Onchocerciasis Control Programme in West Africa and the African Programme for Onchocerciasis Control: Committee of Sponsoring Agencies, report of the seventy-fourth session, London, 17 and 18 July 1997

tRESTzuCTED OCP-APOCICSAIl4 ONCHOCERCIASIS CONTROL PROGRAMME IN WEST AFRICA AND THE AFRICAN PROGRAMME FOR ONCHOCERCIASIS CONTROL COMMITTEE OF SPONSORING AGENCIES Report of the seventy-fourth session London, 17 and 18 July 1997 Draft (04.08.97) CONTENTS OPENING OF THE SESSION ADOPTION OF THE AGENDA APPROVAL OF THE REPORT OF CSA.73 OCP MATTERS OCP EXTERNAL EVALUATION . MACROFIL REVIEW 1998-2002 TRUST FUND AGREEMENT NINTH AERIAL CONTRACT EAC MEMBERSHIP SUPPORT TO SOCIOECONOMIC DEVELOPMENT IN ONCHO-FREED AREAS ECOLOGICAL GROUP DOCUMENTATION FOR JPC. 18 FINANCING OF OCP APOC MATTERS PROGRESS OF THE PROGRAMME . . TCC.3 REPORT REPORT OF THE AD HOC GROUP ON IMPACT ASSESSMENT REPORT OF THE NGDO SUB-GROUP ON SUSTAINABILITY ITEMS PROPOSED BY THE NGDO GROUP JAF.3 SCENARIO DOCUMENTATION FOR JAF,3 FINANCING OF APOC OCP-APOC I\{ATTERS PREPARATION FOR THE DONORS' CONFERENCE PROPOSED CSA.75 AGENDA DATES OF TCC AND CSA SESSIONS Paqe A B C D E. F. G. H. J K. L. M N. o. P. a R. s. T. U, V. w OCP-APOCICSAIT4 Page 1 A. OPENING OF THE SESSION 1. The sevenry-fourth session of csA, held at the London office of the world Bank' was opened by Bruce Benton who welcomed Ms Catherine Cross, chairperson of the NGDO Group for Ivermectin Direction, who was invited to attend the discussion on APOC matters' B. ADOPTION OF THE AGENDA 2. The proposed agenda wittr the addition of items suggested by the NGDO Group was adopted' C. APPROVAL OF THE REPORT OF CSA.73 3. The draft report with a few amendments was approved (distributed together with the present draft of the CSA.73 rePort). OCP MATTERS D. OCP EXTERNAL EVALUATION 4. An intermediate report was presented by the chairman of the External Evaluation Team' Professor A.S. Muller, and the secretary, Professor R.J. Post, who stressed the Teams recommendation that OCP be reinforced with high level expertise in negotiating with governments effective and sustainable integration of onchoceiciasis surveillance and control tools into national health systems and the management of such integration' 5. The committee would review the External Evaluation report at its next session (25'26 September 1997) in preparation for the Donors' Conference rvith particular emphasis on integration' poit-OCP control, recrudescence and "damage control"' E. MACROFIL REVIEW 6. The report of the Review Team was presented to the Committee by Dr G'C' Coles' The need for a substantial increase in compound screening was emphasized, an issue rvith both technical and managerial aspects to be stressea it ttre Donors' Conferenci' Apart from presenting the report to the Donois, it would be considered by both JPC and JAF in Liverpool' F. 1998-2002 FUND AGREEMENT 7. Tom Topping, WHO kgal Counsel, informed CSA ttrat the irnal version of the Memorandum of Agreement with a note verbale, inviting delegates at .the forthcoming session of the African Regional Committee to sign the MemorandJm at ihat session, would be despatched incessantly' A funher opportunity to sigriwould be during the December JPC session at which Donors rvould also be invited to sign the Fund Agreemen-t prepared by the World Bank' If the latter proved impracticable, arrangements would be made uy ttre Bank early during 1998 to obtain Donors' signarure G. NINTH AERTAL CONTRACT 8. Tom Topping informed the committee that a Review Committee had now made recommendations to the WHO Director-General' OCP-APOCICSAIT4 Page 2 H. EAC MEMBERSHIP 9 ' The Committee decided to recommend to the Director-General the appointment to EAC membership of: - Dr Detlef Richard PROZESKY (South Africa) - Dr Pierre Frangis GUILLET (France) - Dr Yoichi YAMAGATA (Japan) I. SUPPORT TO SOCIOECONOMIC DEVELOPMENT IN ONCHO-FREED AREAS 10' FAo had through its country offices, continued the consultation process in participatingCountries (Mali' Guinea and senegal). A policy meeting was held in Burkina Faso attended by representativesof the Ministries of Agriculture and Healthind of FAO, the World Bank and WHO.A follow-up meeting was under way aiming at a high-level ministerial round-table by the end of october and a round-up seminar in ouagadougou on 1g-zt November 1997. 11' Belgium had been approached for assistance to "famine-free" project formulation in Mali.Norway and Sweden would also assist through the FAo cooperative programme. To strengthen theprocess ar the central level FAo had appointed a full-time eipert. 12' FAo would prepare an issue paper for the next session of CSA to serve as the basis for aninformation document for the Donors' Conference. J. ECOLOGICAL GROUP 13 ' As the chairman of the Ecological Group was unable to attend the current session of cSAto clarifiz the requests of the Group to the Committee, it was decided to postpone this item until theDecember sessions of cSA and Jpc which Davide calamari rvould attend. K. DOCUMENTATION FOR JPC.18 14' In approving the 1997 draft PIan of Action and Budget, the Committee was reassured thartransfer of staff from wHo/ocP remuneration and the employrlent on salaries closer ro those offered at the national level were implemented in full recognition by ihe staff concerned of the need for ocpto reduce its budget. An oral summary of the PAB would be given to the Donors, conference. 15' Documents which could not be considered at the autumn sessions of CSA in time fortimely despatch to JPC participants would be mailed to members of the Committee for theirindividual conments, if any. The provisional agenda and list of documents were approved(see Annexes 3 and 4). L. FINANCING OF OCP 16' Bruce Benton informed the Committee that the end of year reserve balances in 1997would amounr to US $ 15.49 million. OCP-APOC ICSAIT4 Page 3 APOC MATTERS M. PROGRESS OF THE PROGRAMME lj. The Prograrnme Manager, Azodoga S6k6t6li, referred briefly to the workshops on Community-Directed Treatment with Ivermectin held in April (in English) and June (in French). F-oltowing a workshop in Uganda, project implementation would commence there at the end of August while the REMO exercise in Malawi had been completed- In September a workshop *ortO be held in Khartoum for northern Sudan and another in Nairobi for southern Sudan, Ethiopia, Kenya and Mozambique during which the oncho situation in the two latter countries would be clarified' 1g. At ttre end of October/beginning of November, Management visits would be paid to Equatorial Guinea, investigating also the prospect of focal vector elimination, and to Chad while an STC would initiate REMO in Angola. lg. The APOC Managementhad "fine-tuned" the budgets for approved projects as at 30 April 1997 (see table in Annex 5). N. TCC.3 REPORT 20. A report on the thirteen projects so far approved would be made to the Donors', Conference which would also be piovided with a list of the projects approved by CSA'75 on 25-26 September immediately foltowing the TCC'4 session' O. REPORT OF THE AD HOC GROUP ON IMPACT ASSESSMENT 21. The fmdings of the ad hoc group would be reported to the Donors' Conference after consideration by CSA.75. P. REPORT OF THE NGDO SUB-GROUP ON SUSTAINABILITY ZZ. The study was so far incomplete and continued. CSA recommended that "somebody" investigate the matter and recommend a list of criteria to be built into projects. Collaboration should be established with John Barrows, who had isolated a series of issues at the most recent NGDO GrouP meeting. 23. Also, following the protocol development meeting on community-Directed Treatment rvith Ivermectin in bruguOorgou (June 1997), TDR had invited operational research proposals for the development of indicators and criteria' 24. A brief oral presentation of progress would be made to the Donors' Conference' A ITEMS PROPOSED BY THE NGDO GROUP 25. ApOC funding of field operations: TCC had listed activities not to be funded; the NGDO Group called for a list of items qualifying for APOC funding; OCP-APOCICSAIT4 Page 4 APoC funding of NGDo administration/overheads: a plea had been made for such costs to be partially borne/reimbursed by ApOC; CSA decided to establish an ad hoc committee to make recommendations regarding the above two issues with the following membership: . The NGDO chairperson . The APOC Managemenr . The World Bank . Daniel Etya'at6 . Chairperson of a NOTF (Uganda or Sudan); consultations would take place with the Carter Center; a verbal report would be givento the next NGDo Group session on 1g and 19 September; and a summary of the recommendations would be presented to the Donors' Conference before reporting toJAF; the World Bank would prepare an issue/working paper for distribution to CSA members early September. 26' Sudan: CSA was reassured that northern and southern Sudan received equal supportfrom the APOC Management as exemplified by the holding of trvo workshops, onein Khartoum and one in Nairobi to which the iouthem pu.t was invited. 27 ' Ethiopia: APoc would put pressure on the wHo Representative to obtain theGovernment signature on the Memorandum before the Nairobi workshop to whichEthiopia was invited, and prior to a visit by Sight Savers in September. Also, theWorld Bank would request its representative to approach the Government. 28' Cameroon: the problems of high-cost distribution, cosr-recovery and insufficient health systems distribution of ivermectin would be considered by rcC ror subsequent reporting to CSA; community-directed distribution was implemented in remote andinaccessible areas while nurses in areas covered by a health infrastrucfure carried outdistribution in close collaboration with the communities thus approaching the concept of CDTI. 29' Nigeria: high-endemicity areas not covered by REMO had already been done so by skinsnip surveys allowing for the application of correlation factori. R. JAF.3 SCENARIO 30' The attached scenario (Annex 6) was approved with the understanding that item 15would be taken during Day I following item -14. Issues to be taken up during country reporting would include the community concept, collaboration with NGDos, partnership andCDTI. OCP-APOCICSAIT4 Page 5 31. The issue of APOC Management staffing would be presented under item 6 (Reflections of CSA) while the report of the ad hoc group on APOC funding would be added as a new item. S. DOCUMENTATION FOR JAF.3 32.. The provisional agenda and a list of documents (Annexes 7 and 8) were approved' T. FINANCING OF APOC 33. Operations were fully financed until the end of 1997. Increasing funding gaps during the following years were expected to be filled by as yet unannounced contributions. OCP-APOC MATTERS U. PREPARATION FOR THE DONORS' CONFERENCE 34. The Conference would consider the following: OCP : - progress - report of the External Evaluation Team (para. 5 above) - report of the Macrofil Review Group (para.6) - OCP Fund Agreement (para. 7) - CSA support to socioeconomic development (para.12) - OCP Plan of Action and Budget for 1998 (para. 14) - financing/pledging; APOC - progress (NOTF and Sight Savers); - iu*mary of projects approved up to CSA.74 and list of TCC.4 recorlmended/CSA.75 approved projects for 1998 implementation (para.20); - report.of the APOC ad hoc group on impact assessment (para. 2l), including appraisal of economic impact of control of skin manifestations (working paper by World Bank/TDR); - report of ad hoc group on sustainability (para. 23); - report of ad hoc group on allowable APOC funding (para' 25); - OCP/APOC staffing; - financing/pledging. V. PROPOSED CSA.75 AGENDA 35. A draft is attached as Annex 9. X. DATES OF TCC AND CSA SESSIONS CSA.75 to be held in conjunction with TCC.4 (22-25 September 1997) in Ouagadougou on 25 (p.m.) and26 September; 36 OCP-APOCICSAIT4 Page 6 csA.76 in conjunction with the Donors' conference (zo-zz ocrober 1997) in Paris; CSA.17 in conjunction with JPC.18/JAF.3 during firsr week of December L997in Liverpool; TCC.5: 23-27 march 1998; CSA.78: 29-30 April 1998; TCC.6 17-21Augusr 1998 (to be confirmed by TCC.4); CSA.79: 24-25 Seprember 1998 OCP-APOCICSAIT4 Page 1 ANNEX 1 Members : FAO Participants ex officio Secretariat Invited UNDP - Gana Fofang World Bank - Bruce Benton (Chairman), - Bernhard Liese wHo - Bjorn Thylefors OCP/APOC - Yankum Dadzie APOC - Azodoga S6ket6li LIST OF PARTICIPANTS - Felix Moukoko Ndoumbe - Ole Worm Christensen (Secretary) - Laura Cooley - Catherine Cross (for APOC matters) - Lex Muller (for External Evaluation) - Rory Post (for External Evaluation) - Gerald Coles (for Macrofil Review) 2OCP-APOCICSAIT4 Page 8 ANNEX 2 LIST OF DECISIONS 1. CSA.75 to review External Evaluation report (para. 5) Drs Prozesky, Guillet and Yamagata to be recommended to the DG for EAC membership (para.9) FAO to prepare issue paper for CSA.75 (para.L}) Davide Calamari to attend CSA.77 in Liverpool (para.13) Early report by NGDO sub-group on sustainability (para.22) Early report of ad hoc committee on APOC funding of field operations and NGDO overheads and World Bank to prepare issue/working paper (para. 25) Working paper on economic impact of control of oncho skin manifestations to be prepared by World Bank/TDR (para.34) 8. List of issues for Donors' Conference consideration in paragraph 34 9. Dates of future sessions (para. 36): CSA.75: 25 (in the afternoon) and 26 September L997 in Ouagadougou; CSA.76: in conjunction with the Donors' Conference (20-22 October 1997) in Paris; CSA.77: in conjunction with JPC.1S/JAF.3 (first week of December 1997) in Liverpool; TCC.5: 23-27 March 1998; CSA.78: 29-30 April 1998; TCC.6: 17-21August 1998 (?) CSA.79: 24-25 September 1998. 3 4 5 6 7 JOINT PROGRAMME COMMITTEE Office of the Chairman JOINT PROGRAMME COMMITTEE Eighteenth session Liverpool. l-3 December 1997 Onchocerciasis Control Programme in West Africa Programme de Lutte contre I'Onchocercose en Afrique de l'Ouest ANNEK 3 COMITE CONJOINT DU PROGRAMME Bureau du President JPC18.I JPC - CCP 2 3 4 5 PROVISIONAL AGENDA Opening of the session Election of Officers Adoption of the Agenda Reflections of ttre Comminee of Sponsoring Agencies Progress report of the World Heatth Organization for 1997 and Report of the Expert Advisory Committee Progress report of Participating Countries' activities for 1997 Audit report PIan of Action and Budget for 1998 Financing of the Onchocerciasis Control Programme - Report of the \\'orld Bank - Pledging of Donor contributions 10. The 1997 External Evaluation of Phase IV of Onchocerciasis Control Programme I 1. Revierv of iVlacrofil 12 Other matters 13. Date and place of the nineteenth session 14. Approval of the report 6 7 8 9 7.07.97 P/to 1-). Closure of the eighteenth session /* onchocerciasis control programme in west Africa ANNEX 4 Prosramme de Lutte contre l'Onchocercose en Afrique de I'Ouest JOINT PROGRAMME COMMITTEE office of the Chairman JPC - ccP coMITE CONJOINT DU PROGRAMMEBureau du pr6sident JOINT PROGRAMME COMMITTEE Eighteenth session Liverpool. 1-3 December 1997 JPCIS JPCI8.1 JPC 18.2 JPC I 8.3 JPCl8..1 JPCI8.5 JPC18.6 JPC 1 8.7 JPC 1 8.8 JPC18.9 PROVISIONAL LIST OF DOCUMENTS Provisional Agenda Progress reporr of the world Hearth organization for 1997 Reporr of the Expert Advisory Comminee Plan of Action and Budget for l99g Onchocerciasis Control activities of ttre I I Participating Counrries of OCp-1997 Report of the annual meeting of the oncho Nationar coordinarors Audit Report Phase IV External Evaluation report _ lggT Review of Macrofil report 7.01 .97 ANNEX 5 SUNIMARY OF THE PROJECT PROPOSALS APPROVED UNDER THE. 1997 BUDGET Approved projects proposals as at 30th April, 1997 IggT APPROVE,D BUDGET FOR PROJECTS - ai CDTI Projects - b: Vector Elimination Project Total (a+b) 4,66o,ooo 213,000 us$ 4,873,000 COIJNTRY PROJECT APOC TRUST FUND (USS) N{ALAWI Tyolo and Mwanza 198,665 UGANDA Kisoro, Kasese, Hoima & Masindi 163,555 Itrvara F. Vector Elimination 162,821 NIGERIA Kaduna 200,400 Taraba 243,522 Cross River 226,736 Kogi 767,243 H.Q. support 160,125 Southern Sector 376,845 SUDAN Northern Sector 262,657 H.Q. support 157,815 TANZANIA Malienge focus t47,492 H.Q. support 150,1 87 TOTAL (C) 13 Proposals 2,606,063 P\1 'APOC I 3 07.97 African Programme for Onchocerciasis Control (APOC) Programme africain de lutte contre ['onchocercose JAF-FAC ANNEX 7 FORUM D'ACTION COMN{UNE Bureau du Pr6sident JOINT ACTION FORUM Office of the Chairman l5 JOINT ACTION FORUM Third session Liverpool. 4-5 Decenrber I997 JA F3. I PROVISIONAL AGENDA 1. Opening of the sessron 2. Election of the Officers 3. Adoption of the Agenda 4. Reflectrons of the Commrttee of Sponsoring Agencres 5. Prosress report of the World Health Organization 6. Report of the Technical Consultative Committee 7 - Report of the NGDO Coordinatron Group for h'emectrn Disrribution including support of the Group to APOC's activities 8. Countries reports: expenences in preparing, launchrng and operating APOC supported projects (Uganda, N{alarvt. Nigena, Tanzania, Sudan. CAR, Chad, Congo, Gabon, Equatonal Guinea. Cameroon) 9. Consideratron of Nationalplans and project proposals 10. OperatronalResearch '11. Plan of Acrion and Budset for 1998 t2 Financrns of the Afncan Programme for onchocerciasls control (Apoc) . Report of the World Bank . Pledgine of Donor conrrrbutrons 13 Other matters Date and place of the fourth sesslon Approval of the reporl Closure of the thrrd sesston 14 I6 P\t/1POC. l0 06 97 JOINT ACTION FORUM Off,rce of the Chairman African Programme for Onchocerciasis Control (APOC) Programme africain de lutte contre l'onchocercose JAF-FAC ANNEX B FORUM D'ACTION COMMUNE Bureau du Prdsident JOINT ACTION FORUM Third session Liverpool. 4-5 December 1997 LIST OF DOCUMENTS JAF3.1 Provisional agenda JAF3.2 WHO Progress rePort JAF3.3 Plan of Action and Budget 1998 JAF3.4 Report of the third session of TCC JAF3.5 Report of the fourth session of TCC JAF3.6 Consideration of National onchocerciasis control plans and Projects Proposals JAF3.7 Onchocerciasis Operational Research (Progress report to JAF3) JAF3.8 Report of the NGDO Coordination Group for Ivermectin Distribution including support of the Group to APOC's activities JAF3.9 Administrative links and collaborative arrangements between APOC and OCP, WHO/AFRO, WHO/HQ INFORMATION DOCUMENTS JAF3/INF/DOC.1 Evaluation of the Epidemiological Impact of APOC (French and English) JAF3/INF/DOC.2 Studies of the Long-term Impact of CDTI on Transmission (English and French) JAF3/INF/DOC.3 Report of the First Workshop on CDTI Project Implementation (English only) JAF3/INF/DOC.4 Report of the Second Workshop on CDTI Project Implementation (French only) JAF3/INF/DOC.5 Report of the Third Workshop on CDTI Project Implementation (English only) JAF3/INF/DOC.6 APOC Projecs Evaluation form (French and English) JAF3/INF/DOC.7 APOC in Uganda: a Case Study (English only) PM/APOC, 30.6.97 OCP-APOCICSA/74 Page 9 ANNFX q PROPOSED CSA.75 AGENDA (Ouagadou gou, 25 -26 September 1997) 1. Opening 2. Adoption of the agenda 3. Approval of the CSA.74 report and matters arising therefrom OCP MATTERS 4. External Evaluation report 5. Support to socioeconomic development in oncho-freed areas6. 1998-2W2 Memorandum of Agreement (status of signature) 7. Preparations for the Donors' Conference 8. Preparations for the JPC APOC MATTERS 9. 10. 11. t2. 13. 14. 15. 16 17 Progress of the Programme TCC. 4 report/reco m m endation s regard i ng proj ect propo sal s Report of ad hoc comminittee on allowable ApOC funding Economic impact of control of skin manifestations Report of NGDO ad hoc group on sustainability Preparations for the Donors' Conference Preparations for JAF.3 OCP-APOC MAT'TERS Provisional agenda for CSA.76 Other matters