PIan of action and budget 2012-2013

JOINTACTION FORUM Office of the Chairman JAF-FAC: Sixteenth session Abuja, Nigeria, 7-9 December 2010 World Health Organisation FORUM D'ACTION COMMUNE Bureau du Pr6sident African Programme for Onchocerciasis Control Programme africain de Iutte contre l'onchocercose PIan of Action and Budget 2012-2013 Item 21 of the Provisional Asenda JAF 15.7 ORIGINAL: ENGtISH September 2010 African Programme for Onchocerciasis Control 0 APOC - Plan of action and budget 2012-2013 PIan of Action and Budget 2012-2013 @Copyright African Programme for Onchocerciasis Control (WHO/APOC) ,20!O. All rights reserved. Publications of the WHO/APOC enjoy copyright protection in accordance with the Universal copyright Convention. Any use of information in the WHO/APOC Plan of Action and Budget 2OL2-2O13 should be accompanied by acknowledgement of WHO/APOC as the source. For rights of reproduction or translation in part or in toto, application should be made to the office of the APOC Director, WHO/APOC, 01 BP 549 Ouagadougou, Burkina Faso, dirapoc@oncho.afro.who.int. WHO/APOC welcomes such applications. African Programme for Onchocerciasis Control JAF16.7 Page ii TABLE OF CONTENTS List of tables. fisures and annexes List of Abbreviations/acronvms SUMMARY OF ACTIVITIES CONDUCTED tN 2009-2010.................. ........1 Part 1: PLAN OF ACTION AND BUDGET FOR 2012-2013.. ............4 l.l Objective 6 Overall Programme Obj ective 5 Specific objectives, strategic approaches and planned activities for attaining 2012-2013 goals 6 Specific Objective 1 ......., Specific Objective 2 ......... Specific Objective 3 ......... Specific Objective 4 1.1.1 1.1.2 t.L.2.t t.L.2.2 1.L.2.3 1.L.2.4 1.L.2.5 1.L.2.6 1.L.2.7 5 7 8 9 Specific Objective 5 ..... Specific Objective 6 Gender.............. BU DG ET B REAKD OWN AN D J U STI FI CATI O N ............... Budget by technical/operational activity Community-Directed Treatment with Ivermectin ....1.2.1 1.2.2 Strengthening health systems / Integration of CDTI and co-implementation with other health interventions .. 10 .. 11 Part 2: 1.2 11 13 13 13 15 15Research and Macrofi I project........... 1.3.1 Human resources, Management & Logistic 1.3.2 Summary of 2012-2013 biennium budget.., List of tables. annexes and fieures Summary of epidemiological evaluations providing evidence for elimination of onchocerciasis infection 2008-2010 Total number of onchocerciasis endemic communities in 108 projects of APOC as of December 2009) Planned cost per specific objective Projected annual Trust Fund expenditure by technical/operational and administrative/management activities 2Ol2-2O73 (USS million) Projected cost by country/site in 2012-2013 Figure 1 Number of projects to be funded by APOC Trust Fund (3 categories of CDTI Project): 2012- 20L3 Budget Breakdown and Justification Pre-control distribution of onchocerciasis endemicity (a) and coverage endemicity zones by Com m unity-directed treatment with ivermecti n projects (b) Technical/operational and administrative cost for years 2012-2013 Annual Trust Funds Expenditure (1996-2010), Financial requirements (2011-2013) (US S million) and number of CDTI projects Organization chart of APOC Programme Figure 2 Figure 3 Figure 4 Figure 5 Enhancing the participation of Women and minorities in CDTI: mainstreaming gender........ 16 Partnerships ......... 16 1.3 Budget by administrative/management activity................. 16 1.2.3 1.2.4 1.2.5 16 t7 Table 1 Table 2 Table 3 Table 4 Table 5 3 4 t7 18 20 22 23 5 Annex 1 Estimated number of National Projects (CDTI and NOTF HQ support) to be implemented and managed in20t2-2O13 Annex 2 Average unit costs used for budget calculations 5 8 20 2L APOC - Plan of action and budget 2012-2013 CO oN I N oN o(,) Ef cr) EE(o E .o o o c(5 (L 6 oo .9, o .g o o(, o o o o o E E G E')IG Go Figure 6 African Programme for Onchocerciasis Control 24 JAFL6.7 Page iii List of abbreviations/acronyms AFRO .........WHO Regional Office for Africa APOC........ African Programme for Onchocerciasis Control CAR ...........Centra1 African Republic CDD ..........Community-directed distributor CDI ............Community-directed intervention CDT|.......... .Community-directed treatment with ivermectin CID ............Community lnformation Database CSA ...........Committee of Sponsoring Agencies DCO .......... Deputy Coordinator DRC............Democratic Republic of Congo ECOWAS.. . Economic Community of West African States HIA ............ Health lmpact Assessment of APOC Operations HMM ........Home Management of Malaria HSAM ....... Health education, Sensitization, Advocacy and Mobilisation IEC ............lnformation, Education and Communication JAF.............Joint Action Forum MDSC ........ Multi-Disease Surveillance Centre NGDO......... Non Governmental Development Organization NOTF ........ National Onchocerciasis Task Force N PO........... National Professional Officer NTD ........... Neglected Tropical Diseases OCP............ Onchocerciasis Control Programme in West Africa OTD ........... Other Tropical Diseases PAB ........... Plan of Action and Budget PBD ........... Prevention of Blindness and Deafness PHC ........... Public Health Care PRO ........... Programme officer Meeting and reporting RAPLOA .... Rapid epidemiological assessment procedure ol Loo loa RC ............. Regional Committee REMO......... Rapid Epidemiological Mapping of Onchocerciasis SAEs ..........Severe adverse events SSI .............Sight Savers lnternational STH ...........Soil-Transmitted Helminths STP ............ Short-Term Professional TCC ............ Technical Consultative Committee TDR............. UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases VAS ........... Vitamin A Supplementation WAHO ......West African Health Organization WHO.......... World Health Organization APOC - Plan of action and budget 2012-2013 CO oN I N roN o o)E =d)p c o c o o o Co o- 6 oo .9, o .g e oo o o o o o E E(! E" o o- (E() L African Programme for Onchocerciasis Control APOC - Plan of action and budget 2012-2013 JAF16.7 Page 1 SUMMARY OF ACTIVITIES CONDUCTED IN 2009-2010 ln 2009-2010, activitiesl were undertaken by 15 countries and APOC Management towards the attainment of the six main objectives as outlined in the Programme's Phase ll and Phasing-Out Plan of Action and Budget 2008-2015. 1 For detailed information on the activities, please refer to WHO/APOC Progress Report document JAF 15.5 CDTI activities Status of implementation Mopping (REMO/RAPLOA) o REMO activities were completed in 4 out of 5 countries with non-delineated areas. RAPLOA undertaken in 2 countries. . Country-wide onchocerciasis endemicity re-assessment carried out in 753 villages in 10 regions in Ghana. o Following the acquisition of new GIS tools, a critical review of all REMO data and maps using the geo-spatial analysis tool, "Kriging" was carried out. This allowed for the maps of onchocerciasis distribution in APOC countries to be improved, and will also allow for a better delineation of areas of high onchocerciasis prevalence. o ln 2010, APOC signed an agreement with Lancaster University in the UK, to conduct collaborative analysis of data from RAPLOA surveys within participating APOC countries. The maps produced will show the risk of exceeding the APOC intervention threshold of 20% parasitological prevalence. r A meeting of 13 NTD programmes managers was held in May 2010 to finalise the mapping of the main NTDs in their respective countries. Seven (7) action plans and budgets submitted to APOC Management are under review. Troining ond copocity building o 292 nationals & NGDO staff trained in CDTI strategy in Ghana, Malawi, Southern Sudan, Tanzania, Uganda. o A cumulative number of 76,000 health workers were trained/re-trained in 15 countries. 503,000 CDDs trained/retrained in 120,000 communities. o 15 fellowships allocated to MoH staff in 10 countries; 67% of lhe beneficiaries are women. r Trained 131 health personnel in data and financial management in 7 countries (Angola, Burundi, Congo, DRC, Liberia, CAR, Tanzania) o 167 individuals trained in data collection and recording of geographic coordinates in Burundi, Congo, Equatorial Guinea, Nigeria, Cameroon, Tanzania. r 28 trained in Entomological surveillance in 9 countries (Burkina (1), Cameroon (6), CAR (2), C6te d'lvoire (2), Guinea-Bissau (2), Malawi (3), Nieer (2), Nigeria (8), Togo (2)). Community dotobose o Ministry of Health staff in 7 countries trained to establish community database for onchocerciasis control. . Supported 4 countries in identification and recording of geographical coordinates of all endemic treated/untreated communities were undertaken, to improve treatment coverage and the likelihood of elimination. lvermectin distribution Treotment dota for 2009 submitted in 2070 o 67 million people treated in 133,000 communities in 15 countries. This represents an increase of L7.2% over the number treated in 2008. Thirty-eight percent (38"/") of the persons treated (.25,769,642 people) were in post-conflict countries. o The re-launching of CDTI in 13 districts was co-financed with the Ghana Health Services. Monogement of SAEs o Financial & Technical support to manage SAEs provided to district & sub-districts health facilities in 3 countries. Direct Support 107 CDTI projects + 7 HQy'NOTF secretariat, surveillance in 2 vector elimination project areas and 4 ex- OCP countries received a total of US S25 million from the APOC Trust Fund, representing 82% for technical/operational activities in 2010. Funded a review and planning meeting of 11 former OCP countries on the status of onchocerciasis control. Technicol Advisors ond Finoncial /Administrotive Assrstonts in country o Six (5) technical advisors confirmed as fixed-term staff and resident in 5 post- conflict countries to support MoH in accelerating the implementation of CDTI. They will also provide support to primary health care. ln addition, three (3) Finonciol/Administrotive Assistants were replaced and one (1) NPO position supported for NTD control in Tanzania. African Programme for Onchocerciasis Control cf) oN IN oN o o)El m EC o c o o o c o()- E o o ,9, o .g o oo o o o o o E E r! E,, o o. o(J L APOC - Plan of action and budget 2012-2013 JAFL6.1 Page 2 As we continue with epidemiological evaluations the number of countries where infection levels have declined significantly will be reported annually and the onchocerciasis map of Africa will shrink. (o oN IN oN o o)Ef m Ec G c o () o C o o- E oo .9 o .g(, o o o o o o o tr E G E" o o- Go L Cross- border colloborotion a a Financed 2 ministerial sub-regional meetings on cross-border disease control and surveillance, with special attention on financing the control of onchocerciasis from national budgets. Financed and co-facilitated cross-border meetings of 4 West African countries on control and su rveilla nce. Monitoring & Evoluation o 10 lndependent Participatory Monitoring exercises completed in 3 post conflict countries. Evaluation for sustainability for 16 CDTI projects completed in 4 countries. ln-country consultation on community-self monitoring completed in Burundi and Congo. r Conducted surveys to monitor therapeutic coverage in the 3 selected projects (Zamfara, Ebony and Ondo in Nigeria and twovillages in the Northern Province of Cameroon. o Epidemiological evaluation to assess residual levels of O. volvulus infection carried out in 13 sites in 4 APOC countries (see toble 7 below). o MeetinB with APOC mid-term Evaluators in Accra and conducted mid-term evaluation support missions to Cameroon, Tanzania. o Funded modelling the impact of APOC operations - Erasmus University, Rotterdam. Equipment/ Supplies ond Logistics for countries ln collaboration with Global Network (GNNTD) provided 1,300 bicycles to CDDs in 3 countries in support of co-implementation efforts. Provided US 53.6 million for capital equipment to CDTI projects in 15 countries. Strengthening Health Systems o Following the introduction of CDI curriculum and training module for medical and nursing schools in 18 Universities in 11 African countries, APOC funded 9 out of 12 budgets submitted for pre- testing in 2010. . Supported 2 countries in the development of co-implementation Plan of action and budget for integrated onchocerciasis and other NTDs control. . Supported MoH Nigeria stakeholders' meeting for consensus building and adoption of National NTDs Plan of Action. o Provided funding to 3 projects in Nigeria to expand CDI co-implementation (malaria, LF, etc). Partnerships e Organized Programme statutory meetings: JAF15 and 15 coupled with 4 meetings of TCC and participated in 3 meetings of CSA. o Joint APOC/MDP/NGDO mission to Angola to increase government, private sector and NGDOs partners support to CDTI. . lnternational conference on Emerging lnfectious Diseases 2010, Atlanta (July 2010). o APOC/NGDO Country representatives meeting in Ouagadougou (March 1-3, 2010). o Working visit in Ouagadougou on Health lmpact Assessment with Erasmus University Rotterdam Medical Centre. r Meeting with community leaders in south Sudan and Angola to improve geographical and therapeutic ivermectln treatment coverage rates. Gender o Recruitment of a consultanU terms of reference and draft work plan on gender mainstreaming in operations, data collection, reporting & planning by member States on-going. r Training on Gender and Participatory management of community health in CAR. Research and drug development o Co-funded with TDR the search and development of a macrofilaricide for onchocerciasis control. o Assisted WHO/TDR in the implementation of moxidectin phase 2 clinical studies. o Funded special entomological study in Kogi & Benue States, Nigeria to determine factors influencing recent unsatisfactory prevalence results of Kogi CDTI. Human resources/APOC HQ Staffing Completed appointment of 5 new fixed-term staff and confirmation for 2 others underway. Administrative support provided by WHO country offices and NGDOs to 104 CDTI projects in 15 cou ntries. African Programme for Onchocerciasis Gontrol APOC - Plan of action and budget 2012-2013 JAF16.7 Page 3 Table 1: Summary of epidemiological evaluations providing evidence for elimination of onchocerciasis infection CDTI project/Focus Number of villages Persons examined Persons % positive surveyed (skin snip) positiveCountry Nigeria Cross River Ebonyi Edo Kaduna Ondo Taraba Zamfara Cameroon North Uganda Adjumani Kasese Moyo Nebbi Chad Chad: Bebedja Chad: Danamadji DRC Kasai Tanzania Mahenge Total: APOC countries 19 22 5 29 3 10 7 19 4 10 5 10 I 9 t2 10 183 2,719 3,239 827 3,966 833 1,696 1,065 2,690 1,293 1,774 1,699 1,950 '1,731 1,336 2,57L 1,199 30,588 81 5 276 0 148 214 0 86 0 10 22 196 0 0 83 283 1,4o4 3.0 0.15 33.4 0 17.8 12.6 0 3.2 0 0.56 1.29 10.0 0 0 3.2 23.6 African Programme for Onchocerciasis Contro! cr) oN IN oN o O)of d) EC o c oEo o c o(L E o o ..2, o .g(, oo o (J o o o E E(! ED o o- (E o L I II APOC - Plan of action and budget 2012-2013 JAF16.7 Page 4 Part 1: PLAN OF ACTION AND BUDGET FOR 2012-2013 To comply with the requirements of the Global Management System (GSM) adopted by WHO and in force at APOC since July 2008, APOC management has aligned the Plan of Action & Budget (PAB) from annual year to biennial as approved by the Committee of Sponsoring Agencies (CSA) in its 124th session. The Plan of Action and Budget for 2012-2013 (hereafter referred to as PAB 2012-2013) is the sixteenth to be submitted by the African Programme for Onchocerciasis Control (APOC) to the Joint Action Forum (JAF), the programme's governing body, for consideration and approval. lt is the fourth PAB (2 annual and 2 Biennium submissions) following the approval of the strategic PAB 2008-2015. The focus of APOC activities under PAB 2012-2013 is the implementation of the Programme's Phasing- out and Exit Strategy Plan of Action and Budget PAB 2008-2015, approved by JAF in December 2007. APOC activities will be implemented and executed in compliance with the seven objectives of PAB 2008-2015 stated below. The activities will include implementation of Community-Directed Treatment with lvermectin (CDTI) projects, Co-implementation, Monitoring & Evaluation of CDTI, Elimination related activities (Epidemiological evaluation, Disease surveillance), Support to strengthening of health systems, Research and Drug development, strengthening Partnership and programme closure related activities, Statutory meetings and missions, Mainstreaming gender in CDTI, Supply and Equipment, Materials/logistics to support mainly CDTI implementation, and Human resources for the Programme (See Figure 2). 15 APOC countries, one hundred and eight (108) CDTI projects, two (2) vector elimination, six (6) NOTF headquarters supports projects, and 4 ex-OCP countries will be supported 2012-2013 in line with the Strategic Plan of Action and Budget of APOC for Phase ll and Phasing out period, PAB 2008-2015, and its addendum (See Table 2 and Figure 1) including additional funding. Table 2: Total number of onchocerciasis endemic communities in 108 projects * of APOC (as at July 2010). Country CDT! projects Total endemic Communities Angola 6 L,587 Burundi 3 358 Cameroon 15 9,640 CAR L 5,0L4 Chad t 3,250 Congo 2 77O DRC 20 39,011 Equatorial Guinea L L29 Ethiopia 9 23,L9O Gabon** 1 - Liberia 3 6,778 Malawi 2 2,L86 Nigeria 27 36,430 Sudan 6 10,270 Tanzania 7 3,93L Uganda 4 4,966 Tota! 108 L47,520 * For detailed information on the estimated number of National Projects (CDTI and NOTF HQ support) to be implemented and managed in 2072-2013 please refer to Annex 1. ** REMO implemented after approval of Gabon project revealed that onchocerciasis is hypo- endemic country-wide except for a few villages. Onchocerciasis is hypo-endemic country-wide in Rwanda, Kenya and Mozambique. ln continuation of the Programme's strategy for the control/elimination of onchocerciasls as a public health and socio-economic problem, 86% of the budget for 20L2-2073 will be devoted to operational costs (See Budget Breakdown and Justification chart). cr) oN IN oN q) o,o =cn EC o c o .E o o co o- 6 oo .t2 o .g() oo o o o o o E E o E" o G (E o L African Programme for Onchocerciasis Control APOC - Plan of action and budget 2012-2013 JAFL6.7 Page 5 Figure 1: Number of projects funded by APOC Trust Fund (3 categories of CDTI Project): 2Ot2-2O13 Figu re 2: Brrdget breakdown and justification 201 2-201 3 Planned activities Six major activities/areas a a I a .2012 2013 30 25 20 15 10 5 0 .go atrr Q 6 t; d o c-g.q 6 cO GE N c ogX E X E E C'.G = E E { g E F 8 X 6 E E 8 6E " S" ",r*3 S ; f ga € H E g " i'o g g E ,f-oc,> surueillance a a I P.oJ.cbwlfiln 6. td nv. F.r.otop.m{on- Proiecls with > 5 )Dars ot operation{eceiving limited/dirinishing ,unding trom APOC to onhance/minhin susbinebilityappon ln .ccod.no. wlfr.POC'. African Programme for Onchocerciasis Contro! CO oN IN oN o o)o :f, m Ec o c .9 o o co(L 6 oo .t2 o .g o o o o o o o o E E o cl) o o- (U o L qrn F.s) Sterlefun lEd rysEm o!a) Reserrch andd dcYelof0ra{il (3r) Prrh.Blitr(8*l G.r*? Hlmn rusgrcl RE',Iol'RAPLOA TEirhg end Bpscity bu#-g h C$?1 CDTI€omnfu datebe* lmphilEntitioll TEstrcnt Equipmntt*pptes and bgalisfurcounti0 llonib,hg and erl/ltim of COTIMonilErinC€y: I utord3 unsitrrnra Eliminalion ofAPOC EI6Ea*$re.ane lntcgEtbn o{CDTI hio lhc hc.lh A,$ttl Co.irpbffitltbn Buadng epecityol n.timsbh ntaatdr OpeEtbnrl e*rrctr studai 1rtsc6fl pErFr't M 6sEE,'wortslEpsl me{dlgs to strtr{aiu Fd[rliF SletutorynEethgi PrcgEm closE.di\ritier Mans;tnsrirg gendcrn APOC opsalinr tuna E@!EaHQ. ma{seil rddriirt|ahg Equgmnt/sgptes and bgidEof l{yAP(rGl*a uglrn rill t I t II JAFT6,7 Page 6 l.l l.l .l Objective Overall Programme Objective The 2012-2013 PAB is based on the Programme's overall objective: To hove established by 2075, a country-led system capoble of eliminoting onchocerciosrs as a public health problem in all African countries endemic for onchocerciosis ,.., The principal aim is to safeguard the more than US53 billion investment in onchocerciasis control by the communities, countries, donors and NGDO partners, and sustain the gains made towards the elimination of the disease as a public health and socio-economic problem in Africa. A study in Senegal and Mali with 17 years of ivermectin treatment provided the proof of principle that onchocerciasis transmission can be eliminated with ivermectin treatment and that treatment can be safely stopped. Recent epidemiological studies in Cameroon, Chad, DRC, Nigeria, Tanzania and Uganda have also shown that elimination of onchocerciasis and interruption of transmission is feasible in different geographical zones in Africa. lt is therefore important that APOC should move from control to elimination of onchocerciasis transmission in as many foci and countries as possible. This major paradigm shift was not foreseen when the strategic plan of action and budget 2008-2015 was prepared in 2007. To achieve elimination and/or shrink the onchocerciasis map in Africa, it is necessary to build the capacity of nationals in epidemiological evaluation, and to determine the residual levels of infection in a given project prior to complete withdrawal of support from the APOC Trust Fund. The policy for withdrawal of APOC financial support to CDTI projects has therefore been revised, extending by two years the end of APOC support to projects for which this was planned to start in 2010.The extension of support by two years will not affect the 2015 final exit date of APOC, but allows APOC management and countries to determine the residual levels of infection in older projects prior to withdrawing APOC financial support. 1.1.2 Specific objectives, strategic approaches and planned activities for attaining 2012-2013 goals t.L.z.t Specific Objective 1 To estoblish sustoinoble onchocerciasis control progrommes in all African countries where they ore needed. Strotegic approaches o Reinforce the capacity of the communities and front-line health facillty levels to maintain sustainable CDTI. . Support health education, sensitization, advocacy and mobilization (HSAM) and the training of health workers and CDDs thereby increasing the capacity of communities to manage the CDTI. o Strengthen supervision, monitoring and evaluation of projects and country capacity in the management of M&E activities. Provide additional technical and financial support to post-conflict countries to improve community ownership of projects, geographical and therapeutic coverage. Activities o To support HSAM and training of more community-directed distributors (CDDs) of ivermectin in 15 countries and increase human resource at the community level to manage CDTI and improve geographical and therapeutic coverage rates. o To undertake advocacy visits to governments to achieve integration of CDTI into health systems in Liberia, Chad, Burundi, Congo, DRC, Equatorial Guinea and Sudan. r To provide technical support and resources to 14 countries (Angola, Burundi, Cameroon, CAR, Chad, Congo, DRC, Equatorial Guinea, Ethiopia, Liberia, Malawi, Nigeria, Sudan and Tanzania) to implement community- self monitoring (CSM). r To carry out independent participatory monitoring of ivermectin projects in Angola o To evaluate the sustainability of CDTI projects in Angola, Cameroon, DRC, and Liberia and assist Governments to develop sustainability plans. a (f) oN IN oN o o)of m oc o c .9 o o c o o_ o oo .t2 o .g() oo o () o o o = E(E E) o o- (E o African Programme for Onchocerciasis Control APOC - Plan of action and budget 2012-2013 APOC - Plan of action and budget 2012-2013 JAIL6,7 Page 7 r To monitor the implementation of CDTI sustainability plans by governments of 4-5 countries (Cameroon, DRC, Ethiopia, Nigeria and Tanzania) and make available the reports to partners. r Continue to build the capacity of health staff in the collection of CDTI community data in several countries. o To train additional health personnel including WHO surveillance teams in the strategy of CDTI in 3 post- conflict countries, in order to improve supervision and monitoring of health personnel and CDDs, and reporting in CDTI. o Finance the posts of Technical Advisors Officers resident in 7 post-conflict countries to assist NOTFs/National Onchocerciasis control Programmes (NOCPs) in improving the implementation of control activities and support to primary health care. r To undertake verification of attainment of 700% geographical coverage in all 15 countries. o To provide technical and financial support for the inclusion of the curriculum and training module in up to 30 medical and nursing schools across West, East and Southern Africa. Targets/indicotors lndicators of Objective 1 Geographical coverage in stable countries Geographical coverage in post conflict countries Therapeutic coverage reached in stable countries Therapeutic coverage reached in post conflict countries No. of CDTI projects with sustainability plans being financed by governments Cumulative No. of community-directed distributors (CDDs) of ivermectin trained. Cumulative No. of health workers trained in CDTI Baseline Year 2OO7 98% 49% 77% 48.5 55 Milestones Year20L2 Year 2013 99% tOO% 84% 85% 78% 79% 67% 70% 90 103 600,165 1,150,000 1,200,000 49,LL9 90,000 100,000 L.1.2.2 Specific Objective 2 To implement onchocerciosis control octivities in conjunction with other heolth interuentions (co- implementotion). Strategic approoches o Provide financial and technical support to countries to develop national policies and/or action plans on co- implementation of the control of onchocerciasis with other interventions and support the use of the CDI strategy as a tool for PHC. o Promote and co-fund integrated large-scale delivery of ivermectin, vitamin A, Albendazole/ Mebendazole, praziquantel and insecticide-treated bed nets in CDTI communities in Tanzania, DRC, Nigeria, Liberia, Chad and Equatorial Guinea; fund technical advisor (nationals) positions in Tanzania, DRC and Nigeria to support MoH in technical and managerial oversight of co-implementation using the CDI model. o Collaborate with the NGDOs, NTD-AFRO, NTD-Geneva and other partners in NTD control. Adivities r To assist eight countries to identify gaps in the distribution of NTDs and complete the mapping of NTDs - (Angola, Cameroon, Chad, DRC, Ghana, Mali, Nigeria, Sudan) o To train nationals in six countries in the use of GIS to produce integrated maps of NTDs after completion of nation-wide mapping of five NTDs- onchocerciasis, LF, schistosomiasis, STH and trachoma. o To leverage existing funds and network structure in CDl, to promote and enhance PHC in all APOC countries. African Programme for Onchocerciasis Control cf) oN IN oN o(,) E =m io C o C o o o C G(L E tr o o .9, o .g() o o oE otr o o o E E r! E'I o o. tr(E(,) L II I I tI APOC - Plan of action and budget 2012-2013 JAFL6.] Page 8 a To continue to co-finance and improve outcomes of integrated large-scale control of NTDs in Tanzania and DRC. To advocate, co-finance and facilitate national and/or regional meetings on the use of the community- intervention (CDl) as an effective tool for integrated delivery of multiple health interventions for projects in 11 countries (Benin, Burkina Faso, Cameroon, DRC, Ethiopia, Nigeria, Senegal, Sudan, Tanzania, Togo and Uganda) To finalise and disseminate the APOC manual for training community directed distributors to countries and partners. Torgets/indicators a lndicators of Objective 2 Number of countries assisted to complete NTD mapping Country has action plan on co- implementation for the control of NTDs and other health interventions No. of CDTI projects co-implementing other health interventions Number of State members contributing to co-implementation of CDTI with other health intervention Strdtegic dpprooches o Fund and conduct epidemiological surveys in 30 endemic foci of projects with more than 10 years of ivermectin treatment to determine residual levels of infection in APOC and four ex-OCP countries. Figure 3: Pre-control distribution of onchocerciasis endemicity (a) and coverage of endemicity zones by Com munity-directed treatment with ivermectin proiects (b) Baseline Year 2007 Milestones Year 2Ot2 Year 2013 808 5110 5 0 55 11 64 6 a a a a cf) o c! IN oN 0)(,, Ef(D oc G c o o o Co TL E o(J .2 o .g() o o ot o o o o E E o E' o o- tr oo African Programme for Onchocerciasis Control , a 1.L.2.3 Specific Objective 3 To determine when and where ivermectin treotment con be stopped and to provide guidance to countries on preporing to stop ivermectin treotment. Develop a global strategic plan on elimination of transmission of onchocerciasis with ivermectin in Africa by 2012. Fund research on annual versus twice-yearly ivermectin treatment in an effort to help countries to determine if and where the control strategy may be adopted in forest and guinea-savannah zones. Train nationals in 4-6 APOC countries on epidemiological evaluations for stopping ivermectin treatment in the savannah and forest zones. Assist countries with development of elimination plans (See Figure 3 below). a b APOC - Plan of action and budget 2012-2013 JAF16.7 Page 9 Activities r To provide funding and coordinate epidemiological surveys in 3-5 projects' foci in APOC countries (CAR, Cameroon, Chad, DRC, Equatorial Guinea, Guinea Bissau, Malawi, Nigeria, Tanzania and Uganda) and in 3-4 ex-OCP countries with more than 10 years of ivermectin treatment, to determine residual levels of infection. o To hire two consultants to build capacity of nationals (from CAR, Cameroon, Chad, Equatorial Guinea, DRC Guinea Bissau, Malawi, Nigeria, Tanzania and Uganda) in entomological evaluations and provide strategic and technical guidance to APOC management for the elimination of onchocerciasis transmission in Africa.. Torgets/indicators lndicators of Objective 3 % of CDTI projects evaluated in which CMFL < 5 mfls No. of projects in APOC countries in which epidemiological surveys for assessing the infection levels on elimination of onchocerciasis transmission were u ndertaken No. of countries in which scientists and national health staff are trained on epidemiological evaluations for assessing the infection levels 13 15 1.1.2.4 Specific Objective 4 To reduce the risk ol transmission ol onchocerciosis lrom lormer OCP countries whose epidemiologicol ond entomologicol situotion threotens neighbouring countries in which the diseose hos been brought under control. Strotegic approoches o Provide time-limited (2008-2012) technical and financial support to 4 countries with high-risk areas in order to intensify and strengthen control activities in these areas. . Support cross-border collaboration and review meetings of ex-OCP countries to maintain the achievements in the freed zones. o Fund and facilitate a meeting of national coordinators of 11 ex-OCP countries to monitor the status of onchocerciasis control in each of the 11 ex-OCP countries. Activities To continue to fund and provide technical support to reinforce large-scale ivermectin distribution in 3 ex-OCP countries (Ghana, C6te d'lvoire and Sierra Leone); strengthen CDTI in communities with a history of poor treatment coverage rates and improve geographical coverage rates of the countries. To provide funding to Ghana, Sierra Leone, C6te d'lvoire and Guinea Bissau for epidemiological evaluation and surveillance activities. Co-finance and facilitate the organization of cross border meetings between (i) Benin and Nigeria; (ii) Togo, Burkina Faso, Ghana and Benin; and also for (iii) Guinea-Bissau, C6te d'lvoire, Sierra Leone, Liberia, and Guinea for onchocerciasis control. To fund and organize a meeting of 11 ex-OCP countries to obtain updates on the status of onchocerciasis control in each country and promote networking among control programme staff. To provide support for logistic supplies, general and other direct activities for national onchocerciasis control programmes in 4 ex-OCP countries. Baseline Year 2007 Milestones Year 2072 Year 2013 87% 90% L4 160 0 a a a a a African Programme for Onchocerciasis Control cf) oN IN oN q) o,of(D rcc o C .o o o c G(L E oo .9, o .g o o o o ,.C o o o o E E o c,) o o. (E a L t1 !I APOC - Plan of action and budget 2012-2013 JAF16.7 Page 10 Torgets/indicators lndicators of Objective 4 Geographical ivermectin coverage in former OCP countries with high-risk areas. Therapeutic coverage in ex-OCP high risk countries % of the 4 ex-OCP high risk countries in which communities microfilaria load is below 0.5mf/s o/o of 4 ex-OCP high risk countries in which infectivity rate < 0.5 infective Simulium / 1000 flies lndicators of Objective 5 No. of APOC countries that have submitted plans for the exit of APOC No. of countries using regular budgets to finance onchocerciasis control activities Baseline Year 2007 60% 30% 2s% 25o/" Milestones Year 2007 2 6 Milestones Year 20L2 Year 2013 9s% 99% 75% 80% 80% 700% t.L.2.5 Specific Objective 5 To ensure thot governments ultimotely take full responsibility for onchocerciosis control. Strotegic opprodches o lntensify advocacy at national and regional levels for sustainable financial and technical support to onchocerciasis control and the use of CDI for PHC programmes. o Continue to promote and co-finance sub-regional Ministerial meetings on cross border collaboration for disease surveillance and sustainable financing of disease surveillance by governments. o Assist countries to elaborate the APOC exit plan based on the Programme's Phase ll & Phasing-Out Plan of Action and Budget 2008-2015. o Promote networking and inter-country meetings of APOC projects and exchange field visits of managers in 15 countries. Activities o To provide technical and financial support to 3 countries to develop country APOC exit plans (Burundi, Equatorial Guinea and Liberia). o To undertake advocacy during regional/sub-regional meetings i.e. ECOWAS and RC 59. o To conduct advocacy visits to 7 countries to increase the financial contributions of governments and NGDOs to CDTI activities in the CAR, DRC, Congo, Equatorial Guinea, Angola, Liberia and Sudan' r To conduct financial review visits to projects in 9 countries (Angola, Cameroon, DRC, Ethiopia, Liberia, Nigeria, South Sudan and Tanzania, Uganda) countries to monitor the release of budgeted funds by Governments for onchocerciasis control activities; document the number of countries implementing the Yaound6 Declaration. r To organize and facilitate a meeting of national coordinators of 15 APOC countries on CDTI implementation, status of onchocerciasis control and government contributions to onchocerciasis control actlvities. Torgets/indicotors s0% 75% Milestones Year2OI2 Year 2013 11 t2 cr) oN IN oN q) o)of c0 Ec o c o o o c G IL o oo ,9 o .g o oa o otr o o o tr E(! E" o o- (! o African Programme for Onchocerciasis Control 13 15 II APOC - Plan of action and budget 2012-2013 JAF76.7 Page 11 1.1.2.6 Specific Objective 5 To ceose all APOC operations by 2075 without jeopordizing the past ochievements of OCP ond APOC. Strdtegic approaches o Set up onchocerciasis surveillance systems in 3-4 APOC countries. o Support entomological surveillance activities in 5 OCP countries. e Support drug development to provide countries with a safe macrofilaricide. o Support basic and applied research on surveillance markers for early detection of any decline in the efficacy of ivermectin. Adivities o To collaborate with the MDSC to continue supporting entomological surveillance activities in OCP countries using DNA pool screening techniques, and build the capacity of nationals of APOC countries on disease. o To continue collaboration with Erasmus University on the development of a comprehensive health impact assessment of APOC operations; study and report annually on the health impact of APOC operations. r To co-fund with the West African Health Organization a review and planning meetin8 of the former OCP countries. o To support WHO/fDR operational research on onchocerciasis control. To continue to support the search for a safe Macrofilaricide. o To provide support to countries carrying out operational research through the TCC or the Director/s lnitiative Grant, to strengthen onchocerciasis control. o To provide support to research on surveillance markers for monitoring and early detection of decline in the efficacy of ivermectin. o Co-fund the use of a mathematical model for completing the analysis of RAPLOA to produce a sub-regional map of Loo loa with Lancaster University. o Train and build the capacity of nationals on operational research. o Programme closure related activities. Targets/indicators lndicators of Objective 6 No. of nationals in APOC countries trained on disease and entomological surveilla nce No. of APOC countries which have established onchocerciasis surveillance systems, with APOC support Cumulative number of DALYs gained 1.1.2.7 Gender Mainstreaming gender in APOC operotions. Strategic approaches 4,810,000 8,240,000 9,s40,000 Milestones Year 2007 5 Milestones Year 2Ot2 Year 2013 65 75 25207 a Advocate for greater involvement of women and other disadvantaged groups in decision-making in planning and management of ivermectin distribution at community level, to improve project performance. Advocate to communities, the importance of increasing the number of female CDDs and minorities where appropriate a African Programme for Onchocerciasis Control (o roN ci oN 0) o)o f m !c o c o o o c(! o- 6 oo .t2 o .g(, o o o o o o o E E G E') o o- (E(, L 1 t I JAF16.7 Page tz a Provide women with opportunities for higher level education in epidemiology, entomology and programme managemenU encourage the participation of women in onchocerciasis and other disease control. Support countries to include indicators on gender in all CDTI data collection and analysis.a Activities a To support operational research on the participation in CDTI of women, girls, minorities and other disadvantaged groups. To promote health education that encourages inclusion of women as supervisors and CDDs by communities where appropriate; training more females on CDTI. To document gender issues from existing data on CDTI activities and provide funds to countries to include indicators on gender in the training and data analysis at national, regional and district levels. To encourage women to apply for APOC support for higher education- diploma, short-term courses or MSc in epidemiology, entomology, programme management or any discipline relevant to onchocerciasis control. a a t / a Torgets/indicotors lndicators of Objective 7 % of female CDDs % of male CDDs Milestones Year 2010 2s% 75% Milestones Year2012 Year 2013 30% 3s% 70% 6s% APOC - Plan of action and budget 2012-2013 cf) oN IN oN c) o)of m Ec o C .9 o o C o o- E oo ,9 o .g o o() o () o o o E E G E" o o- (E o L African Programme for Onchocerciasis Control JAF76.7 Page 13 Part2: BUDGET BREAKDOWN AND JUSTIFIGATION APOC - Plan of action and budget 2012-2013 1.2 1.2.1 Budget by technical/operational activity Community-Directed Treatment with Ivermectin lmplementotion (i). Training and capacity building Training, lnformation, Education and Communication (lEC) and capacity building are critical to the success of APOC and to the sustainability of CDTI. The external evaluation team recommended that these activities should be intensified, and measures put in place to ensure that each country has a reservoir of the required technical expertise for onchocerciasis control at senior management levels. Thus, countries will be supported to prepare appropriate IEC messages and disseminate them at all levels. ln 2OO7, based on the recommendations of TCC, the CSA endorsed the recruitment of technical advisors to be resident in 7 post-conflict countries to support project implementation. The costs will be covered in this budget line item. ln addition, CDTI projects will be provided with both financial and technical support to improve the quality and increase the numbers of trained health workers and CDDs. This will greatly enhance the capacity of communities to effectively manage ivermectin distribution, and improve treatment coverage towards the attainment of APOC's goal. ln post conflict countries, additional health staff and WHO surveillance teams will be trained in the CDTI strategy to assist the NOTFs with supervision of CDDs, reporting and monitoring of implementation of CDTI activities. Other activities include: o Training in the CDTI strategy in order to improve supervision and monitoring of health personnel and CDDs, and reporting for Chad, Equatorial Guinea and WHO staff within countries. o lnclusion of the curriculum and training module on the CDI strategy in medical and nursing schools in Africa (30 medical and nursing schools across West, East and Southern Africa); Two Regional workshops and 3 meetings will be held to promote its inclusion. r Revision and dissemination of the APOC manual for training community directed distributors to countries and partners. o Conduct meetings of National coordinators of 11 ex-OCP countries. o Reinforcement of the CDTI strategy in communities with treatment coverage rates below 80%. o Conduct meetings of National coordinators of 15 APOC countries. o lncrease focus on ministerial meetings on cross border collaboration. The Programme will initiate training and capacity building of nationals in Equatorial Guinea, Nigeria, Cameroon, DRC, Chad, Guinea Bissau, Malawi and Uganda in epidemiological evaluations to determine levels of infection in projects with a long history of ivermectin treatment. For the biennium, a total amount of US 52,025,220 has been budgeted for these activities. This represents 5.61% of the total biennium budget with US s1,163,970 for 20L2 and US 5861,249 for 2013. (ii). Community-directedtreatment with ivermectin (Treatment) Funding and technical support will be provided to all projects with less than 8 years of APOC Trust Fund support to increase and /or maintain high ivermectin treatment coverage. Additional financial support will be provided to projects in the 7 post conflict APOC and 4 ex-OCP countries. Appropriate funds will be available to projects which have achieved interruption of transmission of O. volvulus infection to enable them to maintain the achievements and completely eliminate onchocerciasis. The technical advisors will continue to provide in-country support to Nigeria and to the post-conflict countries (Angola, CAR, Chad, DRC (02), Liberia, Sierra Leone and Sudan). cf) ON IN oN o o)of co Ec o c o .F o o c o(L E o o .9, o .g o o() o () o o o E E(E E') o o- (E o L African Programme for Onchocerciasis Control t I JAFL6.1 Page 14 The staff of APOC technical units will continue to provide strong technical support to national projects: SDD unit (11" professional staff members, including technical advisors in the post-conflict countries and one scientist (at P4) to be recruited)/ EVE unit (07 professional staff members). The Programme will strengthen the capacity of countries by providing operational and communication equipment and logistics to facilitate control and surveillance activities. ln the 4 ex-OCP countries (Ghana, Guinea-Bissau, C6te d'lvoire, and Sierra Leone), the re-launching or strengthening of large- scale ivermectin distribution will continue to improve geographical and treatment coverage rates. The total amount budgeted under this line item (US 54,768,722 for year 2012 and US 54,599,546 for year 2013) represents 2594% of the biennium budget for 2072-2013. This amount also includes the cost of supplies and medication for hospitals or district referral health facilities for the management of cases of SAEs, including encephalopathy in patients infected with onchocerciasis and loiasis following ivermectin treatment. ln communities which are experiencing co- endemicity of onchocerciasis and loiasis, district and sub-district health structures are often very weak or non- existent, therefore APOC needs to invest substantially and assist health systems in the management of SAEs. Advocacy, sensitization and health education are of key importance for the success of control operations. These activities, including the preparation and production of appropriate materials, are very expensive. (iii) Developing a Community lnformation Database (ClD) As of mid-2007, 56 CDTI projects had begun entering their data into the community information database (ClD). By the end of 2009, data from 53,000 communities were integrated into the ClD. lt is expected that this number will reach 53,000 communities by the end of 2010. The sum of US 5427,075 representing l.!8% of the biennium budget has been earmarked for implementation of this activity with US 5209,002 for 2Ot2and US s218,073 for20t3. Monitoring ond evoluation of CDTI projects (iv) Monitoring and evaluation During the period 2072-2013, APOC will continue to support the monitoring and evaluation of ivermectin distribution projects. lndependent participatory monitoring, which has been devolved to the national onchocerciasis task forces (NOTFs) will be supervised by APOC management. This activity will be strengthened in post-conflict countries. There will also be a gradual decentralization of APOC management staff functions related to the evaluation of sustainability of CDTI projects to the WHO country offlces and the NOTFs. US 5717,946 or 7.99% of the biennium budget has been earmarked for monitoring and evaluation with US 5440,993 for 2072 and US 5276,953 for 2013. (v) Elimination of infection and interruption of transmission (Epidemiological evaluation and disease surveillance) Resources will be set aside to undertake epidemiological evaluations in 3-5 project sites in 10 countries to assess the level of infection after more than 10 years of ivermectin distribution. This activity will need special equipment and materials for the teams that will be constituted in the countries for the evaluation. Also, it will require recruiting high level consultants and support from MDSC to assist APOC to accomplish the objective. The cost for this activity has been estimated at US 55,380,953 representingT4.g% of the biennium budget with US $3,232,L24 for 2012 and US 52,148,829 for 20!3. The amount includes the cost of additional studies (if necessary) on the epidemiological situation in Ghana and studies on surveillance markers for early detection of any decline in the efficacy of ivermectin. lt will also include the cost of special meetings of experts and of regional and district health professionals as well as cross-border meetings on su rveilla nce APOC - Plan of action and budget 2012-2013 (r) oN N oN o o)of(D oc o c o o o C o(L E oo .12 o .g(, o o o o o o o E E(! En o o- (g o African Programme for Onchocerciasis Control i \ APOC - Plan of action and budget 2012-2013 JAF16.7 Page 15 (vi) Assessing the health impact of APOC operations A comprehensive health impact assessment of APOC operations will be conducted along with a sensitivity analysis by Erasmus University of Rotterdam (under a special agreement) in order to improve the evidence base for prediction and validation of results and train nationals on modelling. An updated Onchosim model will be available to countries and projects for direct use in the management and planning of control activities. For the biennium, the cost of this activity has been estimated at US S991,700 representin g 2.75% of the total biennium budget with US s842,277 for 20L2 and US 5749,423 for 2013. (vii) lmprovinggeographiccoverage Technical assistance will be provided to countries for verification of attainment of 100% geographical coverage. Total amount of fund allocated for this endeavour is US 5383,687 representin g 706% of total biennium budget with US s2o3,777 for 2Qt2 and US srZg,gro for 2013. Note: The totol omount to be ollocoted to CDT| octivities during 2072-2073 is US$ 23,980,779 out of o totol budget of u's 36,708,600 (i.e. 66% oI the budget (see toble 4)). 1.2.2 Strengthening health systems / Integration of CDTI and co-implementation with other health interventions Mapping of NTDs in APOC selected countries to maintain high ivermectin treatment coverage and support PHC activities Support will be provided for the completion of NTD mapping in selected APOC countries (Angola, Chad, DRC, Ghana, Mali, Nigeria, Sudan, and Uganda). ln addition to providing material resources - such as special vehicles and equipment to access hard-to- reach communities in CDTI projects, APOC will continue to make contributions towards building the capacity of countries' health systems in co-implementation and integration of CDTI. APOC will, through meetings and workshops, continue to invest in Advocacy visits at inter-national, national, regional, and local levels. The Programme will also contribute to the development of tools, guidelines and training manuals on integrated delivery, supervision and M&E using the CDI strategy to strengthen PHC. The programme will support the cost of activities for inclusion of the CDI strategy into the curriculum of nursing and medical schools. By the end of 2073, the CDTI network and strategy will become an integral part of the primary health system of some countries thereby increasing projects'potential to maintain high coverage of the population with ivermectin treatment. An expected total of 65 CDTI projects will be co-implemented with multiple health interventions in 2013; APOC will also co-finance the co-implementation of home management of malaria and CDTI in 2 to 3 countries in collaboration with NGDOs and MAL/AFRO. These activities will be supported with the APOC Trust Fund at a cost of US 52,441,4L9 (covering integration, co-implementation and capacity building of nationals in operational research), representing 6.76% of the total biennium budget with US S1,363,139 for 2012 and uS sr,oza,zeo for 2073. 1.2.3 Research and Macrofil project As recommended by the Working Group on the future of onchocerciasis control and as stated in the Plan of Operations, substantial operational research is needed to strengthen the scientific basis of APOC, to adequately address challenges associated with the implementation of the CDTI projects and to help countries in decision-making. Most of the operational research will be conducted by the countries in collaboration with TDR and various national research institutions. A total of US 51,029,249 or 2.85% of the biennium budget has been earmarked for these important research activities as follows (US 5400,000 each year) for new research on a safe Macrofilaricide and US 5229,249 (US S105,692 for year 2012, US 5L23,557 for year 2013) for operational research. The budget for the research on Moxidectin will be covered largely by Wyeth pharmaceuticals. African Programme for Onchocerciasis Control cf) oN IN oN o o)Ef m oc o c o .E() o c o(L E oo ,9 o .g() o(J o .co o o o E E(! E') o o. (E o t I I IJ JAF1.6.7 Page 16 1.2.4 Enhancing the participation of Women and minorities in CDTI: mainstreaming gender New opportunities will be provided to increase the involvement of women in decision-making in CDTI at community level. CDTI projects will be supported to increase the number of female CDDs trained. APOC will provide academic scholarships to men and women in higher education in epidemiology, entomology and surveillance. The Programme will encourage and promote the participation of women in onchocerciasis and other disease control and mainstream gender in the collection and analysis of data. US 5570,381, representing 1.58% of the total biennium budget has been allocated to this activity with US S:SZ,SOS for year 2012 and US 5218,073 for year 2013. 1.2.5 Partnerships (i) Collaboration with WHO/AFRO, WHO/Geneva/WHO/MDSC and the NGDO coordinatoy's office Collaborative activities will continue and will increase slightly until 2013 in order to strengthen the decentralization process. The WHO country offices and APOC partners, as well as NGDOs will then progressively take over the programme's responsibility. The total cost for this collaborative effort is estimated at US 5409,108, or t.t3% of the total biennium budget with US 5169,108 for 2OL2 and US S24O,OOO for 2O!3. (ii). Missions to strentthen partnerships To strengthen CDTI activities, APOC will reinforce its advocacy at all levels. A total of USS720,310, representing !.99% of the biennium budget is earmarked for this budget line item with USS 365,831 for 20t2 and USS 354,479 for 2013. (iii). Statutorymeetings For the organization of the two statutory meetings of the TCC, as well as two to three statutory sessions of the CSA and the JAF meeting, an amount of US 5540,575, representing L.5O% of the total biennium budget is earmarked with US 5274,800 for 2072 and US 5265,775 for 2073. The amount will cover the cost of travel and per diem of the Programme staff members and consultants as well as the cost for the preparation for these meetings. (iv). Programmeclosureactivities An amount of US S1,245,589, representing 3.45% of the total biennium budget is earmarked with US 5474,262for2012 and US 5771,,327 for2OL3 will set aside for program closure related costs such as: setting up of programme closure committee, personnel liability and legal issues, premises, land title and legal, equlpment and inventory, vehicle renovation, account closure, post APOC closure team, etc. 1.3 1.3.1 Budget by administrative/management activity Human resources, Management & Logistic (i) Human resource management and administration During the period 2012-L3, existing staff (professional and general services) reinforced by temporary appointment will provide efficient support to the implementation of technical and managerial activities for estimated cost of US 54,166,264, representin g LL.54% of the biennium budget, with US 52,295,670 for 2Ot2 and US S1,870,594 for 2013. (ii) Office supplies, equipment/logistics and printing Additional office equipment (including computers) will be purchased for new staff members and also to replace those that are no longer functional. The cost for the production of documents for statutory meetings is also taken into account in this section. An amount of US 5459,450 representingT.2T% of the biennium budget will be allocated to this budget line item for with US 5232,523 f or 2072 and US $225,927 for 2013. APOC - Plan of action and budget 2012-2013 C9 oN IN oN o) o, <,l m E c o c .o o o G(L 6 oo ..2, o .g o oo o o o o o E E(! E'I o o- c(E(J African Programme for Onchocerciasis Gontrol APOC - Plan of action and budget 2012-2013 JAFL6.7 Page !7 (iii). Operating cost / Maintenance of equipment/vehicles at APOC HQ An amount of US 5545,477 representin g !.51% of the total biennium budget with US 5225,477 for 20L2 and US 5320,000 for 2013, has been set aside for the maintenance of APOC Headquarters buildings as well as general running costs of the offices and replacement of some vehicles including those inherited from OCP after its closure in 2002. 1.3.2 Summary of 2012-2013 biennium budget On the basis of the detail provided above, concerning the expenditures planned for the Programme in 2010-201L, tables and figures illustrating the breakdown of the annual budget are presented below. Table 3: Planned cost per specific objective No Specific Objective Planned cost (3US) Yeat 2012 Year 2013 1 To establish sustainable onchocercaasas @ntrol programmes in allAfraEn ountries where they are needed (Obieclive 1) 7,062,0'14 6,505,951 2 Io implement onchoceroasrs control actrvties rn conlunctron wrth other heanhintsruentions (co-im plementation) [Obie6live 2l 1,083,347 838,218 3 To determine when and where ivermeclin treatrnent €n be stopped and to provide guidan@ to countries on preparing to stop ivemectin treatment (Objective 3) 5.294.902 3.402.499 4 To reduce the risk of transmission of onchoerciasis from fomer OCP countries whose epidemiological and entomological situation threaten neighboring countries in which the disease has been brouoht under control (Obiective 4) 449 207 714,750 5 To ensure that govemments ultimately take full responsibility for onchocerciasis @ntrol (Obiective 5) 665,650 61 7.591 6 To cease all APOC operalaons without jeopardizing the past achaevements of OCP and APOC (Obiective 6) 1,221.154 1,644,464 7 Gender - Mainstreamino oender in APOC ooerations (Obiective 7) 352 308 214 O73 8 To provide adequate human resoures, materials and equipment at APOC Saqetariat ftr efficient administration and management of the Programme (Obiective 8) 2,913.618 2.724.853 TOTAL 19,42,200 16,666,400 African Programme for Onchocerciasis Control cf) oN IN oN q) o)Ef d) '1, c o c o o o co(L o o o ,a2 o .g(., o(J o o o o o E E G E" o o- oo Totulyars2U2-13 (Sus) ,1 447 q6i a7 5e I 921 566 5 7)o/" 8.697.lu)1 24.O9o/o I 563 957 4 3ao/6 1-28'3_2t1 3.55o/o , nir atx 'f qao/" 570_3at 1 5Ao/a 5.634.47t 15.62Vo 'I UU-UUYo { I APOC - Plan of action and budget 2012-2013 JAFL6.7 Page 18 Table 4: Proiected annual Trust Fund expenditure by technical/operational and administrative/management activities 20t2-20L3 (USS) - continue on next poge cf) oN IN oN o o)Ef co Ec o c o o o c G(L o oo ,12 o .E o oo o o o o o E(E El) o o- (E o No Amount (usD) Sub total % Amount (usD) Sub total % 1 CDTI L7 555 421 64% 13 183 390 68% lmplementotion t4346 421 52% 8 557 996 45% Diseases mapping (REMO/RAPLOA) 40 000 Training and capacity building in CDTI 2367 390 1 153 970 CDTI - Community database 150 000 209 002 Technical advisers to post-condlict countries 2 21.3 000 1. 900 000 Treatment 8 057 564 4768722 Equipment/ Supplies and logistics for countries 9t8 467 422 526 lmprovement od Geographic coverage (identidication of untreated communities) 600 000 203 777 M o n ito ri n q / Eva I uoti o n /s u ru e i ll a n ce 894 000 3% I 283 270 7% Monitoring and evaluation of CDTI 794 000 440 993 Health impact assessment of APOC operations 100 000 842 277 Elimination 2 315 000 8% 3232124 17% Epidemiological evaluation (Assessing indection trends) 1 985 000 3 161 553 Disease surveillance (collaboration with MDSC) 330 000 70 462 2 Strengthening health systems 3 170 000 11% 1 353 139 7% lntegration od CDTI into the health systems 460 000 530 061 Co-implementation od multiple health intervention 2 5r.0 000 704 616 Building capacity od nationals in operational research 200 000 r28 462 3 Research and Drug development 1 245 000 5% s05 692 3% Operational research studies 545 000 10s 692 Macrofil proiect 700 000 400 000 4 Partnerships 72L750 3% 1 284 000 7% Missions / Workshops/Meetings to strengthen partnerships 331 750 534 939 Statutorv meetings 390 000 274 800 Programme closure related activities 474 262 5 Gender 710 000 3% 352 308 2% Mainstreaming gender in APOC operations 710 000 3s2 308 6 Human resources, Management Losistic 4t82829 15% 2753 670 14% Human resources and management 3 957 829 2295 670 Equipment/ Supplies and logistics of HQ/APOC 225 000 458 000 Total African Programme for Onchocerciasis Control Planned for yeat 2012 27 585 000 100% 1944.2200 700% APOC - Plan of action and budget 2012-2013 JAFL6.1 Page 19 Table 4: Projected annuat Trust Fund expenditure by technica!/operational and administrative/management activities 2OL2-2013 (USS) - continued No Amount (usD) Sub total % Amount (usD) Sub total % 1 CDTI 10 797 389 65% 23 980 779 66% lmplementotion 8222184 49% 16 890 180 47% Diseases mapping (REMO/RAPLOA) Training and capacity building in CDTI 861249 2 02s 220 CDTI - Community database 2L8 073 427 075 Technical advisers to post-condlict countries L 900 000 3 800 000 Treatment 4 599 545 9 368 258 Equipment/ Supplies and logistics for countries 463 405 885 931 lmprovement of Geographic coverage (identidication of untreated communities) t79 970 383 587 M o n ito ri n g / Evo I u ati o n /s u rue i ll a n ce 426 376 3% t709il6 4,7i% Monitoring and evaluation of CDTI 276953 7L7 945 Health impact assessment of APOC operations L49 423 991 700 Eliminotion 2L48829 73% 5 380 953 14,90% Epidemiological evaluation (Assessing indection trends) 2 066 458 5 228 120 Disease surveillance (collaboration with MDSC) 82 371. 152 833 2 Strengthening health svstems t078280 6% 24pL419 6,76% lntegration od CDTI into the health systems 415 372 945 373 Co-implementation of multiple health intervention 545 183 t 249 798 Building capacity of nationals in operational resea rch 117 786 246 247 3 Research and Drug development 523 557 3% 1029249 2,85% Operational research studies L23 557 229 249 Macrofil project 400 000 800 000 4 Partnerships 1 631 580 70% 2 915 581 8% Missions / Workshops/Meetings to strengthen partnerships 594 479 7L29 4L7 Statutory meetings 265775 540 575 Programme closure related activities 77t 327 1 245 589 5 Gender 2L8073 7% 570 381 1,58% Mainstreaming gender in APOC operations 21,8 073 570 381 6 Human resources, Management Logistic 2417 52r 75% 5 L7ttgl 74,32% Human resources and management 1 870 594 4 166 264 Equipment/ Supplies and losistics of HQ/APOC 546927 t 004 927 Total African Programme for Onchocerciasis Control (r) oN IN oN o o)! :f,(D io c o c o o o c$ o- 6 oo .t!, o .g o o o o !() o o o E E G' E'I o o- tr oo L a Planned for vear 2013 Planned for year 2Ol,2-L3 15 666 tr00 100t 36 108 600 100% ti I JAF1.6.7 Page 20 Figures 4: Technical/operational and administrative cost for years 2OL2-2OL3 Technical / Operational cost 85.68% Administrative / Management cost 14.32% N B: ln detail, amounts allocated to tech n ical/operational costs represe nL83.24% in year 2012 and 82.22% in year 2013 compared to the total budget for each year. Table 5: Projected cost by country / site in 2012-2013 APOC - Plan of action and budget 2012-2013 (r, oN IN oN o o) 'rc :f d)p c o c o o o c o o- o oo ,2 o .g o o o oE o o o o E E(! Et) o o. o() L 't,587 368 5,0'14 3,250 39,011 6,778 459,073 222,417 6s8,767 933,688 1,748,263 239,1 99 417,0',t9 137,562 462,305 6'18,500 1,s88,803 124,564 Burundi 1 DRC Liberia to 73 proiocts in stable countries Cameroon Congo Eq. Guinea Ethiopia Malawi Nigeria 9,640 770 't29 23,190 2,186 36,430 3,931 1,750,169 105,016 535,980 292,355 273,517 1,868,252 1,080,701 1,049,582 153,810 304,508 251,013 223,052 '1,471,338 834,130 631 support to 5 ex-OCP countries 93,187 169,159 93,187 80,959 148,425 55,466 d'lvoire 709Leone Bissau to national projects 12,248,585 100% 9,166,516 1 African Programme for Onchocerciasis Contro! Communities Year 2O1|2 o/o Year 2013 total Year 2012 Year 2013Communities o/o 81 556,252 5% 473,753 5o/o APOC - Plan of action and budget 2012-2013 JAF16.7 Page 21 Figure 5: Annual Trust Funds Expenditure (1996-2010), Financial requirements (2011-2013) (US S million) and number of CDTI projects 35.m 30.m 25.m 20.m 15.00 10.00 5.00 120 100 80!o o!g a U'3 o E .9 E o o o 60 o oI E - 40 20 0 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 r Annual Trust Fund Expenditure and Financial requhements +Number of CDTI projects t9'{ $r.gr $a.ss 't 10 327.59 $25.49 74 $19.44 $6.67 t15.50 $12.55 s11.08 $9.36 $4.2s $0.63 $13.43 gt3.5o l.to 110 $29.83 Cf) oN IN oN o o)ioJ d) Ec o c o o o c o(L o oo ,9, o .g o o,o o o o o o E E(E E) o o- oo African Programme for Onchocerciasis Control t E oo .12 o .g o o o o oc o o o E E(E ED o o. tr oo c5u 5 F(J o o- ui o) bos '5 3 0.) (o o o_ c,(J x 0., G,I! =L c f oo .() E oEc o,) oo E .9 ,q (o 'o oU o -cUc o (o -c ooc = o -c o U d. 0) -c -cv =i o .o(!(, .= tro(J oE o t o&i(gC LO0)o c>.!m(!!99 o- YoJ ==-26P3a >;t!!E.L *g c.i I Ztq (n HoN IN o .E t,o@ Gc(! E !,tr G !, o g o Eg CL .E oll o L o CL CL , d I rFo2 -lc o tro(, o o r .Etr .9 t!z o c,lt E 3tr !,o(! E 1! d xocg f\ 6l dN rl(lJt! bog3 F - N dd N 6N 6 r Zd? >EL El N d ._9-- FrdoY;- = l:.: 7,:4Y;oa E= h *.8a a,.E g=E€5EgE E :, =E (t0 n-a O a N N o N rN r d .:2 E 9 uF EE9.= X ineEzi F € d d N €d a r € :n!a -o '= o'>EL tl N N ? .9-at s a.!.z{';!. ->E = | u.I c 4.. E tr =E€5EEi E :, =E 6JU dO3 a d ON 6 N rN r N N .:2E g uF E >!i.=: :u?EzI z n h O Q z oil t ao a E O ?O E () au oO O a cid q o o 3 (5 !J { z ! d N F. ! tr uf N o <o() () (, o J 3 llI ll ll I I I I I lllllllilll (f) oN IN oN q) o,!f -o E c o c. .9 oo o C(E (L o o(L JAF76.7 Page 23 Annex 2: Average unit costs used for budget calculations a 20t2-20L3 2010-2011 2009 * 2008 * Staff Professionals -01-D2 - P4-P5 - P2-P3 - STP4-STP5 - STP2-STP3 - NPO-OB - General Services . STG - Consultant/month - Temporary staff/month (General Services) 291 000 232 500 L77 500 L77 500 145 500 40 000 28 500 28 600 10 100 291 000 232 500 L77 500 L77 500 145 500 40 000 28 600 28 600 10 100 334 000 232 000 194 000 334 000 232000 194 000 39 000 30 000 39 000 30 000 9 900 9 900 28 600 28 600 1200 1 200 Dollar equivalent - CFA Francs (XOF) - Euros (EUR) -Swiss Franc (CHF) - Pound sterling (GBP) - Canadian dollar (CAD) - Japanese Yen (JPY) 487 0.807 1.053 0.543 1.042 89.31 458 0.712 1.100 0.613 L.122 97.50 450 0.585 1.105 0.498 r..009 118.50 480 0.737 1.199 0.496 1.059 116.00 a * Since the biennium 2008-2009, salary costs and non-payroll costs are combined for each staff member of WHO. APOC - Plan of action and budget 2012-2013 African Programme for Onchocerciasis Control Boo .69 9*aEXiu- fEEg =EO5<Oc i eo t c! o; 56 o ; >qo-! E<eob:g 3o e e obgE o FL(9 9a :E odU eff oo9trFr-2o=!eE 6c 33 i o E" E EEP ooc <E EE6E Eg6a <E F .2 o9aO;. =tro EE ;6 .=2 ! HBEip fiEEEE"<Q. c2 EE. 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