Plan of action and budget for 1995

t t Onchocerciasis Control Programme in lVest Africa programme de Lutte contre I'Onchocercose en Afrique de I'Ouest rorNr pRocRAMME coMMrrrEE Jpc - ccp CoMITE€oNi?,HBI].?RoGRAMMEOffice of the Chairman JOINT PROGRAMME COMMITTEE Fifteenth session Yamoussoukro. 2a Nov.- I December loa4 Provisional acenda item a IPCl5.4 ORIGINAL: FRENCH September 1994 PI-AN OF ACTION AND BUDGET FOR 1995 tJPC15.4 ONCHOCERCTASIS CONIROL PROGRAMME in West Africa PLAN OF ACTION AND BI'DGET FOR 1995 WORLD HEALTH ORGANIZATION tJPC15.4 TABLE OF CONIENTS I. INTRODUCTION 2. OVERVIEW OF THE PLAN OF ACTION . . . OVERVIEW OF THE BI,JDGET FOR 1995 ESTIMATED COST BY PROGRAMME AETTVITY 4.1. Vector Control Unit 4.2. Epidemiological Evaluation Unit . 4.3. Biostatistics and lnformation Systems Unit 4.4. Devolution Unit 4.5. Macrofil Chemotherapy Project 4.6. Offrce of the Director 4.7. Administration and Support Services Unit . . . . 4.8. Administrative supPort in Geneva . ' ' 4.9. Statutory meetings 4.10 Capital costs . ANNEXES OCP ORGANIZATION CHART AVERAGE COSTS USED FOR BI.JDGETARY CALC1JLATIONS RATES OF EXCHANGE OF THE US DOLLAR/CFA FROM 1993 TO 1994 BREAKDOWN OF WHO/OCP STAFF MEMBERS BY NATIONALITY AND SEX AS AT 30 JI.'NE 1994 , Page I 3 63 4 t6 l6 22 29 32 36 4t 43 45 49 50 52 53 54 55 56 57 58 59 60 61 62 D( x. u. III. w. v. u. VII. VItr. COST OF PERSONNEL FROM 1986 TO 1995 AERIAL OPERATIONS FROM 1986 TO 1995 MAP . PROPOSED VCU PLAN OF OPERATIONS FOR 1995 VCU ENTOMOLOGICAL EVALUATION NETWORK . 1995 MAP . LARGE-SCALE TVERMECTIN TREATMENT PLAN FOR 1995 VEHICLES IN OPERATION FROM I99O TO 1995 . . . . . IJPC15.4 LIST OF TABLES TABLE I. BI.JDGET BY PROGRAMME ACTTVTTY TABLE 2 BT,'DGET BY CATEGORY OF EXPENDMI.'RE . TABLE 3 BUDGET FOR 1995 . SI,JMMARY BY PROGRAMME ACTTVITY AND CATEGORY OF E)PENDITIJRE TABLE 4. VECTOR CONTROL Page . . . 1l l3 ..21 l5 28TABLE 5. TABLE 6. TABLE 7. TABLE 8. TABLE 9. TABLE IO. TABLE 1I. TABLE 12. TABLE 13. TABLE 14. TABLE 15 EPIDEMOLOGICAL EVALUATION . . BIOSTATISTICS AND INFORMATION SYSTEMS DEVOLUTION MACROFIL CHEMOTHERAPY PROJECT OFFICE OF THE DIRECTOR ADMMSTRATION AND SI.JPPORT SERVTCES ADMIMSTRATTVE SIJPPORT GENEVA OVERVIEW OF ADMIMSTRATTVE COSTS STATUTORY MEETINGS . CAPITAL COSTS BREAKDOWN OF CAPITAL COSTS BY PROGRAMME ACTTVITY .31 .35 .40 .42 .4 .45 ...51 ...51 ...47 49 I1.1. 1.2. JPC15.4 Page 1 I. INTRODUCTION The Plan of Action and Budget for 1995 follows the trend of the past few years in that it envisages a considerable decrease in the expendiures compared to the estimates in the Plan of Operations for the Fourth Finencial Phase (L992-197). The budget, which emounts to US $24,689,000, is 13% less than that approved for 1994 as well as the original estimates in the Plan of Operations for the Fourth Financial Phase. Such a decrease is due to the positive effects which the devaluation of the CFA franc should have on Programme activities, the efforts to restructure, organizationally and operationally, the activities of the Vector Control Unit (VCU) and the increased involvement of the national teams in Prograrnme activities. Devaluation of the CFA franc The 50% devaluation of the CFA franc at the begindng of 1994 will have considerable effects on the budget, particularly as regards the salaries of the general service staff members as well as the emoluments to be paid to the members of the national telms in terms of salary, lump-zums or per diem in the seven countries in the CFA zone. The budget, "r prir.nt"d, shows a 25% decrease in the expenditure on personnel compared 1o the tee+ ngures; it is due to the combined effects of the ievaluation of the CFA franc and the zubstantial decrease in the number of staff members. Thus, the devaluation of the CFA franc will reduce local expenses like the purchase of fuel or security, cleaning and insurance contracts. The devaluation could, in ihe long run, have inflationary effects on some products and services coDsumed by the prograirme but this budget supposes that these effects will be more than offset by the gains made through the devaluation. National teams As planned during the Fourth Financial Phase, the operational activities of the Onchocerciasis Control Programme in West Africa (OCP) will continue to decrease gradually while there will bei greater involvement of the Participating Countries through Itre activities of the national rcams. The integration of the latter into the OCP organization and working methods has now been achieved and planned gaining sessions on" computer science ""a the analysis of data collected during epidemiological surveillance and ivermectin treatment of patients will be maintained. The Devolution Unit will play a leading role in the finalization and establishment of the devolution plans and in the mobilization of the financial resources required for their implementation. Some national teams will get some form of stnrctural and financial autonomy in 1995; OCP's experience and expertise will continue to be offered to them' IJPC15.4 Page 2 1.3. Yector control operations The activities of the Vector Control Unit revised for 1995 will allow a grcat flexibility of the aerial operations; the zuspension of larviciding on the reaches where the transmission of the disease is well under contol will be continued, which will enable savings to be made. A review of the guaranteed flight hours will also make it possible to maintain the costs of the operatioDs at an optimal level according to the clauses of the aerial spraying contract. Important changes will be made in the organizational stnrcture as well as in the number of por6. In the latter case, the unit will reduce its staff by some 16% and this at all levels: professionals, general services and national teams. Furthermore, as regards the 1995 budget, one should note, in particular, the abolition of the P5 posts of 7-one Chief, wtrictr witt take place during the year, and the restnrcturing of the hydrobiology unit which has been entnrsted with additional duties but with a reduced staff. 2.1. 2.2. JPC15.4 Page 3 2. O\TERVIEW OF TIIE PLAI{ OF ACTION .The various units will continue to carry out the duties assigned to them: larviciding, entomological activities, post+ontrol snrdies and apptied tEsearch, epidemiol6gical evaluaiion, ivermectin distribution and field research, data processing zupport aod rt tistical models, administrative support and support to devolution. Vector control (VC[D The essential point of the VCU plan of operations for 1995 is the definitive cessation of aerial larviciding in elmost the whole of the original Programme area (cf. map in Annex VII). In fact, with the exception of some river portions andedges of this oriiinat area, in 1995 only the southern eitensions (Cdte d'Ivoire, Qhana, Togo, Benin) and western extensions (Guinea, Sierra trone) will be covered by aerial larviciding. In the original area, all the entomological studies conducted after the cessation of larviciding have shown that while the vector is present again, the flies are no longer parasite-bearing and therefore no longer transmit onchocerciasis' The fact that the Vector Control Unit now has seven operatioDal insecticides (Vectron or etofenprox having been endorsed by the Ecological Group) makes it possible to remove any ris[ of resistance detrimental to the operational activities. The aerial company has given full satisfaction and the spraying aircraft have functioned perfectly *h.n r the very good tarviciding rezults and savings in flight hours. The entomological evaluation network has continued to evolve according to the requirements and after the clozure of the Ouagadougou, Bolgatanga and Korhogo zubr..tors at the end of 1993, the Bobo-Dioulasso and Seguela subsectors will be closed down at the end of lgg4. With the planned clozure of Kandi and Tamale at the end of 1995, no other subsector will be maintained in the original area. Finally, all the applied researches useful to the Programnre are now carried out by VCU *ori.r.. They mainly concern aquatic moniloring, taxonomy, identification of the vectors and parasites uy bNe probes, monitoring of the operational insecticides (quality tests on batches received and zusceptibility tests) and, finally, the search for new B.t. H-14 formulations. Epidemiological evaluation (EPD Epidemiological evaluation will be carried out in the areas under larviciding. These evaluations will consist of indepth epidemiological surveys in indicator villages and selected zurrounding villages sithin specifrc river basins to help with decision- making as to whether tarviciAing could stop. The ophthalmological evaluations and follow-up surveys in areas under lvermectin distribution will be continued with a view to the assessment of the impact of the treatmeDts on the morbidity of the disease. I JPCI5.4 Page 4 2.3. 2.4. 2.5. Large-scale ivermectin distribution will be carried out in all the epidemiologically mapped arias of the OCP which have been found to be at high risk of onchocercal bfindness. OCP will zupervise and zupport the national teams which will carry out this activity. [n some specified areas, the distribution will be haDdled by non-govemmental organizatioru. Otber means of distribution, for example passive distribution and the community self-treatment, will be encouraged. Biostatistics and Information Systems (BIS) The processing and analysis of the entomological and epidemiological evaluation data will be continued-, using tne staff of the units concerned for the data entry. FmPhasis will be laid on the entry oiO"t from the evaluations of the national teems and on the training of their staff in the field of data processing and enalysis. Epidemiological modell-ing will be used to evaluate the medium and long-terrr impact of the combination of ivermectin and larviciding on onchocerciasis 6ans6ission and to guide the epidemiological zurveillance. Devolution (DEVO) Generally speaking, OCP will accelerate its zupport to the devolution process and continue to intervene in lhree fields in order to give the countries a greater chance to carry out devolution successfully by following closely the rezults obtained by OCP and usini them fully to serve the cause of devolution as well as they can: - ro reduce the disease to the lowest possible level so as to prevent or delay significantly the emergence of recrudescence; - to get as many partners as possible involved at all levels through a *rt"io.a .*.rlo6r-raising campaign to ensure that onchocerciasis no longer becomes a public health problem; - to see to it that the necessary devolution tools (ivermectin, diagnostic methods, different systems of distribution of the drug and of treatment of patieils, etc.) are available and within everyone's reach. Macrofil Chemotherapy Proiect (Macrofil) The Macrofil chemotherapy Project (Macrofrl), managed jointly by ocP and the WHO Special programme for Research and f6ining in Tropical Diseases (TDR), will continue with its -d*g t toning and development Progriamme and try to produce a macrofilaricide by ut"v"tt t997'-Tnis will mainly involve the expansion of its preclinical and clinical facilities to allow a more rapid evaluation of lead compounds like IIMF 078. JPCI5.4 Page 5 2.6. Administration (ADIVO The Administration and Management will conrinue with its role of zuppo( to the other units of the Programme by helping them to manage optimally the resources Put at their disposal. Emphasis will be laid ou financial stringency, the continuous control of expenditures anO oUtigations, and the optimization of the services sf I manPower which is being reduced gradually. JPC15.4 Page 6 3. O\IERYIEW OF TIIE BI.TDGET FOR 1995 3.1. GenerAI structure The Plan of Action and Budget for 1995 is presented according to the uzual pattern, i.e., by 'Programme activity' (sections 4.1 to 4.10). The Programme activities correspond esslntially to the main zuMivisions of OCP's organization chart (Annex f). Table I presenS a synthesis of the costs by Programme activity. It contains the amounts really spent in l99i and lgg3, the budget approved for 1994 and tbat proposed for 1995. Figure 1 presents graphically the proposed budget for 1995. Table 2 presents a synthesis of the costs per category of expendinrre. It contains the amounts reatty spent in 1992 and 1993, the budget approved for L994 and that proposed for 199j. Figure 2 presents graphically by category ofexpendinrre the budget proposed for 1995. Table 3 combines Tables I and 2for 1995 summary by Programme activity and category of exPenditure. 3.2. General remarks As in previous years, during the preparation of the budget, all the units were reviewed, activity by aitivity and post by post, so as to maintain only what is essential to the maintenani. of tn. Programme in itspresent fonn. The budget proposed for 1995 is US$ 24,689,000. Compared with the budget for 1994, there is therefore a decrease of US$ 3,647,500, i'e., t3%. The average costs used for the calculation of the budget are attached hereto as Annex II. The trEnd of the exchange rate of the US dollar to the CFA franc for 1993 and 1994 is given in Annex III. 3.3. Cateeories of expenditure The categories of expenditure are the components of the Programme activities. A study by catefory therefoie gives an account of the various factors which, in addition to the assumed iatc of the dollir, have an effect on the budget level. The order followed inthereviewofthecategoriesisthatofTable2(page13). 3.3.1. Personnel services The gradual decrease in the number of staff members, started at the beginning of this decade,'will be continued in 1995 with the abolition of some 81 posts, i.e., the equivalent of a lO% decrease in the total number of staff members. The financial burden will be considerably reduced, especially since the staff paid in CFA francs will cost the Programme less as a result of the devaluation of this culrency. JPC15.4 Page 7 In view of the above, the breakdown of the staff who should work for the Programme in 1995 is as follows: PHASE TV Status 1992 r993 1994 1995 WHO/OCP staff 5t4 22t 2r2 176 National staff 34 6t2 @7 562 TOTAL 8s8 833 819 738 The following trvo tables present a comparison of the total nrmber of OCP posts for Phase IV including the number proposed for 1995 WHO/OCP staff Unit Professionrls Gencrel Senice 1992 1993 199,4 t995 Proposed 1992 1993 1994 1995 Proposed VCU l8 t4 t5 t2 361 ll0 ll0 85 EPI ) 2 I I 23 It ll ll BIS I I I I 2 2 2 I DEVO 4 5 4 2 I 2 3 I MACROFIL I I I I I I I I DIR/ADM 9 8 8 7 9l 57 55 53 TOTAL 35 3l 30 24 179 t90 t82 ts2 National Staff Unit Year 1992 1993 L994 1995 hoposed VCU 240 467 46t 4t6 EPI 104 111 t12 tt2 DIR/ADM 34 34 34 TOTAL 3U 6L2 607 562 JPC15.4 Page 8 The following are considered as national staff: 1. the western extension staff whose salaries and allowances are already being paid by their respective governments; 2. staff in the original Programme area who were tratrsferred to their respective gorrrir.os on1 January l993,but whose salaries WHO/OCP will continue to pay up to the end of 1997' OCp will pay individual lump suns to the national team staff in the western extension and daily zubsistence allowances to Dational staff in the whole Programme arca when they are on dutY travel. 3.3.2. Consultancy services These services include consultants used by OCP, particularly for activities related to ivermectin distribution, and experts who contribute to work in the fields of insecticides, entomology, hydrology, hydrobiology and cytotaxonomy' lncluded also are 12 short-term professiJnlr ana . Uoit"a Nations voluileer in the field of epidemiology' The planneO eip.rOitot , i.e ., US$ 1,541,000, is slsJs han that of 1994 by US$ 20'000' 3.3.3. Operationd travel Strict measures as regards operational travel will enable this budget item to be the same as that of last year. 3.3.4. Contracts This category covers research and service contracts signed with companies, universities and othlr institutions in support of specific OCP activities, e.g., aquali! monitoring, Argos teletransmission, ,ritt"*o.e oi hydrological stations' Also included are contracts sigfi as part of the Macrofil Chemotherapy Project' [n vjew of the UuOgetary restriitions imposeO by the present ecolomic circumstances, the planned expJnOiture, under this category, is less than that of 1994 by US$ 215'000' 3.3.5. Aerial operations The aircraft and flight hour requirements will be greatly reduced, comnared y-i$ lgg4, i.e., the estimated t6tal numbei of flight hours is 5,790, i.e., a decrease of 22% *a tir budget tine for aerial operations witfUe reduced by US$ 1.1 million. A diagram showing the trena of the costs ;f aerial operations from 1986 to 1995 is attached hereto as Annex YI. 3.4. JPC15.4 Page 9 3.3.6. Operating costs They are costs which concern the logistic needs of the Programme (vehicle fuel, spare parts) and infrastnrcture-related services (electricity, water, telephone). Despite the increase in the costs of the services in general, the Progmmme should maintain the same budget as that of 1994. 3.3.7. Larvicides Larvicide requirements for the first four years of the Fourth Financial Phase (lgg2-lgg7) have bein evolving in a decreasing order. The amount required for 1995 is US$ 1OO,00O less than that of 1994 and still takes into account a realistic safety margin. 3.3.8. Supplies This concerns the procurement of recurrent items as opposed to capital costs. A budget equal to that of 1994 is envisaged. 3.3.9. Statutor.v meetings The amount estimated under this category is similar to that of the previous year although the planned activities are the same. An increased control over expenditure should make it possible to remain within the limits of this budget. 3.3.10. Fellowships and trainine This category will continue to cover current fellowships, new ones and field training, all of *ni.i, are fundamental devolution activities. The estimated amount' i.e., US$ 553,000, is far below that of the previous year, although it takes into account the fact that the commitments for new fellowships should not go beyond the end of the Fourth Financial phase. 3.3.11. National teams The governmens of the western extension countries Put at the disposal of the programme national tesms whose salaries and allowances they pay. In addition to lump ,rrri, OCp pays them per diem when they travel on mission. The tearrs work under the technical zupervision of OCP which also provides vehicles, fuel and other necessary equipment. th..urount required for 1995 has increased by US$ 24,000, compared with that ;f the previous year, and takes into account the increased involvement of the national teams in OCP activities in the context of devolution. Other categories The administrative support in Creneva requires a slightly increased budget, compared to that of 1994, because of the increases in the costs of this type of service. As iegards capital costs, they are similar to the 1994 estimate, but with a notable increase concerning technical equipment. JPC15.4 Page 10 3.5. Budget summary The proposed budget requirements are summarized in the following tables and figures: 1 - Budget by Programme ActivitY 2 - Budget by Category of Expendinre 3 - Budget summary by Programme Activity and Category of Expendinrre Further details are given in Tables 4 to 15 for each Unit. JPC15.4 Page 11 TABLE I BUDGET BY PROGRAMME ACTIVITY(us t) Note lvermectin : 3,ooo,ooo tablets, valued at US $ I a tablet, will be provirJed free ol charge by Merck sharp and Dohme Programme Activity PHASE IV Erpenditure 1992 Expenditurc 1993 Approved r994 Prcposed t995 Vector control Epidemiological Eval uation Biostatistics & lnformation Syatems Devolution Chemotherapy Project Office of the Direcbr Administration & Support Services Ad ministrative Support Geneva Statutory meetings CapitalCosts 21,@8172 1,626,766 253,U2 1,237,051 2,155,665 743,4& 2,622,24 398,577 238,379 852,552 16,396,227 1,608,425 196,555 1,365,354 2,658,382 585,650 2,679,531 408,451 298,7S 366,290 17,E74,0(X) 1,621,5(p 276,0@ 1,9E2,5qC 2,771,W 654,5@ 2,477,O@ 360,0m 300,0m 620,0@ 15,169,5(X' t.5lo.fl)o 279,500 '1,158,(XX) 2.51o.(XX) s72,50fJ 2.O16,500 400,o00 g(xr,(xx) E79,OOO TOTAL 31,716,197 26,503,669 2E,936.500 24.689.000 rPc15.4 Page 12 FIGURE 1 BUDGET BY PROGRAMME ACTIVITY - 1995 8 \ (us $) 15,169,500 2,510,000 2,016,500 1,510,000 i,158,000 679,000 672,500 400,000 300,000 273,500 3 I I 1 Vestor control 2 Macrofil ChemotheraPY Project 3 Administration & Support Services 4 Epidemiological Evaluation 5 Devolution 6 Capital Costs 7 ffice of the Direstor 8 Administrative SuPPort Geneva 9 StaMory meetings 10 Biostatistics & lnformation Systems TOTAL 1 (",6) 61.40 10.20 8.20 6.10 4.70 2.80 2.70 1.60 1.20 1.10 24,689,000 100,00 I IJPC15.4 Page 13TABLE 2 BUDGET BY CATEGORY OF EPENDIruRE(us 3) Category ol Expenditure PHASE IV Erpenditure 1992 Expenditure t993 Approtted '199/t Propoaed {e05 RECURBENTCOSTS Personnel Services Corsullants Operational Travel Contracts (Research & Others) Aerial Operations Operating Costs Larvicides Supplies statutory meetings Felbvrships and Training National Teams I , Ad ministrative SuPPort Geneva 11,104,E34 1,337,821 E23,101 1,926,312 6,583,449 1,964,946 4,453,435 639,160 238,379 570,337 823,2% 398,5r/ 8,660,415 1,312,47i 761,937 2,444,111 5,250,0m r,778,6@ 3,134,898 580,269 zSE,79,3 583,720 983,692 408,451 E,696,00 1,521 ,0@ 970,0o 2,395,5m 5,945,0m 2,260,Oq) 9,040,0@ 555,0@ 300,0m 717,O@ 955,0@ 360,0@ G,saa,5m 1.sat,ooo 065,(XlO ats.5@ a,Boo,ooo 4252,0@ 2"940,ooo 555,(X)O 3(X),(XX) 5Sl,(XrO 079,(XX) 400,ooo Subtotal 30,863,e|5 26,137,373 27,716,fiO ea.olo,(xx) CAPITAL COSTS Otfice Furniture Data Processing EquiPment Vehicles Technical Equipment Buildings 55,277 65,751 565,9E8 151 ,570 15,966 16,925 51,829 r71,580 118,054 7.902 25,O00 90,000 400,0@ r50,0@ 15,OOO 24.000 t5,(x)o 300,o00 310,OOO 10.ooo Subtotal c52,552 t66,290 620,(XX) 579,O00 TOTAL 91.716, t97 26,509,663 20,996,5(X' 24,689,(x)o ) JPCr5.4 Page 14 FIGURE 2 BUDGET BY CATEGORY OF EXPENDITURE - 1995 15 16 6 14 13 I tr 3 1 PersonnelServices 2 AerialOPerations 3 Larvicides 4 Operating Costs 5 Contrasts (Research & Others) 6 Consultants 7 NationalTeams 8 OperationalTravel 9 Supplies 10 FellowshiPs and Training 11 Adminlsffative SuPPort Geneva 12 Technical EquiPment 13 Vehicles 14 Statdory Meetings 15 Data Processing EquiPment 16 Office Furniture 17 Buildings TOTAL 1 000 (us $) 6,#4,500 4,800,000 2,940,000 2,252,@0 2,180,500 1,541,000 979,000 965,000 555,000 553,000 400,000 310,000 300,000 300,000 35,000 24,000 (A) 26.50 19,40 11.95 9.10 9.00 6.20 4.00 3.90 2.20 2.20 1.60 1.30 1.20 '1.20 0.10 0.10 0.05 24,689,000 100.00 11 12 17 10 61 v_i I 1 7 a 4 IPCl5.4 Page 15TABLE 8 SUMMARY RY PROGRAMME ACTMTY AND CATEGORY OF ffENDIruRE 6rs 3) Activity Category of Egenditure Office ol the Director Vec'tor @ntrol Epidemio bgical Evaluation Eliosta- tbtics & information ryltems Devo- lution Chemo- therapY proiect Adminis- tration Tdal 190s 6,5a4,5(X' t,silt,(x)o 965.(x)o 2,lEo,soo 4,8(X).OOo 2,252,ON 2.eao.ooo 555,(X)O 9(X).OOO 553,OOO m).(x)o a(x),{x)o RECXJRRENT@STS Pemonnel Services Consuttants Operational Travel Confacts (Research & Others) al Operations Operating Costs LarvicirCes 532,500 70,000 50,000 10,000 10,000 300,000 Supplles Statutory meetings Fellouahips and Training Mtional Teams Mministrative SuPPort 3,511,5@ 518,0@ 600,00o 200,000 4,800,000 1,800,000 2,940,000 300,000 500,000 961,000 312,000 1m,000 2.,W 126,000 110,0oo 479,000 16E,000 65,0@ 10,0@ 15,000 5,500 10,000 $3,500 231,000 60,0@ 10,500 553,mo n\,ffi 280,000 30,000 1,903,500 25,000 1,S)6,500 65,000 115,000 40,000 900,000 r00,000 400,000 Subtotal 972,WO 15.169,500 1,51O,(X)O 279,5q) 1.158,(X)O 2.5'tO.(X)O 2.416,5(X) 24.OlO,(XX) 10,@0 10,000 200,0@ 290,0@ 10,000 2,5O0 70,000 10,0@ 2,500 15,0@ s,000 6,000 10,000 90,000 10,0@ 21,@O 35,q)O 300,000 81o,(po to.@o Subtotal o 520,OOO a2,5(X) 17.5(X) 3.(X)O o 36,O(X) 679,O(X) TOTAL 972,W 15,6E9,5(X) 1,592,5(X) 291.OOO 1.161,OOO 2.51O,O(X) 2,172,w 24,609,(X)O PITAL CO.STS Office Fumiture Data Processing EquiPment Vehicles Tectnkal EquiPment Ettrildings JPC15.4 Page 16 4.1. Vector Control Unit (VCU) 4.1.1. Zones to be treated Eastern Zone. including the southertr extension 4. ESTIMATED COST BY PROGRAMME ACTTVTTY Following a meeting of the various technical units of the Programme (VCU' EPI' DEVO, BIS), it nas been decided to stop aerial larviciding on the following rivers in the original area in 1995: - the tributaries of river Niger in northern Bsnin, viz., the Alibori and the Sota; - the tributaries of the White Volta in Ghana, viz., the Kulpawn and the Mole' As regards the original area, only the fotlowing will therefore still remain under larviciding: - the lower Black Volta in Ghnna, downstream from the Kohodio, with its tributaries; - the upper basins of the Keranfl(oumongou, the Kara and the Mo. They are areas at the fringe of the original area that had been reinvaded for a long time up to the establishment olthe southern extension and where the epidemiological results are still not satisfactory. In the southern extension zones, vector control will, as in every year, be directed against the savanna species in their usual biotope (Oueme, Okpara, Zorr, Mono basins) aI well as in the phytogeographical zones they could occupy' considering thcir seasonal movements. In pirticular, in the hilly areas to the east of the Volta I:ke, the treatment of certain reachis wiII be determined by their presenc€ which will be closely monitored through the regular morphometric identification of anthropophilic females and the "ytoti.onomic identificarion of larvae collected in the breeding sites of the rivers under monitoring. Particular attention will be paid to the Chai, the Wulubong, the Kpasa/Kou6 as well aJtUe Bonalrye at the treginning of the rainy season. In the mountainous areas where pure S. squamozum and S. yahense populations breed generally (upper basins of rivers Asrkawkaw, Wawa/Ghana-Hou, Dayi, Anie and Amou), v@tor control will in principle be conducted sssssnally, as in previous years, mainly in the dry season, a period during which these vectors of lesser importance multiply raPidlY. The Sio, a small Atlantic river, witl be treated as long as Decessary (10 weekly cycles) in order to prevent, if need be, the development of savanna species there. IPC15.4 Page 17 \ilestern zone. including the extension ln the original area, following the above-mentioned technical meeting, it has been decided to stop laniciding on the Baoule and the Bagoe in Mali, the larvicide spraying having been siopped already on their Ivorian parts. Only the lknkelaba, which had been reinvaded for a long time, will continue to be treated by helicopter from Odienne. The larviciding on rivei Niger and its tributaries in Mali will be made from the ground. Larviciding will also r""rc completely In the White Bandama basin because of the satisfactory entomological and epidemiologicd rezults. In Guinea, the larviciding plan will be similar to tbat of 1994. The reinforced coverage of the upper Milo will be maintained. In Sierra Irone, because of the curent situation, the larviciding zone will be delimited, in the south, by the Rokel, the Seli and the Bagbe' The Bafi will be treated only very seasonally. The coverage of the northern half of the country will be maintained, particularly in the uPpe; Rokel where the Tonkolili will be brought under larviciding in the rainY season. 4.1.2. Larvicides The larvicide rotation principle i5 running smoothly now. !g H-14 will be used mainly in the dry season and on some tributaries during the rainy seasoo' pyraclofos and phoxim will be used particularfy lurin8 the transition.periods (rise in water level and flood-zubsidence) while Abate will be used mainly during the high- water period in rotation with permethrin or carbozulfan' If the operational use of Vectron or etofenprox in 1994 proves to te conclusive as regards its ifficacy and low medium-term toxicity on the non-target fauna then the introduction of this new product will have to be taken into account in 1995 in the insecticide rotation system. It will partly replace phoxim, pyraclofos and Abate, particularly benryeen 15 and 70 m3/s. its cost, dosage and effective carry should allow it to be used up to discharges reaching 200 to 300 m3/s. Because of carbozulfan's high price, it will be used stigtrJUy less. Pirmethrin, the highdischarge insecticide, will be used as in the Past Year. The requirements for 1995 are as follows: - Abate 61,000 litres - B.t. H-14 112,500 litres - Carbozulfan - Permethrin - Phoxim 8,000 litres - Pyraclofos 42,000 litres - Vectron 14,000 litres JPC15.4 Page 18 4.1.3. Entomoloeical evaluation network As regards the western zone, the entomological surveillance Detwork will be practically si,iit6 to that of 1994. In Sierra lrone, the netrvork will comprise oDe sector *itn nn6' operational bases while in Guinea it will compriie two sectors with nine operational bases. After the clozure of the Ouagadougou, Bolgatanga and Korhogo subsectors at the end of Lgg3,the Bobo-Dioulasso -a S.gUtta zubsectors will be closed down at the end of 1994. These subsector clozures and the reduction in staff prove that the budgetary stringency remains an absolute rule. It should be pointed out that entomological evaluation rezults are an indispensable tool for operationai decision-making particularly with regard to the resumption or temporary zuspension of larviciding. Besides, while it has been possible to remove the reinvasion monitoring network because of the excellent rezults obtained in 1989, 1990 and 1991, post-contrJl studies, which are necessary for two years after t!9 final cessation of larviciding, have, on the other hand, had to be increased' These shrdies are aimed at checking thai utacHties which recolonize the onchocerciasis-freed zones are really free from an! infection or that at least their rate of infection is negligible and does not permit recrudescence of the disease. These post-coffrol studies will be coDtinued in the original area in 1995. 4.t.4. Aerial operations 1995 will be the third and final year of the culrent aerial spraying contract' On the whole, the performance of the company (the same as before) has been satisfactory, particularly as regards the new helicopter spraying systems' Furthermore' an automatic ,fr.yiog iecorOing system (number of poiott, thgt insecticide quantity used) in the helicopters allowsi U"tt , monitoring of ihe work of the pilots. The number of estimated gr.runt .a flight hours and additional hours is about 2,590 hours for the eastern zone and 3,200 for the western zone. 4.f .5. Applied research As mentioned already in 1994, the necessary researches in the extension areas have now been completei. New researches on insecticide formulations, vector "yto*ooo-y, identifiLation of adult blacffties or Onchocerca sg2ins, etc'' are now .ioi.A out o-y VCU staff who have received adeguate fiaining in these different fields to which should be added their experience and field knowledge. Research contracts have therefore been reduced to the striCt minimum and are mainly aimed at helping VCU suff in fields in which the workload is excessive (insecticide research, dissections or sortinS of hydrobiological samples during certain periods of the year). rPc15.4 Page 19 4.1.6. Monitoring of aquatic environment The monitoring of the aquatic environment will continue to be carried out according to the recommendations of the Ecological Group the fifteenth session of which was heldin February 1994 in Bamako. It bas, in particular, been decided to evaluate the medium-term impaa of etofenprox (Vectron or OMS 3002) on the noD-target fauna in 1994 with a view to its fully operational use in 1995. In the originel area and southern extension zone, the monitoring of the fish fauna is undertaken by the national teams and that of the entomofauna by VCU teams. In 1995' the latter will participate also in the monitoring of the zusceptibility ol the. non-target insects to the operational larvicides. The aquatic monitoring is centred mainly on the basins treated with 'hard" insecticides lpermethrin, carbozulfan). In the western extension zoie,technical services agreements arJsigned with the national teams; the snrdy stations selected in Guinea and Sierra I-eone are under monitoring. 4.1.7. Research contracts This budget category, which amounts to US$ 200,000, has been decreasing very markedly for many ye; now. This does not mean a decrease in VCU's effort in this field buittrat many risearches conducted have lead to practical rezults and that the others are now carried out in the field and laboratory by VCU teams (AREM Ouagadougou, Bamako, Bouake, Kara). Finally, some researches are carried out in collaboration with WHO/TDR/Filariasis. 4.1.8. Service contracts Service contracts are signed mainly with organizations working in the field of hydrology (teletransmission, maiotenan"e of hydrological nenvork) or hydrobiology (data anatysis,-assistance to national teams). Following the change in the tariff system of the ergos teletransmission contract, in 1995 OCP will have to ask for 12 PTT years instead of the usual 7.5. The price of one PTT year will, on the other hand, be the silme' 4.1.9. Personnel The personnel requirements, including the staff of applied research and of the environmental monitoring groups, will be as follows (comparison indicated since the beginning of the fourttr Phase): t992 1993 1994 1995 - WHO/OCP - Professional staff members - General service staff members - National staff t8 361 t4 110 223 15 1r0 2t0 12 83 185 280Total 379 347 335 IPC15.4 Page 20 The number of professional posts has been reduced by 67%, between 1987 and 1995 (from 37 to l2). This drastic reduction has been made possible by the redistribution of duties within the Unit and the change of some professional posts to short-term professional posts (STP), which allows more flexibility in the use of the staff s abilities. Besides, the unit will have to use the services of temporary workers for post- control studies in the different zones, for the sorting of samples that the hydrobiology division receives from all the Participating Countries, or for generd work (watchmen, drivers, vector collectors). 4.1.10. Short-term professionds and consultants As mentioned above, the drastic decrease in the number of professionals in the past five years will necessitate the use of the services of seven short-term professionals in 1995. ih.y ,r., two insecticide specialists, one based in Bouake, who is responsible for the Insecticide Research Unit and is Research Coordinator in VCU, the other based in Bamako, who is responsible for insecticide trials in the western extension; two entomologists, one based in Bamako and the other in Kara, who assist the officer in charge oi tfr. administration of the two zones with regard to the duty of chief of entoilological evaluation and organize the ren'aining of the different entomology technicians for vector identification; the chief of aerial operations based in Odienne; the officer in charge of hydrology based at the same place; and, finally, the officer in charge of the DNA-probe laboratory in Bouake. In addition, consultancy services related to research activities in the following fields are also required: Number of months - Cytotaxonomy - DNA probe - Hydrobiology - HydrologY Total 4.1.11. Budget The budget proposed iur the Vector Control Unit amouDts to US$ 15,169,500 2 2 2 2 8 IPC15.4 Page 2l TABLE 4 VECTOR CONTROL UNIT(us 3) Category of Erpenditure Grade POSTS 1992 1993 1994 1995 P6 P5IP4 P3/P1 GS 1 I E 361 1 I 5 110 23 1 I 6 110 210 1 6 5 185 Subtotal s79 u7 3{t5 2AO Consuhants Operational Travel Aerial Operations ContracG (Research & Others) National Teams Operating Costs larvicides Supplies Subtotal 979 g7 9{r5 BO TOTAL 979 3a7 9S!5 200 BECURRENT@STS PERSONNEL SERVICES Technical O{ficers Administrative Assistants Clerks, Stenographers and other @neral service Pers. Natio PHASE IV Eryenditure 11,,,.2 henditure lgsl Appmtad tooa Proposed 143,O@ t,(x)8,000 579,000 2,475,W 735,000 23,@0 t50,ooo E40,Oq) 52s,(x)o l,8zE,OOO 6a7,5m 21,O@ 7.195,973 a.739,000 4,96{l,q)O 9,51 t,5(X) 4W,724 523,O21 6,583,449 203,461 4o7,141 1,42.,9'.18 4,rt*1,/135 328,050 506,437 5'.t7,197 5,250,000 141,179 496,977 1,2€/6,762 9,134,898 S?B,7T7 525,000 600,o00 5,945,000 201,O00 500,0@ 1,8o0,mo I,O40,000 $o,o@ 518,O(X) 600,ooo a,E(}0,(xx) 200,ooo 5()0,o00 t,Eoo,o(x) 2,940,OOO S(xr,ooo 1a.a12,190 1l ,c57,227 12,91 1,(xlo It.658,000 21,@O,172 16,896.227 17.874.(XrO 15,t69,50O wHo Chief VCU (1) Scientists (1) (1) Chief VCU and one Scientist under conract with The French lnstitute of Scientifrc Research br Development through Gooperation" (ORSTOM) 83 JPC15.4 Page 22 4.2. Epidemiological Evaluation Unit (EPI) 4.2.L. Overview The activities of the EPI unit for 1995 will fotlow more or less those of the previous year. In this respect the activities are planned to address the following: - the annual ivermectin distribution in the previously high-risk areas of onchocercal btindness and in the new areas brought under treatment last year; - evaluation of villages in areas where intemrption of larviciding is planned. These will be in the r"..'ioiog river basins still under v@tor control in the Central OCP area. As larviciding comes to a stop in more and more river basins, so will more attention be focused on the selection of villages for zurveillance for the detection of possible recrudescence of infection in the oncho-freed areas; - migration sunyeys which have formed part of the epidemiological evaluations, paiicularly in the areas where epidemiological zurveillance is undertaken primarily ior the detection of possible recrudescence of infection; - evaluation of impact of combined vector control and ivermectin treatment oD transmission of infection through epidemiological zurveys; - evaluation of the impact of ivermectin treaEnent on the control of onchocercal eye disease through ophthafunological surveys of follow-up villages; - evaluation of the impact of ivennectin treatment on transmission of infection after medium-term treatment in areas where it is the only means of control; - selection of villages for in vivo monitoring of possible parasite resistance to ivermectin. 4.2.2. Distribution of ivermectin The annual large-scale ivermectin distribution will be continued in all the previously mapped areis with high risk of onchocercal blindness. There will also be Eeatment in the new areas now included in the ivermectin distribution by the widening of the criteria for selection. As in the previous year, it is envisaged that well over I .8 ulittioo people will be covered through active treatment with ivermectin. It is expected that several more NGOs than in the past and other voluntary organizations will take part in the distribution. These NGOs *itt ."..y out their activities in specific areas within the OCp, but in areas which are not already being treated by the national telems. It is .-p"."a that additional NGO support witt Ue forthcoming. This will enable the conversion of areas now under the conventional large-scale distribution, as established by the OCp, to community self-treatment. In all the other river basins the treatuent will be carried out by nationai teams with the required support and zupervision from OCP personnel as before. JPC15.4 Page 23 Adverse reactions to ivermectin have been both very minimal and minor over the years. Serious adverse reactions have not been recorded for the past three to four years' ilo*rr.r, monitoring for and documentation of any severe adverse reactions to ivermectin treatment will be continued. 'Through the ophthalmological evaluations in the follow-up village,s, the effect of ivermectin treament'on oe ryrl i, the form of ocular morbidity and the presence of microfilaria in the eye, will Ue purzued. This is to monitor the beneficial effect of the drug onpatieils aftei repeated treatment. Similarly, changes in the skin 6i"tofitarial load from tfre annual ivermectin treatment will be studied through epidemiological surveys. This will form part of the treginning of the in vivo monitoring for the possibility of parasite resistance to ivermectin use. I^arviciding is not undertaken in the river basins in the northern part of the western extension area. There will be a continuation of ivermectin ftatment, the only means of control of the disease in this area. Further extension of the areas for ivermectin distribution is envisaged to include infected individuals in the areas of low risk of blindness. It is expected that about 250,000 people will receive treatment during the year. As indicated in previous years, the rivei Uaiins north of the Tinkisso river will constitute the zones to Le involreo. fne teirms to perform the distribution will be made wholly of nationals from the various countries, in collaboration with OCP/EPI personnel wtro witt play a minimum supervisory role. Besides more NGOs becoming involved in ivennectin distribution in ttri year, other ways of distributing ivermectin, for example tbrough the community self-treatment, will be utilized to simplify and increase the "orrr:.g. of distribution. The biannual ivermectin treameil in the Mako focus on the River Gambia in Senegal will continue. In addition, a new area, the Bakoye basin, will be placed on biannual ivermectin treatment. These trvo foci of biannual ivennectin treatnent will form part of srudies which will attempt to determine the effect of more frequent ivennectin featment on transmission of the infection. The documentation of ivermectin use through the passive distribution has improved in the past year. However, staff at the health cetrtres and other health institutions ,.rpo*ibl. for passive distribution will be encouraged throughrtre national coordinators to maintain ft; simple up-todate records of treatments given. This passive mode of distribution is hoped 1o benefit those individuals who live in areas where ivermectin is not distributed on a large scale and have symptoms or signs zuggestive of onchocerciasis. Increasing use oi outreach mobile distribution systems will be encouraged particularly in aieas of NGO operations. Staff at the fixed health institutions will be encouraged to provide health education on the need for annual and long-term treatment with iverm..iio, and to motivate the individuals to continue their treatment. The community self-treatment, started on a limited scale through the last year or two, has proved ,.ry-"o"ouraging. ln this regard, it is envisaged to place more and more, ".rlfutty selected, "r."r urorr this mode of ivermectin distribution in line with the devolution process. The involvement of more NGOs in this tlpe of distribution will be encouraged. JPC1s.4 Page 24 With the combination of targe-scale, mobile outreach and passive ivermectin distribution as well as the distribution through community self-treament, it is expected that close to 2,000,000 individuals will be tneated in f995. 4.2.3. Internrotion of lawiciding Like in the past year, e,pidemiological evaluation will be carried out in selected villages within stretches of river basins in the original OCP area where intemrption of tarviiiaing is planned. The surveys will be conducted in indicator (follow-up) villages, usually nrst tine villages. In addition, other villages around the indicator villages will be eviluated in an "tt"mpt to confirm the findings from the indicator villages within the basin. Selection of the villages for evaluation will be done in conjunction with the Vector Control Unit (VCU) and the Biostatistics and Information Systems Unit (BIS). The final decision to stop larviciding will be made after the resuls from the evaluations in these selected areas have been discussed with VCU. The national teams will almost exclusively undertake these epidemiological evaluations under OCP zupervision. Migration history will be obtained from thosJexamined as part of the epidemiological zurveys, in view of the possible role of migrans in the reintroduction of infection into the onchocerciasis- freed zones. 4.2.4. Epidemiological surveillance As larviciding is intemrpted in more and morc river basins following the interpretation of the epidemiological results among others, so will be the need for the selection of more villages for post-control epidemiological srrveillance. The selection of these additional villiges foi surveillance will follow basically what was planned for the previous year. At liast, three first-line villages from each focus will be selected to be evaluated through time on the respective basins. The cycle will be as follows: each village will be .*^trrio.d once every three years and at least, a village in the stretch of the iver basin will be examined each year. It is hoped tbat the low frequency of gaamination in each village will reduce the possible lack of cooperation on the part of patients because of the repeated skin-snipping. The actual surveillance activity will be carried out entirely by the national teams. The EPI unit will undertake selected monitoring and quality control procedures of this activity. 4.2.5. Mignation studies Two forrrs of migration zurveys, as in the past, are planned. The migration surveys undertaken at the time of the standard epidemiological evaluations will be continued. The objective of this is to determine whether residents or migrans are responsible for any new infections discovered in the controlled areas. This will require no additional input, and will be undertaken in all areas undergoing the cycle of epidemiological evaluations. The second'migration surveys are those that may be urd.rt k.o in new settlement areas, in which case a more detailed sociological component will be included. 4.2.6. Epidemiological evaluation The evaluation of the combined effect of vector control and ivermectin treatment in intemrpting transmission in the areas where both larviciding and ivermectin treatment are going oo *ru be continued, mostly in extension areas. The parameter of importance will-be the incidence of infection in i cohort of individuals previously negative on two consecutive occasions and/or in children born after the start of vector control in the areas concerned. These two groups would constitute non-ivermectin treated individuals. 4.2.7 . Ophthalmolosical evaluation The ophthalmological activities will involve the evaluation of the effect of large- scale ivermectin tream*t io the population. It is planned that follow-up villages in Guinea and Sierra I-eone will be examined to monitor the effect of ivermectin itr controlling eye disease and in preventing blindness- The evaluations will have photograp-tric documentation and if possible angiographic recording of findings. These additional recordings are deemed important in view of the known problems of inter- and intra-observer variltioos with ophthalmic examinations. They will therefore be used to ensure comparability of findings between obsenvers' 4.2.8. Research The DNA shrdies already in progress to clarify the onchocerciasis smins together with sequencing of the strain specific clones will be continued. Material for this research will be microfilariae obtained -through the epidemiological evaluations. In addition, there will be a continuation of the collaborative research with the Royal Tropical lnstitute, Amsterdam, over the development and evaluation of the Polymerase Chain Reaction (PCR) assay for detection of o. volrnrlus DNA in blood or senrm. It is hoped that when the test is fully developed, it would help detect early infection in the population. In this respect, tne test is envisaged to serve as an alternative or complement diagnostic tool to the immunodiagnostic test. rPc15.4 Page 25 The migration studies, as combined with the epidemiological evaluation surveys, will continue. Howener, studies on migntion involving complerc transhumance and new settlements will, where ne@ssary, be undertaken as seParate issues. 4.2.9. Personnel In line with the forecast for the Plan of Operations for the Fourth Financial Phase, the following personnel will be required to carry out the activities outlined above: t992 1993 1994 1995 - WHO/OCP . Professional (Medical Doctors) . General service staff members 2 23 18 ll ll 2ll Total 25 20 12 t2 JPC15.4 Page 26 Provision is made for Short-term Professionals, Temporary Advisers and Consultants, to help in carrying out the extension of the ivermectin distribution and to assist in the ophthalmic work. An epidemiologist witl be required as consultant to assist with the management and co-ordination of ivermectin disfibution in line with the task force requirements. The epidemiologist will carry out operational research in an effort to determine other alternatiys 6sans of distributing ivermectin and improving coverage. 4.2.10. Consultancy The following consultancy services are proposed: Medical epidemiologists (Short-Term Professionals and Temporary Advisers) Ophthalmologist 37 months 4 months 4.2.11. National Teams The national teams that are expected to be provided on part-time or full-time basis by their govemments for epidemiological evaluation and ivermectin disribution will be as follows: Each of the govenrments of six countries in the original area @enin, Burkina Faso, cote d'Ivoire, Ghina, Niger, and Togo) will provide a medical offrcer and seven technicians/nurses to the Programme for epidemiological activities. OCP will pay them travel allowances. Guinea Guinea Bissau Mali Senegal Sierra Leone Total PART.TIME PERSONNEL Medical Officers 3 I 3 2 2 ll TechniciansA.lurses t4 6 t2 6 t4 52 Drivers 8 3 6 6 3 26 Sub-total 25 10 2t t4 19 89 FULL.TIME PERSONNEL National Coordinator I I I J Dep . National Coordinator 1 I I 3 Adm. Assistant I I I 3 Radio Operator I I I J Others (drivers, guards) 3 4 4 l1 Sub-total 1 8 8 23 TOTAL 25 t7 29 22 19 112 JPC15.4 Page 27 National medical personnel and health centres Local doctors and nurses will be called upon to help in the treatnent and supervision of the active, passive and community self-treatment. Some fixed centres that witt Ue mainly involved in passive disribution may be required to extend their services through mobile outreaches io tn" population at large in the areas concerned. Travel and subsistence allowances and other togitti.t for this personnel may have to be covered by OCP. 4.2.12. Budget The estimated amount required for 1995 is US$ 1,510,000. JPCI5.4 Page 28 TABLE 5 EP ID EM I OLOGI CAL R'ALUATION(us 3) Category of E:Penditure Grade POSTS 1992 1993 199/t 1995 RECURRENTCOSTS PERSONNEL SERVICES WHO / OCP Staff Chief EPI Medical Officer(Ophthal mologist) Laboratory assistants/N urses I Administrative assistant I I lClerk and Typist P.s P.s G.S G.S G.S 1 1 't9 1 3 1 1 15 1 2 1 E 1 2 1 I 1 2 Subtotal 25 20 12 12 Consultants United Nations Volunteer (1) Operational Travel Operating CosE Supplies Contracts (Others) National Teams Subtotal TOTAL 25 20 12 12 PHASE IV Erpenditure 1992 Expenditure 1993 Approved 1994 Proposed r995 126,0@ 100,0@ 22,500 45,OO0 50,000 1{O,OOO 120,OOO 16,O(X) s2,(xx) 45,OOO 556,943 4,97,652 423,5(X) 96l,o00 282,46 82,365 158,137 130,360 416,153 3/1,7U 36,905 177,61 119,618 13,970 486,7'15 908,0@ 30,000 120,000 140,0(D 110,0m 35,OO0 455,0@ 287,OOO 25.OOO 100,(xx) l26,OOO 1'to,o00 22,OOO 479,OOO 1,o69,E23 1.170,773 1,1gE.O@ ,.t49,OOO 1,626,766 1,GOE,a25 1.621 .5OO t,51O,OOO (1 ) Guinea-Bissau (epidemiology) JPC15.4 Page 29 4.3. Biostatistics and Information Systems (BIS) 4.3.1. Data processine The Unit will continue to process the Programme's routine epidemiological and entomological evaluation data using the staff of the units concerned for the data entry' Depending on the workload, the unii will recruit a temporary data entry clerk to help the VCU or EpI teams. The unit will collaborate with each Participating Country with regard to the transfer, exchange and analysis of evaluation data while undertaking the adequate taining of the national teams if necessary. In this connection, the entry and validation progrurms will be insalled and tested in each country in order to make them completely bpeiational. The unit will zupervise and coordinate the development of data banks on operational research, aerial operations, the Administration (transport, suPply, personnel and budget and finance divisions) and documentation' 4.3.2. Analysis of evaluation data Routine analyses will be continued in the unit. They mainly concern entomological and .pid.-iological evaluation data. Stress will be placed particularly on the medium and long{erm impact of the combination of ivermectin and larviciding on transmission. In thii respect, the analysis of the longitudinal data collected during the incidence studies in the western and southern extensions will be continued in collaboration with the EpI unit. The analysis of the results of the epidemiological sr:nreillance in the original programm e arca will be made in collaboration with the nationals' The oprr;tt ut*oloiical data will also be reviewed with the EPI unit. The interpretation of post- control entoriological evaluation data will also be a priority. The technical support given to the other unitJin data analysis will be maintained. The analysis of the data from the operational research on ivermectin will be continued. To support data analysis, a statistician/computer scientist will be recruited on a temporary basis to help the unit' 4.3.3. Epidemioloeical modelline Epidemiological modelling will continue to play an important role in the interpretation of epidemiological surveillance results. In the original Programme area, where the parasite reservoi is almost znro and where larviciding has ceased, the epidemiological surueillance results will be tested and validated in comparison with the piedicted tr-ends obtained so far with ONCHOSIM. The prospective evaluations of the different OCp stategies based on epidemiological modelling will be refined as and when new epidemiologicai-results are available. Thus, the accent will continue to be put on the simulations of recrudescence detection and its control with ivermectin. Besides, the estimation of the other important parameters (entomological criterig migration, etc.) of the recrudescence of onChocercal infection will be continued, taking into accotutt observations made in the field. 4.3.4. ComPuter network The unit will be responsible for the coordination of data processing in OCP and technical studies in this nita wiU be carried out in it. Its role will be to centralize JPC15.4 Page 30 requests, propose adequate equipment and supervise the maintenanc€ of the existing computer equipment. Stress will be particularly laid on the training of OCP staff and nationals in order to integrate data processing effectively into the working habits. 4.3.5. .Equipment and softrvare Practically the whole of the computer equipment has been replaced. However, provision has to be made in 1995 at least for the purchase of two microcomputers and iheir peripherals to replace those uihich would break down and whose repair cost would be higtr. Some of the computers will have to be upgraded by strengthening.-the memory ana nara disks in order to make them more effective. The operating costs will be slightly increased to take into account the cost of maintenance of the computers. It will be necessary to continue to update the software packages for the Windows system in order to correct the mistakes of the old versions. The transfer of data and the development of relational databases will necessitate the local recruitnent of two consultants to help the unit in the development of software packages. 4.3.6. Personnel The personnel requirements for 1995 are as follows: t992 t993 1994 1995 WHO/OCP . Professional staff member . General service staff members Total 4.3.7. Consultants As in previous years, a short-term professional (Programme analyst) will be responsible foi ttre estabiishment and monitoring of the different progr^ms and software used for the development of the data banks and operational research and in the Adminisfi'ation. 4.3.8 Budeet The budget proposed for the Biostatistics and Information Systems Unit is us$ 273,500. I 2 3332 I 2 I I I 2 JPC15.4 Page 31 TABLE 6 BIOSTATISTICS At{D INFORilATION SYlSTEilS(us 3) Gategory of ErPenditure Grade POST 1992 r993 1994 t995 BECURRENT@STS PERSONNEL SERVICES wHo ocP Statistician analYst Programmer Assistant Adm inistrative Assistant Staff P,4 G.S G.S 1 'l 1 1 1 1 1 1 1 1 1 Subtota! 3 3 3 2 Consultants Operational Travel Contracts (Others) Operating Costs Supplies Subtotal TOTAL 3 I I 2 PHASE IV ProposadApproved t lilo,uro r6.q)o t2,OOO 126,000 2.,fiO 2.,WO 16E,OO0171.(XX)109,797119,689 t6,OOO lo.(x)o l5,oo0 5.500 to,ooo 65,@0 10,000 15,000 5,000 10,000 s3,250 2,W 20,000 2,724 a,z6 61,679 r0,912 90,000 2,789 '14,279 1t}5.s00105,OOOt6.758119,65{l 273,500276.(x)O196,5e528,S,S12 JPC15.4 Page 32 4.4. Devolution Unit (DEVO) 4.4.1. Snecific olan of ection In a specific way, the Devolution Unit will continue to play its role by gradually putting the P-articipating C.ountries in a position to maintain OCP's achievements and, .or" lrrticularly, by helping to reinforce the capability of these countries to prevent, detect and control recrudescence of onchocerciasis. To attain this objective, the Unit will continue with its technical support to the countries in the fields of information, education and communication, epidemiological surveillance and ivermectin treament of patients. - The Unit will also lend its support to operational research particularly on the different ivermectin distributionsystems by laying emphasis on those involving the village communities themselves, migratory movements in the onchocerciasis-freed areas, real community participation in the control of the blackfly nuisance, etc. - It will continue to help the countries to update their devolution plans, if need be, and, particularly, mob-ilize the financial resoruces required for the implementation of these plans. With WHO and, more particularly, its Regional Office for A-frica (AFRO)' the Unit will see to it that the aitivities aimed at maintaining OCP's achievements are integrated into the health systems of the countries concerned. The implementation of this strategy necessarily implies: (a) an adequate training of national personnel at all levels; (b) close contact between the Unit and all the actors concerned, particularly the countries, mainly through periodic meetings with the national-team workers (National Coordinators, technicians' nurses, etc')' 4.4.2. The Unit's operational structure To help to better gnderstand later the heading "Personnel" of the Unit's budge! it should be recalled here that with a view to an optimal utilization of the abilities of Progru**e staff, the members of the Unit have been chosen from among OCP workers who therefore carry out other activities in addition to those specific to devolution. In 1995, the Unit will function according to the following stnrcfire: (a) the Unit will comPrise: - one professional, Unit Chief: he is in charge of the coordination of the activities of all the actors; JPC15.4 Page 33 - one professional in the Vector Control Unit, responsible for the monitoring of entomological activities as part of devolution ; - one general service staff member in charge of adminisfiative zupport and, particularly, secretarial duties. (b) in the field and in the devolution activities' urimation zones. the Unit will comprise: - two professionals (zone animators), glven the responsibility of stimulating and animating devolution activities in the countries composing their _respective zones. These two animators are professionals inthe Epidemiological Evaluation Unit (two short-term professionals). These zone animators will still be based in Bamako (Mali) and Ouagadougou @ukina Faso) ; - four professionals in the Vector Control Unit, based in Benin, Ghana" C6te d'Ivoire and Togo, playing the role of local devolution animators in their respective countries; - four medical officers, National Coordinators of the Onchocerciasis Contol Programme in Guinea-Bissau, Guinea, Sierra Leone and Senegal; - a team based in Bobo-Dioulasso (Burkina Faso), composed of one entomology technician, one laboratory assistant and three driver-vector collectors. This team will be responsible gluinty for the training of the nationals for ground larviciding io g*kina Faso, particularly in the Dienkoa basin, for their supervisiJr in the carrying out oithese larvicide treatnents in order to maintain the intemrption of the tansmission in the Dienkoa basin, and for the carrying out, with the nationals, of the entomological surveillance activities required for a regular evaluation of the larviciding made' In all, the Unit will operate directly with l8 workers chosen from the staff already existing in the Programme and distributed between the central level in Ouagadougou and the two animation zones. In addition to the above-mentioned workers, the Unit will, if necessary, continue to take advantage of the expertise of all the other units of the Prograrnme. It will use, in particular, the clhiefs of entomological zone, sector and subsector to carry out zuccessfully it, progru**e for the information and sensitization of the local authorities and popututt* as well as its programme for the training of nationals and communities in ground larviciding rcshniques. 4.4.3. Personnel From the budgetary viewpoin! ten out of the l8 workers making up the Unit will continue to be under-the EPI aoa VCU budgets. The eight others will be included in the budget of the Devolution unit and are broken down according to their respective status as follows: JPC15.4 Page 34 t992 1993 t994 1995 - WHO/OCP . Professional staff members . General services - National staff Total 4.4.4. Consultants The services of social scientists or primary health care experts will be used for specific studies to be conducted as part of the Unit's support to ope_rational research: human migratory movements, impaci of different aids on the raising of the awareness of the rural communities, acceptability of skin snip in the communities selected for epidemiological surveiliance, sEengthening of primary health care, analysis of national health ,.*i-".r, highlighting of links between devolution activities and existing health structures, identification of adequate training requirements, etc. Thirty-three months of consultancy in these different fields have been earmarked for the Unit in 1995. 4.4.5. Operational travel For the travel in the Participating Countries of professional staff under the Unit's budget, the travel of the entomology team and national parmers in Bobo-Dioulasso and the Lavel of national coordinatorr aod some of their assistants mainly to Ouagadougou to review and plan devolution activities with OCP, an amount of US$ 60,000 will be required in 1995. 4.4.6. Training As mentioned above, to better establish devolution, OCP will continue with its training policy, favouring the following disciplines: epidemiology, public health, health services management, hJalth education, statistics and data processing. Plority will be !i.,rrn to epideiriological training, particularly in the health districts. Training in all these iisciplinei will be re-ceived in universities and training institutions in Africa. Furthermore, p.rtir"t* emphasis will be laid on in-service and field training (for example' refresher courses, seminars, workshoPs)' An amount of US$ 553,000 will be required to continue to finance fellowships already awarded, whose beneficiaries are still continuing with their snrdies, and to finance new fellowships and in-service training' 4.4.7. Budeet Considering the above, the Unit's budgetary requirements will amount to us $ 1,158,000. 8 5 : 7 2 3 3 5 : 3 l 74 JPC15.4 Page 35 TABLE 7 D EVO LUTI O N 1us t) RECURRENT@STS PERSONNEL SEFNflCES wHo OCP Chief Devolution Ivledical Officer Scientist Scientists Lab. Assistant Administrative Assistant and Clerk StenograPher Mtional Stafl Subtotal C;onsulbnts Operational Travel @rating Costs Fellowships and Trainin g Category of Expenditu re Grade POSTS 1992 1993 1994 1995 P.5 P.s P.4 P.3 G.S G.S 1 1 1 1 1 1 't 2 2 1 1 2 1 2 1 1 2 1 I I 7 7 o Subtotal TOTAL I 7 7 a PHASE IV Erpenditure 1992 Expenditure 1993 Approved 1994 Proposed 126,0@ r26,0@ r93,0@ n,w rL5,()o0 '140,(xx) t05,ooo 32,OO0 l6.000 tosoo 502,980 642,696 512,500 m3'5OO 130,664 30,059 3,O11 5/0,337 109,970 28,550 410 5E3,720 98,000 50,m0 5,000 717,000 2S1.(XX, 60.ou) t0.5q) siit,o(x) 794,o71 7?2,6* 870.Oq) 854,500 1,237.O51 1.96!i,931 1,902.500 t.15E.O(X) JPC1s.4 Page 36 4.5. Macrofil Chemotherapy Proiect (Macrofil) 4.5.1. Objectives The primary objective of the Macrofil Chemotherapy Projgct nntinul to be the developmerit of saie aod effective adulticidal dnrgs (macrofilaricides) for onchocerciasis and lymphatic filariasis. In view of the inclusion of lymphatic filariasis, additional frnanciaf support is provided by the Special Programme for Research and Training in Tropical Diseases (TDR) In 1b95, a sum of US$378,000 has been earmarked by TDR for the Macrofil Project. Howevei, this zum covers only research and development of drug candidates, *a if a macrofilaricide becomes available for treatment of lyrrphatic filalasis, then additional funds need to be found for clinical trials. The budget below represents OCP funding of the Macrofil Project. 4.5.2. Specific obiectives for the Macrofil Project in 1995 will be: Following the decision of Ciba Geigy not to register Amocarzine (CGP 6140) for treafinent of filariasis, nor to continue is d-velopment, this responsibiliq h^ been taken over by the Macrofil'project. possible manufaCttuers have been identified in India and sufficient material for continuation of clinical and field trials will be synthesized and formulated. If appropriate, an application for regisnation of the drug for use in onchocerciasis wilit. pr.p*.d by-Wtto. In view of the potentral us9 of the drug for lymphatic filariasis, cottaboration *itt be sought from TDR for all new work on Amocarzine. Assuming that preliminary toxicological studies on UMF 078 have been satisfactory, p..-rlirri.ul ioxicology on this drug will continue in partrrership with the Universiryof Mi"hig- and the pioduct Development Unit (PDU) of TDR. Clinical trials in man will be undertaken as soon as possible' As safety studies undertaken in 1994 indicated that single oral doses of iverrrectin as high as g00 f.g/tg body weight could be administered to onchocerciasis patients, field srudiIs on high aorZLutiiple iose ivermectin will continue to investigate the possible macrofilaricidal activity of such drug regimens' Work will continue on the possibility of ivermectin resistance in onchocerciasis, and its diagnosis in treated patients. Iverrrectin-resistant strains of the parasitic nematode Haemonchus contortus *d tl. free-living nematode Caenorhabditis elesans have been ffimoleculaibiology,andthegeneSforsometypesofivermectin resistance cloned from nematodes and sequenced. Such resistance genes will be sought in Onchocerca worns, and diagnostic tichniques to identiff resistant genes will be developed for field aPPlication' Identification of potential macrofilaricides from primary in vivo and in vitro screening assays, ana tneir synthesis and development for testing in secondary animal models such as the Onchocerca/cattle system will continue. This will require a scale-up of their synthesis i" pr"p*.t"ry chemical laboratories, and formulation for dosing by oral and parenteral routes. JPC15.4 Page 37 In view of the good supplies of novel compounds cur:ently being provided by the drug industry and othi6o*lir, high throughput testing of these potential drugs will "oniin r", in collaboration with other drug development progpmmes of TDR If funds remain available, a small amount of work testing potential inhibitors of specific biochemical targets will continue. 4.5.3. Clinical centres The Onchocerciasis Chemotherapy Research Centre (OCRC) at Hohoe Hospital, Ghana" will be zupported as a year round activity while patients continue to be available' The College of Uldicine at ttri University of Nigeri4 Enugu Campts, was used in 1994' and will be available, as required, for clinical trials with associated pharrracokinetic studies. The Institute Pasteur, Yaound6, C-ameroon, may also be used if an additional centre is required, but as CGI 18041 has been withdrawn from development due to unacceptable toxicity, additional centres will only be needed if numbers of patients treated with Amocarzine need to be increased, or if LIMF 078 enters clinical trials during 1995. The sum requested for such clinical trials is US$293,000. 4.5.4. Reeistration and leeal costs The clinical and preclinical information relating to Amocarzine needs to be thoroughly examined and a registration file prepared. A drug master file- covering the synthesis and quality control of drug components mu:t also be available' Use of ctnsultants for this work may give a total cost up to US$160,000. Legal fees for continuation of patent cover on UMF 078, together with patent costs themselves may amount to US$20,000. Thus, registration and legal costs may amount to approximately US$180,000, but it is hoped that TDR may be able to contribute to these costs. 4.5.5. Preclinical drue development LJMF 078 will be the main compound in the preclinical development phase, but three compounds were scaled up for testing agains gnchocerca in cattle n 1994, and any of these sirowing good macrofilaricidal activity will proceed to preclinical development. pDU of TDR wiil continue to provide resources to assist the work with UMF 078. Approximate costs of US$440,00b have been assumed for such preclinical work, mainly for large-scale synthesis and quality control. 4.5.6. Drus screenins centres primary drug testing will be carried out in laboratories in the USA and the UK. Secondary testing witl continue to use hglg pahanei (in the dog) and Onchocerca eib*"i ana O. ocltrengi (in cattle), and is carried out by laboratories in the USA, Australia and Cameroo, ,rfr"tively. In 1994, two assay systems were terminated namely Wuchereria kalimantani in ieaf monkeys, and use of adult O. volwlus worrns for in vito JPC15.4 Page 38 testing by the Hamburg group. It is anticipated that the latter work will in future be carried out by local staff in Hohoe Hospital. Screening activities will therefore require us$560,000. 4.5.7. Strateeic research This work will be in trryo parts in 1995. Biochemical targets previously identified in filariae, will be used as the basis of in vito assays for identification of novel inhibitors, while work on clnracteization of the genes responsible for ivermectin resistance in nematodes will continue in three laboratories. A laboratory to develop diagnostic techniques to monitor macrofilaricidal activity in humans and animals was set up at the end of 1993, and will continue its work in 1995. Such research will cost approximately US$430,000. 4.5.8. Short-term consultants end technical advisers The Macrofil Project Steering Committee will hold two meetings in 1995, and ad hoc task force meetings will be held wherever required to monitor specific work in drug Iielopment. Particlpants will be paid as technical advisers. Director OCRC will continue as a consultant to the Macrofil Project, and attend meetings in Geneva as required and assist in clinical studies in the OCP area. In Geneva contributions will be made to the office of Legal Counsel and to the Library, for use made of these facilities. Total costs for statutory f,,Iacrofil meetings, consultants and temporary advisers, etc will be US$280,000. 4.5.9. Personnel A manager at the P5 level and one full-time G5 secretary will continue to administer the project at a cost of US$271'500. 4.5.10. Operational travel The manager of the Macrofil Project will need to visit collaborating pharmaceutical and institutional laboratories to coordinate drug development programmes, in addition to clinical trial centres in Africa and India. Some members of the Macrofil Steering Committee may also need to make specific site visits to monitor work in Progress' The approximate costs for these activities will be us$30,000. JPC15.4 Page 39 4.5.11. Budget The Macrofil Project will operate in 1995 at the level of budget proposed in the original Plan of Operations for thi Fourth Financial Phase, i.e. US$2,510,000, which ,"pi.r"nt a fall from a peak in 1994. If any essential, but unforeseen development costs arise in bringing Amocarzine or UIvIF OZti into field 115e during 1995, then additional funds may be requested. JPCl5.4 Page 40 TABLE B MACROFT L CHEMOTHERAPY PHOJECT(us 3) Category of ExPenditure Grade POSTS 1992 1993 1994 1995 RECURBENT@STS PERSONNEL SEBVICES wHo / ocP Statf Scientist Secretary P.5 G.5 1 1 1 1 1 1 1 1 Subtotal 2 2 2 2 Consultantsflemporary advisers (1 ) Operational Travel Besearch Contracts Supplies Cost-sharing Astivity Subtotal TOTAL 2 2 2 2 PHASE IV Erpenditure 1992 Ependiture r993 Approved 1994 Proposed r995 170,0m 96,500 175,(X)O E6.500 209,373 17A,924 266,500 271,50O 246,241 26,265 1,650,448 23,338 179,326 26,553 2,26,89L 24,6i17 20,@0 3so,000 30,000 2,099,500 25,000 2EO,(XX) g),o(x, 1,9O3,s(rc 25,(XX) 1,U!6,82 2,479,61 2,5()4,5OO 2,23E,5m 2,155,665 2.658,382 2,T71,OOO 2,510,O@ (1) cosrts of meetings are included under tonsuttants / Temporary advisers' JPCl5.4 Page 4l 4.6. Office of the Prosramme Director 4.6.1. Activities General policy and Programme management will be the main activities of the Office of the Programme Director in 1995. As in previous years, it will also be responsible for the following: - liaison with the statutory bodies, Donors, Participating Countries and the scientific commtrnity; - coordination of all Programme activities, including research contracts; - statutory meetings. Devolution activities will be directly linked to the Office of the Director. The Documentation Centre will continue to make documents available to internal and external visitors. All documents prepared by OCP will continue to be translated by the Office of the Director. The information and public relations section will be responsible for the raising of the awareness of Participating Countries as regards the different objectives set by the Programme. 4.6.2. Personnel To carry out these duties, the Office of the Director will require: 1992 t993 1994 1995 - WHO/OCP . Professional staff members . General service saff - National staff Total 8 2 : 7 3 5 I 2 5 I 2 5 I 98 4.6.3. Consultants A short-term professional will be responsible for the translation of all documents which need to be translated. A part-time consultant will be recruited to support the Office of the Programme Director in the field of general policy' 4.6.4. Budeet The proposed budget for the Offrce of the Programme Director is US$ 672,500. JPC15.4 Page 42 TABLE 9 OFFICE OF THE DIRECTOR(us $) Gategory of ErPenditure Grade POST 1992 1993 199/t 1995 RECURRENTCOSTS PERSONNEL SERVICES OCP staff Programme Direcbr Administrative Off icer lnlorrnation Officer Ad m inbtrative Ass istant Secretary (Geneva) Clerk StenograPhers Staff D.2 P.3 P.3 G.S G.S G.S 1 'l 2 1 2 1 1 2 1 2 1 1 1 2 't 2 I 1 1 1 2 1 2 I Subtotal 7 I E I Consuhants Operational Travel Operating CosB Supplies Subtotal TOTAL 7 a E I PHASE IV Expenditura 1992 Expendih,trc r993 Approvtd 1994 Proposed 143,O@ 96,500 45,000 96,500 45,000 s,500 150,ooo 1(}5,OOO 105000 82,OOO los.o00 32,(xxl o,500 571,662 ..2AA12 a29,500 592,500 58,894 54,619 12,370 45,896 73,321 54,366 4,785 24,766 145,0@ 60,0o0 10,oo0 10,000 70,ooo 50,oo0 1O,OO0 10.ooo 171,7l,7 157,298 225,q)O 1ao,om 74{t,;149 585,650 654,500 a72,5o,0 JPC15.4 Page 43 4.7. Administration and Support Seruices Unit 4.7.1. Activities The Unit will continue to play its role in the different fields of administrative support. Each of its divisions will work in close collaboration with the other units of the Progrunme. The technical and operational units will continue to receive administrative support for an appropriate management of staff, finances, equipment and transport. The Transport and Suppti divisions will see to the ordering and use of equipment and supplies required for the smooth running of the Programme. The Unit will continue to contribute, as in previous years, to the improvement of cost-effectiveness, to the application of basic management principles and to good management in general. The management seminars will be continued with a format in whicli the participants will be brought together in order to get a wider view of the problems they have encountered. The devaluation of the CFA franc, the main culrency in which the Programme makes its expenses (45% of the expenditure), will lead to a greater frnancial stringency and a regular control over expenditues and obligations. The Finance Division will undertake a detailed and objlctive study of the Programme's different financial obligations. 4.7.2. Personnel The staff requirements for the adminisfative and managerial duties are as follows: 1992 1993 1994 1995 - WHO/OCP . Professsional staff . General service - National staff 8387 5 85 90 6 52 33 6 50 3l 4 48 3l Total 9l 4.7.3 Consultant A short-term professional, based in Ouagadougou" will be in charge of the Supply and Services Division. 4.7.4. Budeet An amount of US$ 2,016,500 is proposed for 1995, which represents a decrease of 18.59% compared with 1994. This decrease is essentially attributable to the reduction in the personnel cost. JPC15.4 Page M RECURRENTCOSTS PERSONNEL SERVICES Staff TABLE 10 ADMINTSTRATION AND SUPPORT SERT'ICES(us $) Chiel Administration & Management Budget and Finance Otficer Transportation & Commu. Officer Supplies and Services Otficer Finance Ofiicer Personnel Otficer Administrative and Technica I Assistants Clerks /Typists & storekeePers Staff Drivers, Messengers and Labourers T, Stafl Category of Etpenditure Grade POST t992 1993 1994 1995 P.6 P.4 P,4 P.3 P.3 P.3 G.S t:.D u.D 'l 1 1 1 1 14 45 6 1 I 1 1 1 1 14 38 aa 1 1 1 't 1 1 13 s7 31 1 1 1 1 1g 35 31 subtotal 90 9l a7 E{t Consuttants Operational Travel Contracts (Others) Openting Costs Supplies Subtotal TOTAL 90 91 a7 a{t PHASE IV Erpenditure 1992 Ependiture 1993 Approved 1gsa Proposed t995 143,00O 126,000 126,000 96,500 96,500 96,500 292,500 E32,sm 108,500 14,000 t50,000 llo,ux) 105,O@ 105.O(x' 206,OOO 560.Om 108,500 20,000 1,955,O19 2,125,115 1.932,(X)O 1,996.500 66,817 95,860 42,&3 364,908 97,z,37 48,465 95,818 40,064 306,059 63,710 r@,000 45,@0 300,0m r00,000 05,q)o tl5,qx) il{r.ooo .goo,ooo 100,o00 G{57,225 531,116 545.Oq) 620.o00 2,6?2,244 2,679,531 2,177,@O 2,O16,5(X) JPCl5.4 Page 45 4.8. Administrative support in Geneva 4.8.1. Activities The prograrrme benefits from an administative zupport in WHO Headquarters' This zupport witt continue to be provided in the fields of Personnel administration, budget, finance, insurance and zupplies' 4.8.2. Budeet For these services, WHO is authorized to charge OCP 13% of the Programme budget (since it is a programme supported from extra-budgetary sogrces)' This would have meant, for OCP, * "ppro*i-"i. arnount of US $l.Z o'ittioo' However' WHO Headquarters has decidedio waive this requirement in OCP's case, and charges OCP only on a cost-recoverable basis' The amount proposed for 1995 is estimated at US $400,000. This budget represents * irrrr.^" of US s+0,000 compared to 1994' This amount is explained by the increase in the costs of personnel services' TABLE 11 ADMIMSTRATWE SI.JPPORT GENEVA(us $) Category of exPenditure Clerical Assistance Finance, SuPPlies, Personnel Operating Costs Supplies TOTAL PHASE TV hoposed 1995 Approved 1994 Expenditure 1993 Erpenditure 1992 350,000310,000329,451y5,420 35,000 15,000 35,000 15,00021,000 58,00033,000 20,157 {00,00036i0,000408,45139t,577 JPC15.4 Page 46 Administrative costs Sections 4.6. - Office of the Programme Director, 4.7. - Arlministration and Support Services Unit, and 4.8. - Administrative Support in Creneva, already discussed on the preceding pages, conc€rn atl the administrative costs of the Programme. Each section is followed by a table based on the usual panern: tables 9, 10 and 11. Table 12, 'Overview of Administrative Costsn, summarizes these three tables. I TABLE 12 OVEM/IEW OF ADMINISTRATIVE @STS(us $) JPC15.4 Page 47 POSTS I1992 GradeCategory of E:Pend iture 1 34 1 2 3 1 16 1 2 38 1 32 1 2 3 1 15 'l 2 37 32 1 1 1 2 1 15 1 2 35 1 1 2 3 't6 1 2 45 27 D.2 P.6 P,4 P.3 P.3 P.3 G.S G.S G.S tr.D G.S PERSONNEL SEFVICES Prcgramme Director CtriEf Administration & Management BJdget & Finance & TransPort Finance & SuPPtY & Tech Officers Admin istrative & Technical Assistants Clerk StenograPhers Clerks, Ty pists/StorekeePers Drivers, Messengers & Labourers Adm in istrative Su PPort Creneva Staff Personnel Officer lnformation Officer Secretary (@neva) National Stafi 9299 9599Subtotal C;onsuhanB Operational Travel ContracG (CIhers) Operating Costs lsuppties Subtotal 99 95 9299TOTAL PHASE VI Prcpced I Approved 1 Expenditu I Erpenditure 150,o(x) 150.0(x) lilo.o(x, 2lo.ooo i05.o(x) to5dlo 24O,(XX) 105,o(x, 82,OOO 560.OOO 400.o(x, ll2,(Do 20.ooo 143,000 143,000 %2,W 289,5@ 96,500 337,500 96,500 45,000 832,500 360,000 112,000 14,0@ e3it9,{x)o2,721 ,ffi2,$3,8.272.526,6E1 t35.OOO 165,OOO {o,ooo Sto,ooo 11o,(x)o 145,000 1@,000 45,000 310,@0 110,@0 12'.t,76 r50,r84 40,064 310,844 E8,476 125,411 150,479 42,&3 977,m tr13,133 770,OOO 760,o00a3E.712 711,954 3.{rE9,(X)O3.265,181 3.a91.5(X)9,965,303 JPCr5.4 Page 4E FIGURE 3 BUDGET BY PROGRAMME ACTIVITY - 1995 ADMINISTRATI\E COSTS o 3 1 1 Vector Control 2 Macrofil ChemotheraPY Project 3 Epidemiological Evaluation 4 Devolution 5 Capital Cosls 6 Statutory meetings (us $) 15,169,500 2,510,000 1,510,000 1,158,000 679,000 300,000 (%) 61.40 10.20 6.10 4.70 2.80 1.20 1.101O Biostatistics & lnformation systems 273'500 TOTAL 24,689,000 100.00 10 g ol Dircstor.Offioe fie rPc15.4 Page 49 4.9. Statutor.v meetings The meetings planned for 1995 are as follows: the Ecological Group, the Expert Advisory gsmmittee, three sessions of the Committee of Sponsoring Agencies, the Joint Programms Qsmmittee. The budgetary provision for these different meetings mainl] oovers the costs of travel and per 1i.., interpretation services, translation of documents, od various supplies. Thi costs of the participation of experts in meetings other 61" thott mentioned above (research, ivermectin distribution, hydrology, hydrobiology, national coordinators) have been included in the "Operational traveln category of the budgets of the host units. One full-time administrative officer and a secretary, budgeted for in the Office of the Director, are employed for the organization of meetings. The budget proposed for 1995 is US$ 300,000, i.e., equal to that approved for 1994. TABLE 13 STATUTORY MEETINGS (rJS $) Category of Expenditure RECURRENT COSTS PERSONNEL SERVICES Temporanv Staff Subtotal Consultants/TemPorarY Advisers Operational Travel Operating Costs Contracts/Translation Subtotal TOTAL PHASE TV Expenditure 1992 Expenditure 1993 Approved 1994 Proposed 1995 40,000 35,000 a,135 26,677 40,(n0 35,(n0 110,586 89,103 13,672 883 116,495 93,U5 1,981 135,000 110,000 10,000 5,000 l40,o0o ll0,00o 10,u)0 5,000 214,244 2t2,tzl 260,fl)o 255,{x)o 238,379 238,798 3(rc,U)0 30o,ooo JPCI5.4 Page 50 4.10. Capital costs 4.10.1. Office equipment The action consisting in favouring equipment reconditioning and repairs will be continued and the purchase of new cquipment will be strictly limited. US $24,000 will be allocated to this category of expenditure. 4.10.2. Computer equipment The purchases will be mainly focussed on a consolidation of the computer tool patiently established during the past two years. A budget of US $35,000 is necessary in view of the present equiPment. 4.10.3. Technical equipment This mainly concenN the scientific equipment Decessary for the smooth nrnning of the different laboratories (hydrobiology,-DNA, insecticides, applied research and aquatic monitoring). Taking into account-the strengthening of the onerali-onal facilities and the unavoidabie rephJment of some old equipment, a consolidated budget of US $310,000 is ProPosed. 4.10.4. Vehicles The zuccessive decreases have led to a stabilization of the Progremme's essential requirements in terms of vehicles. A particular emphasis is laid on the category of 'field operational vehicles" whose decrepitude and state of degradation necessitate replacements estimated at US $300,000. 4.10.5. Buildings It is not planned to undertake new constructions throughout this phase. The existing buildingi will just be maintained in an acceptable state. An amount of US $10,000 will be earmarked for that purPose' Office Furniture Data Processing eq uiPment Equipment Vehicles Buildings Total JPC15.4 Page 51 TABLE 1/r CAPITAL COSTS(us 3) TABLE T5 BBEAKDOWN OF CAPITAL COSTS TO ACNVITIES(us $) P H A S E IV Erpenditure 1992 Erpenditure 1993 Approved 1994 Proposed 55,277 65,751 151,570 565,988 15,966 16,925 51,829 118,054 r71,5m 7,902 25,000 90,000 150,0@ /100,0@ 15,000 24.(X)O 95,(xx, 310.OOO 3(X),OOO lo,ooo a52,552 366,290 620.OOO 1679,OOO Equipment Vehicles Buildings TOTAL Office Furniture Data Processing Technical Vector Control I IEpidemiologicalEvaluation , Biostatistics and I nformation Systems Devoh.ttion Administration and Support Services 10,000 2,500 2,500 3,000 6,000 10,000 15,OO0 10,000 290,000 10,oo0 10,000 200,0@ 70,ooo 30,000 10,000 520,Oq) E2,500 17,500 B,OOO 56,OOO TOTAL 24.(DO 95,q)O gto.(x)o 900.(xx) 10,qro 679,OOO JPC15.4 Page 52 rv ANNEXES I. OCP ORGANIZATION CHART tr. AVERAGE COSTS USED FOR BTJDGETARY CALCULATIONS M. RATES OF EXCHANGE OF THE US DOLLAR/CFA FROM 1993 TO 1994 BREAKDOWN OF WHO/OCP STAFF MEMBERS BY NATIONALITY AND SEX AS AT 30 JUNE 1994 V. COST OF PERSONNEL FROM 1986 TO 1995 vI. AERIAL OPERATIONS FROM 1986 TO 1995 vII.MAP-PRoPoSEDvcuPLANoFoPERATIoNSFoR1995 Vt[. VCU ENTOMOLOGICAL EVALUATION NETWORK - 1995 DK. MAP - LARGE-SCALE TVERMECTIN TREATMENT PLAN FOR 1995 X. VEHICLES IN OPERATION FROM I99O TO 1995 JPCl5.4 Page 53 tltr{Ex I T T 2a EE IE E EEtu BT {o rJa!o E - E0 =2 5 E JE 2 iu HE i o e E E Eo Z E HE 35 ul = =E(, oEr- o' iEJ<O-troE2zoootr eftvr= 66L"F u6 orIoz o n =[8E o 2 oII EBg 3 rJ2 D(, o .,H EHUE o { Er E:l>IJ IJ BI eI H: $ EEE <=lJala EE tg =3 o E EIJo E E3o t E tr E 3 E I( E I E E a rJt C E 2IJ o 2 E 3 - EE <2 E3 Eg E F 3I lrJo EY E: _ag Ei! IE o HBEO ot EHTO tr3(,0 o IEB 3 HIo - oF E oE2 oII , EE EE TE EE rJ(, ET 6Ene) {l Hp6{ E; 5 5 C P E II E EoE E 3 JPCI5.4 Page 54 tfit{Ex II Personnel Professionals - D2-P6 - P5-P4 Programme area Geneva - P3-Pl C'enerd Services Programme area Geneva National Personnel - Conzultant/month - Temporary (General Services/month) Aerial Operations Cost per flying hour (incl. fuel) - Guaranteed helicoPter hours - Excess helicoPter hours - Guaranteed fixed-wing aircraft hours - Excess fixed-wing aircraft hours - Guaranteed liaison aircraft hours - Excess liaison aircraft hours Insecticides Cost per litre - B.t. H-14 - Temephos 20 % EC - Permethrin20% EC - Carbosulfan 25 % EC - Pyraclofos 50% EC - Phoxim - Vectron Value oflUS:lsllar - CFA Franc - French Franc - Swiss Franc - Pound Sterling - Deutsche Mark - Canadian Dollar - Japanese Yen 8 000 900 1992 1993 1994 1995 3 000 7 000 800 3 500 7 000 800 8s3 742 869 758 248 t24 1992 1993 1994 A\TERAGE COSTS USED FOR BUDGETARY CALSLJLATIONS (US$) 1992 1993 1994 1995 t22 W 111 000 155 000 83 000 15 000 88 500 131 500 119 000 165 000 89 500 20 000 95 000 143 000 126 000 175 000 96 500 22 5@ 96 500 150 000 140 000 175 000 105 000 *16 000 105 000 3 500 7 000 E00 823 712 823 7t2 4.& 12.80 10.20 20.s9 26.45 15.03 E23 7t2 1995 tgg2 1993 1994 199s 4.& 14.13 10.64 20.59 26.45 t7.r4 4.U t4.59 10.18 20.82 26.45 4.& 13.85 t0.29 20.82 26.45 14.85 24.t5 580.00 5.80 t.43 o.67 t.67 1.38 103.00 285.00 5.68 t.47 0.60 1.68 1.18 149.00 285.00 5.68 t.47 0.60 r.68 1.18 149.00 28s.00 5.68 1.47 0.60 1.68 r.18 149.00 Th: a.rcraSe cos; of u5 $16,000 used for General Service staff refers o higher-grade suff mcmbers who will 62intein tbe QfP gr r,iS JPC15.4 Page 55 ANTIEX III UJ k E. h(, of c0 =TIJz HlrF ul k CE F trJ ootr=fi;idEiBi IFiaF 3 o lrJ $glF (E = (U = c(U? = C)oo C) o o) trf? L- o- .clolJ- cf? L CL lrol! c(U? oz CL oo =? (E = (U = E Li elit 3{-(9o)ro o o) RI ""'t silN il sil*j -11ol{N:l <o: Iorl I6t :l co:l cot(\tt o @lo rf o)o c, o) o) ILo tr, 5J oo !a -:J z o .IF =Jo EI (f) cE) |* lLolcolot c(tt? [ *ll!*liElisr lipI:(\I lipI i(\Ilial,i: N I 88888EEEF VJC = I$ aJPC15.4 Page 56 AilNEX IV DISTRIBUTION OF WHO/OCP STAIT'MEMBERS BY SEX AT{D NATIONALITY As at 30 June 1994 GENERAL SERVICESPROFE,SSIONAIS Total % TotalFemale% Total MaleTotdMaIe FemaleNATIONALITY 0.59 0.59 6.47 43.53 0.00 14.t2 0.59 0.00 0.00 7.06 O..t) 0.00 t4.12 0.00 11.75 0.m 0 0.00 0.00 I 74 24 I2 24 0 20 I I 0 0 I 0 0 I 0 0 0 11 29 0 0 8 0 0 0 2 0 0 6 0 6 0 0 I 0 I I l6 I 0 0 10 I 0 r8 0 l4 0 0 0 45 0 I l0 0 0 I I 0 0 I 0 2 I I 2 2 1 1 4 0 I I 2 3 0.00 0.00 4.17 0.00 8.33 4.17 4.17 8.33 8.33 4.17 4.t7 16.65 0.00 4.17 4.17 8.33 12.50 4.t7 4.17 0 0 0 0 0 0 0 0 0 0 0 0 0 I 0 0 0 0 0I 0 0 I 0 2 I I 2 2 I 4 0 0 I 2 3 I ALGERI"A AUSTRALIA BEMN BRAZIL BURKINA FASO CANADA CONGO COTE D'TVOIRE FRANCE FED. REP. OF GER GAMBIA GHANA ITALY MADAGASCAR MALI I spNpcru- TOGO UMTED KINGDOM USA 100.0054 170116100.00uI23TOTAL IPCI5.4 Page 57 A,llilEX Y L(U o (UEtr .g(U C) lo o, o) t CD o) $l o) o, o o) o) co @ o) (o @ o) o D a(t b q t N N 8 o o o oo o =o o Io o CL o oll E3z ro o) O) F oF(o @ O) F =o E, lJ. a Lu C) E, UJa J I.JJzz o CD E, tu o- IL o F CD oo d I I!t 6l ri B GItf t a, q o tsk o (U tro tUtr + ILoo #H n I EE[;E.F EbHb(/); frE E E.E Ebs99:", ool? .cl!lL'EE G ,J J Azz E lffi E ro N u, ao !:lt td o oi 8898Re88BR88eBRPo -F- enle^ 986t lo e6eluecled q tl JPCI5.4 Page 58 At{t{Ex vI q(o 6c '= E'ox Etr(d E, Bs EI, €a ur) E: EO Flr :EE E.EE6 E8 HE + O) o) N o, CD o o, CD ct)@ ct) @@ o, (o @ o, F CD o EN t: t? o(ort d) ro ol U' ol|n G?(o ul @ ah oo o =o o o =o .c -tr .9)tr lr) O) o) F oF(o @ o) o E.II az o tr E. tU o- o J E UJ qt c rO 888R888BRPE88R88eBRPoN--t-- enp^ 996t lo e6euecled J PC 15.4 tuge 59 At{NEXE)vll ,o 6 o c lr, r, z 'g ! to i i ) = a \. ? , 2 I o .o!r=aO Ct-a:! :'., EE EE9 EB EE :d EBE= oPcs tO- oo F=!= 6'ir €E P=$o E'3E =rrg AJ 5<t3t:t: - ag I J C, !, z U 3i z I ,t -l: to to t L dt a a tr a.l} E il ) @ lo o) o) (r3o o- L,o oLo(r(L f,() UJo azo F E TU(LI o z J(L rJ1oo Go lJ. U)zo tr G ld(L o lLo z J o- =o o LJao(L o o: o- r, o a I JPC15.4 Page 60 ATIT{EX VIII ORIGINAL AREA Countr.v C6te d'Ivoire Mali WESTERN EXTENSION Countrv Guinea Sierra I-eone Sector Bouake (') (Supervision, HQ WOA) Sector Kankan Faranatt Makeni Sub-sector Odienne Bamako Ooerational Base VCf] ENTOMOI,OGICAL EVALUATION NETWORK . 1995 \ilestern operational area \ilOA - Bamako. Mali 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Kankan Siguiri Beyla Kerouane Kouroussa Faranah Dabola Kissidougou Mamou Makeni Kabala Eastern operational area EOA. Kara. Togo ORIGINAL AREA + SOIJTIIERN EXTENSION Country Sector C6te d'Ivoire (Supervision Bouake) Sub-sector Bouake Bondoukou Togo Kara Kara Atakpam6 Benin Parakou ParakouBohicon Kandi Ghana Tamale TamaleKintampo Hohoe (') As a rcsult of the new delimitatiorr: ,'i tlie a.'e,as, the Bouakc scctor rcmains in the Wcstcrn Arca but is sub-sectors have becn shared bqween the West and the F'ast ot (, o E o)r =!r,OP -cl5.Eo,a= -rE:LE .>C, a=oa A'PO- eG!t 5EfrIs .-E!tLo E E\ .et O stE=3 =sL:Joc,trEz \O9bEEt-9L,q, S 'E=: ogE -L= LLYostn28 JPC t5.4 Pooe 6l arur{e4E) rx o c,Efu st \ o zoFo(, t E(o t 'l I I I I I I I I \ I\ t I It o E Eg CDoFrr&c =9tl clCe,oo E:5P=qto-9oarvIte €rE s 3J Eoi LJos r. Eo =.E 5E 3:co_ 50- ooaE ^eE8EfloouJ I l:l!:lt: + \ , -7- lr)oI z td lrJ o=(')F efi =er- lrJ2>LJ.. =-F< fi r,,EJl-J =HF(Ju trl E r..,Z,A *z :# lr1 I do(J r-ai UJ UJ(9= 5u L(rOp 9s Rg zoN 'l l- f IofI6 I o fu -l-,sI a t I a Nffi a t I JIz {q\ E o o? oo m 8 oo + t oc 2.o :E o E E t' H v) r' s$SEt , I I t I lrlfg(r lL I(r L \tq\ t s .; o 6(D8. o - o a \,1 ofi >\ I I , t\ i\ ta - , ? + I t t ) JPCl5.4 Page 62 4[{NEX X *too E+toF EE=EE oo oEo EE rts (f) CD o) ct) o) $ o) CD N o) o) 1l) o) CD F oF oCDo o-o) -C) =EOsE ,!!lL rr zs 9Ek:trg IJJ .H o.5Oui .YzqIE irt r- UJJo - II IJJ o -9 .9 .co c o .12 .g ffi Eo =L- ql o cr) o) ooorooo GJ o roN oo c) o ro(r) oo$ oolo tot @$l (r) s lr)t ro al...] ot (t) o)ot (?)o(v) oAI(r) ot c)(f) o,(v)(r) (f)N(f)