ua WORLD HEALTH ORGANIZATION ORGANISATION MONDIALE DE LA SANTE SEVENTEETH MEETING OF NGDO COORDINATION GROUP FOR IVERMECTIN DISTRIBUTION Itlarch 20103101 1 2. CONCLUSIONS & RECOMMENDATIONS The meeting accepted the minutes of the ad hoc meeting held in Yaounde (December 2000) and asked that they be included in the report of the proceedings of this meeting. The Group endorsed the nomination of Dr Elizabeth Elhassan as representative on the TCC, replacing Dr Christine Godin, and Moses Katabarwa as the NGDO alternate representative. The Group agreed that the nomination of a NGDO representative to replace Dr Adrian Hopkins on the TCC in 2002 be reviewed at the next meeting. The Group noted with regret that the number of people being treated in Chad has been decreasing each year, in spite of visits by APOC management and OPC to try and improve performance. As the Commitment from the Government of Chad to onchocerciasis control is open to question, the NGDO Group requests the TCC to consider the case for continued intervention in Chad. A sub-committee r*,as create to develop an article for scientific publication on the success story of the Group. The Group recommended that this be submitted for publication as soon as possible. The Group noted the value of continued dialogue with the UN Foundation and recognized the Foundation as a potential source of funding for community based activities particularly in OCP areas. NGDOs interested in pursuing funding from the Foundation should discuss this opportunity with MDP The Group agreed that there was the need to clarify the use and management of the possible Gates Foundation Fund independent of normal APOC guidelines. The NGDO Group endorsed the recommendation from the Meeting of Representatives of National Onchocerciasis Task Forces of APOC countries which stated that "the NOTFs, and not just the international NGDOs, should be responsible for contacts with potential local NGDO partners". Potential NGDOs able to demonstrate that they fulfil the established criteria should be encouraged to apply through the NOTF for APOC funding. The Group notes that the mid-term evaluation found "NGDOs internationally and nationally have tlirougli their financial and human resources contribution been a pillar of these partnerships..". The Group also noted that the mid-term evaluation report recommended "The conrposition of the CSA should be reviewed in view of evolving changes in the partnership". It is the position that it be accorded full membership on the CSA in Phase tI of APOC. The Group reaffirmed its recommendation madeat itsl6'l'Meeting, that Sierra Leone be includcd in the Phase II APOC programme. 3 4. 5 6. 7 8 9 It I t 10 11 12. r3. 14 15 3 The NGDO Coordination Group requests a written confirmation from the NOTF, Cameroon that the MEC/TCC recommendations on treatment in areas of co-infection have been implemented. Whilst waiting for this response, members of the Group will not participate in treatment in areas where these recommendations have not been put into effect. If the MofvCameroon and NGDOs do not succeed in establishing structures to manage the in-country onchocerciasis programme effectively, the NGDO Group recommends the recruitment for a new post. The person recruited would reside in Cameroon and be mandated to build capacity in the NOTF and NGDO Coalition and would assist in the implementation of the recommendation in areas of co- infection. It was recommended that the post be for a minimum of 2 years (2 treatment cycles in affected areas) and the post should be supported under Technical Assistance from APOC funding. The Group received with appreciation the presentation from Sight Savers International regarding its activities and its success in using CDTI as an entry point for eye care services. The Group noted the added value NGDOs bring into health and development activities within participating countries. The Group reviewed the document "An investigation into the administrative requirements of the African Programme for Onchocerciasis Control" by Prozesky et al., which was commissioned by the Group with support from MDP. The Group noted that the conclusion of the study was that APOC administrative overburden has a negative impact on CDTI. The Group once again expressed its appreciation to Merck for the intense testing it has undertaken on the stability and shelf life of Mectizan and noted the enormous significance the results have for the programme. The NGDO Group members expressed their appreciation for all the work done by Pamela Drameh, the NGDO Coordinator at WHO Geneva, and were unanimous in the proposal to prolong her contract for 2years. It was noted that the next steps were to proceed with the iormalities. The Group expressed concern, however, that with all the NGDO Coordination activities for APOC, OCP and OEPA, the coordinator was at risk of being over burdened in the light of the additional work generated by the Gates proposal and the attempts to interest more European NGDOs. Therefore it is the position of the Group that the Coordinator not act as rapporteur for any extra APOC meetings. The NGDO Group having studied the MSF article entitled "Hidden Price Tags: Disease-Spccific Drug Donations: Costs and Alternatives" noted that ivermectin distribution is an example of a sustainable single disease drug donation that has resulted in the alleviation of much misery due to onchocerciasis (both eye and skin disease) using a partnership model that has also led to a unique private/public relationship. It has led equally to the development of the Community Directed Treatment model which is becoming a model for other disease control activities. This negates completely the first conclusion in the article and questions the other conclusions. 16. The Group reviewed and approved the revised membership criteria t7 The Group approved a formula for members to report by June 2001 to the NGDO Coordinator thc direct and indirect costs they incurred in Year 2000 in support of projects. This effort is designed to determine the true cost of the Groups contribution to onchocerciasis control programmes. ln preparation for the Phase ll of APOC, the Group reviewed the report of the recent mid-term evaluation, the report of the meeting of the representatives of the NOTF and the APOC phase Il progranlme docurnent outline. The conclusions and recommendations for.rnd in this report rvill bc presented to the next TCC and CSA. l8 ta t9 The Group received with appreciation reports on the LF Initiative from Drs Guntam Biswal, Johnny Gyapong and Professor David Molyneux. It is becoming clear to the Group that the LF programme strategies are developing at individual country level. Country coordinators will need to explain to interested NGDOs, their possible roles in these initiative. The NGDO Group stands prepared to act as a forum for this contact. 20. It was agreed that the LSth meeting of the Group will take place on 5 - 7 September 2001 in Geneva. I I
ua WORLD HEALTH ORGANIZATION ORGANISATION MONDIALE DE LA SANTE SEVENTEETH MEETING OF NGDO COORDINATION GROUP FOR IVERMECTIN DISTRIBUTION Itlarch 20103101 1 2. CONCLUSIONS & RECOMMENDATIONS The meeting accepted the minutes of the ad hoc meeting held in Yaounde (December 2000) and asked that they be included in the report of the proceedings of this meeting. The Group endorsed the nomination of Dr Elizabeth Elhassan as representative on the TCC, replacing Dr Christine Godin, and Moses Katabarwa as the NGDO alternate representative. The Group agreed that the nomination of a NGDO representative to replace Dr Adrian Hopkins on the TCC in 2002 be reviewed at the next meeting. The Group noted with regret that the number of people being treated in Chad has been decreasing each year, in spite of visits by APOC management and OPC to try and improve performance. As the Commitment from the Government of Chad to onchocerciasis control is open to question, the NGDO Group requests the TCC to consider the case for continued intervention in Chad. A sub-committee r*,as create to develop an article for scientific publication on the success story of the Group. The Group recommended that this be submitted for publication as soon as possible. The Group noted the value of continued dialogue with the UN Foundation and recognized the Foundation as a potential source of funding for community based activities particularly in OCP areas. NGDOs interested in pursuing funding from the Foundation should discuss this opportunity with MDP The Group agreed that there was the need to clarify the use and management of the possible Gates Foundation Fund independent of normal APOC guidelines. The NGDO Group endorsed the recommendation from the Meeting of Representatives of National Onchocerciasis Task Forces of APOC countries which stated that "the NOTFs, and not just the international NGDOs, should be responsible for contacts with potential local NGDO partners". Potential NGDOs able to demonstrate that they fulfil the established criteria should be encouraged to apply through the NOTF for APOC funding. The Group notes that the mid-term evaluation found "NGDOs internationally and nationally have tlirougli their financial and human resources contribution been a pillar of these partnerships..". The Group also noted that the mid-term evaluation report recommended "The conrposition of the CSA should be reviewed in view of evolving changes in the partnership". It is the position that it be accorded full membership on the CSA in Phase tI of APOC. The Group reaffirmed its recommendation madeat itsl6'l'Meeting, that Sierra Leone be includcd in the Phase II APOC programme. 3 4. 5 6. 7 8 9 It I t 10 11 12. r3. 14 15 3 The NGDO Coordination Group requests a written confirmation from the NOTF, Cameroon that the MEC/TCC recommendations on treatment in areas of co-infection have been implemented. Whilst waiting for this response, members of the Group will not participate in treatment in areas where these recommendations have not been put into effect. If the MofvCameroon and NGDOs do not succeed in establishing structures to manage the in-country onchocerciasis programme effectively, the NGDO Group recommends the recruitment for a new post. The person recruited would reside in Cameroon and be mandated to build capacity in the NOTF and NGDO Coalition and would assist in the implementation of the recommendation in areas of co- infection. It was recommended that the post be for a minimum of 2 years (2 treatment cycles in affected areas) and the post should be supported under Technical Assistance from APOC funding. The Group received with appreciation the presentation from Sight Savers International regarding its activities and its success in using CDTI as an entry point for eye care services. The Group noted the added value NGDOs bring into health and development activities within participating countries. The Group reviewed the document "An investigation into the administrative requirements of the African Programme for Onchocerciasis Control" by Prozesky et al., which was commissioned by the Group with support from MDP. The Group noted that the conclusion of the study was that APOC administrative overburden has a negative impact on CDTI. The Group once again expressed its appreciation to Merck for the intense testing it has undertaken on the stability and shelf life of Mectizan and noted the enormous significance the results have for the programme. The NGDO Group members expressed their appreciation for all the work done by Pamela Drameh, the NGDO Coordinator at WHO Geneva, and were unanimous in the proposal to prolong her contract for 2years. It was noted that the next steps were to proceed with the iormalities. The Group expressed concern, however, that with all the NGDO Coordination activities for APOC, OCP and OEPA, the coordinator was at risk of being over burdened in the light of the additional work generated by the Gates proposal and the attempts to interest more European NGDOs. Therefore it is the position of the Group that the Coordinator not act as rapporteur for any extra APOC meetings. The NGDO Group having studied the MSF article entitled "Hidden Price Tags: Disease-Spccific Drug Donations: Costs and Alternatives" noted that ivermectin distribution is an example of a sustainable single disease drug donation that has resulted in the alleviation of much misery due to onchocerciasis (both eye and skin disease) using a partnership model that has also led to a unique private/public relationship. It has led equally to the development of the Community Directed Treatment model which is becoming a model for other disease control activities. This negates completely the first conclusion in the article and questions the other conclusions. 16. The Group reviewed and approved the revised membership criteria t7 The Group approved a formula for members to report by June 2001 to the NGDO Coordinator thc direct and indirect costs they incurred in Year 2000 in support of projects. This effort is designed to determine the true cost of the Groups contribution to onchocerciasis control programmes. ln preparation for the Phase ll of APOC, the Group reviewed the report of the recent mid-term evaluation, the report of the meeting of the representatives of the NOTF and the APOC phase Il progranlme docurnent outline. The conclusions and recommendations for.rnd in this report rvill bc presented to the next TCC and CSA. l8 ta t9 The Group received with appreciation reports on the LF Initiative from Drs Guntam Biswal, Johnny Gyapong and Professor David Molyneux. It is becoming clear to the Group that the LF programme strategies are developing at individual country level. Country coordinators will need to explain to interested NGDOs, their possible roles in these initiative. The NGDO Group stands prepared to act as a forum for this contact. 20. It was agreed that the LSth meeting of the Group will take place on 5 - 7 September 2001 in Geneva. I I