Final communique of the eleventh meeting of the national onchocerciasis committees: Bamako, 3-5 June 1987

Onchocerciasis Control Programme ln West Afrlca Programme de Lutte contre I'Onchocercose en Afriq.re de l'Ouest. JOINT PROGRAMME COMMMTEE Office of the Chairman JPC . CCP COMTTE CONJOINT DU PROGRAMME Bureau du Prdsident JPCS/rNF/DoC.2 ORIGINAL: ENGLISH September 1pB/ JOINT PROGRAMME COMMITTEE Eighth session Rome. 30 November - 3 December 1987 INPORMATION DOCUMENT FINAL COMMI.]NIQUE OF T}IE ELEVEI{TH MEETING OF THE NATIONAL ONCHOCERCIASIS COMMITTEES(Bamako, 3-5 June 1987) The eleventh session of the National Committees of the Onchocerciasis ControlProgrnmme was held at the Sub-region I Headquarters of the Africa Region of the WorldHeal-th 0rganization in Bamako at the kind invitation of the Government of Ma1i. The eleven Participating Countries, Benin, Burkina Faso, COte d'Ivoire, Ghana, Guinea,Guinea-Bissau, Ma11, Niger, Senegal, Siema Leone, and Togo were represented. FA0,UNDP' world Bank and wHO participated in the meeting as observers. The opening session, presided over by H.E. the Prime Minister of Mali, was addressed and opened by the Minister of Public Health and Social Affairs of Ma1i. Theformer chairman, the Minister of Health of Benin, made a statement related to thepast year's activities. The Minister of Public Health and Social Affairs of Mali was subsquently elected to chair the session. H.E. Minister of public Health and SocialAffairs of the Republic of Guinea was elected vice-chairman. The representative of the Regional Dj.rector of the IIHO Regional Office forAfrica, relayed to the session the apologies of Dr G. L. Monekosso for his inabilityto attend due to other engagements and stressed the keen interest that the RegionalDirector maintained in the Programme. The Programme was currently facing a crisis and it was important that the extensions, and devol-ution be carefully considered.The Regional Director was certain that the Participating Countries could successfu115, assume responsibility, especially with ivermectin becomi-ng available, if the district approach was applied and the countries worked closely together with OCp and !iH0. He was convinced that the frank and deep dialogue, which would take place during the session, would result in a satj,sfactory solution being found to the presentdifficul"ties. The Director of OCP summarized the situation in the Programme since the seventh session of t.he Joint Programme Committee (JPC). The progressive spread in resistancerequiring the greater use of alternative larvicides substantially more expensive thantemephos, coupled with the continued fa11 in do1lar vaIue, was presenting theProgramme with budgetary constraints. Despite strict financial management and curtailment of peripheral activities, the funds currently availablu ,.". inadequateto support the extension operations according to the timetable already drawn up. Theextent to which ivermectin could be used with or without larviciding woutd beinvestigated in 1987 and 19BB and a modified strategy with costs presented to theDonors and JPC at the end of 1!BB. The original objective of Ocp would bemaintained. A significant reduction in the cost of Bacillus thuringiensis H-14(8.t. H-14) been obtained and improved formulations rere Uei.ns tried-3ut thesituation regarding the cost of ivermectin after 1!88 was unclear. Contacts werebeing continued with the pharmaceutj,cal company concerned in this respect. Some advances had been made towards finding a macrofilaricide. \ \. JPCB/INF/DoC.2 page 2 In introducing the item of devotution, the Prograrnme Director explained that the paper presented was in response to the JPC request for summary guidelines and budget clarification. It had to be recogni-zed that devolution was a dynanic activity and the availability of a drug would greatly facilitate its implementation. In its discussions, the delegates stressed the importance of mu1ti1atera1, in preference to bilateral, funding for devolution in order to ensure a harmonized common approach and integrated action by the countries. Those countries who had presented reports to the JPC confirmed some activities were being implemented but enphasized that further advances would be dependent on extra funding. The potential large-sca1e distribution of ivermectin would require carelul planning and identification of costs, and considerable concern was expressed at the lack of clarity regarding the possible price of ivermectin as this could be a major factor in the cost of devolution. The Director was urged to pursue this matter urgently with the pharmaceutical company. The delegates requested the opportunity to suggest modifications to the devolution document before it was sent to the JPC and it was agreed that a revised version would be circulated to them by end of September 1987. As socioeconomic development of the Onchocerciasis area was now the responsibility of the Committee of Sponsoring Agencies (CSA), the World Bank Representative gave a resum6 of action taken since JPC.]. A contract for the Preparatory Phase Work Programme was about to be signed, details of which were presented by the OCP economist. UNDP outlined the proposal for resettlement studies in the countries and requested comments on it from the participants. The draft terms of reference hrere endorsed and the delegates expressed the wish that the study proceed without deIay. The delegates welcomed the current round of consultations by the CSA with each of the Participating Countries to discuss the scope, content and institutional arrangements for socioeconomic development of the oncho-controlled zones. The representatives of the Participating Countries described their own experience with regard to the resettlement of the oncho-controlled zones as well as the development of those zones. However, the delegates present stressed that socioeconomic devetopment was the responsibility of others in their Governments and considered that the NOC meeting, as constituted, was not a suitable forum to discuss this subject. Several delegations reviewed the current composition of their National Onchocerciasis Committees. Discussions then took place as to the changing roles of the NOCs as the emphasis moved in the Countries from control by OCP to devolution on the one hand, and, on the other, to the socioeconomic development of the areas where onchocerciasis had been controlled. The CSA and OCP would continue to reflect on this subject with the countries, particularly with regard to participation at meetings and the result of this reflection would be presented to the next NOC session. Regarding the timetable for the extension of operations into the Senegal basin the Director of OCP stated that this would depend on the revised strategy but it was planned that the ivermectin field studies would start in that area by the end of 1988. In response to the question from the Minister of Public Health and Population of COte d'Ivoire concerning the recommendation of the JPC.] in Accra on the study of forest onchocerciasis to be made by the Expert Advisory Committee (EAC) in C6te d'Ivoire, the Programme Director said that he would remind the chairman of the EAC of this matter. ( aJ JPCB/rNF/DoC.2 page 3 Following an invitation by the delegation of Guinea, it was agreed that the twelfth session of the National Onchocerciasis Committees would be held in Conakry during the first week of June 1988. The meeting expressed its sincere gratitutde to the Government of Mali for the warm welcome and the hospitality extended to the participants and for the efficiency of the conference arrangements which greatly contributed to the successful conduct of the meeting. The delegates unanimously requested the chairperson to convey their best wishes to His Excellency the President Moussa Traor6, President of the Republic of Mali, Secretary General of UDPM, and the People of Mali.