju ly August S ept ember 339.9 2 80.0 290.t 264.L 590.7 4s8. 6 567.7 597 .7 462.9 8.2 31. o 27 .5 t2.6 57.0 L20.9 t22.4 178.1 L62.7 4 0L4.3 2 059.5 L 822.7 2 482.3 L2 957.4 L9 748.5 22 L96.L 3s 547.3 37 8s4.6 To ta Is 3 851. 7 720.4 L38 682.7 3. As the dry season progressed and Iow fIy catches rrere recorded it was possible to suspendtreatment in a number of areas: in Mali on the Farako and Lotio rivers, and also on thePlandi, Guenako, Diendoa and Comoe basins. However, due to poor flow of certain rivers, theinsecticide was not effectively distributed and difficult urelai.ng sites became hard tocontrol. The ttrestrictor,t system was then put inEo use. 4' The rains started almost six weeks early and as rivers started to frow treatment recolEtrenced over the whole Progranme area. The Sota river i.n Benin, left untreated lastyear' was treated by helicoPter for Ehe first time in March during the l4th cycle. TheMekrou and Alibori came under treatment in May, initially by helicopter. rn the third weekof June this circuit was extended to include the Tapoa river in Niglr. 5' rn the rrrestern part of the Programme area increase in river discharge was slow, and evenin July tioth the Baoul6 and Bagi5e rivers, normally treated by fixed-wing, were still-underhelicopter treatment. rn the Programme extension area of rvory coast, treatment of theMarahou6 and Banoroni rivers started during the 17th treatment cycle in April; this wasfollowed by treatment of the sassandra complex starting in the first week of June. 6' rn May the helicoPLer contractual requirement reverted to eight machines, and sixhelicopters were employed weekly on treatment missions, leaving tio for prospection flying,one at each base' Both fixed-wing aircraft were put back into treatment configuration by Ehebeginning of June. By JuIy most of the rivers in the Prograrnme area r{ere being treatedtogether with the Marahou6 and sassandra complexes t.o the south. AII eight helicopters andthe tno fixed-wing aircraft were fully utilized. 7 ' raking into account the need to extend activities to the south in rvory coast and undertakestudies in Ghana, Togo and Benin, the entomological evaluation network \ras reorganized. Theouagadougou sector headquarters, and the Leo, Banfora, Dabakala and yendi subsector officeswere closed' A11 Phase rr Ghana and upper Volta evaluation activities are nord managed fromTamale sector headquarters. The Korhogo sector rras transferred to Bouak6, and additionalsubsectors were opened in Hohoe (Ghana), Bouak6 (Ivory Coast), Seguela (Ivory Coast),Atakpam6 (Togo) and parakou (Benin). oc?/Pt /78.4 page 4 8. Altogether an everage of 230 catching stations have been visited on a daily or weekly schedule. The results show t.hat the criteria established for resettlement are already being met over 75% of the original Prograrome area. The situation is particularly encouraging in the Phase II area, and the northern part of the Phase I area where at most sites only occasional flies are caught. 9. The peripheral area of the Progra"rme, particularly the south-west, continues to be affected seasonally by the naEural redistribution of flies from untreated rivers. While fly counts can be high at riverine catching sites in the long-recognized reinvasion areas, thehighly effective control operations prevent these flies from becoming established and subsequently spreading to the interior of the Prograrrme area. Consequently, the programeis movj-ng towards an intensive barrier of control operations effectively protecting a large central core of the original OCP area as envisaged in the pAG Mission Report. 10. During the first thiee months of 1978 fly populations were reduced to very low levels everlzwhere with virtually no transmission. Excellent results rrere noted especially on theWhite Volta, Red Volta, the oti/rena3ari, rhe Black Volta (except betr^reen Chache and Bui), andthe Niger tributaries in Ma1i, Niger and Upper Volta. In all these areas, the vector waspractically nonexistent. However, as a result of heavy rainfall experienced in April overEost of the area, there was an early build-up of fly populations, particularly in itre south- west. This reinvasion was first observed on 1O April and the plan prepared for its studyirnng6iaa.ty set in motion. rnitially, events followed a siroilar p"it".r, to previous years with a high parous rate aoongst the captured flies. 11. rhe reinvasion research was conducted frm a base at seguela (rvory coast) by a team ofthree consultants and two Progrrme entmologists. The Progiame research scientists alsoparticipated. Thirty-eight vector collectors and nine vehicles were assigned to these studi-es. Six catching points were established in therrdeparturett zone and nine in theilarrivallr zonel three Johnson sucti.on traps were installed as well as trro meteorological stations on the rivers L6raba and Marahou6. L2. Ttre combined treatment of the l,liarahou6 and Sassandra had a pronounced effect on thetraditional reinvaded rivers of the south-west. The experimental treatments in 1977 markedly improved the situation on the L6raba, Bandama and Bou rivers during August and September.In 1978 the Upper Marahou6 was treated frorn the time flqs started and this prevented thedevelopnent of a serious reinvasion problem on all three rivers. with the extension of controL to the Upper Sassandra that reinvasion alobst ceased. 13. 1978 was also m:rked by detailed discussions with the Canadian Conmercial Corporation and Viking Ilelicopters Linited to review the first year of operations. One important outcooe of these discussions has been the adoption by Viking of the WHO definition of "flying timetr.As a regult, tachometers \rere installed in all contractual helicopters to record "Iift off', toI'touch downrr. Following the installation of tachometers, it was calculated that of the 1174 helicoPter hours flown in the first four months of the year, 70 of those hours were "ground runningrron the old definition of flying time" These extra hours wilt be credited to WIIO at the end of the year. Other interesting developments included the issuance of new radio procedures for Viking aircraft and the implementation of a standardized method of completing flight reports. 14- A mission visited Benin, Ghana and Togo at the beginning of the year for discussions withthe national authorities on the organization of the operations and on the entomological, medical and hydrological studies to be carried out in the proposed extension areas. Eighthydrological stations are being installed on the Ouem6 river system in Benin, and three stations on the Mono river in Iogo. By the end of March, five new stations had been installedby the authorities in Ghana on the Bassa, Bonakye, Asukawkaw, Wawa and Mono rivers. In each country the Government is expected to provide buildings to house the new subsectors. 15. At the end of February a new technical officer was appointed to assisr the aerial operations officer, and following a period of training in Bobo-Dioulasso, he assumed his duties at the Tama1e base. COMPARISON OF FLY CATCI1ES - 1975-1978 t oc?/PB./l8.4 Page 5 L6raba River - Pont Routier t97 5 L97 6 L97 7 1978 I"lay June Ju 1y Augus t September q) 141 26 50 t15 129 t34 39 151 105 60 33 114 86 6 2 69 54 I 1 Bandama River - Bema L97 5 L97 6 L97 7 197 8 57 56 6 33 94 68 82 18 L82 40 L2 7 116 34 3 2 35 L4 2 1 Bou River - Gite 3 L97 5 L97 6 L977 197 8 153 2L9 48 108 270 r70 256 33 344 103 58 2L tiz 15 11 iu t7 32 EPIDE}IIOIOGICAL EVALUAT ION 16. The Epideniological Evaluation Unit has been re-examining villages in Phase I to assess Ehe evolution of the disease following a period of vector control, completing its collection of baseline data in the Programe area and examining villages in the proposed exEension areas. 17. Altogether, 18 villages in Upper Volta and two in Ghana were evaluated for the second time. Results from the second passage revealed that, in villages close to ri.vers where control had been carried out and transmission interrupted, Ehe disease was no longer recorded in children under five-years-of-age. In Ehe next, younger, age-groups the severity of the disease had not increased as was normal in pre-control situations. In the older, serious cases no significant change sras observed, which is understandable after such a short period of control. The exception to this encouraging pattern was the village of Dangouadougou, which is situated in the reinvasion zone of Upper Volta, where no improvement was observed and, where, in fact, if anything the severity of the disease had slighEly increased. 18. In Benin, baseline data rnas collected ftorm 24 villages. Siroilar examinations were undertaken in 1O villages in Mali, and 10 in Upper Volt.a. A further 12 villages were surveyed in Ghana 19. In collaboration with the Bernhard-Nocht Institute, the Epidemiological Evaluation Unit has experimented with a new method of parasitological examinat.ion based on collagenase. The method proved no more effective than that previously followed and, in fact, is more suited to use in laboratory rather than field conditions. 20. Also with the Bernhard-Nocht InstiEute, the nodulectomy experiment in Upper Volta was followed up. Preliminary resulEs show that the removal of head nodules from the younger age- group had a favourable impact on the ocular lesions. 21. The chemotherapy trials wiCh levamisole together wirh diethylcarbarnazine, as well as with metrifonate, have continued in association with OCCGE (Centre Muraz). In the first case the results do not seem significantly better than with DEC alone. In the second case, the results are less encouraging in view of che toxicity of the product. ocP/PR/78.4 22. The village of Mou16, Upper Volta, was re-exami-ned in deLail three years after a treatment with suramin used at the classic dose of 5.2 g administered over six weeks. the parasite load was found to be greatly diminished, but an increased incidence of optic atrophy was found in the treated groups when compared to untreated control groups. 23. Research on dermal nicrofilaria of T. streptocerca has been carried out in the Volta Region in Ghana. Several carriers of this filaria were detected of whom all except one were also suffering from onchocerciasis. In four villages all ages were affected, suggesting local transmission, while in other villages the infection was probably imported. 24. babies The in utero transmission studies at born to oothers with onchocerciasis P0 hospital were completed and show that 2% of are carrying microf ilariae. 25. For the three-year period L975-L978, the evaluation part of the activity of the Epidemiological Evaluation Unit can !s srrnmalized as follows: Total sample Prograrmne area Areas outside present OCP boundaries Number of vi I lages Popu Ia t ion concerned 333 28 96 625 808a Total 36I los 433 ECONOMIC DEVELOPMENT 26. The main activity of the Unit has been the preparation of'the annual report on the socioeconomic development of the oncho zone. In the process, very close cooperation \nas mainteined with National Onchocerciasis Committees and national authorities responsible forhealth, planning and rural development and also with multinaEional and bilateral aid agencies. Contact was made with TAMS-EARTHSAT, the contractors for the earth sarellite stud,,'oI the oncho zones of Benin, Ghana and Upper Volta. Country Conpos it ion of sample Population examined at least once by EPI Number of examinations IN: Number of people S tunp le eva luat ion Detailed evaluation L975 L976 L977 L978(to 1. Io) lliger Togo Ivory Coast Benin Uali Upper Volta Ghana 3 578 LO 764 14 186 8 931 L6 440 32 562 L8 972 L 246 7 43L 7 637 5 929 LI 480 23 743 13 084 794 L 797 3 168 L 436 L 256 4 L77 3 336 4 L74 11 260 3 422 560 3 966 3 480 s 444 9 223 8 175 L 469 5 L97 2 375 2 68L 7 99L 6 268 4 662 4 442 4 885 Tota 1 105 433 70 550 L5 964 18 856 30 848 25 98t 13 989 86 5r4 89 674 ocP/PR/78.4 Page 7 27. In March a Public Health Adviser was recruited. llis initial tasks included missions t,o each of the participating countries to investigate public health problems in the oncho zone. Topics discussed included integration of the blind people into Ehe cormnunity as well as appropriate healt.h structures for newly established settlements in areas made safe from onchocerciasis. APPLIED RESEARCH 28. As a result of the establishment of criteria for resettleoent of the populations in the ri.ver valleys, and the need to ensure a correct interpretation of the AnnuaI Transmission Potentials, the Progranutre convened a Eeeting in February on the coordination of research in the field of helminthology and transmission of onchocerciasis. The participants recqumended that. further sEudies be undertaken on animal onchocerciasis transmitted by differenE species of the S. damnosum complex, on the u""to./p^rasite association and its relation to the different aspects of the disease, and on the influence of human and vector migrations on Progranme strategy. Two consultants were subsequently engaged for eight months to pursue specific studies in this respect. 29. In order to assess what had already been achieved, and to stimulate activity towards the develoPment and testing of larvicides and formulations potentially suitable as alternatives to Abate, a Scientific Advisory Panel (SAP) t{orking Group met in Geneva in July as ProPosed by STAC at its meeting in November L977. Representatives of 10 chemical companies attended. Recoilrmendations were made on the testing facilities that would be required to screen new products. The type of cooperation expected by industry to stimulateinterest and prooote a flow of larvicides in different formulatione rraa defined. The needfor products selective against Simulium larvae and as innocuoue as possible against non-target organisms was recognized. It was noted, however, that the quantities required wereinsufficient to justify special research lnto a new technical ingredient. Varieties of formulations could be developed for testing and it was emphasized that some products may be more suited to formulations other than euulsifiable concentrates, in which form Abate is used. 30. Canadian scientists under contract to the Programe have made encouraging progress indeveloping a key for the identification of the different species of the S. darnnosum cmplex using a series of morphological characters. This key has been tested in the field with a measure of success. In order to determine how it could be oodified and adapted for generalfield use, a SAP Working Group of taxonooists and scientists from Canada, France, Gernany andthe United Kingdom met. with staff from the Vector Control unit in the prograrme area fro,m16 to 20 October. 31. Supported by OCP, research has continued at the Institut de Recherches sur 1'Onchocercose, complexr'the restingBouakd, on the vector potential of the different species of the S. damnosumsites of the adults and new insecticides. As a result of the "*tEilf6., otoPerations in lvory Coast a new site had Eo be found on an untreated riverformulations of larvicide could be tested. the control where different 32. with the assistance of a consultant., a large-scale trial was undertaken with chlorphoximto determine its efficacy for operational use. while it is effective against S. damnosumlarvae at concentrations Lower than are required with Abare, chlorphoxim is "o.rifEEETffror"toxic against the non-target organisms. A modification of the formulation would possiLlyimprove its selectivity against S. damnosum. 33. A contract was established wich the Llniversit.y of Ttbingen, Federal Republic of Germany,for a continuation of longitudinal studies on S. damnosum and o. volvulus in Northern Cameroon.rE is anticipated that thi.s work will be co*piffiEIifry rsTt-;? rI;E rhe ."r.rt"-r'tr be used in Ehe deveropment of a mathematical model on onchocerciasis. 34. In July, supPort to t.he Tamale Chemotherapeutic Research Centre was transferred Eo the wHo special Programme for Research and Training in Tropical Diseases (TDR)- ocp, however,will continue to maintain a close link with the Centre, particularly in the larger-scale village trials of drugs cleared by the centre. rn this respect, discussions have taken prace ocPftB./78.4 Page 8 with the health authorities in Upper Volta regarding the possibility of undertaking onchocerciasis medical treatment and drug trials. A protocol is in preparation. 35. To sErengthen the medical research component, an epidemiologist was recruited in May. ENVIRONMENTAL PROTECTION 36. The annual meeting of hydrobiologists engaged in the aquatic rnonitoring activities uasheld in 0uagadougou i.n January. The group reviewed the 1977 results and the prograrme for1978, and discussed the analysis and storage of data as well as matters concerning reports and publications. Recomendations were made regarding: (a) the timing, methods, sites andfrequency for the surveillance of invertebrates, in rivers both in the present programe area and the proposed extension areas; (b) the intensification of chemical monitori.,g of Abatein fish, mud and larger molluscs; and (c) the timing of first treatment of new rivers. 37. A consultant was recruited to collect baseline data from 4 nrrmber of rivers in the eastern part of the Programe area, not covered by the routine monitoring progragme. TRAINING 38. The n'merous contacts made during the year by visits to the countries, by correspondenceor in the course of the annual meeting of the National Onchocerciasis Comittees, have led toa better understanding of the objectives of the Programe and the means available in respectof treining. Also, the countries have defined their needs. A tinetable of action has bcendrawn up. Already, for the year 1978, more than 25 candidates have been presented fortraintng suPPort and the si.tuation to date is shown in the following table. TMINING PROVIDED BY OCP IN 1978 BY I.IATIOI.IALITY, FTINCTION AND FINLD OF TMINING Gi lbert DTENSAH Germain OUSSA Djokodjo Cl6ment GLELE Martin CODJO Ghana AKOGBETO iames SAI,IMAN Itydrobiologiste Charg6.de Recherche. MinistEre de 1a Sant6 Publigue Cotonou Chef des Services de M6decine et de P6diatrie H6pital Parakou M6decin-Chef Circonscription m6dicale Dj ougou Professeur de Biologie- G6ologie i Porto-Novo, au Lyc6e Behanzin Assistant Research Officer Institlrte of Aquatic Biology Ach imota Research Officer at Council for Scientific and Industrial Research, Accra 6 months t training in hydrobiology at ORSTOMT/Bouakd, started August 1978 3 yearsr specialization in ophthalmology at Dakar University, starting 2 November 1978 Training in epidemiology requested by government. OCP exploring possibiliries with institutions Training in entomology at ORSTOVPaTis - 15 months, starting 12 October 1978 3-year course in hydrobiology ar Salford Universiry (UK) with field work in Ghana initially 3-year course in hydrobiology, field work in Ghana inirially Country/Name Current occupati.on /titte Field of training Joseph Sonrna AMAKYE t. Ghana (continued) L6onard Abraham Kwame ANIIII Samuel Zanya BUGRI Michael D. Guinea WILSON Ars6ne SAGI{O Roger Topko IAI,IA Kabine I(ABA Mamadou Sarifou BAIDE Raymond Koho KONE Souleymane KOUROUNA Theoue OUIARE S6kou Yalani CAMAM Research 0fficer at Council for Scient.ific and lndustrial Research, Accra Medical Officer in charge of Communicable Disease Cont.rol and Public Health Hospital Tamale Entomologis t Biologiste chargE des enquBtes paludon6triques au Service de Pr6vention Projet Paludisoe Conakrv Professeur de Biologie Facult6 des Sciences de 1a Nature, I.P.K. Conakry Assistant auprEs de ltExpert Entomologiste OMS pour projet pilote Oncho-Guln6e Chef d'Equipe Entomologie Projet pilote Oncho-Guin6e Chef d'Equipe Parasitologie Service de Pr6vention Projet Paludisme ocP/Ps./l8.4 page 9 On-the-job training in pesticide residue analysis at University of Miami, Florida(USA), srarring Sept. 1978, 6 months Miami, and I month At lanta Postgraduate publlc health training course with special emphasis on parasit.ology in Teheran, Iran 1-year course medical parasitology at London School of Hygiene and Tropical Medicine, started 25 September 1978 4 monthst training in entomology at IRO/Bouak6. Reported 20 Septeober 1978. Subsequently I nonth training with OCP 4 months' training in entomology at IRO/Bouak6. Reported 20 Septenber 1978. Subsequently 1 month with OCP -do- -do- 4 monthsr craining in entomology at IRO/Bouak6 starting January 1979. Subsequently I month training with OCP -do- -do- Prior to attending IRO/Bouak6 will undergo 6 weekst training in parasitology ar OCP (EPI), starting 0ctober 1978 12 monthsr training at IOTA Bamako. Reported 13 September 1978. SubsequenEly 2 months with OCP Chef drEquipe Projet pilote Paras ito logie 0ncho-Guin6e Assistant auprEs Expert Entomologiste. OMS Projet pilote Oncho-Guin6e M6decin i ltlnspection M6dicale des Ecoles Conakry M6decin Opthalmologist.e eE. Directeur du Projet Oncho- cercose, Kankan Country/Name Current. occupaE ion /'t ittu Field of training Yaya KASSE Country/Name Current occupation ft;,tt" Field of training Guinea (continued) Lah DORE Amadou DIALI0 Siba GBAMOU Niger Eaoadi ADAIIOU Rahiou IAB0 Nigeria Candidaters name not yet Tanzania Nicholas John MASAOE Iogo Ketevi KOUMOUVI Dr Ayit6 Folly ABOUSSA known Chef dr Equipe d6pistage L6sions oculaires, projet pilote Onchocercose Chef Section Parasitologie Laboratoire national Projet Paludisne Techn ici.en Parasito logie Projet pilote Onchocercose Laborantin Direction de lrHygiEne et de la M6decine Niamey Adjoint Chef Section Para s ito logie-Iabora toire drElevage, Nianey Ophthalnologist District Health Officer at Regional Development Director, Arusha Assistant d rEntomologie auprEs du Service Grandes End6mies et Paludisme, Lom6 M6decin Chef Subdiv. Sanit. Aneho 12 months' training at IOTA Bamako. Reported 13 September 1978. Subsequently 2 months with OCP 8 weeks t traini.ng in parasitology wirh 0CP (EpI), starting October 1978 Practical field training in entmology within Progranrmg area. prior to his attending IRO/Bouak6. Reporred Bouakd 18 Septernber L978 OphthaLnological training with OCP do do 4 monthsr training in entomology at IRO/Bouak6 starting January 1979 4 months I training in entomology at IRO/Bouak6. Reported 2 October 1978 3 years I specialization in ophthalmology at University of Dakar. Started November 1976 ocv/PR/7s.4 Pag. 10 LIAISON ACTIVITIES lJith the participating countries 39. The second meeting of National Onchocerciasis Conunittees was held at Cotonou, Benin,from6to8Juneandwasp.ua,MinisterofPub1icHealthand Social Affairs. Delegates reported on activities in their counEries since the Iast meeting ofNoCs in June 1977. A report r"ras made on the progress of the Programme. participants then reviewed and cormnented on the draft evaluation report of the entomological and medical aspects of the Progranrme as well as on the draft report for 1978 on socioeconomic development in the Programme area. Discussions also took place regarding overflight and landing rights. Ar theinvitation of the GovernmenE of Mali, the next meeting of the NOCs will take place in tsamako inJune 1979. ocP/PRfl8.4 Page ll 40. On behalf of the World Bank, the Prograrmoe organized a two-day meeting of representatives of the participating countries in Ouagadougou on 7-8 September, to review Ehe draft report on Ehe economic development aspect.s of the Prograrmne. Eighteen country represenEatives aEtended. The meeting was opened bv H.E. Dr Tinga Douamba, Minister of Public Health and Social Affairs of Upper Volta, in the presence of the Minister of Planning and Cooperation and other Government officials. 41. The Programme also participated in the Annual General Assembly of the Union des Radios eE T6l6visions Nationales drAfrique (URTNA) which Eook place this year at Lom6, Togo, in early February. The theme discussed at this Assembly r"ras the role of radio in mass campaigns, on which the Programme had organized a seminar for Rural Radios of the participating countries in May 1977. OCP reported to the General Assembly on this seminar, and the representative of Mali reviewed the activities undertaken subsequently by the rural radios of the seven countries. 42. The Programme also informed the Institute of the Sahel that it. wished co follow closely the work of the Conrnission on "l'lass conrnunication in development", established during the meet.ing of the CILSS Human Resources Tearn at Niamey in March. with the statutory organisms 43. The Steering Cornmittee for Onchocerciasis Control in the Volta River Basin area held its twenty-second session in June and its twenty-third and trrenty-fourth sessions in September and October respectively. 44. A small group of Scientific and Technical Advisory Cmittee meobers met with Progra'rme staff in Ouagadougou in early May to review the first draft of the evaluati-on report. A meeting of the full cormittee subsequently took place at the WtlO Reglonal Offlce for Africa La Brazzaville from 21 to 25 August. This meeting, which was opened by the WIIO RegionalDirector, was attended by the Independent Chairman of the JCC and by a representatlve of the World Bank. 45. A meeting of che Ecological Panel took place ot 29 and 3O May, to review the results of the aquatic monitoring programtre with particular eophasis on the fish population of the treated rivers. While recognizing that weekly treatment was resulting in a certain reductionin the number of invertebrate organisms, the Panel considered that this was not important aa long as the overall productivity of the rivers was unaffected. 46. From 11 to 13 September the Economic Development Advisory Panel met to review the draft report of the economic review mission. -''.'' 47. In line with the recomrnendation made by SIAC at its sixth meeting in November 'L977, a Scientific Advisory Panel working group was called in Geneva in early July to consider the developmenE of insecticides. Participants included representatives of the chemical industry who indicated the readiness of their companies to cooperate in submitting nes, compounds andformulations for testing. 48. A second SAP working group held from 16 to 20 October brought together five cytotaxono- mists and Programme personnel Eo review the progress made in Ehe study of the the species of Ehe S. damnosum complex cortrnon to West Africa. The aim of the undertook actual examinaEion of specimens, was to devise a practical method of adults of S. damnosum s.l. in the field. morphology of grouP, which ident i fying With the general public 49. Information on the Programme was disseminated through t.he presentari.on of films, art.icles, fact sheets and radio and television interviews. 50- On a number of occasions, OCP staff have presented the work of the prograrune atinformation sessions or seminars organized in 0uagadougou. In collaboration with the Ministry of Health of Upper VoIta and the Autorite des Amenagements des Vall6es des Volta (AVV), aninformation neeLine was organized on lo April. This included a presentaEion of both the ocP/?8,/7s.4 Page 12' activities of the Programe and those of Aw, the projection of films, and a,,question andanslter" session. During the same period, films on onchocerciasis were shown daily in theloca1 cinemas; interviews with Programne and Aw personnel were broadcast, and a round-tabrediscussion was televised. 51' similar information sessions were held for the Ecole Nationale de sant6 publique, andother ouagadougou schools, as well as for 18 university professors from the united States ofAmerica visiting ouagadougou under the auspices of the Fulbright Foundation and anothergrouP of 23 American professors on a study tour under the auspices of the phelps stokes Fund. 52' Progra"me oPerations were described and films on onchocerciasis were shown at. semi,narsorganized by the Secretariat drEtat aux Affaires sociares of Upper volta for participants frmNigeria, upper volta, Senegal and Mali. A sinilar presentation was arranged for some30 radio specialists from different countries of Africa within the framework of a serninarorganized by the Voice of Gernany as well as at a seminar held by the Institute forrnternational cooperation and the university of ottawa. 53. Apart from fact sheets, the Programe provided background mpterial for articles whictrappeared in ttl^lorld Healthtt, ttFrance outremerir, and the new cDA magazine, ,,Directions du 54' Assi'stance was given to the Canadian National Film office in the making of aneducati'onal filn in the t'sant6-Afriguertseries, as well as to the I'lali Nationar cinema centrewhich prepared a film on onchocerciasis and other ocurar diseases. 55' In collaboration with the Division of rnformation, wHo, Geneva, the programe hasincreased its library of infornation nateri.al. Also, a series of radio recordings wasprepared including interviews with the Programe staff as well as with several participantaat the 1978 meeting of National Onchocerciasis Comittees. In addition to these recordi.ngo,the Prograrrme norT has at its disposal six films on onchocerciasis and a number of photographsand slides. 56' Amongst the many visitors received by the Programme during the course of the year rdereMr vernon Johnson, Assistant to the under-secretary of state foi Foreign Affairs, unitedstateg of America, Mr D. Conroy, Director of Regional Programes for the Africa Bureau, usArD,washlogton, Dr Kern and Dr Pulst of the Ministry of cooperation of the Federal Republic ofGermany, and Mr Moise Mensah, Vice-President of the rnternational Fund for the Developmentof Agriculture. 57' The information bulletin "Oncho Flash", which appeared in February and May this year,rePorts matters of special interest concerni-ng the Programe. General acti-vities are '\ryregularly reported in the monthly and quarterly reports. MANAGEMENT AND COSTS 58. The Administrative Services Unit evaluation network in phases I, II and Coast and the initiation of extension structure of the Prograrrne has evolved sectors artd 25 subsectors. was involved in the reorganlzation of the entomological III, the extension of programne activities in Ivory studies in Benin, Ghana and Togo. The physical infra_from six sectors ar.d 24 subsectors in L977 to five 59. The total personnel complement now service postsl compared to 47 and 756 as 1 Including liaison/support and WHO headquarters. stands at 50 professional posts and 731 general originally anticipated ar 3l December 1977. services from the htlo Regional office for Africa, Brazzavi1Le, 60. Salary revisions for general service Togo. These revisions represented annual and 3-8% (Togo), depending on the grade. oct/vxfia.t page 13 staff were implemented in Ivory Coast, Ghana and increases of. 24-47% (Ivory Coast), 2O-113% (Ghana) 61. The building to house Progranme headquarters in Ouagadougou, which includes a Conference Room, has been completed. 62. In addition to modifications to the physical infrastrucEure associated with the opening and closing of various subsectors, in Mali a garage was constructed at Bougouni and modifica- Ei.ons were effected Eo the Bamako sector office. In Ouagadougou, the garage complex was modified and work started on a body and paint shop for vehicle repairs. Also, a warehouse was construcEed. 63. The radio conrnunications network was slightly modified and new units were installed at Seguela (IvoryCoast), Hohoe (Ghana), Bandiagara (Mali) and Atakpane (togo), bringing the number of stations to 24. 64. The closing of accounts for L977 revealed that the savi.ngs for the year in fact totalled US$ 2 428 729, i.e. USS 269 729 more E.han the figure announced at the Kuwait session of the Joint CoordinaEing Committee. 65. In 1978, weekly expenditure reporting was instituted. Expenditures for 1978 are expected to be in the order of US$ 12 100 OOO reflecting a further saving of about US$ 1 70O O0O. The 1979 Budget was prepared on the basis of this revised 1978 expenditure.