CSA review of OCT operations

lb EXPERT ADVISORY COMMITTEE Ninth session 0u t3-77 June 1988 fntroduction of recommend ations WORLD HEALTH ORGANIZATION ORGANISATION MONDIALE DE T.A SANTE ONCHOCERCIASIS CONTROL PROGRAMME IN hIEST AFRICA PROGRAMME DE LUTTE CONTRE L'ONCHOCERCOSE EN AFRIQUE DE L'OUEST ocP /EAC?.6 (A) ORIGINAL: ENGLISH CSA REVIEW OF OCT OPERATIONS The Joint Programme Committee (JPC) at its eighth session in Rome(lo November - J December 1987) recommended (paragraph / of the finalcommuniqu6) that 'rln order to accelerate the identification of candidatemacrofilaricidal drugs, the Comnittee of Sponsoring Agencies (CSA) will reviewthe nandate and mErnagement structure of Ocr, and its annual funding, andconsider alternative sources of funding. Members of the donor community and theExpert Advisory committee (EAc) will assist in the review.,, rn response^to this request the csA convened a review meeting on20-27 January 19BB to assist in the preparation of its response to JpC,srequest' Members of the donor community were invited to participate and threecountries, Belgium, France and Switzerland, asked that thlir representatives bepresent' The neeting was also attended by four representatives of the CSA, tworepresentatives of the EAC, chief ocP Liaison office, Directors pDp and rDR fromhlHO, and Secretary OCT. The transcript of the review meeting was discussed at the CSA meeting heldon 24-25 February 1988. rn view of the importance and urgency of these matters,the CSA decided that the nemagement recommendations referred to below should beintroduced as early as possible by Ocr, pending formal approvar by Jpc.9. 1' It was reaffirmed that, with appropriate changes, ocT remained the optimalmechanism for drug development for ocP.- The sole objective of ocT in futureyears wourd be the development of a safe and effective macrofilaricide withproperties compatible with public health usage. continued corlaboration withthe pharmaceutical- industry was recommended but a greater number of companiesshould be involved. 2' The original mandate of Ocr was reviewed and the group agreed that changeswere needed in the drug discovery and development processes of OCT. Thefollowing changes were recommended: (a) new collaborative agreements for accelerated drug development shouldbe concluded similar to those with Merck Sharp & Dohm6 and ciba-Geigy, inpreference to further investment in the long-term and expensive use ofmultidisciplinary research groups engaged in drug arscovlry; ocP/EACg.6 (A) page 2 (b) a firm commitment to pursue the development of any macrofilaricidesidentified in such collaboration should be sought from the companies concerned, in the form of appropriate 1egal agreements; and (c) support for crinical triars centres in endemic areas, and drug screening centres where potential drugs from industriat sources could betested for their anti-Onchocerca activity, should be continued, or expanded, as they forn-a-valuable resource giving comparative advantage toindustrial collaborators. 3. It was recommended that the nanagement of OCT become more transparent tothe constituent bodies of OCP, and this would require an increased fl-ow ofinformation relating to all activities of OCT. 4. There is the requirement for a more focussed yet flexible management structure to allow the rapid development of any identified macrofilaricide.Such a management structure should give more responsibility to the OCTSecretariat. 5, The WHO Secretariat responsible for OCT should be the full-time Secretary, supported by the Directors of oCP, TDR and PDP, the Secretary of the TDR-Filariasis Steering Committee, Chief PDP/Filariasis and Chief pharnaceuticars. 5. The recommendation was made that all decisions related to the day-to-day management of the collaboration with the pharmaceutical industry should be theresponsibility of the Secretariat, rather than the Steering Committee, and thefunction of this Committee should be to comment upon the scientific quality,progress and Ieve1 of funding of research contracts. Observers from thepharmaceutical industry should not routinely attend Steering Committee meetings. 7. A Steering Committee for the overseeing of OCT activities shouLd beretained, but its composition should reflect the changes in emphasis recommendedabove. The Chairman of the Steering Committee should be an inlernationallyknown figure, with first-hand expertise in drug development and with personal contacts and rapport with senior figures within industry and, if possible,university laboratories. 8' A list of appropriate persons suitable for appointment to the ocT SteeringCommittee should be maintained by the Secretariat, fron which a conmittee ofabout seven members should be selected by Directors OCp, pDp and TDR. A balanceshould be maintained between persons with a broad knowledge of drug developmentand technical experts with specific knowledge of disciplines of reLevance toOcT' The duration of their appointment should be the same as that of the members of the EAC. 9. The Chairman of the Steering Committee should not be in receipt offinancial support from OCT, and only in exceptional circumstances should anySteering Committee member carry out research projects on behalf of oCT. Anyexceptions for a Steering Committee member would be explicitly approved byDirectors OCP, pDp and TDR. 10' It was felt by the revieh, group that OCT would benefit from the greaterinvolvement of the current Director of PDP, who has many personar contacts withthe pharmaceutical industry. The possibilities by which pDp courd become moreinvolved in, or share responsibility of, the scientific management of OCT shouldbe explored by the Director-General of WHO. d { b ocP /EAcg. 6 (A) page 3 11. In future the technicaL review of OCT activities should be theresponsibility of EAC rather than the STAC of TDR as at present, and the annualreport of EAC to JPC will incLude an OCT conponent. It is recognized that to dothis, EAC may need to be strengthened by appropriate persons knowledgeabl-e ofdrug development in an industrial environrl"t. Directors TDR or pDp will reporton oCT progress directly to EAC and JPC at their annuaL meetings, and should beaccompanied by Secretary OCT. 12' Based on histori.c requirements it was agreed that maximum tota] funding forocr shourd be approximately uS$J mirlion durinc 19g9-199i, ;; rhar all ocpexpenditure for OCT be fu1ly integrated into the overall ocp budget. Severalalternative sources of funding for OCT were suggested by members of the reviewgroup' These possibilities were to be pursued by the OCT Secretariat in closecollaboration with the World Bank. ouring a visit by the Secretariat and theBank to the EEC, possible support of approximately US$3 million to assist infinancing ocr research priorities durin! L9g9-L9gL was identified.