Plan of action and budget for 2000

Onchocerciasis Control Programme in West Africa Programme de lutte contre I'onchocercose en Afrique de I'Ouest JOINT PROGRAMME COMMITTEE JPC - CCP COMITE CONJOINT DU PROGRAMME Office of the Chairman Bureau du Président JOINT PROGRAMME COMMITTEE Twentieth session .The Hague. 6-8 December 1999 Item 10 of the provisional agenda lPc20.4 ORIGINAL: FRENCH September 1999 PLAN OF ACTION AND BUDGET FOR 2OOO JPC 20.4 ONCHOCERCIASIS CONTROL PROGRAMME in V/est Africa PLAN OF ACTION AND BUDGET FOR 2OOO V/ORLD HEALTH ORGANIZATION (i) TABLE OF CONTENTS Page INTRODUCTION ...1 OVERVIEIù/ OF THE PLAN OF ACTION . . . OVERVIEW OF THE BUDGET FOR 2OOO 4. ESTIMATED COST BY PROGRAMME ACTIVITY 15 4.1. Vector Control Unit 4.2. Plarming,Evaluation and Transfer Unit 4.3. Macrofil Chemotherapy Project . . . 4.4. Office of the Director 4.5. Administration and Support Services Unit 4.6. Statutory meetings 4.7. Capital costs ANNEXES I. OCP ORGANIZATION CHART AVERAGE COSTS USED FOR BUDGETARY CALCULATIONS RATES OF EXCHANGE OF THE US DOLLAR/CFA FROM 1998 TO 1999 . . . 44 CHANGES IN PERSONNEL FIGURES FROM 1993 TO 2OOO . V. AERIAL OPERATIONS FROM 1993 TO 2OOO Vt. MAP - VCU PLAN OF OPERATIONS FOR 2OOO VII. MAP - VCU SECTORS, SUB-SECTORS AND OPERATIONAL BASES FOR 2OOO . VM. ENTOMOLOGICAL NETWORK IN 2OOO Ix. MAP - AREAS EARMARKED FOR LARGE-SCALE IVERMECTIN TREATMENT IN 2OOO . . . 50 MACROFILCHEMOTHERAPYPROJECT .....5I 3 6 15 20 28 30 33 38 39 42 43II. m. Iv. 46 47 48 49 XI. EVOLUTION OF VEHICLE FLEET FROM 1993 TO 2OOO . (ii) TABLE 1. TABLE 2. TABLE 3. TABLE 4. TABLE 5. TABLE 6. TABLE 7. TABLE 8. TABLE 9. TABLE 10. TABLE 11. LIST OF TABLES Palge BUDGET BY PROGRAMME ACTIVITY [O BUDGET BY CATEGORY OF EXPENDTTURE LINE ITEM L2 BUDGET FOR 2OOO - SUMMARY BY PROGRAMME ACTIVITY AND CATEGORY OF EXPENDITURE [4 VECTOR CONTROL UNIT T9 PLANNING,EVALUATIONANDTRANSFERUNIT ..... L7 MACROFIL CHEMOTHERAPY PROJECT . , 2g oFFTCEoFTHEDTRECToR . _.... lz ADMrNrsrRATroN AND suppoRT SERvICES . . . $s ovERVrEwoFADMrNrsrRATrvECosrs ......i0 STATUToRYMEETINGS ...1a CAPTTALCoSTS ....40 JPCaO.4 Page 1 1. INTRODUCTION The plan of Action and Budget for 2000 is the third budget in Phase V of the Programme, which corresponds to the s-year Plan of operations (1998 -2002) that was approved by the Joint Prograrnme Commiuee (JPC) in December 1996. It is supposed to take the Programme to its conclusion by ensuring its orderly and progressive disengagement. The two main thrusts of this final phase are the çsafinrring reduction of vector control activities and the strengthening of the capacity the Participating Countries to effectively detect and control recrudescence of the disease, with active support from the Planning, Evaluation and Transfer Unit. The amount proposed for the 2000 budget is US$ 14,974,000, a figure which, similarly to the 1999 budget, is higer than the one provided for in the Plan of Operations. The reasons for this remain the same: continuation of seasonal larviciding in the Sassandra basin in accordance with a recommendation made by the Expert Advisory Committee and approved by JPC19, and funding for the engagement of a senior public health expert as approved by JPC on the recommendation of the External Evaluation Group. Although this budget is 4% hrgber than the amount projected for the year 2000 in the Phase V Plan of Operations , it is 47o lower than the 1999 budget approved by JPC last year. The Plan of Action and Budget for 2000 has beenprepared on the same general format as in previous years. The text sections are intended to present the main components of the Programme's activities, their evolution in relation to Phase V of operations, and to shed light on the expenditure proposed. The tables, grapbs and fïgures summarize the various items related to the expenditure and personnel, and provide a synoptic view ofthe different budget components. The annexes present some basic elements of the report such as the organizational strucnlre, operational costs and resources utilized, and data of an operational or administrative nature seen in the context of their evolution. Vector Control Activities. The 2000 budget for vector control operations takes into account the continuation of larviciding on the Sassandra in Côte d'Ivoire, on the Dienkoa focus in Burkina Faso, on the Niger focus near Bamako in Mali, on the Oti and its tributaries in Togo, in the Western Extensions (Guinea) and South-Eastern Extension (Ghana, Benin and Togo). It is further characterized by (i) the cessation of larviciding in Sierra Leone, (ii) an increased use of B.t. H-14 mainly in ground larviciding to supplement aerial larviciding which is more costly, (iü) the consolidation of the transfer of the residual entomological activities to the countries (entomological detection of the recrudescence of transmission of onchocerciasis, impact of ivermectin treatment on the transmission, and blackfly nuisance control) to be carried out by the national entomologists appointed in the different ministries of health, and (iv) a higher cost of aerial operations resulting from the new aerial contract which came into effect in 1999. 1.2. Planning, Evaluation and Transfer actiüties The important cross sectional epidemiological evaluation of villages in the Original Programme area will be completed in the year 2000 by staff from the respective countries supported financially and logistically by the PET Unit. The thrust of affairs in the Unit will be the consolidation of retraining of middle level staff in techniques for epidemiological surveillance and community distributors for ivermectin treatment. A new dimension of activities will be the teaming up with national Information, Education and Communication (IEC) Units l.t IPC20.4 Page 2 to prepare additional and appropriate health education material on onchocerciasis for use by flre countries. Limited higher level training in epidemiology, public health, health planning lnd health education will be supported by the Unit. The Unit will carry out systemaric updatin! of data that has already been transferred to the countries as well as continue the "on+heJob training" of national staff in data analysis for decision making. Furthermore, the Unit i+rill support the countries in implementing ivermectin distribution through the commun§ direded approach. The Unit will be closely involved in the creation of a WHO Centre for multidis4se epidemiological surveillance at OCP premises. Finally, the Unit will work closely with {he University of Rotterdam on integrated analysis of the Programme's data and the updating of {he ONCHOSIM model. 1.3. The Macrofil Project The main objective of the Macrofil project will continue to be the development of sffe and effective adulticidal drugs (macrofilaricides) for the treafinent of onchocerciasis {rd lymphatic filariasis. A complete presentation of the Project is set out in Annex X (pages 5lrto 53) 1.4. The Office of the Director The Office of the Director will continue to ensure the management and implementatifrn of the Programme within the framework of the strategy, orientations and general policy defirled by the Statutory Bodies, and reflected in the annual budgets. These duties comprise close liais§n with the Stanrtory Bodies, the Donors, the Participating Countries, the Scientific Communi(y, as well as coordinating all Programme activities, including research contracts. The Director of OCP also ensures coordination with the APOC Programme for wnl[h he has been appointed to act as Director ad interim since February 1996. He delegated ttre Ofy to day management of the APOC Programme to the Coordinator of the Office of the Directdr, who functions as Programme Manager. This arrangement which contributes to effective collaboration and harmony between $e two Programmes includes a financial component whereby as long as the arrangement remaif» in force, the APOC Programme is to re-imburse OCP for 25 percent of the Director's salaly and 75 percent of the Coordinator's salary. 1.5 [dministrative and Management support Services The Administration and Support Services Unit will continue to give support to tfre Programme's operational Units. It will strive to manage the human, financial and mater{al resources available to OCP in the best interest of the organization. In addition to ensurifg compliance with basic management principles, the Unit's support will be provided through fts four departments: personnel, budget and finance, supply, transport and telecommunicationp This phasing-out period of the Prograrnme is a subject of legitimate concern for tfre national staff employed by OCP as to their future outside the Programme and their chances 0n the job market - whether they are under WHO contract or Special Services Agreement whi{h gives them an even less advantageous status. Much practical advice will have to be given $y the Administration to those concerned as well as adequate briefing on the terminal benefits thfy are entitled to including pension and insurance benefits. The Administration will also have lo coordinate and strengthen the training of the staff in various areas. Maintaining the quality of work, staff morale and the efficiency of the Organization should be the subject of renewêd efforts by the Administration and OCP Management. 2.1 JPC20.4 Page 3 2. OVERVIEW OF TIIE PLAN OF ACTION The Plan of Action sets out the work which will be done by the various units of the Programme. Office of the Director In 2000, the Office of the Director will continue to ensure the overall management of the Programme in accordance with the general policy defined and maintain all the external contacts needed for that purpose. Two posts which up to now had been under WHO status viz. theposts of Programme Officer and CommunicationOfficer willbe downgraded to Professional Special Services Agreement contracts which are less costly to the Prograulme. The liaison office in Geneva will be maintained, and its cost will continue to be shared with the WHO Regional Office for Africa. Vector Control (VC[D The Plan of Action for vector control activities in 2000 is shown (on a map) in Annex VI. It may be summarized as follows: in the original Programme area, only theDienkoa focus in Burkina Faso and the focus on the tributaries of the Oti in Northern Togo (Kéran, Kara and Mô) will continue to be treated; in the Southern Extension in Côte d'Ivoire, only the mean course of the Sassandra and its tributaries, the Bagbé and Bafing will continue to be treated from the air; the same will apply in the South-Eastern Extension (southern Ghana, Togo and Benin); in the Western Extension vector control activities have officially been suspended in Sierra [æone since the 1 January 1999 but will continue in Guinea. The principle of rotation of insecticides has from 1999 elected to concentrate on four products among the most cost-effective ones i.e. temephos, pyraclofos, permethrin and Bacillus thurtngiensis H-t4 (8.t. H-14) which will be increasingly used with the introduction of a more efficient formulation than the one used up to 1998. As of 1 January 1999, the Vector Control Unit consists of 2 (nvo) "National Team" q4)e entomological sectors and 15 (fifteen) "Operational Bases" (O.B.). As a consequence to the cessation of larviciding operations in Sierra I-eone the total number of catching points will be reduced from 124 to 109 throughout 2000. The contract signed int997 with "Evergreen Helicopters Inc." for aerial spraying of larvicides will continue to be in force. As originally projected, the cost of the flight hour is from 1999, 25% higher than the amount provided for in the Plan of Operations of Phase V of the Programme. Research activities on insecticides will be limited to the monitoring of blackfly susceptibility and to routine monitoring of the quality of operational insecticides. However, collaboration with the molecular biology laboratory of the University of Alabama, Birmingham (UAB), and with the molecular biology laboratory of IRD (former ORSTOM) in Montpellier, will continue as in the previous years. Monitoring of the aquatic environment will continue,with special emphasis on i) habitat quality studies, so that the influence of factors other than the larvicides on the results of the aquatic environment monitoring can be better appraised and ii) on the valorization of the aquatic monitoring activities implemented by the Programme. In addition, the activities of routine monitoring of the long-term effects of the least selective larvicides on the non-target aquatic fauna will continue. 2.2. tPC20.4 Page 4 2.3. Planning, Evaluation and Transfert Unit (PET) For the year 2000 the Planning Evaluation and Transfer Unit will as in the previqus year provide technical, logistic and financial support to the countries. This support is aime{ et rendering the countries technically capable of taking over the responsibility for residiral onchocerciasis control activities and more especially for detection and control of 4ny recrudescence of onchocerciasis infection within the framework of their national health systerirs. The efforts already made towards the promotion of the process of integrating onchocercia§is control into the national health system will be reinforced . The Unit will continue to suppfrt the community directed treatment with ivermectin effort in the communities, the countfy- specific analysis and interpretation of data as well as operational research. The objective islto safeguard the health improvements and economic gains which have resulted from ltp Onchocerciasis Control Programme. Large scale ivermectin distribution through the community directed approach witl be carried out in an estimated 27,W villages. It is therefore expected that more than nine miUi[r people will be treated in 20O0. Experience from the preceding years suggests the need {or reinforcement of Information, Education and Communication (IEC) interventions. This Uhit will support this activity working closely with nationalilocal experts. Epidemiological evaluations planned by this Unit in collaboration with the national tea+Ë will be carried out by the countries in the villages in basins where there is combined tarvicid$B and ivermectin distribution. There will also be the continuation of evaluations in the areas w{th only ivermectin treàtment as a follow-up to the study on the effect of long term iverme{in treatment on transmission. There will be a continuation of ophthalmological evaluations in a number of villagesiin the original Programme area to help assess the long-term impact of combined vector con{ol and ivermectin treaünent on (a) the transmission of infection and (b) on onchocercal efe disease. The Unit will continue the ongoing transfer of the epidemiological data collected by OÇP to the countries, the training in data entry, validation of data, analysis and interpretation pf results obtained. Updating of the data entry and validationprogrammes thathave been instal$d in each of the countries will be continued. This will help the nationals to be completety airO independently operational in data management. Modelling of different epidemiological siruations (areas of larviciding alone, areas bf ivemectin treatment alone and areas with combined treatment) will continue in OCP in 20@ using the ONCHOSIM model. Additional data collected from epidemiological surveillance in the original Programme area where the parasite reservoir is virnrally eliminated, will be us@ to test and validate predictions of the simulation, with particular reference to recrudescenfe detection, and its control with ivermectin. An extensive integrated analysis of the data that has been collected since 1974 in the Programme will be initiated, in collaboration with the University of Rotterdam, in an effort to refine the ONCHOSIM model, and to arrive at likely scenarios of the onchocerciasis situatiQn at the end of 2002. Training will be at the foundation of all activities. The unit will concentrate on the following disciplines: epidemiology, public health, health planning and management, health education as in the past, statistics and the use of computers. Higher level training which w{ll be limited will generally be undertaken in institutions in Africa. The emphasis will be on f,refd training, on- the-job training and training through seminars and workshops. Retraining at tlie community level for community directed treatment with ivermectin will be continued. 2.4. JPC2O.4 Page 5 The Unit will be closely involved, both in terms of technical expertise and logistics, in the setting up of a WHO Centre for multidisease epidemiological surveillance at OCP premises. Macrofil Chemotherapy Project (MACROFIL) The discovery and development of safe and effective macrofilaricides for onchocerciasis and lymphatic filariasis control remain the primary objective of the Macrofil Project. As has been the case since 1998, OCP contribution to this project will amount to US$ 700,000,with two other contributions in the same amount expected from the African Programme for Onchocerciasis Control (APOC) and from the special Research and Training Programme on communicable diseases (TDR). The total amount is therefore US$ 2.1 million. OCP will continue to fund the salaries of a scientist and of a secretarÿ, âs well as the Oncho Chemotherapy Research Centre in Ghana. To the extent feasible, OCP and APOC funds will be used for the pre-clinical and clinical development of drugs for onchocerciasis treatrnent, and for the development of a test to detect ivermectin resistance. It is worth noting that Moxidectin has been identified as the most promising compound for the development of a novel macrofilaricide. Administration The Administration and Management Support Services Unit will continue to support the technical units of the Programme. Being in charge of managing the human, material and financial resources available, it has to work in the perspective of the phasing-out of the Programme by the end of the year 2N2. For some sectors of activ§, this disengagement is already reflected in the budget, as, for instance, the decline in capital expenditure since 1998. For some other sectors, on the other hand, the drive must be kept up or even increased. This applies, especially, to the Personnel deparEnent, which must intensiÿ its activities in the area of counselling and orientation of staff members whose posts have either been abolished or changed to a less favourable status, or who have concerns about their future prospects of employment after the end of the Programme. Besides, the Personnel and Finance Offices, and to a lesser extent, the Supply and Services Office, must provide increased support to APOC. To meet these requirements and maintain the quality of the management, there is need for additional help, which is provided through the recruiunent of temporary and short-term staff. 2.5. JPCZO.4 Page 6 3. OVERVIEW OF TIIE BIJDGET FOR 2OOO 3.1. General structure For this overview, the Plan of Action and Bugdet for 2000 is presented in two waü/s: "Programme activity", and "Category of expenditure". The programme activities are basic{ly structured according to the organization chart of OCP shown in Annex L The categorie{ of expenditure are the components of the Programme activities The summaries of tt{ese components are shown in the following tables and figures: Table 1: budget by programme activ§, from 1995 to 2000 Table 2: budget by category ofexpenditure from 1995 to 2000 The two tables are illustrated by the pie charts in figures I and2 respectively. Table 3: combines tables I and 2 for 2000, the category of expenditure befng shown for each Programme activity. I 3.2. General remarks The amount proposed for the 2000 budget is US$ 14,974,WO. In the context of phasing-out of the Programme, only the essential activities have been retained, and for staff, each post was reviewed with the aim of retaining only those which were absolu essential. Two measures which were recommended by the Expert Advisory Committee already implemented in 1999, will have to be maintained in 2000: continuation of seas treatrnent in the Sassandra basin (Côte d'Ivoire), and engagement of a public health expert. addition, particular attention will be given to the fine-tuning of the ONCHOSIM model in perspective of the post-OCP period. These measures, which proved to be indispensable, Programme Committee at its 17ü session (Cotonou, December 1996). They resulted in a l% increase in the budget provided for the year 2000 in the Plan of Operations. The average costs used for the calculation of the budget are set out in Annex II. Ifhe trend of the exchange rate of the US dollar to the CFA franc for 1998 and up to May 199{ is shown in Annex III. 3.2. Categories of expenditure The categories of expenditure are reviewed in the order followed in table 2. 3.3.1. Personnel Services For a better undertanding of this category of expenditure, the three main categoriesrof posts used by OCP will be recalled here: WHO/OCP staff Professional and General Services staff contracted under WHO staff Regulatiqn, with UN salary scales. JPC20.4 Page 7 SSA staff Staff whose contracts stipulate that they are not members of wHo staff, and that they are exclusively subject to the terms and conditions, salaries and allowances specified in their contracts (salary scales may be based on those of Participating Countries, of the private sector or of the UN, depending on the position). National staff Staff of the national teams of the Western extension whose salaries and allowances are paid by their respective Governments, supplemented by individual flat rate allowances paid by OCP. Since 1 January 1993 many of the General Services Staff have seen their WHO/OCP status changed to SSA status, while they continued to assume more or less the same functions. This process is still on-going. For such staff members, this results in less favourable salaries and allowances but these are partially compensated for by a IWHO severance pay atthe time of leaving post. For the Programme the SSA status is less costly as compared to the WHO/OCP status. The changes in these various categories of staff since 1994 are shown in the following figure: 1994 1995 ffi wHo/ocP 1 997 ffiffi ssA staff 1 998 WVZ Nationalstaff In 2000 there will be a reduction in the total number of posts, especially in the national staff category which has noticeably been on the decline mainly due to the cessation of vector control activities in Sierra Leone. In addition, four WHO/OCP posts will be abolished, two of which will be changed to SSA status. However, the staff reduction is virtually completed. A summary figure of the personnel costs from 1993 to 2000 is shown in Annex IV. TPCZO.4 Page 8 The proposed expenditure for personnel for 2000 is US$ 4,686,000, i.e.2.5o less tfran the amount approved for 1999. 3.3.2. Consultancy services. These services include high level experts and short+erm professionals used by Of," to strenghen certain activities, particularly those related to capacity building in the countrles. The main areas in which consultancy services are used are in the fields of insectici$s, entomology, hydrology, hydrobiology, cytotaxonomy and public health. The planriod expenditure of US$ 695,000 is l7 % less than that approved for 1999. 3.3.3. Operational travel. Strict controls will continue to be applied to this budget item. The planned expendi$re amounts to US$ 360,000, which is slightly less than that of 1999. 3.3.4. Contracts This expenditure category covers research and service contracts signed wfth companies, universities and other institutions in support of specific OCP activities such ias monitoring of the aquatic environment, Argos teletransmission, maintenance of hydrologi{al stations. Also included are some research contracts relating to the Macrofil Chemother$y Project. The expenditure proposed under this category is US$ 450,000, i.e. 4.5%o less than t{rat approved for 1999. 3.3.5. Aerial operations. Two factors remain determinant in 2000, as they were in 1999, leading to an ovemrnlof the amount proposed in the Plan of Operations of Phase Y (1998-2002): the continuation of seasonal larviciding in the Sassandra basin; the cost of the flight hour, which is higher than the amount estimated, starting fr(rn I January 1999. However, the cessation of larviciding in Sierra Leone has made it possible ltopartially offset these increases. The proposed amount of US$ 3,436,000 is2.5%o less than that §f 1999. The trend of aerial operations between 1993 and 2000 (flight hours and cost) is shovi,n in Annex V. 3.3.6. Operating costs These are costs which concern the logistic needs ofthe Programme ( vehicle fuel, spa;e parts, etc.) and infrastructure-related services (electriciÿ, water, telephone). The amoufrt proposed is US$ 804,000, i.e.l2o less, compared to that of 1999. 3.3.7. Larvicides Careful analysis ofthe 1998 stocks and usage rate and the larviciding activities projectQd for 1999 were taken into account in determining the cost of purchasing the minimum quantiÿ of larvicides in 2000. The amount proposed is US$ 2,270,000, which is 20% less than that ôf 1999. 3.4. JPCaO.4 Page 9 3.3.8. Supplies This category covers the procurement of recurrent items such as office supplies, small contracts for security, ofÏice cleaning and maintenance of office equipment, and miscellaneous items. TheamountrequiredwillbeUS$195,000,i.e.anincreaseof6.5olo,comparedtothel999 projection which were underestimated. 3.3.9. Statutory meetings The amount estimated under this category is US$ 250,000, which is the same as that of 1999, the planned activities remaining the same. 3.3.10. Fellowships and training This category will continue to cover current fellowships, new ones and in-service and field training. These are fundamental activities to increase the technical capacity of countries to take up responsibiliÿ for the residual activities of onchocerciasis control. On the basis of available data, including the training plans submitted by several Participating Countries, the amount proposed for this item is US$ 420,000, i.e. an amount 7Yo lower than that of 1999. However, this category will be closely monitored. Should additional funds become necessary in the course of the fiscal year, every effort will be made to mobilize the needed funds, be it at the expense ofother expenditure categories. 3.3.11. National teams The Governments ofthe !ÿestern Extension countries continuetoputunderthetechnical supervision of the Programme, national teams to undertake vector control activities such as ground larviciding and entomological evaluation. These teams are also placed under the supervision ofthe Programme tocarq/outepidemiological evaluation, distribution ofivermectin and awarness-raising, activities which are also undertaken by the national teams in the other Programme areas . OCP provides technical and financial support to these activities. The amount required for this category is US$ 721,000 i.e.7.5%o less than that of 1999. 3.3.12. Administrative support from Geneva For administrative Support from Geneva, the amount proposed on the basis ofthe actual expenditure made in the previous years, is US$ 375,000. 3.3. 13. Sub-regional Centre for Multidisease Surveillance In support of the installation of the AFRO Sub-regional Centre for Multidisease Surveillance within OCP's premises, the Programme will make available to the Centre an amount of US$ 100,000. 3.3.14. ONCHOSIM integrated data analysis This project is to be implemented in collaboration with the University of Rotterdam to carry out an integrated analysis of ivermectin treatment data over the life ofthe Programme. The estimated cost is US$ 120,000. Capital costs Capital costs, estimated at US$ 92,000, is 802 less than thel999 estimate, which is consonant with the phasing-out process. Budget srunmary The total amount of the budget for 2000 is therefore US$ 14, 974,000, i.e.3.7% less than the amount approved for 1999. J.5. JPC}O.4 Page 10 TABLE I BUDGET BY PROGRAMME ACTIVITY (us $) Programme Activiÿ ;':'.,:i .:F.H A'§.É',,.1 ..:..... ,:i...r Approved 1999 Expenditure 1 998 Expenditure 1997 Expenditure 1 996 Expenditure r995 Vector control Planning Evaluation & Transfer Unit (P E T) Chernotherapy Project Office of the Director Administrative & Support Services Administrative Support Geneva Statulory meetings CapitalCosts I 955 000 1 919 000 700 000 869 000 1 278 000 475 000 250 000 100 000 11 873 531 1 796 184 518 116 879 727 'l 345 471 360 068 20/.463 228 661 1 3 572 558 1 958 417 1 730 528 765 967 1 715 580 311 467 2æ201 851 853 13 985 652 1 703 297 1 747 690 1 411 554 1 842 570 u8 451 173 600 579 880 13.196 365 2325 450 1 775 421 718 500 1 910737 405 480 320729 658 028 tg* ']:*.ilr :iii:i.ii,d:rûi iiiiffi i:i:r,:.:.,+ :: *sii ..i:i "- ::i ' . i'§! ...:: TOTAL 15 546 000 17 206 221 21 112 571 21 792 694 I z'r auro :::: lvermecttn : 27,000,000 tablets of 3mg, valued at US $ 1.5 a tablet, will be provided through OCP free of charge by Merck Sharp and Dohme. JPC2O.4 Page I I FIGURE 1 BUDGET BY PROGRAMME ACTIVITY - 2OOO 78 1 2 3 4 5 6 7 B Vector control Planning Evaluation and Transfer Administrative & Support Seruices Office of the Director Chemotherapy Project (Macrof il) Ad ministrative Support Geneva Statutory Meetings Capital Costs (us $) 9,613,000 1,981,000 1,204,000 759,000 700,000 375,000 250,000 92,000 (%) 64.20 13.23 8.04 5.07 4.68 2.50 1.67 0.61 TOTAL 14,974,000 100.00 1JPCZO,4 Page 12 TABLE 2 BUDGET BY CATEGORY OF EXPENDITURE(us $) Category of Expenditure .PHA§:E Y Approved 1999 Expenditure 1998 Expenditure 1997 Expenditure 1996 Expinditurc lsgs IRECURRENT COSTS I lPersonnel Services I lConsultants I lOperational travel IlContracts (Research & Others) Aerial Operations Operating Costs Larvicides Supplies Statutory Meetings Fellowships and Training National Teams Administrative Support Geneva \flHO Sub-Regional Centre lntegrated Data Analysis 'lanHIo 4 800 000 873 000 365 000 502 000 3 530 000 917 000 2321000 183 000 250 000 450 000 780 000 475 000 5 142 985 988 1149 432848 172331 3 865 001 1 328 419 28',11226 44',1992 204 463 438 905 790 873 360 068 5 311 648 1 036 251 399 618 1 764 419 4 093 475 1 344247 3 774 667 ,44873 2æ201 422767 1 051 085 311 467 6 395 360 1 019 779 605 820 1 465751 4 020 990 1 493 493 3659214 420763 173 600 529 393 1 080 200 348 451 6 T78 8s2 lp.}66/ {ao see r $ze ras 3 qes 61s 1 7i10 6s6 a (æ roo 1s1 7e1 læzze lso zt+ dæ +zs I 4p5 480 Subtotal 15 446 000 16 977 560 20260718 21 212 814 20 eF6 682 CAPITAL COSTS Office Furniture Data Processing Equipment Vehicles Technical Equipment Buildrngs ? OqII 3û ü00 45 080 15 000 2 000 30 000 60 000 3 000 5 000 2251 56728 97 970 65 667 6 045 34 269 90 105 590 690 1 36 789 37 870 65 930 359 01 1 104 992 12 077 pl 103 1P6 827 4[7 589 la azz 3 882 Subtotal 92 ü)0 100 000 228661 851 853 579 880 6f8 028 TOTAL $974tAü 15 546 000 17 206 221 21 112571 21 792 694 21 611710 FIGURE 2 BUDGET BY CATEGORY OF EXPENDITURE 14 1s (us $) 1 Personnel Services 4,686,000 2 Aerial Operations 3,436,000 3 Laruicides 2,270,000 4 Operating Costs 804,000 5 National Teams 721,000 6 Consultants 695,000 7 Contracts (Research & Others) 450,000I Fellowships and Training 420,000 9 Administrative Support Geneva 375,000 10 Operational Travel 360,000 11 Statutory Meetings 250,000 12 Supplies 195,000 13 lntegrated Data Analysis 120,000 14 WHO Sub-regional Centre 100,000 15 Capital Costs 92,000 TPCaO.4 Page 13 - 2000 (Yù 31.29 22.95 15.16 5.37 4.82 4.64 3.01 2.81 2.50 2.40 1.67 1.30 0.80 0.67 0.61 TOTAL 14,974,000 100.00 lPc20.4 Page 14 TABLE 3 YEAR 2OOO SUMMARY BY PROGRAMME ACTIVITY AND CATEGORY OF EXPENDITURE 1us $) Activiÿ Category \ of Expenditure Office of the Director Vector Control Planning Evaluaüon & Transfer Chemo- therapy project Adminis- tration Tc 20 rl r! RECURRENT COSTS Personnel Services Consultants Operational Travel Contracts(Research & Others) Aerial Operations Operating Costs Larvicides Supplies §tatutory Meetings Fellowships and Training National Teams Administrative Support Geneva WHO Sub-Regional Centre lntegrated Data Analysis 659 000 40 000 40 000 10 000 10 000 250 000 2 069 000 300 000 200 000 1 8s 000 3 436 000 592 000 2270000 90 000 471 000 721 000 170 000 50 000 40 000 60 000 50 000 420 000 250 000 100 000 120 000 285 000 185 000 25 000 205 000 952 000 45 000 20 000 142000 45 000 375 000 4 'l 1 1 I 1 1 1 1i ,l 4l ,l ,i ,I 'l 3 2 B 000 1!1000 l0oæ' I om' 60æ I'0 00O l0 000' E oooj' ['o*rt h.'ootf It ooo 8000 I ooo o 000 Subtotal 1 009 000 I 613 000 1 98't 000 700 000 1 579 000 14 8l 2 000 CAPITAL COSTS Office Furniture Data Processing Equipment Vehicles Technical Equipment Buildings 8 000 45 000 15 000 10 000 2 000 12 000 lz ooo I i tro 000 {s ooo 'ls ooo Subtotal 0 68 000 10 000 0 14 000 {z ooo I TOTAL 1 009 000 I 681 000 1 991 000 700 000 1 593 000 149 4 000 JPC20.4 Page 15 4.1. ESTIMATED COSTS BY PROGRAMME ACTTVITY Vector Control Unit (VCU) 4.1.1 Zones to be treated (Annex VI) Original Programme Area Aerial larviciding has ceased on the watercourses of almost all of the original Programme area, except on the tributaries of the Oti (Keran, Kara and Mo), which are considered as part of the South-eastern Extension. Ground larviciding will continue on the Dienkoa, under the responsibility of the national team of Burkina Faso, with technical and financial support from OCP. Southern extension Côte d'Ivoire The satisfactory results recorded on the lower Comoe, lower Nzi, lower Bandama and upper Sassandra led to the decision to cease aerial spraying at the end of 1998 in these basins in Côte d'Ivoire. Only the middle course of the Sassandra and its tributaries Bafing and Bagbé remain under seasonal larviciding. However, the size of this watercourse being in no way comparable to that of the watercourses no longer under treatment since 1999, this situation will not have any significant effects on the budget of the Vector Control Unit in 2000. Western and South-eastern Extensions In the Western extension, larviciding was definitively suspended in Sierra Leone at the end of 1998, due to the persistent insecur§ and to the fact that it'will be impossible to achieve, before the end of the Prograrrune, the twelve years of combined treatment (larvicides * ivermectin) necessary to interrupt the transmission. Indeed, actual larviciding in this country did no go on for more than four years. With regard to ground larviciding on the Niger and its tributaries in the Bamako area, it will continue to be carried out, as in 1999, by the national team of Mali, with technical and financial support from the Vector Control Unit. In Guinea, and in the basins of the South eastern extension, larviciding coverage will remain the same as in 1999. 4.1.2. Larvicides With regard to larvicides , one significant development in this last financial phase of the Programme is the operational use, starting from 1999, of Teknar, a B.t. H-14 formulation which is more stable and more efficient than the Vectobac 12 AS. Treatments were successfully carried out at discharges above 15 m3/s and with a lower operational dose (/a of the current dose). Hcrvever, both formulations will continue to be retained due to the difficulties in mastering fermentationparameters for an industrial production of batches of B.t. H-14 of constant quality. Furthermore, in accordance with one of the recommendations in the Plan of Operations for the phase of progressive disengagement Phase approved in 1996 by the Joint Programme Committee,.the principle of insecticide rotation has from 1999, prioritized the use of four insecticides among the most cost-effective ones. These are: temephos, pyraclofos, permethrin and Bacillus thuringiensi,s H-14 (8.t. H-L4). JPCZO.4 Page 16 - This change in strategy, mainly related to the cessation of larviciding in Côte d'lvoife on the hydrological basins where resistance to temephos had led to the use of substitutiqn insecticides which were less effective, such as Etofenprox and Carbosulfan and, to a lessfr extent, Phoxim, will be maintained in 2000. This strategy does not completely exclude thde three products which could be resorted to in case of necessity (decrease in blackffy susceptibilitytoorganophosphorouscompounds, defectivebatches of B.t. H-14, failuretoke{p within the number of cycles authorized with permethrin, etc.) The requirements for the year 2000 are as follows: - Temephos - B.t. H-I4 (Vectobac) - B.r. H-14 (Teknar) - §raclofos - Permethrin 24 400litres (02 containers) 25 000litres (02 containers) 134 2O0litres (11 containers) 28 000 litres (02 containers) 14 000 litres (02 containers) 4.L.3. Entomological evaluation network In accordance with the Plan of Action for the phase of progressive disengagement aûd the projections of the 1999 Plan of Action and Budget, the Bouake sector and its two sub- sectors, Bouake and Odienne, were closed at the end of 1998, even though larviciding was npt suspended in the entire basin of the Sassandra. Entomological activities in this basin, as wdll as in the other basins in Côte d'Ivoire are being ensured since the beginning of 1999 bV 4e national team of this country. The Makeni sector in Sierra Leone was officially closed on I June 1999, following the cessation of vector control activities in Sierra Leone on 1 Januafy 1999. Lastly, and in accordance with the 1999 Plan of Operations, the sub-sectors of Kar[, Atakpame, Hohoe, Parakou and Bohicon in the Eastern zone have acquired the status ôf Operational Base (OB) with officers under local contracts of the SSA type. The OB chiefs wfll report directly to the Eastern zone office at Kara and no longer to the Kard sector, which trNs been closed since 31 December 1998. The Vector Control Unit is henceforth represented by two (2) "national team" type sectors (Kanakan and Faranah in the western zone), and fifteen (15) Operational Basfs (Bohicon, Parakou, Atakpame, Kara and Hohoe, in the Eastern zone, Bamako, Beyla, Dabol[, Faranah, Kankan, Kerouane, Kissidougou, Kouroussa, Mamou and Siguiri in the Westefn zone) (Annex VII). With the cessation of larviciding in Sierra Leone, but its continuation on part of tSe Sassandra, the number of catching points regularly visited (points "A" and "B") which wfs planned to be 124 in 1999 has been reduced to 109, a number which will be maintainôd through the year 2000 (Annex VIII). 4.1.4. Aerial operations 2000 will be the second year of a new 4-year contract with the "Evergreen Helicopte[s Inc. " company. This agreement takes into account three essential factors, namely i) tfre cessation of larviciding in Côte d'Ivoire, except for a part of the Sassandra, beginnirfig 1 January 1999, iD the stabilization of larviciding coverage between 1999 and 2001 and iii) the drastic reduction in aerial operations in2002. 4.1.5. Applied research Overall, research activities will gradually be reduced as the Programme winds down to a close. Thus, in 2000, with repect to research on insecticides, activities related to the JPC}O.4 Page 17 preparation ôf genetically recombined formulations of B.t. H-14, as well as the development of a hemolytic technique for quality control of the operational batches of B.t. H-14 will be suspended. Only the routine quality controls of the operational insecticides, and a few tests of comparison of the formulations of the four insecticides retained for the fifth phase, will continue. Regarding the activities of the DNA laboratory (which is now based in Ouagadougou since 1 January L999), cooperation with the molecular biology laboratory of the University of Alabama in Birmingham (UAB), and the molecular biology laboratory of IRD (formerly ORSTOM) in Montpellier (France), will continue at the same level as in previous years. 4.1.6. Monitoring of the aquatic environment. One of the major components of.this monitoring is, henceforth, the study of habitat quality, which was introduced in 1999 (after a training session organized for the hydrobiologists) to better assess the influence of factors other than larvicides, on the results of the monitoring of the aquatic environment. Routine monitoring activities of the long-term effects of the less selective larvicides (permethrin, carbosulfan and etofenprox) on the non- target aquatic fauna will continue with reduced intensity, given the new strategy of using principally four larvicides (temephos, p1'raclofos, B.t. H-14, permerhrin) established in 1999. With the cessation of larviciding on many watercourses, emphasis will be placed on the evaluation of the recolonization of these by the invertebrates essentially, and to a lesser extent, by the fish populations. Monitoring is officially interrupted in Sierra Leone, but will continue in Côte d'Ivoire, Ghana and Guinea, through letters of agreement to be submitted by the Coordinator of hydrobiological monitoring. The workplan will also include major activities of valorization and promotion of the work done by OCP in the fields of larvicide selection and protection of the aquatic environment. 4.L.7. Research contracts Research contracts will be limited to those signed in 1999 with the University of Alabama in Birmingham (DNA probes) and the IRD laboratory of Montpellier (DNA microsatellites). After the upper basin of the Niger and the tributaries of the Oti in 1999, an amount earmarked for special studies will be made available in 2000 for the continuation of more in-depth entomological studies on the Pru in Ghana, and the Tinkisso in Guinea. 4.1.8. Service contracts As in previous years, service contracts will be signed with organizations working in the field of hydrobiology (analysis of data/valorization of activities, assistance to national teams), and hydrology (teletransmission, maintenance of the hydrological network). Fifty-four (54) beacons in "back-up" service, i.e. eleven hydrological platforms (10.8 PTT) will cover the hydrological network of the basins of the Western and South-eastern Extensions in 2000. However, a minimum subscription for 10.91 PTT, i.e. 55 beacons in "back-up" service, and a lump sum for recording service are required by the Satellite Collection and Location Service(scl). 4.1.9. Personnel The number of staff members on WHO contracts (Professional and General Services) will be almost the same in 2000 compared to 1999 (only one staff member less). However, a reclassification of a P3 position to P4 is planned for equity between the chiefs of the two zones. With respect to the staff under the SSA type contracts, two members will be seconded lJPCaO.4 Page 18 to strengthen the national team of Ghana, thus reducing by one unit the number of captufe teams in the Hohoe operational base. STAFFING FOR THE VECTOR CONTROL UNIT WHO/OCP Professionals P6-D2 P4-P5 P1.P3 STP (Short-term) Generai Service Sub-Total \ryHO/OCP SSA National Staff TOTAL PHASE V PIIASE TV 20ü0. tsss 1ee8 rssT rss6 199i .:. _ i 54s 234 555 26 27 48 111 ss6 ss$ ssl s6 6s 8x -38 39 63 72 81 t0l, t28 t43 233 244 ry r9S r34 Ls4 18$ 247 260 259 400 450363 4s3 4ss s4f 4.1.10. Consultants In 2000, as in previous years, scientists working for less than thirty days within tlre Programme will no longer be awarded the status of consultant but that of temporary advis(r, or service contractor, which is less remunerative. Contractual Service Agreement (CSA) type of contracts will be also proposed for investigations on the non-treated watercourses, and lto assist in addressing the issue of overburdening of the vector control professional staff whichris presently working under reduced capacity. - Insecticides (temporary adviser) - Control strategy (tenrporary adviser) 20 days 21 days Total temporary adviser 41 days - Hydrobiology (CSA type) 02 months - Cytotaxonomy (CSA type) 21 days - Consolidated reports and vector control (CSA) 07 months 4.1.11. Budget The budget prepared for the Vector control unit (VCU) for 2000 is US$ 9,613,00. TABLE 4 VECTOR CONTROL UNIT (us $) JPC20.4 Page 19 Category of Expenditure I iH Approved 1999 Expenditure 1998 Expenditure 1997 Expenditure 1996 Expenditure 1995 PERSONNEL SERVICES WHO / OCP Staff Chief VCU Scientists Technical Officers Administrative Assistants, Clerks, Stenograp her-typists and other General Service Staff Personnel SSA SSA Temporary Staff 145 000 435 000 345 000 540 000 592 000 11 000 Subtotal ii;rt 0§9 000 2 068 000 2845094 2 946 689 3 461 038 3 397 974 Consultants Operational Travel Aerial Operations Contracts (Research & Others) National Teams Operating Costs Larvicides Supplies 300 000 200 000 3 530 000 203 000 530 000 705 000 2321 000 9q 000 349 357 270 455 3 865 001 124 622 511 140 902 984 2811226 193 652 419 398 253937 4 093 475 326 018 625 895 885 365 3774 667 247 114 375 174 326 432 4 020 990 173 185 591 815 1 136 498 3 659 214 241 306 578 383 326 600 3 895 615 221 897 451 464 '1 270 281 3 096 100 258 051 Subtota! 7 887 000 I O28 437 10 625 869 't0 524 614 10 098 391 TOTAL ÈÈts:ô0ü I 955 000 11 873 531 13 572 558 13 985 652 13 496 365 tPC20.4 Page20 42- The Planning, Evaluation and Trrnsfer (PET) Unit - 4.2.1 Introduction The year 2000 will mark the mid point of the fifth and final Phase of the Thus the activities of the Planning, Evaluation and Transfer Unit (PET) for 2000, will geared towards consolidation of the direct support that the Programme has given to Participating Countries, as in the previous years. The areas of particular interest will be transfer of alternative tools for diagnosis and the conclusion and consolidation of installation of Communiÿ-Directed Treafrnent with Ivermectin (CDTI). The transfer appropriate technical skills for epidemiological evaluation and integrated surveillance, and d{ra within the national health surveillance systems and management skills will be reinforcdd. Support for entomological activities as they pertain to the maintenance of residual activities;of the OCP will also be provided by the Unit in collaboration with the Vector Control Unit. Às Participating'Countries forge ahead with.the'establishment of multidisease surveillance, Ste Unit will place emphasis on facilitating decentralisation and integration of onchocerciafis control activities into national health systems, as well as reinforce national skills in the arealof Information, Education and Communication (IEC) interventions with the help from experts afrd specialised NGOs in this field. Special emphasis will be placed on the retraining in skilh for data management in the countries, as well as the provision of the necessary tools that 4re required for this activity. The necessary logistics and financial support will be providedlto enable the countries absorb these techniques and skills. Training will continue to be a key component of the Unit's endeavours and will p necessary for all categories of health staff at the different levels in the health services. Althouph higher level institutional training will continue as before in epidemiology, public health, he4th education and health planning and management, the emphasis will be shifted on to "on-the-j$" training and retraining in simple epidemiological evaluation/surveillance methods in the fiefd, for middle-level staff in the districts. This will help to make available in the countries, s$ff with the appropriate skills for decentralized and integrated epidemiological surveillance for onchocerciasis. Advantage will be taken of the recently trained national oncho entomolog$ts who will train other staff in the countries in simple entomological methods. Assessment of the impact of control activities through epidemiological evaluations, ufill continue to be carried out bÿ the Unit in collaboration with the countries. Furthermore, fhe Unit will ensure that patient treatrnent through ivermectin distribution, data analysis +d interpretation for decision-making, operational research and informatics support, will conti(ue during this last Phase of progressive disengagement. The Unit will liaise closely with the Health Education services in the Participat{ng Countries through dialogue with the appropriate experts to develop the relevant materials fÔr, and reinforce. IEC intervention campaigns at all levels, including Government and communiity levels. These will aim at giving a wider exposure to the new approach of CDTI lrd decentralized integrated post-control epidemiological surveillance. In collaboration with WHO-AFRO and the Participating Countries, the Unit ÿill continue its catalytic rcle in the integration of CDTI and the decentralized epidemiolog+al surveillance/evaluation activities into the health delivery systems of the countries. Tfris collaboration will focus attention on integrating post-control onchocerciasis surveillance wi$in the multidisease surveillance and control divisions of the national ministries of health. In this connection the preparations that are afoot for the setting up of a WHO Ce{tre for multidisease epidemiological surveillance at OCP premises, to support multidis$se surveillance and control units in the countries, will gain momentum in the year 2000. The PpT Unit will be closely involved in this creation both in terms of technical expertise and logistics. JPCZO.4 Page 2l 4.2.2 Specific action plans Epi.d e miolo gic al ev aluüia n s In the past the Unit has provided support in the form of supervision, quality control, logistics and funding to national staff to undertake evaluations in their respective countries. This action will be pursued this year in the following areas : evaluations to assess the impact of combined vector control and ivermectin on: (a) the transmission of infection, and (b) on onchocercal eye disease in the Pru and Niger basins. Consultants from the Participating Countries will be engaged to carry out the ophthalmological examinations and surveys. These will include photographic documentation as well as angiographic recordings where necessary. continuation and conclusion of the general epidemiological evaluation in the entire Prograrlme area to record the general epidemiological situation midway through the Final Phase of the Prograrnme. This will include migration surveys, in selected foci or in some of the "residual foci". The Unit will obtain and provide field material (microfilaria) from epidemiological surveys to the DNA laboratory of OCP, for the deoxyribonucleic acid (DNA) studies. These are needed to characterize strains of onchocerciasis, an important activity to aid in the determination of the nature of infection which is still encountered in some of the "residual foci". The laboratory will take on training of molecular biologiss from some of the Participating Countries in molecular biology methods that have been developed by the laboratory to help with epidemiological surveillance. The introduction of the alternative community diagnostic tools (the DEC Patch test) for epidemiological surveillance/evaluation in the countries will be pursued. This activity which will end with the installation of the test in the countries will be concluded in 2000. The test will then run side by side with the skin snip test. Likewise the laboratory will aim at improving the highly sensitive and at the same time fuIly specific Polymerase Chain Reaction (PCR) scratch test. 4.2.3 Distribution of ivermectin large-scale ivermectin distribution by CDTI will continue. The areas to benefit from this treatnent will be the extension areas as well as in specific areas in the Original Programme area (Annex IX). Attempts will be made to restart treatrnent in Sierra Leone and Guinea Bissau should the security situation permit. There will be consolidation of the treatment in the southern parts of Côte d'Ivoire, Ghana, and Guinea, this being the second year of treatrnent in these areas. [t is foreseen'.hat over 27,OO0 villages will be treated in the year 2000, and the estimated number of persons to be treated will be in the order of nine million. The Unit will continue to ensure the regular monitoring of the ivermectin distribution campaigns, in a combined effort with the field staff of the Vector Control Unit (VCU) as well as with external independent observers. An independent evaluation of the CDTI will be carried out by a team consisting of a consultant (independent) epidemiologist, a member of the PET Unit, a sociologist, and national coordinators. This will be a continuation of the ongoing activity which allows several but different countries to be evaluated each year. With the exception of Sierra I-eone and Guinea Bissau the installation of the system of CDTI which stârted in 1996 is expected to be completéd by the end of 1999. The year 2000 will see the continuation of retraining of the community distributors and consolidation of this approach to large-scale treatment with ivermectin. The training itself, with technical JPCaO.4 Page 22 supervision from the Unit, will be carried out by the national teams and trained nurses in tt* districts concerned, together with, non-governmental organizations (NGOs) and voluntary organizations. The responsibility of the Unit in the retraining exercise will be to provide i technical, logistic and financial support. In spite of the fact that no serious adverse reactions to ivermectin have been recorded for several years, monitoring and documentation of any adverse reactions to ivermectin wi1[ continue. The services of the peripheral health units will be solicited, they being responsib$ for the immediate supervision of the CDTI. . 4.2.4. Entomological activities I The PET Unit will continue its programme of transferring the simple activities require{ for entomological control to the countries. It will provide support and training in groun{ larviciding to enable countries to carry out the minimal entomological activities required, i$ specific areas that need such intervention. 4.2.5. Data Management The process and scheduling for the training of nationals in data analysis and thg interpretation of survey data collected from epidemiological evaluations and post-controf epidemiological surveillance activities will be continued with an increased tempo. Programme$ for the updating of data entry and validation programmes that were installed in 1998 in eacli of the countries will be provided. The aim is to render the Participating Countries completelÿ and independently operational in data management. Furthermore, the unit will continue td transfer the additional large body of accumulated epidemiological and entomological data t{ the Participating Countries with the accompanying training to help them access and use suc{ data. Retraining of nationals will continue in the use of mapping software, and the Globaf Positioning System (GPS) in the field for village locations. This training will, as necessary, b( contracted out to experts in this field. This activity is to ensure the transfer of the requisit( skills in the management of the epidemiological and entomological databases, with th( Geographic Information System (GIS). Thus, rhere will be the need to update the GIS dat{ bank. The computer equipment installed in the countries by OCP will be used extensively bÿ national te,rms in this training activity. The Unit will carry out the routine analysis and interpretation of the Programme'( epidemiological and entomological evaluation data. This is to study the medium and long-teu{ impact of the combination of ivermectin distributiou and larviciding on transmission and o{ ocular manifestations. Data entry and analysis will be carried out by staff from OCP and thd countries concerned, but temporary staff will be recruited to help when the need arises. Supervision and coordination of the development of data banks on operational research, aeriaf operations, administration and documentation will continue. Epidemiological modelling will continue to play an important role in the interpretatio( of data collected in different domains. Thus, ONCHOSIM will be used intensively to facilitatd the integrated analysis of these data. The prospective evaluations of the different OCP strategies based on epidemiological modelling will be refined as new epidemiological results become available, particularly wit[ regard to recrudescence detection and the monitoring/distribution of ivermectin and its i-pa4 on transmission. Furtherrnore, the estimation of the other important parameters (entomologicat criteria, migration, the importance of different species in transmission, etc.) of thd rPc20.4 Page23 recrudescence of onchocercal infection will continue, taking into account observations made in the field. In this context, a contract will be signed with the Erasmus University of Rotterdam where a considerable number of simulations will be made in order to continue the validation of the model's important parameters, in the light of t}re new epidemiological results. 4.2.6. National teams and national medical personnel of health centres The Unit will support health personnel in the countries as well as community workers in routine field activities concerning epidemiological evaluation, retraining of distributors for ivermectin distribution and awareness-raising through IEC. The national teams with their coordinator, deputy coordinator, an epidemiologist and six other technicians who are called upon for specific duties, will be responsible for the "on-the-job" training of district staff for epidemiological surveillance and for quality control of the evaluation to be carried out by decentralized district or regional teams. With the distribution of ivermectin now fully in the hands of the communities, doctors and nurses in the local health centres will be responsible for the supervision of this CDTI in their respective districts. Additional supervision and monitoring of CDTI, will be required of the national teams. Support for this activity will be provided by the Unit. For the residual control in the Dienkoa basin in Burkina Faso, a national entomological team based in Bobo-Dioulasso will be supported by the Unit through a Technical Service Agreement with the country and supervised directly by the trained national onchocerciasis entomologist. 4.2.7. Personnel The staff of the Planning, Evaluation and Transfer Unit is set out in the table below. JPCaO.4 Page 24 STAFFING FOR THE PLANNING EVALUATION AND TRANSFER UNIT WHO/OCP Professionals P4-P5 P2-P3 STP (short -term) NPO (National Professionals) General Service Sub-total WIIO/OCP ssA National Staff TOTAL PHASE V PHASE IV 2û0f, 1999 1998 ? 3 1 6 2 J 7 2 3 7 1997 1996 1995 23 24 814 3 1 4 15 t2 t2 t2 768 60 70 70 t2 2t 23 733 70 70 70 908879 969489 The expertise of all the other units of the Programme will be called upon whefe indicated for support. In particular, the Unit will use VCU chiefs of zones, and th(ir entomological staff to carry out its programme of information and awareness-raising of $e local authorities and population. Additionally the fietd staff of VCU will be used for ttre training of nationals and communities in ground larviciding techniques as well as ûc monitoring of ivermectin treatment. One National Professional Officer (NPO) is added to PET for the year 2000. Thislis a long awaited statisticâl assistant to help with data analysis and transfer. This additional s4ff is also needed to augment the team to carry out on-the-job training in data analysis. 4.2.8. Consultants The Unit will broaden its approach to IEC interventions. For this purpose, experts rin this field within the Participating Countries will be called upon, and in collaboration with the information section of OCP and the National Onchocerciasis Coordinators develop tfre appropriate training materials for carrying out this activity. In-country experts in social aird behavioural sciences will as in the past be contracted for specific studies to be conducted Bs part of the Unit's support to operational research. Subjects for study include general humpn migratory movements within large tracts of the Original Programme Area, and motivatipn factors for community distributors. They will also conduct follow-up studies on the iverme{in distribution system as well as studies to ascertain the communities' perception of blac(ly nuisance. The services of a senior public health expert will be engaged to help with fte integration of the residual control activities into the national health services. Consult$nt JPCaO.4 Page 25 ophthalmologists will also be engaged for the detailed evaluation of villages in the Prograrnme area. The Unit will, if necessary, use temporary general service staff to help in ivermectin monitoring and in epidemiological evaluation especially for quality control purposes, data entry, data processing and analysis, and ophthalmological evaluation. Fifty-five man-months of SSA level consultancy have been earmarked for 2000. 4.2.9. Temporary Staff The Unit has a large backlog of data for entry and analysis which is being added on with subsequent evaluations. Temporary staff are called upon to help the Unit in data entry and clearing. Additionally, two temporary hands are needed, one to help the only sitting ophtalmic nurse with the follow-up of ophtalmological surveys, and one temporary secretary to reinforce support to the epidemiologists in the Unit and to help cope with the large amount of secretarial and typing work which the Unit undertakes with the National Coordinators. 4.2.10. Supplies The Unit will be calling more and more on the molecular biology laboratory for assistance as the entomological method for the detection of recrudescence is further developed and introduced in the countries. Funds from PET will thus be required in 2000 to offset cost of supplies for this laboratory. 4.2.11. Operational travel An amount of US$ 50,000 will be required in 2000 for duty travel of OCP professional staff and the travel of national coordinators and some of their assistants, mainly to Ouagadougou to review and plan specific activities with OCP. 4.2.12. Service contracts A service contract for US$ 30,000 will be signed with the Erasmus University, Rotterdam, in support of the epidemiological modelling activities. In addition, an amount of US$ 10,000 will be required for research on the different diagnostic tests. Contracts for training on the use of the geographical information system (GIS) will require US$ 30,000. 4.2.13. Training Training will continue to be an important component of the Unit's activites. Thus, fellowships for higher level training in planning and management, health education, in institutions in Africa will be granted to the countries. More emphasis will be placed on "on- the-job", in-service and field training for mid level personnel in statistics and data processing. Refresher courses, in the form of seminars and workshops, will be undertaken. This will be in continuation of OCP's policy for the transfer of skills and appropriate techniques to the countries. Priority will be given to epidemiological training, particularly at the district level. The Unit has undertaken consultations with the countries to establish what constitutes the "critical mass"of trained personnel in these disciplines and areas of training will be guided by such information received from the countries. An amount of US$ 420,000 will be required in 2000 to finance new fellowships and in-service training as well as to complete on-going fellowships. JPCaO.4 Page26 4.2.14. Sub-regional Centre for Multidisease Surveillance In support of the installation within OCP's premises, of the AFRO sub-regional Centfe for multidisease surveillance, and in accordance with the request made by the Committfe of Sponsoring Agencies, the Programme will make available to the Centre an amount pf US$ 100,000. This amount is intended to defray the cost of local staff and of the procureme[t of basic materials and equipment. OCP intends to pursue its participation in the approprir[c running of the Centre by contributing similar amounts in 2001 and2002. 4.2.15. Integrated data analysis A collaborative project for an integrated analysis of data collected during the periqd of OCP activities between 1974 and 1999 (i.e. period of 25 1,ears) will be undertaken with tfrc University of Rotterdam. This will draw ireavily on the ONCHOSIM model which will bc further validated for bettering its utilization. Advantage will be taken during the validation bf the ONCHOSIM model to include such new parameters as compliance with ivermec{in treatment, multiple annual treatrnents and the likely effect of ivermectin resistance monitorifrg tools. 4.2.16. Computer Operations Management The Bio-statistics and Information Systems (BIS) sub-unit will continue to supervise 1ll activities related to the use of the computers in OCP. Emphasis will continue to be placed on the transfer of data to the Participatilrg Countries in the computers installed in the countries by OCP in 1998. Cleaning and updatijrg the data and the computer programs will be a major part of the activities in BIS. tn $is context, the targeted training of selected national staff in the Participating Countries r{ill continue with retraining to be done to enable them continue independent analysis of the da{a. The local area computer network installed in the OCP headquarters requires human a[d financial resources to ensure its proper maintenance. Consolidation of the use of the financfal management software recently installed will be necessary. It is expected that in 2000 twellve obsolete computers will have to be replaced to strengthen the computer network installediin OCP headquarters and at the two main VCU bases. The improvement of the use of Internet E-mail and file transfers through specfal telephone lines will be required. 4.2.17. Budget In view of the above, the budget proposed for the Planning, Evaluation and Transfer Unit for 2000 is US$ 1,981,000. Category of Expenditure .P H A§E V. PH.A§':E tÿ 'Proposed ::.. '2Oûü Approved 1 999 Expenditure 1 998 Expenditure 1 997 Expenditure 1996 PERSONNEL SERVICES WHO / OCP Staff Chief PET Biostatistician Temp. Professionals (STP) Clerks, Typists Laboratory Assistants Administrative Assistants Personnel SSA Temporary Staff '" it*§'(nü' 'ri"i:i'i- 'l45:t!§0 'i::::i:i:::ii.::ri.2{§ û0Ü. ;t00û0.. .6û 000 42 000 '24000 145 000 145 000 1 95 000 40 000 60 000 40 000 36 000 Subtotal 661 000 438 831 497 684 538 001 Consultants Operational Travel Operating Costs Supplies Contracts (Others) National Teams Fellowships anci Tra,ring WHO Sub-Regronal Centre lntegrated Data Analysis 1?$.0ûü 5û1100 ':'§{, $ûü 5û ü00 4û ûtû 250 000 420 000 100 000 120 000 348 000 50 000 60 000 30 000 70 000 250 000 450 000 345 254 54 231 124 978 104 877 9 375 279 733 438 905 295 787 50 870 1 57 039 63 763 45 317 425 190 422 767 390 298 91 782 117 144 60 886 16 801 488 385 Subtotal I 26û000 1 258 000 1 357 353 1 460 733 1 165 296 TOTAL 1 98{ t00 1 919 000 1 796 184 1 958 417 1 703 297 tPC20.4 Page 27 TABLE 5 PLANNING EVALUATION AND TRANSFER UNIT (us $) * OCP contribution to WHO Sub-Regional Centre for multidisease epidemiological surveillance. JPC}O.4 Page 28 4.3. Macrofil Chemotherapy Project (Macrofil) 4.3.L. Objectives for the Macrofil Project in 2000 The primary objective of the Macrofil Project continues to be the development of saff and effective adulticidal drugs (macrofilaricides) for onchocerciasis and lymphatic filariasis{. The secondary objectives of the project are: a) discovery and development of a back-u$ microfilaricide to ivermectin that could be more advantageous (e.g.: longer time betweeil treatments) or that could substitute ivermectin in case of resistance, and b) development of N molecular diagnostic tool/method that could be used to detect Onchocerca volvulus resistan{t to ivermectin. In view of the inclusion of lymphatic filariasis, additional financial support ib provided by the Special Programme for Research and Training in Tropical Diseases (TDR)! At its meeting in Accra in December 1998, the Joint Programme Committee recognise{ that a safe and effective macrofilaricide would provide better therapeutic control (f onchocerciasis than ivermectin both in the lifetime of OCP and in the post-OCP period. Als(, a field applicable macrofilaricide would reduce the period of intervention. Additionally, thp occurrence of ivermectin resistance in onchocerciasis would be disastrous in a contrdl programme based on a single drug. The Committee therefore agreed to the proposed financing of the Macrofil project bÿ OCP, APOC and TDR with OCP's contribution directed as far as possible for preclinical anfl clinical development of drugs for onchocerciasis and a test for ivermectin resistance. 4.3.2. Activities The complete jointly funded Macrofil Project is setout inAnnexX, pages 51 to 53. It indicates that Moxidectin has been identified as a lead compound for the development of & novel macrofilaricide. The Onchocerciasis Chemotherapy Research Centre (OCRC) in Gham will continue conducting clinical studies of drug combinations. Drug screening centres will continue high output primary animal assays, and strategic research will be supported to validale new molecular Onchocerca entities as targets for drug discovery and their use as hig[r throughput screening. The information emerging from the research on the mechanism(s) df ivermectin drug resistance in parasitic nematodes will be applied towards the development Qf diagnostic tools. 4.3.3. Budget For 2000, funding of the Macrofil Project will be shared equally between OCP, APOC and TDR, each contributing US$ 700,000, to give a total of $ 2.l million. This arrangemeht has been in force since 1998 . The posts of a P5 scientist and a G5 secretary and the costs of the Onchocerciasis Chemotherapy Research Centre in Ghana will continue to be funded directty b1, OCP as part of its contribution. JPCzO,4 Page29 TABLE 6 MACROFIL CHEMOTHERAPY PROJECT (us $) Category of Expenditure Pft À§ E IV Approved 1 999 Expenditure 1998 Expenditure 1 997 Expenditure 1996 Expenditure I 995 PERSONNEL SERVICES WHO / OCP Staff Scientrst Secretary rr,.: . 180 000 ..... ,: {ü5 0ûü '..':. ... . 180 000 1 05 000 Subtotal 285 000 319 803 165 005 249 675 242912 Consultants/Temporary advisers (1 ) Operational Travel Research Contracts Supplies Other Activities .' . 18,3.000 .250t1ùi .' .'. ::i::i,1 '-., 2S5,:9ûO 185 000 25 000 205 000 170 042 5 162 3 109 20 000 164 406 7 046 1 362 676 21 395 10 000 1 96 505 15 255 1223464 32791 30 000 218 695 11 004 1 258 009 28 801 20 000 Subtotal 4r15.0s0 415 000 198 313 1 565 523 1 498 015 1 536 509 ÏOTAL ?0ô üôû 700 000 518 116 1 730 528 1 747 690 1 779 421 (1) Costs of meetings are rncluded under "Consultants/Temporary advisers" JPCaO.4 Page 30 4.4. Office of the Programme Director 4.4.1. Activities The office of the Director will continue to ensure the general management of t$e Programme. The duties assigned to the Office include supervision and coordination of 4ll administrative, technical, scientific and operational activities, as well as close liaison with tlie Statutory Bodies which set the general policy, the Donors, the Participating Countries and tfie Scientific community. Also, the Office of the Director will continue to ensure clo+e coordination between OCP and the African Programme for Onchocerciasis Control (APO$. consequently, part of the Director's salary will be charged to the Apoc budget. The following activities and services will come directly under the Office of the Directôr and will be charged thereto: The office of the coordinator, which assists the Director in all of his dutifs A greater part of the Coordinator's salary will be charged to APOC budge(; The Documentation centre, which offers increasingly computerized servicÈs to OCP, APOC and an external clientele; The organisation of meetings, dissemination of information and raisi/pg awareness at all levels, on the different objectives and achievements of tlre Programme The liaison office at WHO/Geneva, which contributes to ensuri{g communication between the structures of the Programme, V/HO Headquart$s and the outside world. 4.4.2. Personnel To carry out the above activities, four professional posts were created in addition to those of Director and Coordinator; they are: Two National Professional Officer (NPO) positions: one "DocumentatiQn Officer" and one "Translator". Two SSA positions: One "Programme Officer" for preparation and organisation of meetings, and one "Communications Officer" in charge of the dissemination of information, and sensitization. WHO/OCP Professionals P6-D2 P4-P5 P1-P3 STP (Short term) NPO (National Professionals) General Service Sub-total WHO/OCP SSA professionals SSA others TOTAL PIIASE V PHASE IV :..200û' 1999 1998 1 1 2 J I ':': . . ''. . iir,;i,I:ffi"-l 'i"::.' " 'i ::.. '. .1r ;:. - .:. a '::: ': ..." 3 1997 1996 199s 9 1 2 :.'. ':7 9 1 2 811 9 1- 222 '.......--tz', 12 12 111311 JPC2O.4 Page 3l OFFICE OF THE DIRECTOR: STAFF 4.4.3. Consultants Consultant services are regularly used to assist the Office of the Director in the areas of general policy definition and Programme management. 4.4.4. Budget The budget proposed for the Office of the Programme Director for 2000 is us$ 759,000. JPC2O.4 Page 32 TABLE 7 OFFICE OF THE DIRECÎOR (us $) N o t e : The APOC Programme will reimburse 75 percent of the salary of the Coordinator / Programme Manager and 25 percent of the salary of the Director. Category of Expenditure 20ô0 Approved 1999 Expenditure 1998 ixpenditure I 997 Expenditure 1996 Expen{iture 1sp5 PERSONNEL SERVICES WHO / OCP staff Programme Director Coordinator, Director's Office Administrative Officers (NPO) Administrative Assistants Secretary (Geneva) Clerk Stenographer-typists Personnel SSA SSA Professionals SSA Others . ..:.'--:-:' ,,: ....... i .:.- -. ii- ' .".::i:i.: .:: ,. t§6.,ù0.0- ' ' ':.: -''.',l- i:' . r' : . 15511ü0 :.. ' ,.1s0 û00 40 {t0ü 10§.CI00 ' ..: 2û üü0 ' 71r 000 ,t4.CI0u 'I - '.: ..i:. : .:1... 1 55 000 't55 000 280 000 40 000 1 05 000 20 000 14 000 Subtotal 769 000 558 014 450 499 734 800 slt tsz Consultants Operational Travel Operating Costs Supplies Fellowships and Training :: .:.-.. - :iti) û0ü j 4û 000 : : 'ir rù0 1$ 000 40 000 40 000 10 000 10 000 92 125 58 660 98927 72 001 131 150 34 983 46 802 102 533 12 505 76 420 24 713 33723 529 393 6o +at dz tzs 15 zat 17 211 Strbtotal 100 §ü0 1 00 000 321 713 31 5 468 676 754 1 lo 708 TOTAL 75S O00 869 000 879 727 765 967 1 411 554 718 500 4.5. JPCzO.4 Page 33 Administration and Support Services Unit 4.5.1. Ouagadougou In this Phase V of the Prograrrune, which is the Phase of progressive disengagement, OCP must continue to reduce its staff, and operate with decreasing budgets. In this context, the Administration and Support Services Unit must contribute to the best management of the Organization's resources - human, financial and material - by maintaining the gains made and enabling OCP to keep up the quality of its services until the folding up of its activities. The Unit will also continue to provide administrative and financial support to APOC. The Personnel Service will continue to ensure its triple task of recruiting staff (when needed), administering and managing existing staff, and to see that the inevitable staff reductions are made gradually and in the best of conditions for both the Organization and the affected staff. On the first point, some posts are still to be filled in the event of the departure of their present holders, but most of the staff to be recruited will be on short-term contracts. With respect to the administration and management of the staff, the set of regulations and statutory provisions will be applied with the necessary flexibility to maintain staff motivation and morale. Finally, the staff reduction exercise is a complex operation, which comprises two components: the staff cutbacks themselves, which must meet criteria of justice and equity, and the preparation of staff, in the form of counseling and training - or even assistance in job searching - for re-integration into their national systems after several years, sometimes almost a whole career, of service to the Programme. The Budget and Finance Service will ensure implementation of the 2000 budget, carry out the necessary analyses and inform the units concerned of the status of their respective budgets during the year in order to help the various unit chiefs ensure proper management. In the area of finance, the unit will operate 14 bank accounts in 10 countries, handle the payroll, settle miscellaneous staff claims as well as invoices presented to OCP by suppliers of goods and services, after verification. To facilitate the accomplishment of all these tasks, it is worth mentioning the recent modernization of the computer programmes used, with the assistance of experts from WHO Headquarters. This makes the system faster and interactive, and better suited for carrying out analyses. The Supply and Support Services will continue with its multiple duties, including maintenance of the infrastructure and support to the sectors and operational bases (field offices) by providing them with the necessary equipment and supplies. They will make sure to adjust to the decreasing needs of the Programme, by cutting down to the extent feasible, capital costs and expenditure on equipment. Increased rigorous monitoring will be ensured in order to have a better control of stocks of materials and equipment. With respect to procurement, the guiding principle will continue to be keeping down costs withoutjeopardizing quality. Overall, the planning aspect and the dynamic adjustment of supplies and stocks to the changes in needs, will be emphasized. The Transport and Telecommunications Services will continue to manage two major components of the support to the Programme: the fleet ot vehicles and the telecommunications system. The vehicles in use will be reduced from 255 in 1999 to 218 in 2000 due to the disposal of old vehicles and the non-replacement of those being phased out during this last phase of the Programme. Only three new vehicles will be purchased in 2000. This service will continue to give special attention to the training and re-training of the mechanics and drivers, as well as to the sensitization of the staff of this service on subjects such as: the need to reduce the number of accidents, the importance of preventive maintenance of vehicles, and the preservation of fleet quality. With respect to the radio communication system, it should be noted that the equipment is currently being modernized. JPCZO.4 Page 34 4.5.2. Geneva The Programme will continue to benefit from the administrative support of WHO Headquarters, especially in the fields of Personnel administration, budget and finance. TIF Programme will also use the procurement and Legal services of Headquarters as needed, For these services, WHO is authorized to charge OCP l3 % of the Programme budgÇt, i.e. close to US$ 2,000,000 for the year 2000, since it is a programme supported from extrp- budgetary sources. However, WHO Headquarters has decided to waive this requirement [n the case of OCP, and rather charges the amount due on the basis of the actual costs of the four General Service positions. These past years, the annual amount proposed and approvfd by the JPC for that purpose has been US$ 475,000. So far, the amounts recovered were wfH below the budgeted amounts; on the basis of this experience, the amount proposed for 2000 is US$ 375,000. 4.5.3. Personnel The staff requirements will remain unchanged. Indeed, for some services, the drive needs to be maintained during this phasing-out period of the Programme. This applies particularly to the Personnel service which is required to intensify its counselling afrd orientation activities for members of the staff whose positions are or will be abolished, in order to facilitate in the best possible way the transition to their national systems. In addition, lhe Administration Service (Personnel, Budget and Finance, and to a lesser extent Supplies {nd Services) must continue to provide assistance to APOC. Consequently, the needs are as follows: 4.5.4. Budget The budget proposed for the Administration and Management Support Services Unit for 2000 is US$ 1,579,000. WHO/OCP Professionals P6-D2 P4-P5 P1-P3 NPO STP General Service Sub-total WHO/OCP SSA TOTAL PHASE V PHASE IV 2000 ï T 3 2A 1999 1998 I 2 3 26 1 3 2 30 1997 t996 1995 11 11 22 l1 38 46 I I 2 I 47 31 4t 32 36 40 40 43 51 '52 33 33 3l 72 72 76 76 84 83 TPCZO.4 Page 35 TABLE 8 ADMINISTRATION AND SUPPORT SERVICES (us $) ( Ouagadougou and Geneva ) Category of Expenditure Pt{A§ E..TV Approved 1999 Expenditure 1998 Expenditure 1 997 Expenditure 1996 Expenditure 1 995 PERSONNEL SERVICES WHO / OCP Staff Administration & Finance Officer Personnel Officer Finance Officer Budget Officer Transportation & Commu. Officer Supply Officer Administrative assistants,Clerks Typists & Storekeepers Administrative Support Geneva I lssR statr ',.'.,J48.000 {{5 0üû 50 000 §0 00s ..... 3o oüo ":'360'000 -:.,... ..:.;:'tttt- ''ï.37§ nos 182 0Uû. 145 000 115 000 65 000 50 000 50 000 50 000 360 000 475 000 182 000 Subtotal 1.32? ü00 1 492 000 1 341 311 1 251 771 1 411 846 1 389 721 Consultants Operational Travel Contracts (Oiners) Operating Costs Supplies 45 odÙ 20 000 142 000 45 006 50 000 24 000 14? OOO 45 000 31 671 44 340 18 334 201 187 68 696 . 25 510 52782 20 408 255 041 1 10 068 45 297 95 931 22301 2't5138 s2 057 63 354 61 589 22 801 321 252 52020 Subtotal 2§2 0q0 261 000 364228 463 809 430 724 521 016 TOTAL I 5?s U00 1 753 000 1 705 539 1 715 580 1 842 570 1 910 737 JPC}O.4 Pege 36 TABLE I OVERVIEW OF ADMINISTRATIVE AND EXECUTIVE MANAGEMENT COSTS - (us $) * Summary of tables : 7 - Office of the Director ; I - Administration and Support Services ( Ouagadougou and Geneva ) Category of Expenditure Ft**§E,V .'È+{lse t'v .: Fropçped Approved 1999 Expenditure 1998 ixpenditure 1 997 Expenditure 1996 Expefditure r1905 PERSONNEL SERVICES WHO / OCP Staff Programme Director Coord inator, Director's Office Chicf Administration & Finance Personnel Officer Transport & Communications Officer Finance & Tech. Officers Administrative & Technical Assistants, Clerks, Steno. Secretary (Geneva) Administrative support Geneva SSA staff ISSA Professionals I I ISSA others .,. !:., .f,, ..i .-: ,,15ô 0üû ::.165:§ôS:l t4ô00t-; '1'lü ü0$,r 5ô 000 200 0ôê 4a0 00û, " {05 00û 'a 375 00û. '..1. rsnoa- ::;:l rtt nOO : --:: . ,:. '' 155 000 155 000 145 000 115 000 50 000 445 000 420 000 1 05 000 475 000 196 000 Subtotal I 986 00ü 2 261 000 1 899 325 1702270 2 145 579 23/.2993 Cqrsultants Operational Travel Contracts (Others) Operating Costs Supplies Fellowships and Training 40 000 sù ü0r! 20 0üo 152 ü0ü. 55 0üû 40 000 90 000 24 000 152 000 55 000 123 796 103 000 18 334 300 1 14 140 697 156 660 . 87 765 20 408 301 843 212 601 57 802 172355 23 301 239 851 85 780 529 393 123 835 129 318 22801 336 539 79 231 Subtotal 352 n00 361 000 685 941 779 277 1 108 482 691 724 TOTAL 2 338 0üO 2622000 2 585 266 2 481 547 3 2r4 061 I o34 717 IPC}O.4 Page 37 FIGURE 3 BUDGET BY PROGRAMME ACTIVITY - 2OOO OVERVIEW ADMINISTRATIVE AND EXECUTIVE MANAGEMENT COSTS 1 2 3 4 Vector Control Planning Evaluation and Transfer Chemotherapy Project (Macrofil) Statutory Meetings Office ol the Direetor Administraüye & Support Seruices Administrative S (us $) 9,613,000 1,981,000 700,000 250,000 92,000 (%) 64.20 13.23 4.68 1.67 0.61 75g,OOOl 5.07-l 1,aO4,QAO) Z,33A,OOO S.o4 )15,61375;OO0l 2.50f B Capital Costs TOTAL Geneva 14,974,OO0 100.00 JPCaO.4 Page 38 4.6. Statutory meetings The meetings planned for 2000 are similar to those of past years: the Ecologi(al Group, the Expert Advisory Committee, three or four sessions of the Committee of Sponsori{tg Agencies and a meeting of the Joint Programme Committee. The budgetary provision for these different meetings mainly covers the costs of traÿel and per diem, interpretation services, translation of documents, and various supplies. The costs of the participation of experts in meetings other than those mentioned above (resear(h, ivermectin distribution, hydrology, hydrobiology, national coordinators), have been includ§d in the "Operational Travel" category of the budgets of the host units. The same applies to consultations which will be organized with the countires to help them achieve ownership rof the residual activities of surveillance and control of recrudescence of onchocerciasis. One full-time administrative officer and a secretary, budgeted for in the Office of üe Director, are assigned to the organization of meetings. They are also required to handle pn additional workload for the Statutory Meetings of APOC. The budget proposed for 2000 is US$ 250,000, which is the same amount as t@t proposed for 1999. TABLE 10 STATUTORY MEETINGS (us $) Category of Expenditure Approved 1999 Expenditure 1998 Expenditure 1997 Expenditure 1996 Expdrditure 19ss : r.: !l!Ë.ra!PTl.|-* .:.;:.;ili*::1. :,,,ii.:.{0üü:,:+ii; ]ERSONNEL SERVICES l-emporary Staff o{Hr:. 35 000 34264 39 143 43977 Subtota! 35 000 u2æ 39 143 43 977 r51 926 Consultants/Temporary Advisers Operational Travel Operating Costs Contracls / Translation {00 00û . goo0ô 15 000 l0 ütû 1 00 000 90 000 15 000 10 000 113 047 53 850 3302 90 122 74 092 2844 90 101 37 521 2001 113 093 !s+ ssr 1 179 Subtotal 21§Oû§ 215 000 170 199 167 058 129623 æ8 803 rOTAL 25û 00û 250 000 204 463 206 201 1 73 600 §zotzs 4.7. JPCaO.4 Page 39 Capital costs 4.7.1. Office equipment $ 2,ooo The purchase of new equipment will be strictly limited to essential items. Most of the needs for office furniture will be satisfied, as in the past years, by the redeployment of stocked surplus materials from closed sectors and sub-sectors. The corresponding inventories have been carefully taken. A budget of US$ 2,000 has been reserved for small office items which are still necessary. 4.7.2. Computer eqüpment $ 30,000 The modernization of the computer equipment must continue. For Ouagadougou and the field offices, a dozen computers are still to be purchased or upgraded with modems and larger memories to allow optimal use of the modern software for office work such as Windows 97,Excel and Powerpoint. Appropriate training of all the staff concerned started in 1999 and will continue in 2000. In addition, the procurement of a total of ten Laser Jet and Desk Jet printers will be necessary. A budget of US$ 30,000 will be required to meet these needs. 4.7.3. Technical equipment $ t5,o0o A small amount of routine replacements for scientific equipment will be needed for the research laboratories. Furthermore, four Zodiac boats will have to be procured for ground larviciding in three countries of the Prograrnme. A budget of US$ 15,000 is proposed for this ÿpe of expenditure. 4.7.4. Vehicles $ 45,ooo Due to the closure of the sectors and sub-sectors these past years, the cessation of larviciding operations in Sierra Leone and the progressive transfer of residual activities to the national teams, the number of vehicles required for the running of the Programme in 2000 has been set at 218. It is estimated that after the yearly phasing-out of old vehicles at the end of 1999, only 215 relatively new or vehicles in good running condition will be left. The purchase of three 4x4 Hilux vehicles will, therefore, still be required in 2000. A budget of US$ 45,000 is proposed for that purpose. The status of the current fleet, and a small number of future purchases, should enable the Programme to give up a certain number of vehicles in good running condition to the Participating Countries within the framework of the transfer of the Programme activities. Annex XI shows the evolution of the vehicule fleet from 1993 to 2000. lPC20.4 Page 40 TABLE,Il CAPITAL COSTS US $) Category of Expenditure PTTA§ E V Ploncgeu 2000,':' Approved 1999 Expenditure 1998 Expenditure 1 997 Expenditure 1996 Expen{iture 19Ô5 Office Furniture Data Processing Equipment ïechnical Equipment Vehicles Buildings r.0û0 t0 0ü0 :i:.:=:,{5:00t: :*.ri:ii4§:0IHI. 2 000 30 000 3 000 60 000 5 000 2251 56728 65 667 97 970 6 045 34269 90 105 136 789 590 690 37 870 65 930 104 992 359 01 1 12 077 31r 103 1*827 tb627 417 589 13 882 Tota! 100 000 228661 851 853 579 880 6{8 028 tPC20.4 Page 4l ANNEXES Page OCPORGANIZATIONCHART .....42 II. AVERAGE COSTS USED FOR BUDGETARY CALCULATIONS RATES OF EXCHANGE OF THE US DOLLAR/CFA FROM 1998 TO 1999 CHANGES IN PERSONNEL FIGURES AND COSTS FROM 1993 TO 2OOO V. AERIAL OPERATIONS FROM 1993 TO 2OOO vI. MAP - VCU PLAN OF OPERATTONS FOR 2OOO 43 44 45 u. IV. 46 47 vII. MAP - VCU SECTORS, OPERATIONAL BASES SUB-SECTORS AND FOR 2000 48 49Vru. ENTOMOLOGICAL NETWORK IN 2OOO Ix. MAP - AREAS EARMARKED FOR LARGE-SCALE IVERMECTINTREATMENTIN2OOO ..... 50 X. MACROFILCHEMOTHERAPYPROJECT ...,...5I XI. EVOLUTION OF VEHICLE FLEET TO 2OOO . . . . . . 54 o B a . É .e atr ! e !o Ég- EÊE ËËai Eo EgUJO =9Eg(!,o o E us *E^ -.oÉ; Eg.IE0-o HEg 8E - H9tg)o ,É, Pfl< u,r -lEÉ,J 3. I =o.t-o§ EHFOÉoü,o lû JPCZO.4 Page 42 ANNEX I F CE Io z o kN 2 oÉ, ? IJJ = = 0E ooGÈ J o c(t-z oo I U) o(r[! O oIozo lPc20.4 Page 43 ANNEX II AVERAGE COSTS USED FOR BTJDGETARY CALCTJLATIONS (US$) t999 1998 t997 Personnel Professionals - P6-Dl - P4-P5 - Pl-P3 - STP4-STP5 - STP1-STP3 National Professional OffÏcers General Service Programme area Geneva Programme area Geneva 155,000 145,000 180,000 ,rt,î 50,000 20,000 105,000 6,000 4,000 7,000 800 155,000 145,000 180,000 115,000 50,000 20,000 105,000 6,000 4,000 7,000 800 155,000 145,000 175,000 ,tr,ï ,0,ry 20,000 4,000 7,000 800 SSA New formula National Personnel - Consultants/month - Temporary (General Service/month) Aerial Operations Cost per flying hour (incl. fuel) - Guaranteed helicopter hours - Excess helicopter hours Insecticides - Cost per lire (CIF) - Vectobac (8.r. H-14) - Tecknar (8.t. H-14) - Temephos 20 % EC - Permethrin}D% EC - Carbosulfan 25% EC - Pyraclofos 50% EC - Phoxim - vectron Value of US dollar - CFA Franc - French Franc - Swiss Franc - Pound Sterling - DeuSche Mark - Canadian Dollar - Japanese Yen 1,050 1,050 6.54 8.28 15.96 t0.29 20.82 26.45 t4.71 24.r5 550.00 s.50 1.46 0.60 1.80 t.42 125.00 4.93 15.58 r0.29 20.82 26.45 16.05 24.15 4.64 13.94 t0.29 20.82 26.45 t7.02 24.15 924 722 924 722 'i,ï3 rfg ,,irn 500.00 500.005.00 5.001.43 t.t40.62 0.621.60 r.371.36 r.36 115.00 102.00 (*) The average cost of US$ 20,000 used for General Service staff refers to higher-grade staff members who will maintain the OCP stanrs. JPCaO.4 Page 44 ANNEX III -ot -88 IIJE3 F28 :, ûl (Jrol GL:8l E" = -> .T ËzEoFf aU^E \., UJ L@CL; f (E = CL r§ = tt oIL olo ro .hsNro i ! i i i I ,o iro E ll o Lt- -@§s robrtolot oo 14, o r{)lo oo(o VJC = $ Sn r6tio I l_!9 l lr o É. J J o oE C»q: Joo o) o)z- o F f J o lU o r() «, JPC2O,4 Page 45 ANNEX IV ooo§t C') o) C') - N or o) - J IIJzz oaÉ. ut o- 3o oF :)o1 o@. a:)lJl 9.o(E 6z1'O PoVxF O:f §tb -ll:t §= \.-(â aq.Fl U'oëo= IJ. \. F U' lr o z o trfJ o TU olo .o6)tro)tr FG (E CL (= ooto)\ ot (E o o o. Go 9,BÙ -w Y:A rlÀ oooooooooooOO)@1.-(Ot()t(v)N- g66L apseguuop sel rns gseq a6eluaolnod / enle^ g66t Jo e6eluacta6 o JPCzO.4 Page 46 ANNEX V E(l,.0, ^ahu, =ooËe3§lÈÀ= a EE ->3rarôôB EàF << G' or o) N o) o) - U'llJ .o Z=aru*É,E ï.c o8Z* o(I) l-o É.aolu oc) â qT -. -Q cnIO)a_o,z;- P§ É,d Heo9. .= -lo<-cEzlU .o)< rr- oooN ooo(9 l JPC20.4 Page 47 ANNEX VI oooN t :) o o- lo I.IJo ct)z o tr É. LUÈ o b z J o. ooo c{ É. o TL U)z o tr É. uJ o- o II o z J o_ :) C) Efo o ooao oco oc(,ç 0, ooE o =E J à6 l,cfoc) 6 0, 6 co ocoço c o .c. f,ooï,c6 c o oo B I 'rê- - =-lfô- à -\a -à \- o'.. \./ê-Ë \ J.'-fr''NId r li-- 1 -lti)t -:i/tfr: t- ti' op g E{, :>É. ( {.\ t- .1. i( -/I --ÿ' ,-\ I it E 0, IU lÙ o É. , ;\ t,',( -.'- r- , -lu l§ tPC20.4 Page 48 ANNEX VII EE -oloô9ÿôo) EE!-t;(â(r'lo o)Ë-lF3 LgH l(t ! lo(§ ICL Clôo .E(,(§ 18Et(t (+hto l q tll oI \ \ \ i t I I oo 8RO-Nfi =a(g,u) rx -l ?-yû2iqzt eÉ EHul- o- u)oa o<zû{p @uÉ.@ P5()ru r-u t-a<) LU CD èa EI ot, .E6ia2o .; ato = 'iE à2ô ,ïtoËE g ,û =ôc o -C, DEi Ë -atsE E *e EË5 t I g 6 = .c !, .!o o -_E3 àoECCa .oo à-o (§ oo!Ë8sot9Eûrogts ;o cuo6 o= o do I t û ru f,o oc -oocoço -c6 :E lU .=(U È o og(, , oo oz E3 co 6 c oço oEoc o E o !c(U c tuË. foo i o oo; o .c_o o à oEc I o -o(L o o c o ooÀ I o c c tU .E -(t, o oo G co o oo -o 6 o fr o o ..6§ ; ËEo o _-to6!! a a çàc \ Yo-g x îÉoJ!OË. 3 E*0() a oco o I ocoN t <i u) u) a -"N F .\\ \§ àg Jo qolr- )I /;ri ,.))ri t\: ) I i) ( o o .Ë. o :f ./ -'/ i aI I ! I a It ! I I /I /i /( -\f tug o o IUl'- o o oË-\.P Ë ^/é tl-----z a , -t=>{-sto \tt \a \ ! , ---^^ i , É.g I I [!zz ul ) t-r- a\/ \)i)a /tl "uÏ-\?ol . ,r'- -i oq{lr- ëYq) CO _3frc of oo (, l o zg zsr I z u. LLI ar-olEI A, § 6 '.8(l)c(u f ôô: EËq\Eô \(l)c ëLXo) f:E h3rr> \o)- \ -\!A.h I c(l) J c. .t -l- o(t, \ .= -O \(§- s'L(§ / .O)Ê1ox \. l.Ë'^1-./EE ) rugà' I g osod ) =eE I d d)ô -)Ës ral üË r. JPC2O.4 Page 49 ANNEX VIII 9o ,-L ea Por .-L sÈ8E Por =o9o cL=8§ 8g ï= e= BE cD o)oo o)oo)ooro s(\ d =o o oofo oE .ooc(, xo o o)E o = .EJ è(E !c =o -o (U E(§ c .9oc o) x c, c os f oo E' c(E c o û 0) = -q(! .E E3.5 lo.=3e i =96eOc'î o >,y sE ô È c ô 6- =:P:.= E É 9.9 oË tuàËsq HpIo- H o = oo e E6 so C Eof or I E 3 rEe goü8Ë o EËË; tË 00).O E E .Y'à Ei; ô ô{É §J§à > L' -§\§ § ..1 §_ Êa § -: a(§§) § .§§§\ § oooN z Yt o = F ulz z o tr f TU J I(, o o oFz -JJ oooôl z J z tU tuf o ooJ o oFz TU z o tr fJ \*\!( O.r '(.-) JPC}O.4 Page 50 ANNEX IX q UJ o 2 l----.l\ àEsS(Uô =ôÊ_ f §(!.Y -= o9.'d o c: = - o o:a es 5 E*ËË à:EEE E Ë; ?, Ë.Ë" f gg ËL:go o.9 o o I'l :iEs Ê E; t§.ea E E* E EËË Ë ÈË Ë âtE Ë ËË Ë Ë0 6 e, ' t-I .zn.t E ='îË!E g; !6iÈ gç :s:ï èÈ .s€Ètr €È .tBE: E§ eF.5 ib rôrE : - 02 O o (LÈ §e§E 8 §r EE EË!: : :lÈ EÈ€ Ê E -Êi§ :§.i§: i i f, q t4 c0 tu Ur =) o \f,{§ ooo ^!!8c e8 .i o@t-r Z.;x Ëur ==F-(JzwurE =É,Fu lll îÉJF< zuFJ üur =*É. YugH wz 3fi 3"igl- qg ;HO= âË 9ru6oNU) lUz oN II I i,'i ' I .1 ");Ç\r /i,-(,ii.'i )' ,/ ,"' 1 -!)-/t,/ t'or-j , u)- t 7A ra % N ffi \)\\ t. JPCZO.4 Page 5 I ANNEX X MACROFIL CTMMOTTMRAPY PROJECT FOR TRIPARTITE FTJI\DING BY OCP, APOC AND TDR Breakdovm of 2000 Budget Objectives for the MacrofÏl Project in 2000 The primary objective of the Macrofil Project continues to be the discovery and development of safe and effective adulticidal drugs (macrofilaricides) for onchocerciasis and lymphatic filariasis. The secondary objectives of the project are: a) discovery and development of back-up drugs which, while not killing adult worms, would pennanently sterilise them, or provide alternative microfilaricides to ivermectin (e.g.: permiting larger time interval between treatments or to replace ivermectin in case of resistance), and b) development of a molecular diagnostic tool/method that could be used to detectOnchocercavolvulus resistant to ivermectin. Since 1998, funding of the Macrofil Project has been shared equally between OCP, APOC and TDR, each contributing US$ 700 000 to give a total of US$ 2.1 millionper annum. In 2000, the posts of a P5 scientist and a GS staffsecretary will continue to be funded by OCP, and as far as possible OCP and APOC funds will be utilised for preclinical and clinical development of drugs and diagnostic tools (ivermectin resistance and DEC patch) for onchocerciasis, while TDR funds will be utilised for development of drugs for lymphatic filariasis, and for more fundamental work on identification of molecular targets for drug development. Background The Macrofil programme integrates the activities aimed towards the evaluation of molecular targets for the discovery of new drugs against filariases with that of a rapid drug screening strategy in animals. The flow of chemical structures from several sources (Walter Reed Army Institute of Research, GlaxoAMellcome and other academic institutions) have been optimised through the use of a company that provides the necessary logistic support and the "in house" availability of a chemistry expert. Macrofil continues to support basic research to elucidate at the genetic level changes associated with parasite resistance to ivermectin. In this context Macrofil has liaised the researchers from academia with those from OCP and APOC. The Macrofil project has now been fully integrated within the operational, administrative and managerial structure of TDR/PRD, which has one drug discovery steering committee for all TDR diseases. This integration yielded synergistic use of resources available at TDR as well as in disease endemic regions. It also resulted in an enhanced partnership with industry and NGOs. Macrofil benefited from the availability of TDR in-house professionals in the fields of chemistry, planning, pre-clinical and clinical activities. The progress assessment of Macrofil sponsored activities is conducted on a monthly basis through a TDR R&D Committee. The lead compounds for development are moxidectin and oxyteracycline. Moxidectin was developed for the animal healthcare market and therefore all the necessary technical and preclinical development required prior to clinical sfudies in man have been completed. While having a similar mechanism of action as ivermectin (potent microfilaricidal) it has shown a significantly different pharmacokinetic profile with a longer one and a half-life span. This has resulted in clear sterilising effect characterised by adult female worms, as well as death of adults in some models. 2. JPC2O.4 Page 52 Annex X Oxytetracycline has been shown by Macrofil sponsored researchers to also have in effect on killing adult worms in the animal models. This action is presumed to be mediaÇd through the effect of the antibiotic on a micro organism (Wolbachia) present in the filarlal parasites, including Onchocerca volvulus. Further ongoing studies (in animals) are addressi{g selection of optimal antibiotics as well as determination of minimal dose and treatmdrt regimens; these studies could lead to rapid evaluation in humans. 3. Clinicâl centre This year (1999), the Onchocerciasis Chemotherapy Research Centre (OCRC) iin Ghana, is continuing clinical studies of combinations of ivermectin with other drugs f,s potential macrofilaricidals. In this context OCRC, in collaboration with other specialistd laboratories is studying the pharmacokinetics of combined ivermectin and albendazole lin onchocerciasis patients. This study will be extended to support the use of these dr$g combinations in lymphatic filariasis. Furthermore, OCRC is conducting a safety and effic{y study of levamisole plus ivermectin or albendazole to evaluate the macrofilaricidal potential pf these combinations. This study will be bontinued through year 2000. Moxidectin appears to be a strong candidate for clinical investigations. Possibly pha§. IA and certainly Phase IB studies will be carried out in OCRC, if justified, once medi(al clearance has been obtained. It is estimated that approximately US$ 520, 000 will be required for all the clini(al studies; (this includes costs of monitors for all clinical trials, pharmacokinetic determinatiof» and histological examinations), plus US$ 115 000 for Dr Awadzi's consultancy fee. Drug screening centres High throughput primary in vivo assays usrng Brugia patnngi in the gerbil, with $e B.pahangildog and O.ochengilcattle models as subsequent development assays will contin{e. An approximate total cost of US$ 400 000 for compound screening is estimated. TechnicaliPreclinical development Following the outcome of the "ivermectin resistance meeting" in Ouagadougqu, Burkina Faso (12-13 June 1999), if data allows, it is envisaged, during the year 2000 trc initiation of the technical and preclinical development of tools to detect ivermectin drfrg resistance in Onchocerca volvulus. For this purpose US$ 250 000 will be allocated. On ** other hand, if the need for additional basic research is recognised, the above amount will E committed to this research. Strategic Research Following the outcome of the "New Molecular Targets for Onchocerciasis" meetilhg (November 1998) the funding of new drug discovery initiatives is planned that will aim towa{ds the validation of additional molecular targets and their development for automated high throughput screening assays. US$ 425 000 will be allocated towards the funding of th$se activities. 4. 5. 6. 7. JPC2O.4 "ïi?ii Meetings/Temporary Advisers The costs of the Drug Discovery Steering Committee will be met from TDP/TDR central funds, and Macrofil will be expected to contribute towards the cost of its meetings. Meetings of clinical drug screening and specific product development teams for macrofilaricides will still be required. The total costs of bringing temporary advisers to such meetings is estimated at US$ 70 000. Operational travel The scientist employed to develop macrofilaricides will need to visit collaborating laboratories, screening and clinical centres, pharmaceutical companies, etc, and attend statutory meetings of OCP and APOC when required. A total cost of approximately US$ 25 000 is estimated. Personnel Personnel requirements for the Macrofil Project remains unchanged for 2000, namely one scientific post at the P5 level and one secretary at the G5 level. A total personnel cost of approximately US$ 285,000 (as in 1999) is estimated. Miscellaneous supplies and service It is recommended that a sum of US$ 10 000 be set aside for the purchase of small equipment, books, journals, etc. Total budget It is therefore proposed that a total budget of approximately US$ 2.1 million be allocated to the Macrofil Project in 2000, in this third year of operation of the collaborative funding system, US$ 700 000 each from APOC, OCP and TDR. MACROFTL SUMMARY BUDGET 2OOO 8. 9. 10. 11. Clinical studies Screening Technical/Preclinical Development Strategic Research * Consultant (Awadzi) * Meetings/Temporary Advisers * Operational travel * Personnel Miscellaneous Supplies us$ 520,000 400,000 250,000 425,040 115,000 70,000 25,000 285,000 10,000 * To be retained by OCP. TOTAL 2,100,000 JPCZO.4 Page 54 ANNEX XI § oF E_l ffi. 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