Quarterly report of APOC management to the Regional Director: third quarter (July to September 2014)

QR3/20L4 Qua rterly Report of APOC Management to the Regional Director THrRD QUARTER (JULY TO SEPTEMBER 2OL4l AFRICAN PROGRAMME FOR ONCHOCERCIASIS CONTROL OUAGADOUGOU, BURKINA FASO A. Introduction: The third quarter of 2OL4 in the transition period of the Programme (2OL4-2OL5) has been marked by implementation of activities with a reduced budget. ln fact, owing to limited resources, the Sponsoring Agencies, during their meeting in Ouagadougou in June 2014, decided that APOC Management implements a USS19 million budget instead of USS25 million approved by JAF, and directed the Management to prioritize very important activities that are needed to upscale treatment and curtail on other activities. Hence many important activities such as epidemiological and entomological evaluations that needed to be carried out to demonstrate that eliminations has been reached in some countries like Senegal, Mali, Niger, Burundi and Chad, have to be halted. Nevertheless, the Management of the Programme is striving to implement priority activities and continues with advocacy visits to some participating countries to mobilize resources. Many meetings and teleconferences were also carried out during the quarter, mainly for the preparation of the 20th session of the Joint Action Forum which is jointly organized this year with the Global Alliance to Eliminate Lymphatic Filariasis (GAELF) and the stakeholders of Uniting to combat NTDs (BMGF) and that will take place in Addis Ababa from 08 to 12 December 2074. As the theme of this year's JAF indicates "Building partnerships to achieve the accelerated elimination of Preventive Chemotherapy NTDs in the African Region", it is a demonstration that partners are joining their forces to combat Preventive Chemotherapy NTDs in the African Region. Highlights of some of these events are summarized below. B. Strategic events During this period the Management continued providing support to the control of other NTDs. The Programme also attended and facilitated many Regional meetings organized jointly with WHO/AFRO. Some of these meetings are as follows. 1, Reeional NTD Master Plan Review & TIPAC Trainins meetinss. Lu a. Zambia 21-25 Julv 2074 This meeting was organized by AFRO in Lusaka. The main objective was to strengthen the capacity of national NTD programmes, to revise and update their NTD Master Plans up to 2020 and annual NTD plans for 2015. 2. Facilitators' meetins on M aster olan. 26-29 Julv 2014 Following the Regional meeting on Master plans review, a facilitators' meeting on master plan was held in Geneva, from 26 to 29 July 2014. The objectives of this meeting were to reflect on workshop process and current NTD Master Plan format, assess NTD Master Plans developed by countries, review status of draft Master Plans developed by countries and review tools and schedules for supporting countries. t t 3. APOC-HQ./NTD/Geneva Collaboration. Paris Meetine, 15-19 Septembre 20L4 Following online work that was going on for the past four months lead developers met at a meeting for the finalization of District Level NTD training modules in Paris, from 15 to 19 September 2OL4. APOC was the lead developer for module five and 10 respectively. A total of 10 training modules are being finalized. Job aides were also developed to help CDDs and FLHW perform their assigned tasks. r- ) :,t. ri t The objective of the training was to , build the capacity of district level managers to train lower level staff (FLHW, CDD, etc.) in implementing MDA. C. Policy events Meetings and teleconferences continued through the third quarter, the outcome of some of which is briefly summarized below: 1. 147th Session of the Committee of Sponsorins Aeencies (CSA) (Teleconference The 146th session of the CSA which took place in Ouagadougou from 25 to 27 June 2OL4 decided to call a teleconference on 21't August 2014 to follow up on the decisions and recommendations of the 146th session. Partners who were connected to the teleconference included the Director of Preventive Services of the Ministry of Health of Tanzania, The Director General of Health of the Ministry of Health, Cote d'lvoire, AfDB, Merck & Co. lnc., Sabin lnstitute, the World Bank, NGDOs Chair, MDP, BADEA, Bill and Melinda Gates Foundation, MITOSATH, SightSavers, USAID, WHO/HQ, and WHO/APOC. lssues discussed during the teleconference were on Communication strategy, Government contribution, lnvestment Case for the new entity, Transition Task Force (TfF), Management Review Report, Governance structure of the new entity, APOC work plan with reduced budget, Resource Mobilization Plan, Venue of next JAF, AfDB's closing report on APOC, APOC's land title 856, Chairmanship of CSA, Need for Communication, and funding opportunities with OFID. CSA was informed during the teleconference that the Regional Director of WHO/AFRO has appointed Dr Lucien Manga to be the Chair of the CSA. Regarding the Governance structure of the new entity, a lot of progress was made in drafting the governance structure and a document was going to be presented to CSA148 in Geneva after a face to face meeting of WGG in Geneva on 20 and 21't October 2014. With regard to the closing report on APOC requested by the AfDB, CSA was informed that AfDB will liaise with APOC to start the preparations by the fourth quarter of 2OL4 as the last 2 -l \A t I I tt' disbursement of the Bank to Apoc is in 2015 and the report can be finalized just after the last payment. The AfDB representative further indicated that they are in discussion with their regional department for the inclusion of PENDA in their pipeline. 2. 39th Session of the Technical Consultative Committee : The 39th session of the Technical Consultative Committee (TCC) took place in Ouagadougou from 08 to 12 September 20L4, in the new Conference Hall of APOC baptised "Salle Luis Gomes Sambo". lt was attended by TCC members, technical advisers, three former Directors of ex-OCP and APOC, Observers, NGDO partners as well as representatives of PATH, WAHO, CDc/Atlanta, DDTD, La Trobe University (Autralia), LF-RPRG/AFRO, WHO/HQ/NTD, and APOC management. Strategic and technical issues discussed during the meeting included updates on entomological/epidemiological evaluations, delineation of treatment boundaries and transmission zones, the evidence and rationale for the current APOC monitoring and evaluation framework for elimination, black flies trapping and other studies related to Onchocerciasis, Moxidectin and research on the vulnerability of Onchocerciasis and LF to emergence of resistance, the DEC patch test and Lohmann; assessment of the impact of community directed treatment with ivermectin on the Parasitological indicators of Loa loa in areas of co-endemicity with Onchocerciasis in Cameroon; new diagnostics of PATH for elimination of O. volvulus infection; new diagnostic technology for tropical diseases, specifically for detection of loa loa infection; results of the OV-16 studies in Africa; LF and Oncho co-evaluation study; sub-optimal responses to ivermectin, WHO Guidelines on verification of elimination of human Onchocerciasis, roadmap for alternative treatment strategies for the acceleration of the elimination of Onchocerciasis: 2014-2015; proposed algorithm for deciding on areas to refine loa loa map, results of test and treat study in Cameroon within the framework of perspectives for LF and Oncho elimination; review of Uganda Dossier for the four sites that have interrupted tra nsmission of Onchocerciasis. The committee also contributed to the preparatory activities for the launching of the new entity, specifically the LF/Oncho programmes scale up. TCC also reviewed two new CDTI project proposals from Ethiopia as well as 35 annual technical reports of ongoing projects from L2 countries and received reports of National Review Committees (TRCs) of Cameroon, Malawi, Nigeria and Uganda. lt is worth noting that the TRCs of the four countries reviewed 29 annual technical reports of ongoing projects in those countries, as well as operational research proposals. @ Ip :l *,tt '*\ 3 Some of the key recommendations of the TCC are as follows {t 1 I a a 1 I h - t- (i) Despite financial challenges, the epidemiological results with entomological transmission assessment survey should be complemented in 2Ot4-2O15 to know the situation in the vectors; (ii) DEC patch and moxidectin should be made available quickly to accelerate upscaling of Alternative Treatment Strategies (ATS); (iii) lncorporation in the modelling of issues raised by the situational analysis from poorly performing projects in order to understand the impact of determinants for poor performance which could include political reasons, decentralization, data flow from the periphery to centre; (iv) Differentiate project areas which started CDTI late but achieved good coverage from those which started CDTI late and implemented it with bad coverage; (v) Reconsider the algorithm for categorization of projects and pool projects with late start and projects with poor performance and create a high level advocacy group to visit countries with areas requiring intensified control efforts to sensitize the authorities on the poor performing projects; (vi) Use mobile teams approach in some areas and introduce treatment cards to provide more reliable data on treatments received; (vii) Mapping for LF with appropriate tools, in Loa loa areas should be done without delay; (viii) Address the issue of how to identify atypical responses to ivermectin and document iU (ix) Address the issue of pharmacovigilance when including new drugs in addition to the other NTD drugs already in the community and in the LF impact assessment guidelines. 3. Fifth session of NTD NGDO Network (NNN) meetins, Paris22-25 September 2014 APOC Management actively participated in the fifth session of the NNN meeting. Over 200 Participants from the following Networks attended the meeting: LF Network, NGDO coordination Group for onchocerciasis elimination, Morbidity Management and Disability Prevention Working Group (MMDP), STH/SCH NGDO Coordination Group and NNN WASH Working Group. The presentation of the Management was on "Update on transition to the Programme for Elimination of Neglected Diseases in Africa (PENDA): ONCHO/LF integrotion". During this meeting, the LF Network agreed to create an LF Africa Network to work in close collaboration with the NGDO coordination Group for onchocerciasis elimination, on issues of elimination of Oncho and LF. A very positive attitude towards PENDA was observed. D. !mplementation Many implementation activities took place in the field during the period under review. Some of them are highlighted below: 1. MeetinR on alternative treatment st : Ouasadou eou. 6-7 Seotember 2014 ln order to accelerate the elimination of Onchocerciasis and LF in some problematic areas in Africa, previous meetings of TCC and JAF had emphasized the importance of using Alternative Treatment Strategy (ATS). , I I t II t ApOC Management therefore convened an Experts' Consultative meeting on APOC's Road map for Alternative treatment strategies for the acceleration of the elimination of onchocerciasis/LF in problem areas. The meeting was held in Ouagadougou on 6 and 7 September 20t4. The objective was to have discussions with experts on how to operationalize alternative treatment strategies during the period 2OL4-20L5 in problem areas. 2. Technical support mission to Democratic Republic of Congo (DRC). 4-8 Ausust 2014 This mission took place in the framework of the support of APOC Programme to the process of planning and implementation of Mass Drug Distribution (MDD) in DRC. lt was to review the situation of the preparation of the MDD coordinated campaign, to follow up on the receipts of the 2nd quarter 2014 DFCs, to discuss on the documentation of the MDD and to follow up on the process for recruitment of the NPOs. ln addition to these missions, many in-country missions and activities were carried out by APOC Technical Advisers and temporary advisers in the countries. 3. lndependent Evaluation of Therapeutic coverage of CDTI proiects To verify that data reported by countries are valid data, the Programme developed a protocol for lndependent Evaluation of Therapeutic coverage of CDTI projects. This protocol was pre tested in two countries (Burkina Faso and Burundi) during the period under review. The results indicated that figures reported to APOC by countries are little higher than the independent evaluation results even though they are in the same threshold and confirm that reported data are accurate. 4. Entomolosical assessment and acitv buildine in entomolosv Despite the reduced budget, the Programme was able to carry out entomological assessments in some countries during the period under review. Blackfly catching points networks were established in all endemic districts in Senegal, Niger and Burundi, and collection of blackfly ongoing in Senegal, Niger and Burundi. There was processing of blackflies collected at 8 sites in Malawi, distributed around the pre- treatment highest infection levels, to determine infection rates. Results indicated zero infection at the levels of all the sites. 22 entomology Lab technicians from 3 countries (Senegal, Niger and Burundi) were also trained. Laboratory equipment (Microscopes) and logistics (Motorbikes, bicycles) were also provided to three countries (Senegal, Niger and Burundi). Large trap platforms with numerous modifications and bait variations were evaluated in Banfora, Burkina Faso, for their ability to collect 5 *.-7' :.ft ,a|: ' a onchocerciasis vectors. Prediction of blackflies breeding sites in onchocerciasis endemic areas in Niger was made by remote sensing. Many other activities were carried out during the period by APOC Technical Advisers posted in some post-conflict countries. E. Advocacy and Resource Mobilization 1. Advocacv visits to Usanda .participation in the EAC. 5-7 Aueust 2014 APOC Management, led by the Director, paid an advocacy visit to Uganda. The aim of the visit was to raise awareness of the highest authorities on financial contributions toward elimination of onchocerciasis and LF. F. AOB 1. Briefins of WHO Staff in Burkina Faso on the Ebola Virus ln the capacity of Acting WR/BF while Dr Cabral was on leave, the Director of APOC convened a meeting of all WHO staff in Burkina Faso (|ST/WA, WCO and APOC)for a briefing on the outbreak of the Ebola virus disease currently riffing in some of the West African countries. Presentations were made to the staff on the history and the manifestation of the disease as well as the animal host of the virus. These presentations were followed by questions and answers. Many behavioural advices were also given to the staff in this regard. Below are some of the pictures captured during the briefing. 6 I .l J. I