Devolution

ONCHOCERCIASIS CONTROL PROGRAMME IN WEST AFRICA Expert Advisory Committee Thirteenth session Ouagadougou. 8-L2 June 1992 Briefing session, 6 Jlune 1992 ocP/EAclr/uteffne paper noo 4 DEVOLUTION 1. The Devolution Unit was officially set up on 1 August 1991. It was subsequently strengthened by the recruitment of a social scientist. tt immediately prepared plans of activity covering the periods of August-December 1991 and then January-December 1992. These plans highlight the advisory and catalytic role that the Unit has to play as regards training, the raising of the awareness of the authorities and of the general public, epidemiological surveillance and treatment of patients with Mectizaru the writing and updating of devolution ptans of the countries, mobilization of resources for the implementation of the plans and operational research. The Unit has worked in close collaboration with the other OCP units and with the WHO Regional Office for Africa, particularly through the intercountry Devolution Coordinator. Contacts between the Unit and the Participating Countries have been constant, notably with Burkina Faso, Mali and Niger, the first countries to have prepared and got approved their devolution plans. 2. Training From August 1991 to April 1992, about 90 fellowship application forms from Participating Countries were processed and some 40 fellowships awarded, about LZVo of which were for women. In this connection, it should be noted that despite the appeals made by the Programme to the countries concerned, female applications are still small compared to those of men. A review of the overall fellowship situation shows the following, as of 30 April 1992: - 370 nationals of the Participating Countries have received an OCP fellowship. As/jos oCP/DEVO/18s.92 -2- - 13 OCP fellowships have been awarded to countries located outside the OCP area. Furthermore, in-service and field training is being continued and is based mainly on the epidemiological evaluation methodology, Mectizan distribution and post-treatment surveillance. With regard to the planning of training, seven countries have expressed their needs for the period L992-1997. 3. Public awareness and population mobilization effort. Through the impetus given by the Programme Director, the Devolution Unit and the Vector Control Unit coordinate a vast information campaign conducted every week by sector and subsector chiefs during their routine field visits. The main themes treated during these sessions are the return of the blackfly after the cessation of larviciding, the role o-f Mectizan in the prevention of blindness and in the control of onchocerciasis-caused morbidity. Furthermore, films on onchocerciasis and the socioeconomic effects of the control of this scourge have been made, notably in Burkina Faso, Niger and Guinea-Bissau, with the active participation of the Devolution Unit. The official handing over of OCP's activities in Burkina Faso to its government in November 1991 was the occasion for a greater raising of the awareness of the country,s highest political and administrative authorities and populations as regards the need to give priority to activities related to the maintenance and strenghtening of OCP's achievements. 4. Epidemiological surveillance and Mectizan treatment. To facilitate the coordination of the work of the different partners concerned with devolution activities in the field (Participating Countries, OCP, NGOs, etc.) it has been consid-ered timely to define clearly the zones which wilt be under epidemiologicat surveillance and those eligible for Mectizan treatment in the initial Programme area and the southern extension in Cdte d'Ivoire (see map attached). The first epidemiological surveillance surveys within the framework of devolutionwill be conducted in April-May 1992 in Burkina Faso and Niger by the QCP-trained national teams. With regard to the Mectizan treatment of the populations, it continues to be carried out almost completely by these national teams: for example, in Mali and Burkina Faso in the Pendie area, no OCP worker participates any longer directly in the field in the treatment of onchocerciasis-patients. 5. Preparation, updating and financing of national devolution plans. In December 1991, the Unit took part in an initial revision of Burkina Faso's devolution plan. This updated plan has been approved by the Wortd Bank which has 6. -3- pledged to finance it for five years. In April 1992, Burkina Faso's government decided to extend its devolution plan to the eradication of dracunculosis. OCP has participated again in a second revision of Burkina Faso's devolution plan which in addition to onchocerciasis and human tr,?anosomiasis, now comprises the eradication of Guinea worm. The World Bank has accepted also to finance for five years this enlarged devolution plan. A first funding tranche will be available in April 1992 to allow the real take-off of devolution activities in Burkina Faso. In Niger, the authorities also intend to include the control of Guinea worm and schistosomiasis in their devolution plan. At the right time, OCP will help Niger in its effort to revise its plan. The steps for the financing of Niger's devolution plan are currently being taken with the support of OCP. C6te d'Ivoire has also updated its devolution plan. For the western extension countries, such as Senegal, Guinea and Guinea-Bissau, steps have already been taken with a view to the preparation of their devolution plans. The first of these countries which will see its plan prepared with the support of the Devolution Unit will be Guinea-Bissau which intends to submit this plan to donors for appraisalinl992. Support to operational research. - Blacldly nuisance and socioeconomic development. Discussions have already been started between OCCGE and OCP for studies to be conducted mainly by OCCGE with a view to determining the possible impact of blackfly nuisance on socioeconomic development in the oncho-freed zones. OCCGE is currently formulating an operational research project to that effect. With the recnritment of a social scientist in each Participating Country, OCP also may be able to contribute directly to these blackfly-nuisance studies. - Community participation in Mectizan treatment. Trials of patient treatment with Mectizan by village communities themselves are going on in Mali. These trials are carried out by nationals and a non-governmental organization with OCP support. - Human migration studies. Studies have been conducted on human population migratory movements in the oncho-freed zones by a social scientist recruited by the Devolution Unit. These studies have already revealed the presence in the Banifing IV basin in Mali of a considerable number of onchocerciasis-infected immigrants. These studies will be extended soon to the White Bandama basin in C0te- d'lvoire as well as to other basins where the presence of immigrants infected with O. volrmlus could constitute an onchocerciasis recrudescence risk. -4- 7. Devolution process surveillance system. The Devolution Task Forc. hT drawn.up a number of parameters permitting themonitoring and evaluation of the implementation of Jevolution. rtir. f"."*"t..s will besubmitted to the EAc for appraisal during ttris ttriiieenth session in June lgg2. 8. Preparation of documents. - Two manuals on ground larviciding of blackfly breeding sites have been preparedand distributed to the ocP participating c-ountries.-' ' In line with the recommendations of JPC12, two other documents have beenprepared, entitled as follows : - Main lines of devolution activities related to onchocerciasis in the initial OCp areaand southern extension in c6te d'Ivoire lociToCio,ttolioctrii>;"- - Institutional frameworks for devolution and the roles of the main actors(ocP/DEV O / 106 / Doc / e2). These last nvo documents are attached to this briefing paper to enable EACmembers get the time to study them. .;Ei 5xl E! 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