Plan of action and budget for 2001

tJOINT PROGRAMME COMMITTEE Offrce of the Chairman Onchocerciasis Control Programme in West Africa Programme de Lutte contre I'Onchocercose en Afrique de I'Ouest JPC - CCP COMITE CONJOINT DU PROGRAMME Bureau du President TPC2I.4 ORIGINAL: FRENCH September 2000 JOINT PROGRAMME COMMITTEE Twenty-first session Yaounde. 14-15 December 2000 Provisional Agenda ltem 12 PL,AN or Acrlom B,uocnr FoR zool t5 t0 'E E^g isIo 0 re6 17,26. II El!-&raPrndoara r5,@5 11,974 14,770 '11,979 :j .!* loeo 200 ,tD'l N2, f )-, I F- IPC 21.4 ONCHOCERCIASIS CONTROL PROGRAMME in West Africa PLAN OF ACTION AND BUDGET FOR 2OO1 t WORLD HEALTH ORGANIZATION t*" I ? ( i) CONTENTS I. INTRODUCTION OVERVIEW OF THE PLAN OF ACTION OVERVIEW OF THE BUDGET FOR 2OO1 ESTIMATED COSTS BY PROGRAMME ACTIVITY Page I 2. J. 4. 4.r 4.2 4.3 4.4 4.5 Vector Control Unit.... Planning,Evaluation and Transfer Unit ... Macrofi I Chemotherapy Project. Office of the Director.... Administration and Support Services Unit ry. V. vI. VII. VIII IX. X. XI. L 4.6. Statutory meetings 4.7 . Capital costs. ANNEXES I. OCP ORGANIZATION CHART II. AVERAGE COSTS USED FOR BUDGETARY CALCULATIONS M. RATES OF EXCHANGE OF THE US DOLLAR/CFA FROM 1999 TO 2OOO CHANGES IN PERSONNEL COSTS FROM I994TO 2OOI AERIAL OPERATIONS FROM 1994 TO 2OOI.. MAP. VCU PLAN OF OPERATIONS FOR 2OO1 MAP - VCU SECTORS, SUB:SECTORS AND OPERATIONAL BASES FOR 2OOI.. ENTOMOLOGICAL EVALUATION NETWORK IN 2OO1 MAP - AREAS EARMARKED FOR LARGE-SCALE IVERMECTIN TREATMENT IN 2OOI . MACROFIL CHEMOTHERAPY PROJECT .42 43 .44 .45 .46 .47 .48 .49 .50 .51 .55 { EVOLUTION OF VEHICLE FLEET FRON{ 1994 TO 2OOI .... 15 15 22 30 32 34 39 40 ( ii) LIST OF TABLES TABLE 1. BUDGET BY PROGRAMME ACTIVITY TABLE 2. BUDGET BY CATEGORY OF EXPENDITURE LINE ITEM TABLE 3. BUDGET FOR 2OO1 - SUMMARY BY PROGRAMME ACTIVITY AND CATEGORY OF EXPENDITURE TABLE 4. VECTOR CONTROL UNIT TABLE 5. PLANNING, EVALUATION AND TRANSFER UNIT TABLE 6. MACROFIL CHEMOTHERAPY PROJECT TABLE 7. OFFICE OF THE DIRECTOR... TABLE 8. ADMINISTRATION AND SUPPORT SERVICES TABLE 9. OVERVIEW OF ADMINISTRATIVE COSTS TABLE 10. STATUTORY MEETINGS TABLE I1. CAPITAL COSTS .. Page 10 t2 I4 2l 29 31 JJ 36 37 39 40 J JPC2I 4 I)aqe I 1. INTRODUCTION The Plan of Action and Budget for 2001 is the fourth and penultimate budget in Phase V of Programme, which corresponds to the 5-year Plan of operations (1998-2C[J2) that was approved by the Joint Programme Committee (JPC) in December 1996. The two main thrusts of this year are: 1) the continuing reduction in vector control activities and 2) the strengthening of the capacity of Participating Countries to effectively detect and control recrudescence of infection with onchocerciasis, by setting up all the necessary structures, with the active support of the Planning, Evaluation and Transfer Unit. The 2fi)1 budget is US$ L4r770,000. However, despite the cuts in overhead costs, the amount proposed is slightly higher than the one provided-for in the Planlof Operations, due to the following reasons: i) the increase in the cost of the flight hour in the new aerial contract in force since 1999 (+ 25% instead of SVo as originally planned), ii) ttre continuation of larviciding on the Sassandra in Cote D'Ivoire iii) the intensification of specific actions in the "shady" zones and iv) the support to be provided to staff during this phasing-out period in order to prepare them for their reintegration into other types of employment. Thus, the proposed budget is 3% higher than the amount earmarked for 2001 by the Plan of Operations. The Plan of Action and Budget for 2001 -has been prepared on the same general format as inprevious years, for ease of analysis. The text sections are intended to present the main components of the Programme activities, their evolution in relation to Phase V operations, and to justiff the expenditure proposed. The tables, graphs and figures summarize the various items pertaining to the expenditure and personnel, and provide a synoptic view of the different budget components. The annexes present some basic elements of the report such as the organizational chart, the average costs applied, and data of an operational or administrative nature seen in the context of their evolution. 1.1 Vector Control Activities The 2001 budget for vector control operations gives prominence to the additional investigations to be conducted in the zones where larviciding can be stopped at the end of 2001. It also puts emphasis on the strengthening of vector control operations in the specific intervention zones or "trouble spots" zones. It is a budget which takes into account the continuation of larviciding in the foci of the Dienkoa in Burkina Faso, and on the Niger near Bamako in Mali, on the Oti and is tributaries in Togo, in the Western Extensions (Guinea) and South-Eastern Extension (Ghana, Benin and Togo). The 2001 budget is also characterized by i) a much higher cost of aerial operations, as in the year 2000, with the application of the new aerial contract in 1999, ii) an increased use of B.t. H-14, due mainly to the improvement in its operational performance, iii) an increased utilization of etofenprox during the rainy season in Guinea, where the sensitivity of the blackflies is hot satisfactory, iv) the consolidation of transferable entomological activities, through a much greater involvement of national entomologists and the countries, in the implementation of these activities. 1.2. Planning, Evaluation and Transfer activities The epidemiological evaluation of indicator villages situated in the basins of the Eastern and Western extensions of the Programme that are still under combined vector control and ivermectin distribution, will be a priority for the PET Unit in 2001. The thrust of affairs in the Unit will be the consolidation of retraining of middle level staff in epidemiological surveillance techniques and community distributors in ivermectin treatment. Collaboration with the national IEC units for the the preparation of appropriate material for sensitization on onchocerciasis in the various countries will be pursued. Higher level training in epidemiology, public health, health planning and health education will be supported by the Unit. The Unit will carry out systematic updating of data that has already been transferred to the f .rPCl I .i I)ugc l countries :rs rvell as c()ntluue the on the-.;ob traruiug o['national stalf in data analy'srs tor decisiott-tnakr Furthermore, the Unit u,ill continue to sive minirnal support to the countrics in implernenting iverurectirt distribution through the cornrnunity directed approach. The Unit will be closely involved in the creation of a WHO Centre for rnultidisease epidemiological surveillance at OCP premises. Finally, the Unit will work closely with the University of Rotterdam on integrated analysis of the Progranlme's data and the updating of the ONCHOSIM rnodel. 1.3. The Macrofil Project The main objective of the Macrofil project will continue to be the development of safe and effective adulticidal drugs (macrofilaricides) for the treatment of onchocerciasis and lymphatic filariasis. A complete presentation of the Project is set out in Annex X (pages 51 to 54). t.4. Office of the Director The Office of the Director will continue to ensure the management and implementation of the Programme in its last phase of gradual disengagement, and within the framework of the strategy, orientations and general policy defined by the Statutory Bodies, and reflected in the annual budges. These duties comprise close liaison with the Statutory Bodies, the Donors, the Participating Countries, the Scientific Community, as well as coordinating all Programme activities, including research contracts. Following some internal restructuring the following functions, which were previously under the Coordinator of the Office of the Director, have been transferred to the Planning, Evaluation and Transfer Unit (PET) as con@rns Communication and Documentation, and to the Administration Unit and Support Services as concerns Translation, the organisation of Statutory meetings and the Liaison Office in Geneva. These budget items, which were formerly charged to the budget of the Director's Office have, therefore, been transferred to the budgets of the various units concerned. Furthermore, to support the final part of the phasing-out period of the OCP Prograrlme, a budget in the amount of US$ 350,000 over the 2001-20C2 period was earrnarked to meet among other things the needs for training, retraining and sensitization of the staff, as well as calling on external consultants in support of some technical and management studies which will be required. 1.5. Administrative and Management Support Services The Administration and Support Services Unit will continue to give support to the Programme's operational Units. tt will strive to manage the human, financial and material resources available to OCP in the best interest of the organization. The Administration is represented by its four departments, namely - personnel - budget and finance - supplies and general services - transport and telecommunications. It also manages the sub-units of translation and the organisation of statutory meetings In this last phase of the Programme. the Sensitization and Staff Support Committee will continue to provide practical advice, training and retraining opportunities as well as assistance for guiding staff members in their search for future jobs. The training and retraining of staff rvill continue this year, rvith a view to helping staff members reposition themselves on the job market after 2002. Maintaining the quality of rvork, staff morale and the efficiency of the Organization should be the subject of renewed efforts by the Adurinistration and OCP Management. JPCZI.4 Page 3 2. OVERVIEW OF'tHE PLAN OF AC'IION The Plan of Action sets out the activities which rvrll be carried out by the various units of the Programme during 2001. 2.1 Oflice of the Director In 2001, the Office of the Director will continue to ensure the overall management of the Programme in accordance with the general policy defined with the Donors and the Participating Countries. It will also maintain all the external contacts needed for that purpose and help as much as possible in the reintegration of the staff into other rypes of employment between now and the end of the Programme. The liaison office for Africa based at the WHO Headquarters in Geneva will continue to be solicited by OCP for ensuring a follow-up of the contacts between the institutions. OCP will continue to participate, as it did in the past, in the operational cost of this liaison office. 2.2. Vector Control (VC[D The Plan of Action for 2001 shown (on a map) in Annex I is fairly similar to that of 2000 for vector control activities, and may be summarized as follows: in the original Programme area, only the Dienkoa focus in Burkina Faso and the focus on the tributaries of the Oti in Northern Togo (K6ran, Kara and Md) will continue to be treated; in the Southern Extension in COte d'Ivoire, only the middle portion of the Sassandra and its tributaries, the Bagbe and Bafing will continue to have aerial treaEnent. Vector control activities in the Western extension have officially been suspended in Sierra kone since January I 1999, but will continue in Guinea. They will also continue in the South-Eastern Extension (southern Ghana, Togo and Benin). The principle of rotation of insecticides concentrates on five producs among the least harmful to the non-target fauna, and ttre most cost-effective ones. These are temephos, pyraclofos, permethrin, etofenprox, and Bacillus thuringiensis H-14 (8.t. H-14) which has increasingly been used since 1999 with the introduction of more efficient formulations. The entomological evaluation network of which the total number of carching poins regularly visited was reduced from I24 to 107 in 2000, mainly as a consequence of the cessation of larviciding in Sierra Leone, will not undergo any changes in 2001. The new aerial contract that was signed with "Evergreen Helicopters International" in 1997 will continue to be in force with a flight hour cost of 25% higher than the amount provided for in the Plan of Operations of Phase V of the Programme. Research activities on insecticides will basically be centred on the monitoring of blackfly susceptibility and to routine monitoring of the qualiry of operational insecticides. However, collaboration with the molecular biology laboratory of the University of Alabama, Birmingham (UAB), and with the molecular biology laboratory of IRD (former ORSTOM) in Montpellier, will continue as in the previous years. The habitat qualiry assessment will be one of the major components of the monitoring of the aquatic environment for a better interpretation of the resuls of the aquatic environment monitoring. The activities o[ routine monitoring of the long-term effects of the least selective larvicides on the non-target aquatic fauna will continue, and the on-going valorization of the aquatic monitoring activrties implemented by the Programme, should come to a successful conclusion. \ 7 TPCZI.4 Page 4 2.3. Planning. Bvaluation and Transfer Unit (PET) For the year 2001, the Planning Evaluation and Transfer Unit will, as in the previous year provide technical, logistic and financial support to the countries. This minimal support is aimed at rendering the countries technically capable of taking over the responsibility for residual onchocerciasis control activities, and more especially for detection and control of any recrudescence of onchocerciasis infection within the framework of their national health systems. The efforts already made towards the promotion of the process of integrating onchocerciasis control into the national health system will be reinforced. The Unit will continue to support the community directed treatment with ivermectin effort in the communities, the country-specific analysis and interpretation of data as well as operational research. The objective is to safeguard the health improvement and economic gains which have resulted from the Onchocerciasis Control Programme. Large-scale ivermectin distribution through the communiry directed approach will be carried out in an estimated 27 ,00O villages, as in 2000. It is therefore exp6cted that more than nine million people will be treated in 2001. Experience from the preceding years suggests the need for reinforcement of Information, Education and Communication (IEC) interventions. This Unit will support this activity working closely with national/local experts. Epidemiological evaluations planned by this Unit in collaboration with the national teams will be carried out by the countries in the villages in basins where there is combined larviciding and ivermectin distribution. There will also be the continuation of evaluations in the areas with only ivermectin treatrnent, as a follow-up to the study on the long-term effect of ivermectin treatment on transmission. There will be a continuation of ophthalmological evaluations in a number of villages in the basins of the eastern and western extensions to help assess the long-term impact of combined vector control and ivermectin treatrnent on (a) the transmission of infection and (b) on onchocercal eye disease. The Unit will continue the ongoing transfer of the epidemiological data collected by OCP to the countries, the training in data entry, data validation, analysis and interpretation of results obtained. Updating of the data entry and validation programmes that have been installed in each of the countries will be continued. This will help the nationals to be completely and independently operational in data management. Modelling of different epidemiological sinrations (areas under larviciding alone, areas undergoing only ivemectin treatrnent, and areas undergoing combined treatrnent) will continue in OCP in 2001 using the ONCHOSIM model. Additional data collected from epidemiological surveillance will be used to test and validate predictions of the simulation, with particular reference to the long-term impact of treatrnent with ivermectin, the detection of recredescence, and its control with ivermectin. The extensive integrated analysis of all the data collected since 1974 by the Programme, which was initiated in 2000 in collaboration with the Universiry of Rotterdam, will be completed. This is to refine the ONCHOSIM model, and to arrive at likely scenarios of the onchocerciasis siruation at the end of 2002. The Unit will continue its suport to the computer-based activities of the Programme, both through the maintencance and management of the local network set up at the Programme headquarters in Ouagadougou as rvell as through the development and updating of the software and the various technical and administrative data banks. The trvo departrnents in charge of doculnentation and communication will continue to be supervised by the Unit. These two departments are to play an important role in the valorization of the Programme's achievements. ^t, r JPCZI.4 Page 5 The various trarning programmes, which are the foundatron of all the actrvrtres of the Unit, will be consolidated in 2001. High-level trainirrg, which rvill be lirnited, willgenerally be undertaken in instirutions in Africa. As in the previous years, the unit will concentrate on the following disciplines: epidemiology, public health, health planning and management, health education. The emphasis will be on field training, on-the-job training and training through seminars and workshops. Retraining at the communiry level for communiry directed treatment with ivermectin will be continued. In collaboration with WHO/AFRO, the unit will be closely involved, both in terms of technical expertise and logistics, in setting up a functional WHO Centre for multidisease epidemiological surveillance at OCP premises. 2.4. Macrofil Chemotherapy Project (MACROFIL) The discovery and development of effective macrofilaricides for onchocerciasis and lymphatic filariasis control remain the primary objectife of the Macrofil Project. However, emphasis will also be placed on the search for a substitute for ivermectin to address any cases of resistance that would be encountered. The total amount for the project in 2001 will be US$ 1,700,000, with OCP contributing US$ 570,000. The remaining balance will be shared equally between APOC and TDR. OCP will continue to fund the salaries of a scientist and of a secretary, as well as the Oncho Chemotherapy Research Centre in Ghana. 2.5. Administration The Administration and Management Support Services Unit will continue to support the technical units of the Programme. As a Unit in charge of managing the human, material and financial resources available, it has to work in the perspective of the Phasing-out of the Programme by the end of the year 2N2. For some sectors of activity, this Phasing-out is already reflected in the budget, as, for instance, the decline in capital expendinrre these past years. For the Personnel office however, the drive must be kept up in order to provide counselling and orientation to staff members whose concerns are centred on their future prospects of employment after the end of the Programme. Besides, all the Administrative Offices must provide increased support to APOC. Thus, to maintain the quality of the management, and comply with reporting deadlines, especially to Headquarters, the Administration Unit will, according the needs, recruit short-term and temporary staff which is less expensive compared to fixed term staff. !i lPczl 4 Page 6 3. OVERVIEW OF THE BUDGET FOR 2OO1 3.1. General structure For this overview, the Plan of Action and Budget for 2001. is presented in two ways: by "Programme activity", and by "Category of expendinare". The prograrnme activities are basically structured according to the organization chart of OCP shown in Annex I. The categories of expenditure are the components of the Prograrnme activities The summaries of these components are shown in the following tables and figures: Table 1: budget by programme activity, from 1996 to 2001 Table 2: budget by category of expenditure frdm 1996 to 2001 The two tables are illustrated by the pie charts in figures I arrd 2 respectively Table 3: combines tables 1 and 2 for 2001, the category of expenditure being shown for each Programme activity. 3.2. General remarks The amount proposed for the 2001 budget is US$ L4,770,000. In the context of the phasing-out of the Prograrlme, only the essential activities have been retained. A measure which was recorrmended by the Expert Advisory Committee and already implemented in 2000 i.e., the continuation of seasonal treatrnent in the Sassandra basin in COte d'Ivoire will have to be maintained in 2001. In addition, particular attention will be given to the fine- tuning of the ONCHOSIM model in the perspective of the post-OCP perid. These measures, which have proved to be indispensable, had not been provided for in the 5-year Plan of Operations (1998- 2002) approved by the Joint Programme Committee at its 17h session (Cotonou, December 1996). They resulted, in a 3% increase in the budget provided for the year 2001 in the Plan of Operations. The average costs used for the calculation of the budget are set out in Annex II. The trend of the exchange rate of the US dollar to the CFA franc for 1999 up to May 2000 is shown in Annex III. 3.3. Categories of expenditure The categories of expenditure are reviewed in the order followed in table 2 3.3.1. Personnel Services For a better understanding of this category of expenditure, the three main categories of posts used by OCP will be recalled here: WHO/OCP staff Professional and General Services staff contracted under WHO staff Regulation, with UN salary scales. t" JPCZI.4 PageT SSA staff Staff whose contracts stipulate that they are not members of WHO staff, and that they are exclusively subject to the terms and conditions, salaries and allowances specified in their conffacts (salary scales may be based on those of Participating Countries, of the private sector or of the UN, depending on the position). National staff Staff of the national teams of the Western extension whose salaries and allowances are paid by their respective Governments, supplemented by individual flat rate allowances paid by OCP. The changes in these various categories of staff since 1995 are shown in the following figure: 1995 1996 1997 1998 1999 2000 a00l E= National Staff In 2001 the total number of posts will remain the same. Staff costs have been contained and even reduced, as compared to 2@0. A summary figure of personnel coss from 1994 to 2001 is shown in Annex fV. The proposed expenditure for personnel for 2001 isUS$ 41617,W, i.e. 1.47% less than the amount approved for 2000. 3.3.2. Consultancy services. Contracting for external services is meant to reinforce certain activities, particularly those related to capacity building in the countries. These services include that of high level experts and short-term professionals. The main areas in which consultancy services are used are in the fields of insecticides research, entomology, hydrology, hydrobiology, cytotaxonomy and public health. The planned expendiurre of US$ 595r(n0 is 14.39% less than that approved for 2000. 800 700 600 500 400 300 200 100 0 -** t87 160 t14 90 94221 205 177 178 329 330 330 303 259 737 531 695 635 620 570 s30E n tPczt.4 Page 8 3.3.3. Operational travel. As in previous years, strict controls will continue to be applied to this budget item which amounts to US$ 355,000 for 2001 which is 1.39% less than 2000. 3.3.4. Contracts This expenditure category covers research and service contracts signed with companies, universities and other institutions in support of specific OCP activities such as monitoring of the aquatic environment, Argos teletransmission, maintenance of hydrological stations. Also included are some research contracts for the Macrofil Project. The expenditure proposed under this category iilJS$ 415,(X)0, i.e.8.4% lesser than that approved for 2000. 3.3.5. Aerial operations. Two factors remain determinant in 2001, as they were in 2000, leading to an overrun of the amount proposed in the Plan of Operations of Phase V (1998-2002): the continuation of seasonal larviciding in the Sassandra basin; the cost of the flight hour, which is higher than the amount estimated, starting from I January 1999. However, the cessation of larviciding in Sierra Leone has made it possible to partially offset these increases. The proposed amount of US$ 3,414,A00 is 0.5 % less than that of 2000. The rend of aerial operations between 1994 and 2001 (flight hours and cost) is shown in Annex V. 3.3.6. Operating costs These are costs which concern the logistic needs of the Programme (vehicle fuel, spare parts, etc.) and infrastructure-related services (electricity, water, telephone). The amount proposed is US$ 7821000, i.e.2.7% less than that of 2000. Particular efforts will continue to be made to bring down this expenditure to the extent possible. '-- 3.3.7. Larvicides Taking into account the stocks and usage rate for 2000, the cost of ttre quantity of larvicides that will be needed in 2001 was estimated at US$ 211861000, which is 3.7% less than that 2000. 3.3.8. Supplies This category covers the procurement of recurrent items such as office supplies, small contracts for security, office cleaning and maintenance of office equipment, and miscellaneous items. The amount required will be US$ 170,000 which is 123% less than that of 2000. 3.3.9. Statutory meetings The amount estimated under this category isUS$ 210,000, which is l9Vo less than that of 2000, due to projected efforts that will be made to cut down on this expenditure. rTPCZI.4 Page 9 3.3.10. F'ellorvships and training The financing of current fellowships, new ones, in-service and field training are still deemed essential to increase the technical capacity of countries to take up responsibility for the residual activities of onchocerciasis control. On the basis of available data, including the training plans submitted by several Participating Countries, the amount proposed for this item is US$ 300,000, i.e. 28.6Vo less than that of 2000. 3.3.11. National teams The Governments of the Western Extension Countries continue to put under the technical supervision of the Prograrnrne, national teams to undermke vector control activities such as ground larviciding and entomological evaluation. These teams, like all others in the Participating Countries, also carry out epidemiological evaluation, management of ivermectin distribution and awarness- raising activities. OCP provides technical and financial support to these activities. The amount proposed for this category is US$ 7LL,OOO i.e. the same alnount is in 2000. 3.3.L2. Administrative support from Geneva This relates to the administrative support the Programme receives from the WHO Headquarters in Geneva. The flat amount proposed on the basis of the actual expendinrre made in the previous years, is US$ 375,000, which is the same amount as in 2000. 3.3. 13. Sub-regional Centre for Multidisease Surveillance In support of the installation of the AFRO Sub-regional Centre for Multidisease Surveillance the Programme will again make available to the Centre an amount of US$ 100,000. This budget item is charged to the Planning, Evaluation and Transfer Unit (PET) 3.3.L4. ONCHOSIM integrated analysis This project is to be implemented in collaboration with the University of Rotterdam to carry out an integrated analysis of entomo-epidemiological data and the fine-tunig of the ONCHOSIM epidemiological prediction model. The budgeted cost is US$ 120,000. 3.3.15. Phasing-out period As a support measure during the 2001-2002 part of the phasing-out period, a special fund was established for the training, retraining and sensitization of staff, as well as calling on external consultants for the resolution of some technical and managerial problems. An amount of US$ 350,000 has been budgeted to this end. This amount will be included in the budget of the Director's Office. 3.4. Other category - Capital costs The amount proposed for Capital costs in 2001 has been reduced to the minimum, given the approaching end of the Programme. An amount of US$ 60,000 has therefore been budgeted. This amount is 50% lower than that provided for in 2000. 3.5. Budget summary The total amount of the budget for 2001 is US$ 14,770,000, i.e.barely 3% higher than the amount provided for in the Planops in 1996. tPC2t.4 Page l0 TABLE 1 BUDGET BY PROGRAMME ACTIVITY(US$) Nots: lvermectin : 3.000.000 tablets of 3 mg, valued at US $ 1.5 a tablet, will be provided through Mectizan Donation Program (MDP) to OCP, free of charge, to Sierra Leone and Bissau Guinea. The other countries will receive ivermectin directly from MDP without passing through check OCP. a Programme Activity PHASE V Proposed 2001 A,pproved Expenditure Expenditure 1 9982000 1999 PHASE IV Expenditure 1997 Expenditure 1 996 Vector Control Planning, Evaluation &Transfer Unit Chemotherapy Project Office of the Director Administrative & Support Services Administrative Support Geneva Statutory Meetings CapitalCosts 9,59i.000 1,920J)0G ",, ,', , 570-000 ' ': i',' ,'.' 833.,000 -,.:ri.. i':,1.295S00 1.. 375.0u0 l:.:. .: : :.: ll:ill:iiii210l0o0: l:, ';6olo0o,l:' l:... 9.613.000 1.S81.000 700.000 7s9.000 1.204.000 375.000 250.000 92.000 9.772.448 2.075.206 664.992 688.230 1 .169.398 363.532 190.390 101.731 11.873.531 1.796.184 518.116 879.727 1.345.471 360.068 204.463 228.661 13.572.558 1.958.417 1.730.528 765.967 1 .715.580 311.467 206.201 851.853 13.985.652 1.703.297 1.747.690 1.411.554 1.842.570 348.451 173.600 579.880 TOTAL 14.974.000 15.025.927 17.206.221 21.112.571 21.792.694 !IPC?L.4 Page 11 FIGURE 1 BUDGET BY PROGRAMME ACTIVITY .2001 6 7 8 5 US$ 9,507,000 1,920,000 1,295,000 833,000 570,000 375,000 210,000 60,000 4 3 2 1 1. Vector Control 2. Planning, Evaluation and Transfer 3. Administrative & Support Services 4. Office of the Director 5. Chemotherapy Project (Macrofil) 6. Administrative Support Geneva 7. Statutory Meetings 8. CapitalCosts (To) u.37 13.00 8.77 5.64 3.86 2.U 1.42 0.41 \.. S.. '.'r\'a' TOTAL 14,770,000 100.00 * JPCZL.4 Page 12 TABLE 2 BUDGET BY CATEGORY OF EXPENDITURE(us$) r Category of Expenditure PHASE V PHASE IV Proposed 2041 Approved 2000 Expenditure 1999 Expenditure {998 Expenditure 1997 Expenditure 1996 RECURRENT COSTS Personnel Services Consultants Operational Travel Contracts (research & others) Aerial Operations Operating Costs LaMcides Supplies Statutory Meetings Fellowships and Training NationalTeams Adm in istrative Su pport Geneva WHO SubregionalCentre I lorucuosna I I lPhasing-out 4,6{7,0001 I 595,0001 I 355,000 4t5,000 3,41rt,000 782,000 2,t961000 {?0,000 2t0,ooo 300,000 721,000 375,000 {00,000 ,t20,000 350,000 t. 4,686,000 695,000 360,000 450,000 3,436,000 804,000 2,270,000 195,000 250,000 420,000 721,000 375,000 100,000 120,000 3,750,283 827,148 386,936 585,741 3,358,118 1,295,894 2,530,047 325,919 190,390 415,553 794,636 363,532 99,999 'lllli 432,8481 1723s1l 3,865,0011 1,328,4191 2.811.226 441p92 204,463 438,905 790,873 360,068 5,311,648 1,036,251 399,618 1,764,4',19 4,093,475 1,344,247 3,774,667 544,873 206,201 422,767 1,051,085 311,467 6,395,360 1.019,779 605,820 1,465,751 4,020,990 1,493,493 3,659,214 420,763 173,600 529,393 1,080,200 348,451 Subtotal 'I4,710,000 14,882,000 14,924,196 16,977,560 20,260,718 21,212,814 CAPITAL COSTS Office Furniture Data Processing Equipment Vehicles Technical Equipment Building 7,000 33,000 20,000 2,000 30,000 4s,000 15,000 1,198 26,664 62,575 11,294 2,251 56,728 97,970 65,667 6,045 34,269 90,105 590,690 136,789 37,870 65,93G 359,011 104,992 12,077 Subtotal 60,000 92,000 101,731 228,661 851,853 579,880 TOTAL 14,770,000 14,974,000 15,025,927 17,206,221 21,112,571 21,792,694 tPczt. Page I 4 3 FIGURE 2 BUDGET BY CATEGORY OF EXPENDITURE.2OOl 13 14 15 16 1112 10 9 8 7 1 6 5 4 3 2 1. Personnel Services 2. AerialOperations 3. Larvicides 4. Operating Costs 5. NationalTeams 6. Consultants 7. Contracts (Research & Others) 8. Administrative Support Geneva 9. OperationalTravel 10. Phasing-out 11. Fellowships and Training 12. Statutory Meetings 13. Supplies 14. ONCHOSIM 15. W-lO Subregional Centre 16. CapitalCosts TOTAL US$ 4,617,000 3,414,000 2,186,000 782,000 721,000 595,000 415,000 375,000 355,000 350,000 300,000 210,000 170,000 120,000 100,000 60,000 o/o 31.26 23.11 14.80 5.29 4.88 4.03 2.81 2.54 2.40 2.37 2.03 1.42 1.15 0.81 0.68 0.41 14,770,000 100.00 JPCZL.4 Page 14 TABLE 3 YEAR 2OOI SUMMARY BY PROGRAITIIME ACNVTTY AND CATEGORY OF EXPENDM'RE(us$) Category Office of Director Vector Control Unit Planning, Evaluation & Transfer Macrofil ProJect Adminls- tration Total 2000 RECURRENT COSTS Personnel Services Consultants Operational Travel Contracts (research & others) Aerial Operations Operating Costs Larvicides Supplies Statutory Meetings Fellowships and Training NationalTeams Administrative Su pport Geneva \A/FIO Subregional Centre ONCHOSIM Phasing-out 393,000 35,000 35,000 10,000 10,000 210,000 350,0001 2,069,000 300,000 200,000 185,000 3,414,000 592,000 2,186,000 90,000 471,000 780,000 140,000 50,000 70,000 60,000 50,000 300,000 250,000 1 oo,oool 20,oool I 1 285,000 120,000 25,000 140,000 1,090,000 45,000 20,000 120,000 20,000 375,000 4,617,000 595,000 355,000 415,000 3,4{4,000 782,000 2,196,000 170,000 210,000 300,000 721,OO0 375,000 100,000 120,000 350,000 Subtotal 1,043,000 9,507,000 1,920,000 570,000 1,670,000 14,710,000 CAPITAL COSTS Office Furniture Data Processing Equipment Vehicles Technical Equipment Buildings 5,000 10,000 10,000 13,000 3,000 2,000 10,000 7,000 7,000 33,000 20,000 Subtotal 25,000 16,000 19,000 60,000 TOTAL 1,043,000 9,532,000 1,935,000 570,000 {,699,000 14,770,000 of Eroenditure JPC21.4 Page 15 4. ESlIMATED COSTS BY PROGRAMME ACTIVITY 4.1. Vector Control Unit (VC[D 4.1.1 Zones to be treated (Annex VI) Oiginal Programme Area Aerial larviciding will continue on the tributaries of the Oti (Keran, Kara and Mo), which are considered as part of the South-eastern Extension. Ground larviciding will continue in the basin of the Dienkoa, under the responsibility of the national team of Burkina Faso, with technical and financial support from OCP. Southern extension COte d'Ivoire Larviciding was suspended at the end of 1998 in almost all the basins of the southern extension of Cote d'Ivoire, except the middle course of the Sassandra and is tributaries Bafing and Bagbe, which are still being fteated, but on a se:rsonal basis. However, the size of this watercourse being in no way comparable to that of the watercourses no longer under treatrnent since 1999, this situation did not have any significant effects in 1999 and 2000, and will not have any significant effects on the budget of the Vector Control Unit in 2001. Western and South-eastern Extensions No changes in larviciding coverage are planned for the Western extension in 2001. Ground larviciding on the Niger and is tributaries in the Bamako area will continue to be carrid out, as in 2000, by the national team of Mali, with technical and financial support from the Vector Control Unit. In the South-Eastern extension, larviciding coverage will also remain the same in 2000. 4.1.2. Larvicides 1999 was marked by the improvement of ttre efficiency of the Vectobac 12 AS formulation. The two biological larvicides (Teknar HPD and Vectobac 12 AS of Bacillus thuringiensis H-14 (8.t. H-14) can now be used at the dose of 0.54 llflf ls (75% of the operational dose), and at discharges far above 15 m3/s, with carries over 20 krn at discharges above 100 m3/s. Due to the difficulties in mastering fermentation parameters for an industrial production of batches of B.t. H-14 of constant quality, we will continue to retain the nvo formulations (Vectobac 12 AS and Teknar HPD). It is to be noted that in addition to the B.r. H-14, four chemical larvicides are mainly used by the Programme in accordance with the insecticide rotation strategy. These are temephos, pyraclofos, permethrin and etofenprox. This strategy does not completely exclude the rwo other products (carbosulfan and phoxim) which could be resorted to in case of necessity. After taking into account the available stocks of carbosulfan, and given its limited use, we shall not order this product in 2001 and beyond. The same will apply to phoxim. On the other hand, in accordance with the recommendation by the Expert Advisory Committee to maintain etofenprox in the areas of low susceptibiliry of larvae to organophosphorous compounds, and given the low quantity of the stocks available, an order of this product is planned in 2001. The requirements for the year 2001 are estimated to be 211,900 litres of insecticides, i.e. a slightly lower figure than to that of 2000 (225,000litres). This is mainly due to the smaller quantity of chemical larvicides ordered, taking into consideration the end of the Programme, and to the improvement of JPCZI.4 Page 16 tlre perfonlance of B.t. H-14 which ts rnore selectrve than the chenrrcal larvrcides and which has not yet met with any vector resistance. However, it was necessary to order etofenprox to replenish our stock, and to effectively control the lowered susceptibility of blackflies to organophosphorous compounds in the Western zone of the Programme. With respect to cost, a reduction of nearly 3.77o, compared to the budget approved for 2000, can also be noted due to the reduction of the unit price of Teknar and Vectobac, of which the quantity proposed for purchase represents 75% of the total quantiry projected to be ordered, i.e.: - Temephos - B.t. H-14 (Vectobac) - B.t. H-t4 (Teknar) - Pyraclofos - Permethrin - Etofenprox 24 400litres (2 containers) 37 500 litres (3 containers) 122 0N litres (10 containers) 28 000 litres (1 container) 7 000 litres (1 container) 14 000 litres (1 container). 4.1.3. Entomological evaluation network (Annexes VII and VIID This year as before, the Plans of Action and Budgets of the national teams of Cote d'Ivoire, Guinea and Mali will be presented in separate documents (Letters of Agreement), to be drafted by the Western Zone's CAT. Apart from these entomological letters of agreement signed in the framework of the onchocerciasis transmission control activities, other agreements will be made with the national entomologiss of these countries, to carry out entomological snrdies, either for the early detection of any possible recrudescence or on ttre impact of ivermectin on transmission. One of the two entomological letters of agreement signed with the national team of Ghana, and prepared by the Eastern Zone's CAT, will be renewed in 2001 for the continuation of the entomological investigations on the Pru. This watercourse is actually located nearer to the former Kintampo sub-sector, which is now the base of the national team (100 kn), than to the Operational Base of Hohoe (887 l<rn, i.e. a nvo-day journey away by road) which was responsible for the entomological studies. The Eastern Znne's CAT will also be involved, as in 2000, in the supervision of entomological studies for the detection of any recrudescence in the oncho.freed areas in the original Programme area, and of the studies on the impact of ivermectin on transmission in the areas concerned by this type of control only. The resources needed for the conduct of these studies which are part of the transfer activities (about US$ 27,000) are to be provided for in the budget of the PET Unit. Contrary to the projections of the progressive disengagement phase, larviciding was not suspended in the entire Sassandra basin at the end of 1998. The entomological activities in this basin as well as in the other basins in COte d'Ivoire are being carried out by the national team of this country since the beginning of 1999. The epidemiological investigations that are planned to be undertaken in 2000 will enable us to determine whether larviciding activities should be stopped or continued in 2001. The Vector Control Unit is henceforth represented (Annex VII) by two (2) sectors of the "national team" type (Kankan and Faranah in the western zone), and fifteen (15) Operational Bases (Bohicon, Parakou, Atakpame, Kara and Hohoe, in the Eastern zone, Bamako, Beyla, Dabola, Faranah, Kankan, Kerouane, Kissidougou, Kouroussa, Mamou and Siguiri in the Western zone) With the complete cessation of entomological evaluation activities in Sierra Leone as of June 1 ,1999, but their continuation on part of the Sassandra, the number of catching points that are regularly visited (points "A" and "B") which was reduced froml24 in 1999 to 107 in 2000, will remain the same in 2001 (Annex XIII) if larviciding is to continue on the Sassandra. tPCzt.4 Pagc I 7 4.1.4. Aerial operations Larviciding coverage in 200i having been planned to be the same as in 2000, aenal operations will also remain the same as in the past year. This stabilization of larviciding coverage between 1999 and 2001 was taken into account in the new four-year aerial contract signed in 1991 with the "Evergreen Helicopter Inc." company. However, a drastic reduction in aerial operations is planned in 2002 which is the last year of the Programme. The main clauses of the new contract are as follows 1) The price of an additional flight hour is, henceforth, the same as that of the guaranteed hour during the entire period concerned. 2) From 1999 to 2001, five (5) "fully operational" helicopters will be on contract from January to February and from.May to December; then three (3) from March to April. Taking into account the factors encountered in the field these past years, and in concert with the officials of the company, the number of helicopters will be increased from ttrree (3) to four (4) in March 2001, and reduced from five (5) to four (4) in May 2001. The Programme guarantees the company 53.6 flight hours per month for each helicopter on contract, at a cost of US$ 1,050 per hour ( i.e the equivalent of US$ 1,126, with Jet A1). 3) Ir2AO2, three (3) "fully operational" helicopters will be on contract from January to February, and from May to December; then trryo (2) from March to April. The Programme will guarantee ttre company 58.8 flight hours per month for each helicopter on contract, at a cost of US$ 1,030 per hour (i.e. the equivalent of $ 1,106 with Jet A1). In 2001, the distribution of the number of helicopters/months per zone will be as follows Month Eastern Zone Western Total January February March April May June July August September October November D6cember 2 2 I I 2 J J 3 J J 3 2 J 3 J 2 2 2 2 2 2 2 2 3 5 5 4 3 4 5 5 5 5 5 5 5 Total 28 28 56 tPC21.4 Page I 8 4.1.5. Applied researclr Overall, research activities will gradually be reduced as the Programme winds down to a close. Thus, in 2000, with respect to research on insecticides, activities relating to the preparation of genetically recombined formulations of B.t. H-14, as well as the developmenr of a hemolytic technique for quality control of the operational batches of B.r. H-14 have been suspended. Only the routine quality controls of the operational insecticides, monitoring of the susceptibility of the larvae of the vector to the organophosphorous compounds, and a few tests of comparison of the formulations of the insecticides retained for the fifth financial phase, will continue. Regarding the activities of the Molecular biology laboratory (which is now based in Ouagadougou since I January 1999), cooperation with the molecular biology laboratory of the Universiry of Alabama in Birmingham (UAB), and the molecular biology laboratory of IRD (formerly ORSTOM) in Montpellier (France), will continue at the_same level as in previous years. The University of Alabama will continue to carry out'quality control of the identification of parasites and vectors through-the classic techniques (Heteroduplex, DNA probes). It will also continue to cooperate with OCP for the use of microsatellite DNA markers applied first to parasite populations (lower Comoe). The identification of vector populations by microsatellite DNA markers will be carried out by the OCP staff who were trained in 1998 by researchers from the molecular biology laboratory of IRD based in Montpellier. In 2001, the role of IRD will be limited mainly to the control of skills, quality control and possibly the transfer of technology in the use of additional microsatellite markers applied to parasite populations. Finally, the research team as a whole will ensure that the high degree of knowledge of the Programme technicians is maintained through appropriate retraining, and ensure regular quality control in all their respective areas of competency (cytotaxonomy, morphology, morphometry, catches, dissection, fixing of infective larvae, ground larviciding, reading of water gauges etc.). 4.1.6. Monitoring of the aquatic environment. The snrdy of habitat quality which was introduced in 1999 (after training of the hydrobiologiss), is now one of the main components of this monitoring. It helps to better assess the influence of factors other than larvicides, on the results of the monitoring of the aquatic environment. ln addition, measures are being taken to involve the hydrobiologists in activities aimed at monitoring biodiversity in the oncho-freed zones, even after the end of the Prograrnme. Routine monitoring activities of the long-term effects of the less selective larvicides (permethrin, carbosulfan and etofenprox) on the non-target aquatic fauna will continue. Emphasis is placed on the evaluation of recolonization, mainly by the invertebrates and to a lesser extent, by the fish populations, of the watercourses that are no longer treated. The workplan will also include major activities of valorization and promotion of the work done by OCP in the field of larvicide selection and protection of the aquatic environment. 4.L7. Research contracts Research contracts will be limited to those signed with the Universiry of Alabama in Birmingham (DNA probes) and the IRD laboratory of Montpellier (DNA microsatellites). However, an earmarked amount will be made available in 2001 for: i) special entomological studies on the transmission by S. sirbanum of O. volvultu strains encountered in the seasonal migration foci of the savana species of S. danmosanl s.l. in the western zone, and, ii) research on the origin of the infective blackflies of the Pru in Ghana, of the tributaries of the Oti in Togo, of the Mafou and Tinkisso in Guinea. tPczt.4 Page 19 {.1.8. Service contracts No particular changes are planned in the servrce contracts in 2001. These will continue to do with organizations working in the held of hydrobiology (analysis of data/valorization of activities, assistance to national teams), and hydrology (teletransmission, maintenance of the hydrological network). Fifty-three (53) beacons in "back-up" service will cover the hydrological network of the basins of the Western and South-eastern Extensions in 2001. However, they will not be running on a continuous basis all year round, so that the total consumption of the 53 beacons should be equivalent to that of 50 beacons working all year round i.e. 10.00 PTT*. Therefore, the contract with the SCL will only take into account 10.00 PTT, instead of 10.6 PTT for the 53 hydrological platforms. 4.1.9. Personnel Since no reduction of vector control activities is planned for 2001, there will be no change either in the number of staff as a whole. 4.1 .9.1 Professionals The number of professional posts in 2001 (see Organization chart - Annex I) will be similar to that of the previous year (7 posts). 4.L.9.2 Short-termprofessionals (STP) The number of STP posts in 2001 will also remain unchanged, compared to the figures for 2000 (5 agents on contract for l1 months, i.e. a total of 55 months). 4.1.9.3 General Services with WHO status After the reductions of posts in the General Services category in 1999 and 2000, the number of staff in this category (26 agents) will not undergo any changes in 2001. 4.1.9.4 Special Services Agreement (SSA) / General Services The number of SSA contracts (22) of levels 4-5 and 6-7 will not change in 2001. The SSA contracts of levels l-3 will also remain the same as for 2000 (104). 4.1.9.5 Temporary staff The hydrobiology department continues to receive samples from all the countries of the Programme and must therefore employ, when needed, 1 laboratory assistant who can carry out screening of the samples collected for the studies of the potential of recolonization of watercourses that are no longer treated. This requires specialised staff who have to do meticulous work. l0 months/assistants are necessary in 2001. Furthermore, given the location of some of the depots, the reduced number of agents, and the need for the latter to take their annual leave, 25 months/temporary labourers (guards, drivers, catchers) will be required in 2001. In addition, the reinforcement of prospections / ground larviciding will necessitate the recruitment of 3 temporary agents for a period of six months. Plattbrm Transmitter Terminal JPC21.4 Page 20 4. 1.9.6 National Staff In 2000, the staff of the national teams in the Western extension saw their number reduced (199 against 233 in 1999) due to the closure of the Sierra Leone enronological bases. It may be recalled that under a Letter of Agreement, the Programme pays only the per diem and the flat-rate indemnity to these employees who are otherwise remunerated by their respective governments. 4.1.9.6. Summary of staffing for the Vector Control Unit in 2001 WHO/OCP Professionals P6-D2 P4-P5 PI-P3 STP (Shorrterm General Services Subtotal WHO/OCP SSA (Professionals and others) National Staff Total PHASE V PHASE IV 2001 2000 1999 1998 1997 1996 5 2 5 5 2 5 4 3 5 I 5 4 5 26 27 48 1 5 5 5 I 5 5 5 56 65 38 39 63 72 81 126 , 199-, t26 r99 t28 233 147 244 134 247 r54 260 .1,9-3€ 363 400 454 453 495 4.1.10. Consultants Emphasis will be put on the use of less remunerative contracts which will make it possible to call upon a higher number of experts. The status of consultant will not be awarded in 2001; rather, temporary advisers or service contractors will be used in support of vector control operations or to help resolve the problem of work overload experienced by the professional staff of the Unit whose number has been cut back. - Insecticides (temporary adviser) - Control strategy (temporary adviser) Total temporary adviser - Cytotaxonomy (CSA type) - Consolidated reports and vecror control (CSA) 20 days 2l days 4l days 21 days 09 months 4.1.11. Budget The budget prepared for the vector conrrol unit (vcu) for 2001 is US$ 9,507,000. tPczt.4 Page 2l TABLE 4 VECTOR CONTROL UNIT (us$) Category of Expenditure PHASE V PHASE I\I Propoged 200'l Approved 2000 Expenditure 1 999 Expenditure 1998 Expenditure 1 997 Expenditure 1 995 PERSONNEL SERVICES lfflf"Ps'[aff lr""nni""t officers Administrative Assistants, Clerks, Stenographer-typists and other General Service Staff Personnel SSA SSA Temporary Sfaff 145,000 580,000 230,000 520,000 584,000 10,000 Subtota! 2,069,000 1,846,503 2,845,094 2,946,689 3,461,038 Consultants Operational Travel Aerial Operations Contracts (research & others) NationalTeams Operating Costs Larvicides Supplies : 47:1,000 59e000 2.196,000 90,000 300,000 200,000 3,436,000 185,000 471,000 592,000 2,270,00O 90,000 332,406 220,425 3,358,118 133,2U 484,233 720,456 2,530,047 147,006 349,357 270,455 3,865,001 124,622 511,140 902,984 2,811,226 193,652 419,398 253,937 4,O93,475 326,018 625,895 885,365 3,774,667 274,114 375,174 326,432 4,020,990 173,185 591,815 1 ,136,498 3,659,214 241,306 Subtotal 7,438,000 7,544,000 7,925,945 9,028,437 1 1,873,531 10,652,869 10,524,614 TOTAL 9,507,000 9,613,000 9,772,448 13,599,558 13,985,652 JPCZI.4 Page 22 4.2. The Planning, Bvaluation and Transfer (PET) Unit 4.2.1 Introduction The year 2001 will be for the Planning, Evaluation and Transfer Unit (PET) an exceptional year whose main objective will be to ascertain whether the residual activities transferred to the Participating Countries are actually integrated into their national health systems. Thus the activities of PET will be geared towards the consolidation of the direct support that the Programme has given to the Participating Countries, as in the previous years, and the objective assessment of the capacity of the countries to maintain the achievements of the Programme. The main areas concerned will be the transfer of alternative tools for diagnosis and the consolidation of Communiry-Directed Treatment with Ivermectin (CDTI). Thus, the Unit will continue to strengthen the skills in the management of activities related to CDTI, epidemiological evaluation and surveillance in the countries, while putting particular emphasis on the analysis of epidemiological data for decision- making, and the integration of these activities into the national health systems. As the Participating Countries forge ahead with the establishment of their multidisease surveillance systems, the Unit will place emphasis on facilitating decentralization and integration of oncho-control activities into the national health systems, as well as reinforce national capacity in the area of Information, Education and Communication (IEC) interventions with ttre help from experts and specialised NGOs in this field. Training will continue to be a key component of the Unit's activities, and will be necessary for all categories of health staff at the different levels in the health services. Although higher level institutional training will continue as before in epidemiology, public health, health education and health planning and management, the emphasis will be shifted on to training or retraining of mid- level health staff. This will enable the countries to have available staff with the appropriate skills for decentralized and integrated epidemiological surveillance of onchocerciasis. The Unit, in collaboration with VCU, will also give support to entomological activities related to the maintenance of the residual activities of OCP. Thus, the skills acquired by national entomologists during the last two years in setting up a simple network for the entomological surveillance of onchocerciasis in the countries will be consolidated. In collaboration with the countries, the Unit will continue to measure the impact of control activities through epidemiological evaluations. Particular emphasis will be placed on retraining in the area of data management in the countries, and making available to them the necessary tools for carrying out this activity. The countries will also receive the logistic and financial assistance needed to enable them to acquire these skills and techniques. Additionally, the Unit will continue to ensure that CDTI, operational research and computer-based assistance for the analysis of epidemiological data are continued during this last phase of progressive disengagement. In collaboration with the appropriate experts, the Unit will ensure closer ties with the health education services of Participating Countries to develop relevant materials for IEC campaigns, and to reinforce the latter at all levels, including government and community levels. This will aim at giving the control players a wider exposure to the CDTI approach and decentralized integrated epidemiological surveillance. In collaboration with WHO-AFRO and the Participating Countries, the Unit will continue its catalytic role in the integration of CDTI and the decentralized epidemiological surveillance/evaluation activities into the health delivery systenls of the countries. Emphasis will continue to be placed on the integration of these residual activities into the multidisease surveillance and endemic disease control units of the National Minisrries of Health. In this connection, the PET TPCZI.4 Page 23 Unrt rvill be closely involved both rn terrns of technical expertrse and logrstrcs, in the settine up at OCP premises of a functional WHO Centre for rnultirlisease epiderniological sun'eillance, to support the control and surveillance units in the countries 4.2.2 Specific plans of action 4.2.2.1 Epidemiologicalevaluations In the past, the Unit has provided support in the form of supervision, quality control, logistics and funding to national teams to undertake evaluations in their respective countries. This action will again be pursued in 2001 in the following areas : evaluations to assess the impact of combined vector control and ivermectin on: (a) the transmission of infection, and (b) on onchocercal eye disease in the basin of the Niger in Guinea. Consultants from the Participating Cotrntr_ies will, as in the previous years, be engaged to carry out the ophthalmologicil examinations and surveys. These will include, where necessary, photographic documentation as well as angiographic recordings. general epidemiological evaluation in ttre entire Programme area to assess the general epidemiological situation prior to the end of the Programme. This will include migration surveys in selected foci or in some of the "residual foci". The Unit will obtain and provide specimens (skin snip, microfilaria) collected during epidemiological surveys to the molecular biolgy laboratory of OCP for the deoxyribonucleic acid (DNA) studies. Likewise, the laboratory will aim at improving the Polymerase Chain Reaction (PCR) scratch test which is at ttre same time highly sensitive and fully specific in order to assess the actual level of endemicity of a zone under ivermectin freatrnent. These studies will help identiff the onchocerciasis strains, which is important in helping determine the naure of the infection that is still encountered in some "residual foci". The laboratory will also take on training of molecular biologiss from the Participating Countries or from the zub'region in molecular biology methods that have been developed by the OCP laboratory for onchocerciasis surveillance. The introduction of the alternative community diagnostic tools (the DEC Patch test) for epidemiological surveillance/evaluation, will be pursued in the countries, coupled with the skin snip test. The training activity on the use of the DEC patch test in all the countries will be concluded during 2001. 4.2.2.2. Distribution of ivermectin Large-scale ivermectin distribution will continue. The areas to benefit from this treatrnent will be the extension areas as well as some specific areas in the Original Programme area (Annex IX). Attempts will be made to continue and extend the treatment in Sierra Leone and Guinea Bissau, if the securiry siruation permits. There will be consolidation of the treatment in the southern parts of Cdte d'Ivoire, Ghana, and Guinea, this being the third year of treafinent in these areas. It is projected that over 27 ,0N villages will be treated in the year 2001 , and the estimated number of people to be treated will be about nine million. The Unit will continue to ensure the regular monitoring of the ivermectin distribution campaigns, in a combined effort with the field staff of the Vector Conrrol Unit (VCU) as well as with external independent observers. An independent evaluation of the CDTI will be carried out by a team of epidemiologists, sociologists, and national coordinators. TPC2I.4 Page 24 With the exception of Sierra Leone and Guinea Bissau the installation of the CDTI method of trcatment which started in 1996 is expected to be completed by the end of 2000, with continuation of the retraining of communiry distributors. The CDTI approach will be consolidated in 2001 in the countries through an intensive monitoring by the national teams and trained nurses in the districts concerned, in collaboration with NGOs and voluntary organisations, under the supervision of the Unit which will provide technical, logistic and financial support. In spite of the fact that no serious adverse reactions of ivermectin use have been recorded for several years, monitoring and documentation of any adverse reactions to ivermectin will continue. The services of the peripheral health units will be solicited, they being responsible for the direct supervision of CDTI. 4.2.2.i Entomologicalactivities The PET Unit will continue its programme of rarpferringthe simple activities required for entomological control to the countries. It will provide support and training in ground larviciding to enable countries to carry out the minimal entomological activities required in specific areas that need such intervention. ln collaboration with vcu, the PET Unit will take on the entomological studies aimed at detecting any resumption of transmission in some selected basins of the original prograrnme area, and those relating to the impact of ivermectin on transmission. 4.2.2.4 Data Management The training of nationals in the analysis and interpretation of survey data collected during epidemiological evaluations and epidemiological surveillance activities following the intemrption of vector control in the basins will be continued and consolidated. This will enable each national onchocerciasis control coordination to effectively transfer this epidemiological data to the intermediate levels. In collaboration with the national teams, the Unit will continue to update the large body of epidemiological and entomological data collected by OCP, and ensure the adequate training necessary to analyse and use this data. Furthermore, during this process the software intended for data entry and validation prograrnmes that were installed in each of the countries will again be reviewed in order to take into account the rapid evolution of computer tools and thus render the Participating Countries completely independent and operational in data management. " Emphasis will continue to be placed on the use of the Geographic Information System (GIS) by the national teams. The Unit will procure a number of Global Positioning Systems (GPS) in order to enable the countries update their village data banks. These GlS-related activities will require the services of the Health Map Unit at WHO Headquarters in the form of ad hoc contracts for the development of an integrated multidisease data management system. The Unit will carry out the routine analysis and interpretation of the Prog.ramme's epidemiological and entomological evaluation data. This is mainly to study the medium and long- term impact of the combination of ivermectin distribution and larviciding on transmission and on ocular manifestations. Data entry and analysis will be carried out by OCP staff in collaboration with nationals of the countries concerned, but temporary staff will be recruited to help when the need arises. Supervision and coordination of the development of data banks on operational research, aerial operations, administration and documentation will continue. Epidemiological modelling will continue to play an important role in the interpretation of data collected in different domains. Thus, the ONCHOSIM model which is being revised, (cf paragraph 4.2.12) will be used intensively to lacilitate the integrated analysis of these data, in collaboration rvith the Erasmus University of Rorterdanr TPCZI.4 Page 25 .1.2.2.5 Documentotiort The Unit will be responsible for the supervision of the activities of the Docunrentation Centre which was formerly under the Office of the Director. In addition to the routine activities of document management, this department will process the technical documents of the two Programmes, OCP and APOC, to be stored in electronic format, as well as archive the old documents accumulated by the two Programmes. 4.2.2.6 Communication, Information and Sensitizttion The Programme's communication, information and sensitization activities will continue to be devolved to the Unit which will strengthen the channels of information regarding the activities of the Programme directed to the countries, the general public, or other specific groups such as reporters, journalists, film makers etc.. 4.2.3. National team5 and national medical personnel ofiealth centres The Unit will support health personnel in the countries as well as community workers in routine field activities concerning epidemiological evaluation, retraining of distributors for ivermectin distribution, and awareness-raising through IEC methods. The national teams and their Coordinator, deputy coordinator, an epidemiologist and six other technicians who are called upon for specific duties, will continue up to 2001 to be responsible for the practical training and retraining of the staff of the decentralized teams for epidemiological surveillance and quality control. With the distribution of ivermectin now fully in the hands of the communities, doctors and nurses of the local health centres will be responsible for the supervision of CDTI in their respective districts. Additional supervision and monitoring of CDTI will be required of the national teams. Support for this activity will be provided by the Unit in 2001. 4.2.4. Personnel The staff of the Planning, Evaluation and Transfer Unit is set out in the table below. STAFFTNG FOR THE PLANNING EVALUATION AND TRANSFER UNIT WHO/OCP Professionals P4-P5 P2-P3 STP (Short-term) NPO (National Professionals) General Services , Subtotal WHO/OCP SSA (Professionals and others) National Staff Total PHASE V PHASE IV 2W 2000 1999 1998 1997 1996 2 2 I 7 2 J 7 2 J 7 2 2 8 J 4 t4 3 4 l4 t2 t2 12 t2 2t 2t 6 6 8 7 60 70 10 10 J J 70 70 78 88 90 89 94 96 t JPCZI.4 Page 26 The Unit will see its strength increased by one national prot-essiorral respttnsible for documentation and two temporary professionals under SSA contracts in charge respectively of communication activities, and informatics. However, the total number of the staff, excluding the national staff, will remain unchanged compared to 2000. The expertise of all the other units of the Programme will be called upon, where indicated, for their support. In particular, the Unit will use VCU chiefs of zones, and their entomological staff to carry out its programme of information and awareness-raising of the local authorities and population. Additionally, the field staff of VCU will be used for the training of nationals and communities in ground larviciding techniques as well as the monitoring of ivermectin treatment. 4.2.5 Consultants Two experts, one in public health and the other in health systems, will be called upon to help in the integration of onchocerciasis control residual agtivlties-into the national healttr services. Consultant ophthalmologists will also be called upon to carry out a detailed evaluation of some villages in the original Programme area. If necessary, the Unit will call on the temporary staff of the General Services to help in the monitoring of ivermectin distribution, epidemiological evaluation, especially for quality control purposes, data entry, data analysis and processing, as well as ophthalmological evaluation. The Unit will call upon IEC experts, social scientists and epidemiologists from Participating Countries, and in collaboration with the Oncho National Coordinators, will a) set up Oncho IEC activities in the Countries, b) undertake specific studies as part of the Unit's support to operational research, and c) evaluate the activities transferred to the counffies. The Unit will also conduct follow-up studies of the system of ivermectin distribution, as well as studies to ascertain the communities' perception of the nuisances caused by the blacKlies. Forty (40) man-months consultancy representing a total amount of US$ 140,000 have been earmarked in the Unit's budget for 2001. 4.2.6. Temporary Staff The Unit has a large backlog of data for entry and analysis which is being added on with subsequent evaluations. Temporary staff (10) will be called upon to help the Unit in the quality control of data entry by the countrids, the clearing of this data, secretarial work, archiving and the recording on CD-ROM of OCP and APOC documents. Additionally, two temporary hands wilt be recruited, one to help the only sitting ophthalmic nurse of the Unit with the follow-up of ophthalmological surveys, and the other (a temporary secretary), to reinforce support to the epidemiologists in the Unit and to help cope with the heavy secretarial and typing work which the Unit undertakes with the National Coordinators. With respect to the residual control in the Dienkoa basin in Burkina Faso, a national entomological team based in Bobo-Dioulasso will get support from the Unit through the funding of five temporary staff under the supervision of the national oncho entomologist. 4.2.7. Supplies An amount of US$ 50,000 will be allocated to purchasing important medicines, equipment and medical reagents, computer consumables, light office supplies, books as well as scientific review subscriptions. The Unit will be calling more and more on the molecular biology laboratory for assistance as the entomological method for the detection of recrudescencd is further developed and introduced in the countries. Funds from PET rvill thus be required in 2001 to offset the cost of supplies for this laboratory. JPCZI.4 Page 27 4.2.8. Operationaltravel An amount of US$ 50,000 will be required in 2001 for duty travel of OCP professional staff and the travel of national coordinators and some of their assistanrs, nrainly to Ouagadougou to review and plan specific activiries with OCP. 4.2.9. Service contracts A service contract for US$ 40,000 will be signed with national computer experts for updating or designing software, and with the Health Map Unit of WHO Headquarters for finalizing an Oncho Geographic Information System (GIS) to be integrated into the other disease control data. Additionally, an amount of US$ 30,000 will be required for research on rhe different diagnostic tests, and for the DNA laboratory tests. 4.2.10. Training Training will continue to be an important component of the Unit's activites. Thus, fellowships for higher level traininih-ptanning, management, health education in institutions in Africa, will be granted to the countries. More emphasis will be placed on training for mid-level personnel in statistics and data processing. Refresher courses, in the form of seminars and workshops, will be undertaken. This will be in continuation of OCP's policy for the transfer of skills and appropriate techniques to the countries. Priority will be given to epidemiological training at the district level. The Unit will improve is training plan in consultation with the countries in order to consolidate the take over of residual onchocerciasis control activities by the Countries. An amount of US$ 300,000 will be required in 2001 to finance new fellowships and in- service-training, as well as on-going fellowships. 4.2.11. Sub-regional Centre for Multidisease Surveillance In support of the installation at the OCP premises, of the AFRO sub-regional Centre for multidisease surveillance, and in accordance with the request made by the Committee of Sponsoring Agencies, the Programme will make available to the Centre an amount of US$ 100,000 in 2001. This amount is intended to defray the cost of local staff and to procure basic materials and equipment. OCP intends to pursue its financial contribution to the smooth running of the Centre by making available to it the same amountin2CfJl2. 4.2.12. Integrated data analysis The two-year collaborative project in progress with the Universiry of Rotterdam for the integrated analysis of data collected during the period of OCP activities berween L974 and 2000 will be pursued and completed in 2001. This project will draw heavily on the ONCHOSIM model which will be further fine-runed and validated to improve its utilization. Advantage will be taken during the validation of the model to include such new parameters as compliance with ivermectin treatment, multiple annual treatments, and the likely effect of a possible macrofilaricide as well as ivermectin resistance monitoring tools. 4.2.13. Management of Computer Operations The Biostatistics and Information Systems (BIS) sub-unit will continue to supervise all activities pertaining to the use of the contputers in OCP. JPCZI.4 Page 28 Emphasis will continue to be placed on the transfer of data to the Participating Countries using the computers installed in the countries by OCP in 1998 and which need to be upgraded or replaced if necessary in 2001. Cleaning and updating the data and the computer programs will be a major part of the activities in BIS. In this context, collaboration with the national team staff will continue in the area of updating of the epidemiological data bases, while emphasizing decentralized training in data processing at the intermediate structure level. 4.2.L4. Budget In view of the above, the budget proposed for the Planning, Evaluation and Transfer Unit for 2001 is US$ 1,920,000. JPCZI 4 Page 29 TABLE 5 PLANNING. EVALUATION AND TRANSFER UNIT(US$) Category of Expenditure PHASE V Proposed 2001 Approved 2000 Expenditure 1999 Expenditure 1998 Expenditure 1997 Expenditure 1996 PERSONNEL SERVICES WHO / OCP Staff Chief PET Biostatistician Temp. Professionals (STP) Administrative Assistants, Clerks, Typists Laboratory Assistants Personnel SSA Temporary Sfaff 't45,000 r45,qgo 145,000 145,000 245,000 60,000 60,000 42,000 24,OOO Subtotal 721,000 495,404 438,831 497,6U 538,001 Consultants Operational Travel Operating Costs Supplies Contracts (others) NationalTeams Fellowships and Training WHO Subregional Centre' ONCHOSIM :,15Qi000 ':: ' 259,000 300;800 100;000 120r000 170,000 50,000 60,000 50,000 40,000 250,000 420,000 100,000 120,000 302,739 50,800 138,989 101,572 159,747 310,403 415,553 99,999 345,254 54,231 124,978 104,877 9,375 279,733 438,905 295,787 50,870 157,039 63,763 45,317 425J90 422,767 390,298 91,782 117,',t44 60,886 16,801 488,385 Subtotal 1,,140,000 1,260,000 1,579,802 1,357,353 1,460,733 1 ,165,296 TOTAL 1,920,000 1,981,000 2,O75,206 1,796,184 1,958,417 1,703297 . OCP Contributron to WHO Subregional Centre for multidisease eprdemrological surverllance PHASE IV : i;:::ifBO:000 lPczt.4 Page 30 4.3. Macrofil Chemotherapy Project (Macrofil) 4.3.1. Objectives for the Macrofil Project in 2001 The primary objective of the Macrofil Project continues to be the development of safe and effective adulticidal drugs (macrofilaricides) for onchocerciasis and lymphatic filariasis. The secondary objectives of the project are: a) discovery and development of a back-up microfilaricide to ivermectin that could be more advantageous (e.g.: longer time between treatrnents) or that could substitute ivermectin in case of resistance, and b) development of a molecular diagnostic tool/method that could be used to detect Onchocerca volvulus resistance to ivermectin, and optimization of DEC skin patch test, as a surveillance tool. At its meeting in the Hague in December 1999, the Joint Programme Committee recognised that a safe and effective macrofilaricide would provide better therapeutic control of onchocerciasis than ivermectin both in the lifetime of OCP and in the posrQCP period. Also, a field-applicable macrofilaricide would reduce the period of intervention. Additionally, the occurrence of ivermectin resistance in onchocerciasis would be disastrous in a control programme based on a single drug. The Committee therefore agreed to the proposed financing of the Macrofil project by OCp, APOC and TDR with OCP's contribution directed, as much as possible, for preclinical and clinical development of drugs for onchocerciasis and a test for ivermectin resistance. 4.3.2. Activities The complete, jointly-funded Macrofil Project is set out in Annex X, pages 51 to 54. It indicates that Moxidectin has been identified as a lead compound for the development of a novel macrofilaricide. The Onchocerciasis Chemotherapy Research Cenre (OCRC) in Ghana will continue conducting clinical studies on drug combinations. Drug screening centres will be rationalized through support of a single centre to conduct primary animal assays and relevant in vitro screens. Strategic research will be supported to validate new molecular onchocerca entities as targets for drug discovery and their use as high throughput screening. The information emerging from the research on the mechanism(s) of ivermectin drug resistance in parasitic nematodes will be applied towards the development of diagnostic tools. 4.3.3. Budget For 2001, funding of the Macrofil Project will be shared equally among OCP, APOC and TDR, each contributing US$ 566,667, to give a total of $ 1.7 million. This arrangement has been in force since 1998. The posts of a P5 scientist and a G5 secretary, and the costs of the Onchocerciasis Chemotherapy Research Centre in Ghana, will continue to be funded directly by OCP as part of its contribution. JPC2I.4 Page 3 I TABLE 6 MACROFIL CHEMOTHERAPY PROJECT (US$) (t) costs of meetings are included under "consultants/Temoorary Advisers" Category of Expenditure PHASEV PHASE IV ' PIp ':: posed. 2001 Approved 2000 Expenditure 1999 Expenditure 1998 Expenditure 1997 Expenditure 1996 PERSONNEL SEVICES WHO / OCP Staff Scientist Secretary 180,000 105,000 Subtotal 285,000 235,463 319,803 165,005 249,675 Consultants/Temp. Advisers (') Operational Travel Research Contracts Supplies Other activities 185,000 25,000 205,000 128,317 25,558 275,000 654 170,O42 5,162 3,109 20,000 164,406 7,046 1,362,676 21,395 10,000 196,505 15,255 1,223,4U 32,791 30,000 Subtotal 415,000 429,529 198,313 1,565,523 1,498,015 TOTAL 700,000 6il,992 518,116 1,730,528 1,747,690 :;!80!000 :::.:::.:105S00 ':ig8i,00q i:$10,000 lPC2t.4 Pase 32 {.4. Oftice of the Programme Director 4.4.1. Activities The office of the Director will continue to ensure the general management of the Programme. The duties assigned to the Office include supervision and coordination of all administrative, technical, scientific and operational activities, as well as close liaison with the Starutory Bodies which set the general policy, the Donors, the Participating Countries and the Scientific community. 4.4.2. Personnel To carry out the above activities, the office of the Director comprises, in addition to the Director himself, the following staff : - a coordinator - an administrator - a secretary to the Director - a secretary to the coordinator - a clerk - a driver. For practical reasons, all the functions regarding communication, translation, documentation, organisation of statutory meetings, and liaison with WHO Geneva were put under the Administration and PET Units. This will allow for better monitoring of some of these activities which are becoming more and more important in view of the approaching end of the Programme. OFFICE OF THE DIRECTOR: STAFF WHO/OCP Professionals P6-D2 P4-P5 P1.P3 STP (Short-term) NPO General Services Subtotal WHO/OCP SSA Total PIHSE V PIHSE IV Z0otrfr zooo 1999 tq98i ..'i!-.=13+I r9y7 1996 -'::" -i:lt,r \ -j _ =:=h.r '.1 1. 2 22 1 2 3 I 1 2 J 1 I 2 3 2 1 1 2 I 1 2 1 6J 4799 911 3533 J 2 7t2t2t2 t2 13 4.4.3. Consultants Consultant services are regularly used to assist the Office of the Director in the areas of general policy definition and Programme management, especially in this phasing-out period during which the future of the personnel and all OCP property is at stake. 4.4.4. Budget The budget proposed for the Office of the Programme Director for 2001 is US$ 833,000. I 1..,. JPCZI.4 Page 33 TABLE 7 OFFICE OF THE DIRECTOR(us$) PHASE V PHASE IV Proposed 2w1 Approved 2000 Expenditure 1999 Expenditure 1998 Expenditure 1997 Expenditure 1 996 PERSONNEL SERVICES WHO / OCP Staff Programme Director Coordinator, Director's Office Adm inistrative Officer Administrative Assistants Secretary (Geneva) Clerk, Stenographer-typists Personnel SSA SSA Professionals SSA others : 155,000 000 ::tlqi000 :,'_ ,:,.:::::'::,.:::. .:: : i:: ,;: : ]: ::::i::.:... ._::i:: : ':::-- -::- ::::,2$.;qgo; :i;::::::i::.,;:: . :. - ::: :' . . ,..:.:-: .,.: ., : '::,:':li:',.,,: ,';.i::., it;,;'i:i:: .. i:::,' i;.iii::,.:.. ,'iii|,sigqq : . :::.:.:..-:-.-,.:.. 155,000 155,OOb 100,000 40,000 105,000 20,000 70,000 14,000 Subtotal 659,000 483,989 558,014 450,499 734,800 Consultants Operational Travel Operating Costs Supplies Fellowships and Training Phasing-out | -:: -::: i . l;,: rcioUo' t. _ l:,:iir$iooo: l: :10,000 _ .'.: _- : :i'i: ':10,000 350,000 40,000 40,000 10,000 10,000 15,204 42,370 119,551 27,116 92,125 58,660 98,927 72,001 131,150 34,983 46,802 102,533 12,505 76,420 24,713 33,723 529,393 Subtotal 440,000 100,000 204,241 321,713 315,468 676,754 TOTAL 833,000 759,000 688,230 879,727 765,967 1 ,411 ,554 JPCZI.4 Page 34 .1.5 Admiuistration aud Support Services Unit 4.5.1. Ouagadougou Headquarters In this last Phase of progressive disengagement, OCP must continue to operate with decreasing budgets. In this context, the Administration and Support Services Unit must contribute to the best management of the Organization's resources - human, financial and material - by maintaining the gains made and enabling OCP to keep up the quality of its services until the folding up of its activities. The Unit will also, as in previous years, continue to provide administrative and financial support to APOC. The Personnel Service will continue to recruit staff when needed (mainly for APOC) or for replacement, to administer and manage existing staff, and to see to it that future staff reductions are made gradually and in the best of conditions for both the Organization and the affected staff. On the first point, some posts might have to be filled in theevent 5f the deparnrre of their present holders, but most of the staff to be recruited will be on short-term contracts. With respect to the administration and management of the staff, the set of regulations and statutory provisions will be applied with the necessary flexibility to maintain staff motivation and morale. Finally, the staff reduction exercise is a complex operation which comprises two components: the staff cut backs themselves, which must meet criteria of justice and equity, and the preparation of staff in the form of counseling and training - or even assistance in job searching - for re-integration into their national systems after many years, sometimes almost a whole career, of service to the Prograrnme. The Budget and Finance Service will ensure implementation and monitoring of the 2001 budget, carry out the necessary analyses and inform the Units concerned of the status of their respective budgets during the year in order to help the various Unit chiefs ensure proper management. ln the area of frnance, the Unit will operate 14 bank accounts in 11 countries, handle the payroll, settle miscellaneous staff claims as well as invoices presented to OCP by suppliers of goods and services. To facilitate the accomplishment of all these tasks, it is worth mentioning the constant modernization of the computer programmes of WHO Headquarters, which makes the system faster and more interactive, and better suited for carrying out analyses. The Supply and Support Services will continue with its multiple duties, including maintenance of the infrastructure and support to the sectors and operational bases, by providing them with the necessary equipment and supplies, while cutting down, to the extent feasible, capital costs and expenditure on equipment. lncreased rigorous monitoring will continue to be ensured in order to have a better control over stocks of materials and equipment. With respect to pr@urement, the guiding principle will continue to be that of keeping down costs without jeopardizing quality. Overall, the planning aspect and the dynamic adjustment of supplies and stocks to the changes in needs will be emphasized. The Transport and Telecommunications Services will continue to manage two major components of support to the Programme: the fleet of vehicles and the telecommunications system. The vehicles in use will be reduced from 218 in 2000 to 183 in 2001 due to the disposal of old vehicles and the non procurement of new ones in 2001. This service will continue to give special attention to the training and re-training of the mechanics and drivers, as well as to the sensitization of the staff of this service on subjects such as the need to reduce the number of accidents, the importance of preventive maintenance of vehicles, and the preservation of fleet qualiry. These actions will also be directed to the staff of national teams as this is also part of the transfer exercise. With respect to telecommunications, the system put in place has been fully satisfactory and communications in the entire Programme area have been facilitated, by this system. 2J 14 35 PC Page Three additional sections have been transferred to the Administration Unit, with a total of four posts formerly under the Office of the Director. They are: the translation section which consists of one translator, with an SSA professional contract. the section in charge of the organisation of statutory meetings which comprises two posts (a SSA professional and a GS) positions. Is function is the organisation of all stahrtory meetings of OCP and APOC. the liaison office in WHO/Geneva which comprises an administrative assistant in charge of facilitating liaison between OCP and WHO Headquarters. This section has a General Service category staff member. 4.5.2. Geneva The Programme will continue to benefit from the administrative support of WHO Headquarters, especially in the fields of personnel administration, budget and finance. The Programme will also use the procurement and kgal services of Headquarters as needed. For these services, WHO is authorized to charge OCP 13% of the Programme's budget, i.e. close to US$ 1,900,000 for the year Z00l, since it is a programme supported from extra-budgetary sources. However, WHO Headquarters has decided to waive this requirement in the case of OCP, and rather charges the amount due on the basis of the acaral costs of the four General Service positions. The annual amount proposed for 2001 is the same as that approved for 2000, which is US$ 375,000. 4.5.3. Personnel Overall, the staff requirements will remain unchanged in 200I. However, the Administration services (Personnel, Budget and Finance, Supplies and General Services, as well as Transport and Communication) must continue to provide assistance to the APOC Programme. The various needs are therefore as follows: WHO/OCP Professionals P6-D2 P4-P5 P1-P3 STP (Short-term) . NPO General Services Sub-total WHO/OCP SSA Total PTIASE V PHASE IV 2001 2000 1999 1998 L997 1996 1 I 1 1 2 I J 3 28 J 26 J 26 z 30 I 1 2 I 1 1 2 I 38 46 32 31 32 36 43 51 4t 4t 40 40 33 33 73 72 72 76 76 84 4.5.4. Budget The budget proposed for the Administration and Support Services unit for 2001 is us$ 1,670,000. JPCZI.4 Page 3(r TABLE 8 ADMINISTRATION AND SUPPORT SERVTCES(US$) (Ouaqadouqou and Geneva) Category of Expenditure PHASE V PHASE IV Froposed 2001 Approved 2000 Expenditure 1999 Expenditure 1998 Expenditure 1997 Expenditure 1996 PERSONNEL SERVICES WHO / OCP Sfaff Administration and Finance Officer Personnel Officer Budget and Finance Officer Transportation & Commu. Officer Supply Officer Administrative Assistants, Clerks, Typists & Storekeepers Secretary, Geneva Administrative Support Geneva SSA Sfaff Professionals Others : $o.togc . ..: i:. ' .i . *99n ,..,,',,.,s.,a9c ,.: '.32e9!A ''. !-::::i,:il:l: ,;: ,iotq0o :: . ::_:! .:::l::: ' , ,,t*'n* , ,,,,:,," ,] '{05;0qq] '::...1 .?oL,.Qggl 145,000 115,000 50,000 50,000 50,000 360,000 375,000 182,000 Subtotal _-. :: :: J465$00 1,327,000 1,052,456 1,341,311 1,251,771 1,411,946 Consultants Operational Travel Contracts (others) Operationg Costs Supplies 45, 20 120,000 20,000 205,000 45,000 20,000 142,OOO 45,000 48,482 47,783 17,740 316,898 49,571 31,671 44,340 18,334 201,187 68,696 25,510 52,782 20,408 255,041 110,068 45,297 95,931 22,301 215,138 52,057 Subtotal 252,000 480,474 364,228 463,809 430,724 TOTAL 1,670,000 1,579,000 1,532,930 1,705,539 1 ,715,580 1,942,570 :,,{ t I tPczt.4 Page 37 TABLE 9 OVERVIEW OF ADUINISTRATIVE AND EXECUTIVE MANAGEMENT COSTS'(us$) 7 - Office of the Director 8 - Administration and Support Services (Ouagadougou and Geneva) Gategory by Expenditure PHASEV PfulsEtv Proposed fr01 Approved 2000 Expenditure 1999 Expenditure 1998 Expenditurc 1997 Expenditure 1996 PERSONNEL SERVICES WtlO / OCP Staff Programme Director Coordinator, Directo/s Offi ce Chief Administration and Finance PersonnelOfficer Transport & Communication Officer Budget and Finance Officer Supply Officer Administrative Officer Administrative & Technical Assistants, Clerks, Stenographer-$ pists Secretary (Geneva) Administrative Support Geneva SSA Sfaff Professionals Others t6610Qo *$,000 r{$,00p $0,000 50rpo0 ,5t}'ms r{5,0P tgg,000 l0+000 37+000 {os 000 22$,000 155,000 155,000 145,000 115,000 50,000 50,000 50,000 100,000 420,000 105,000 375,000 70,000 196,000 Subtotal {r858,0m l,986,ouo tr536/f{5 1,899 325 1l02,na a{45,579 Consultants Operational Travel Contracts (others) Operating Costs Supplies Fellowships Phasingout 35,000 80,000 20,000 130,000 30,000 350,000 40,000 85,000 20,000 152,000 55,000 63,686 90,153 17,740 436,449 76,687 123,796 103,000 18,334 300,114] 140,6971 156,660 87,765 20,408 301,843 2',t2,601 57,802 172,355 23,301 239,951 85,780 529,393 Subtotal 645,000 352,000 684J15 685,941 TI9,27T 1i1081482 TOTAL 2,503,000 2,338,000 2,221,160 2,595,266 2#1,ill 3,2&1,061 ' Summary of tables JPC21.4 Page 38 FIGURE 3 BUDGET BY PROGRAMME ACTIVITY -2001 OVERVIEW ADMINISTRATIVE AND EXECUTIVE MANAGEMENT COSTS 7 8 4 3 1. Vector Control 2. Planning, Evaluation and Transfer 3. Chemotherapy Project (Macrofil) 4. Statutory Meetin 8. CapitalCosts TOTAL 2 1 (us$) 9,507,000 1,920,000 570,000 210,000 60,000 0.41 (Yo) u.37 13.00 3.86 1.42 5. Offce of the Director 6. Administrafive & Support Services 933,000 1,295,000 5.64 8.77 2,il 16,952,503,000 7 14,770,000 100.00 5 6 1PC2t.4 Page 39 4.6. Statutory meetings The meetings planned for 2001 are similar to those of previous years: a meeting of the Ecological Group, a meeting of the Expert Advisory Committee, three or four sessions of the Committee of Sponsoring Agencies, and a meeting of the Joint Programme Committee. The budgetary provision for the different meetings mainly covers the costs of travel and per diem, interpretation services, translation of documents, and various supplies. It is worth noting that the costs of meetings other than those mentioned above (research, ivermectin distribution, hydrology, hydrobiology, national coordinators) as well as the costs of the participation of expers have been included in the "Operational Travel " category of the budgets of the host units. The same applies to consultations which will be organized with the countries to help them achieve ownership of the residual activities of surveillance and the control of recrudescence of onchocerciasis. One full-time administrative officer and a secretary, budgeted for under the Administration Unit, are assigned to the organization of meetings. They are also required to handle the Statutory Meetings of APOC. The budget proposed for 2001 is US$ 210,000, which is L6% less than that proposed for 2000 TABLE 10 STATUTORY MEETINGS(US$) Category of Expenditure Approved 2000 Erpenditure 1999 Expenditure 1998 Expenditure 1997 Expenditure 1996 PERSONNEL SERVICES Temporary Staff 35,000 35,36s 34,2il 39,143 43,977 Subtotal i:35;000 35,000 35,365 34,264 39,143 43,977 Consultants/Temporary Advisers Operational Travel Operating Costs Contracts / Translation ,: 100,000 55,000 10,000 10,000 100,000 90,000 15,000 10,000 9s,553 52,630 4,802 2,040 113,047 53,850 3,302 90,122 74,O92 2,844 90,1 01 37,521 2,001 Subtotal 175,000 215,000 155,025 1 70,1 99 167,058 129,623 TOTAL 210,000 250,000 190,390 204,463 206,201 173,600 :iii;ii,:ilFHAI :::::..::::-.:,:::._::, :Erqpgsid. :;.:'.200t: ,: lPczt 4 Page 40 4.7. Capital costs 4.7.1. Office equipment us$ 7,000 The purchase of new equipment will be strictly limited to essential items. Most of the needs for office furniture items were satisfied in the previous years; therefore, only US$ 7,000 has been reserved for purchase of this kind of items which might still be needed. 4.7.2. Computer equipment ...US$ 33,000 The modernization of the computer equipment was carried out essentially in 2000 by the purchasing of an important number of items. The local computer network at the OCP Headquarters will required human resource and financial support for its proper maintenance. The Unit will also continue to ensure the maintenance of the financial management data base of the nyo Programmes: OCP and APOC. In 2001, the replacement of five obsolete computers and accessories is planned in order to enhance the capacity of the computer network in place at the OCP Headquarters and at the two VCU bases. Appropriate training of all the staff using computers started in 1999, continued in 2000 and will be pursued in 2001. A budget of US$ 33,000 will be required to meet these procurement and training needs. 4.7.3. Technical equipment ....US$ 20,000 A small amount of routine replacements for scientific equipment will be needed for the research laboratories. A budget of US$ 20,000 is proposed for this type of expenditure. TABLE 11 CAPITAL COSTS(us$) Category of Expenditure Proposed Approved Expenditure Expenditure 2000 1 999 1 998 Office Furniture Data Processing Equipment Technical Equipment Vehicles Burldings 7,000 33,000 20,000 0 2,000 30,000 15,000 45,000 1,198 26,664 11,294 62,575 2,251 56,728 65,667 97,970 6,045 34,269 90,105 136,789 590,690 37,870 65,930 104,992 359,011 12,077 TOTAL 60,000 92,000 101,731 228,661 851,853 579,880 Expenditure Expenditure 1997 't996 lPczt 4 l'}age 4 i ANNEXES I. OCP ORGANIZATTON CHART... II. AVERAGE COSTS USED FOR BUDGETARY CALCULATIONS III. RATES OF EXCHANGE OF THE US DOLLAR/CFA FROM 1999 TO 2OOO IV. PERSONNEL COSTS FROM 1994 TO z00I V. AERIAL OPERATIONS FROM 1994 TO z00L vI. MAP - VCU PLAN OF OPERATTONS FOR 2OO1 VII MAP - VCU SECTORS, SUB-SECTORS AND OPERATIONAL BASES FOR 2OO1 VM. ENTOMOLOGICAL EVALUATION NETWORK IN 2OO1 MAP - AREAS EARMARKED FOR LARGE-SCALE IVERMECTIN TREATMENT IN 2OO1 . X. MACROFIL CHEMOTHERAPY PROJECT Page 42 43 IX .44 .45 .46 .47 .48 .49 .50 .51 .55XI. EVOLUTION OF VEHICLE FLEET FROM 1994 TO 2OOI Ez* e5Q 958 E9= u,E z ar ulF(t u, J(r 69tr<<ulEo uJ u, .LCE o ;EE2'i <66? HEI <)fi oziPs EE3<ur- o.o 299 E#E6<H8o J otr E oo tr oFo UJ =ooJ oEo I J 69otr92<Y.rziao "*6. ,o.9 0o*:Eo; I o .68 =tr2E<u'urE=<H6 o ulE zE tu h ul = o. Eu*6At =ForU- r Io J o6> 9Sotr =oo< E Lr.l 3 "..8E=E 8EE ,=- Eo b= urO tE (, ;e =< =Eg6TE(L z o F lJ ut(, =zzI o. G Hoz EF oz z.otr F u-t 5E #E de9e 8e dE =2Hgft6 a9t9 EEo-zo)z= ETFo -z69 EEzz E= HE tlJ2Zu ooQ(9Fur =19EETE3:FO o = ozo :Eato-E o. uJ)o @ EP =f;EUJotrL.za sa '"3Fur <o- E3oe FU' Ue93ei .otr 9otg z= 9.GF lr,<qtrr- E5 zo- =o- 2n IPCZ|.4 Page 42 ANNEX I F E, -o J z o F N z oE o t lrJ = = E,(, oE o. J oEFz oo L @ so E, u.l o ot oz o J UIzzo anE IUc AVERAGE COSTS USED FOR BTJDGETARY CALCULATIONS (US$) 2001 2000 1999 1998 155,000 145,000 180,000 115,000 85,000 65,000 50,000 20,000 105,000 6,000 155,000 145,000 180,000 115,000 50,000 20,000 105,000 6,000 JPC2I 4 Page 43 ANNEX II 155,000 145,000 180,000 115,000 50,000 20,000 105,000 6,000 4.93 15.58 t0.29 20.82 26.45 16.05 24.r5 Personnel Professionals - P6-D2 - P4-P5 - Pl-P3 - STP4-STP5 - STP1-STP3 National Professional Officers General Service Programme area Geneva Programrne area Geneva 155 1 ,:i1 SSA New formula National Personnel - Consultans/month - Temporary (General Service/month) Aerial Operations Cost per flying hour (incl. fuel) - Guaranteed helicopter hours - Excess helicopter hours Insecticides - Cost per litre (CIF) - Vectobac (8.r. H-14) - Tecknar (8.t. H-14) - Temephos 20 % EC - Permethrin}O% EC - Carbosulfan25% EC - Pyraclofos 5O% EC - Phoxim - Vectron 4 7 I 1 000 000 800 4 7 000 000 800 I I 4,000 7,000 800 , iJ: 17:35 24.15 1,050 1,050 6.54 8.28 15.96 t0.29 20.82 26.45 t4.7 r 24.t5 924 722 26 26 ,il 1 7.87 5.86 15.96 10.98 20.82 26.45 t7.35 24.t5 Value of US dollar - CFA Franc - French Franc - Swiss Franc - Pound Sterling - Deutsche Mark - Japanese Yen ssO.00 5.50 r.42 0.58 t.73 112.00 ss0.00 5.50 r.42 0.58 t.73 1i2.00 s50.00 5.50 1.46 0.60 1.80 125.00 500.00 5 I 0 I l5I .00 .43 .62 .60 .00 The average cost of US$ 20,000 used tbr General Services staff refers to higher-grade staff members who will maintain the OCP status. (*) JPC2I.4 Page 44 ANNEX III o- oo E'I =-, c) -) (U = L o. G = -o 0,lr G = L CL L G = d F \ oN o; o' ts o!o ts ! ooFts fl a@ @ FF .,i @ @ o Fa N N o o oo ri No @ Fcl @ 6 o r o N N o; N n F d F .i o(:, ult iro Il(9 Il\l lUF tr F trl oo :)(D ro(o (o ao(o € ao or- o Fi- ooo$t oF(n ct) C') F =otrlr L o E, JJ o o @f uJ IFlr o UJ oz ox IU lJ- o a TUF u -oKP .N (, oo oz o o o. oo o) = = -t c a -) z o t-f o ur @ (t) -l a Tt--l16r Il@ I rl) c)(o ,ror--l r-19 l * : ! ! ! l I I : ! ! I o) (o (o(\t @ =riro lO o) rO -oo TL -a{E to i.- ut C{(0 r{) oot o ro\t o ro r() oo(o oto(o ooi,- o l(,i- oo@ o i- CD@(o \t @(0 c) ro(0 !t ot(o t (0 oo ro : ! ! ! l "! ! : ! l JPC21.4 Page 45 ANNEX IV oo ol ooo$t C') o) o) F o\o tr tr6 l-998B eEF.E6 E- ;r 5 $8.PE o (0 C') o) F lo o) o) sf CD CD oo6 .C o. =oo Gt o. oo$lIr+ o) CD J UIzz o @ E, IIJ o- =)o^ a@EOJ-t 8€OoUJtro.9 -Z9E =@d3 iE cn]=Ftra9 oolrIL Fa !I o z o F =)J o ul (oro$(Y)$t $ sn suo!illtI / $ sn uo!il!u!l ,i_- - it ., .j-.1 :,:"-' ; q$ \ sf q \f rO e) lO a @ a(o CY o@N cf) o (f) $ $(9 (o(9 v CE o (f, rf) (f) tt(o (o (9 o)(.) (o @totif N@s$ ot\t-$ c\l(oolo @$o(o t." ,i JPC2I .4 Page 46 ANNEX V ooN @ U)f ooo o o oo (= oo @ oooN o) o) o) (o o) o) r tr) o) o) a lUzz 1IJ e ul U'z o F v, ul(L o rooq t+ C" o) l:. az o F t UJ o- o J t tu o (u o @ o) o) r r- o) o) t o) o) r o =o -tr Eg l.r. -\o ot, o o o -tr ooo oooN ooo CO ooos ooo 1r) ooo(o ooot- o srnoq qq6!u'oN / slsoc .........^.-\ wal.4 Page 47 AI{NEX VI -e .,-4 i.,l ,o\\1 ,\f\a; f., Yaraor ctnodg. t \ I -i"] 1y^ ,u*dI s ,4 v tlo tr tar)ary a -rtdd 1 ) { \ I' I Jf'I .il A\'4 Vej:aaa:l a I 7 l_t9r^- ,"c *#'' ;..5t!i oYl s.rf ' 1/' ' ') \ !i,o o ao5o oco 'a co 1lto 6g o E) a6 E)I 6o 6 Eo o 1{o c I5too Ec6 Eo oo 3 It I € EE Eoco .o= Etat; EEiEgE EEEigE# EEEE 8rl r '+-io.2'6 "'o rI % oa ai9-c EE EE iE Bg03 aa a, l, t ottoo=6So-5o !se.n )J 5oC{ & oA U trl o C,) zIH il rrl Oro A z Jt oo c.l &o tJr(t) zo H & EIAo fJ.{o z J A{ U /4.a, / ] I n ,;' s,) ) -.1 s L L JPCzI.4 Page 48 ANNEX VII o-o .!l _an ob LX,bo EE -fi8SE\ E8 *E5no-Eo.o ra lugE Eo* F 5oN z rrl V)HJJ rjl zzo EIU) ca H r4 u)il H E{U rilU) oo c.t z (/) 14U) la J zIF il tq F{o CI z V)il o F,.U rqV) t o a co .9Eo @ o = =ur c0 I I I =I o o .Po - C' I oqI = Yq5a I ,I , aI aI ut( 9 -a H oo a I a utzz ul -t = al,o =o .9oc o x o) c .9oco x o) E o lt,o =ooo(U -o o .9 o)cc .9 E .o o-o $H q IJJIe 65 oll oP =ooaJ EE ,U' z Y2 E C!to TJa5-9 al, oG 36oa - z tr lrI lx trr =5 o fi =5 o !o .a aco L ao C!c:o! aco3Cz C!c 3a a E,; ETCr €!o6 EE -.3 E5C'E{ €s .F =5 ! o d .s ea 3 E3 : T5 3 ao a o E E EEo o- a2E o aco aE!a -f!^TE;€:oa!fr 8E oEi9 toUC aogt C! J' E o ac eo o3o 'C o C3 e !ta c o5 ea i 3 a 3:Cs a o F e!E ctoA o.oo toap o. atc .95iICo oat =t fl .g oI IErtti Ei o =o ooo o oaU' I ocox a siIa alE s6 clPczt.4 Page 49 ANNEX VIII 9o e'a 9or 9b 8E Ep 9o cL=II' 3g 9o 8B ts 1\oo O-ooooc{N EoE vEa HE:EE E:EEE *'83;i i*. EEiE€ $E EgEEEEElil o!!| ^t €r6 *1UG .}b\ts*B:lEE 8S!s!6 \E EE e& oo oo ot =Y G,o =FuJz zo f UI 9(9 o o =oFzlx ooN z s z UJ TUf 9,(, o o =oFz IU z o tr f, ]Ub 3 ul U't!t c I I @ I lt ,I t. I \ i rY'*i kii; i{ .'i :?:i .f,:r I t ttPc2t.4 Page 50 ANNEX tX =oo ^q9 EE sr9 o-Joot-i Z.;x *ur2= t-o z tl-lgE Fru LlJ -tJF< z ttl rJ()uJ lll - =60a ur 5xtt z- -r{<d.oc, u?a U;qg ;H 8E cn l- LU ,,r zH, Rffi zoN 7 i:-. o { t. I a 3J 3 I s I .f I : 3 i o' at,[_ =gYq5o I q ul o =72 f, s \ \ C TEfr iir iff EI{ B$E 1 { EE Eg IIi- EiEi IEg! ii as; r i E:! IEIX; ilI !:: aI T EE, IiEo oL aN'a i-trl + \l ffi aTPCZI 4 Page 5 I ANNEX X FILARIASES R&D (MACROFIL PROJECT) FOR TRIPARTITE FTJNDING BY OCP, APOC AND TDR 1. Objectives for the Filariases R&D (Macrofil) Project in 2001 The primary objective of the Filariases R&D (Macrofil) continues to be the discovery and development of safe and effective adulticidal drugs (macrofilaricides) for onchocerciasis and lymphatic filariasis. The secondary objectives of the project are: a) discovery and development of a back-up drugs which, while not killing adult worms, would permanently sterilise them, or provide alternative microfilaricides to ivermectin (e.g.: larger time between treatrnents or to replace ivermectin in case of resistance), and b) development of a molecular diagnostic tool/method that could be used to detect Onchocerca volvulus resistant to ivermectin as well as to optimise DEC skin patch test as surveillance tool . The funding of the Filariases R&D (Macrofil) will be constituted by a collaborative effort between APOC, OCP and TDR (each contributing with US$ 566,667) to give a total of US$ 1.7 million per annum. In 2001, the posts of a P5 scientist and a GS staff secretary will continue to be funded by OCP, and as far as possible OCP and APOC funds will be utilised for preclinical and clinical development of drugs and diagnostic tools (ivermectin resistance and DEC patch) for onchocerciasis, while TDR funds will be utilised for more fundamental work on identification of molecular targets for drug discovery activities and drug screening/evaluation. 2 Drug discovery and compound screening The acquisition of chemical structures from several sources (Walter Reed Army lnstiute of Research, GlaxoAMellcome and several academic institutions) will be through a facility sponsored by TDR that provides the logistic support as well as the 'in house" chemistry expertise. The drug discovery activities have been fully integrated within the operational, administrative and managerial structure of TDR/PRD, which has one drug discovery steering committee for all TDR diseases. This integration will allow for the use of the "multi-parasite integrated" drug screening system at Tibotec; availability of TDR in-house professionals in the fields of chemistry and compound data management. The key drug discovery activities to be pursued in the year 2000 are Characterisation as drug discovery target of aminoacyl-tRNA synthetaes establishment of a high through-put assay and screening for inhibitors. Investigation based on genetic information with the scope to identify novel drug discovery targets. Establishment of an in vitro screening method to evaluate the effect of potential leads. Maintenance of the Brugia palnngi in the gerbil animal models for compound evaluation. Due to the low flow of compounds expected during this period it is foreseen that the use of more advanced animal models (8. pahangildog and O. ochengilcattle) will be considered on a case per case basis and no longer funded as maintenance of screening facilities. a r' a 3IPCZ|.4 Page 52 Annex X For the above activities a budget at US$ 419 000 will be allocated, from which US$120,000 will be for drug discovery grants and US$ 299,000 for drug screening activities. Technical and Preclinical development 3.1. Ivermectin resistance detection tool Following the outcome of the 'ivermectin resistance meeting" in Ouagadougou, Burkina Faso (12-L3 June 1999), and the recommendation from the Drug Discovery Steering Committee, the activities regarding identification of genetic markers of ivermectin resistance previously supported as individual research grants were integrated in a single "product development' team. This team is comprised by rese_archres-from McGill University, Canada; Flinders University of South Australia; Pastoral Research laboratory CSIRO, Australia and Medical Biotech I-aboratories Uganda. For the yar ZOOL this team's aim will be to: compile candidate genes from H. contortus and C. elegans, evaluate the candidates in H. contortus, construct O. volvulus libraries, clone the candidate homologues rn O. volvulus and initiate population studies tnO. volvulus collected from human cohorts. For the appropriate support of these activities US$ 288,000 has been allocated. The above team is supported by a 'field team" (see section Clinical Research) composed by members from OCRC, Ghana; Noguchi Memorial Institute for Medical Research, Qfuana and Ministry of Health, Ghana. 4. Clinical research 4.L Combinations The Onchocerciasis Chemotherapy Research Centre (OCRC) in Ghana, will continue conducting clinical studies on combinations on ivermectin with other drugs as potential macrofilaricidals; particularly levamisole plus ivermectin or albendazole will be finalised during 2001. Oxytetracycline plus ivermectin (Wolbachta), Filariases R&D (Macrofil) sponsored researchers have demonstrated that oxytetracycline has an effect on inducing death of adult worms in relevant animal models. This action is presumed to be mediated through the effect of the antibiotic on a microorganism (Wolbachrc) present in the filarial parasites, including O. volvulus. A collaborative clinical snrdy between the Bernhard Nocht lnstitute for Tropical Medicine (Hamburg, Germany) and OCRC will examine the effect of combining oxytetracycline with ivermectin on the viability of adult O. volvulus in patients. 4.2 Moxidectin The lead compounds for development are moxidectin and oxyteracycline. Moxidectin was developed for the animal healthcare market and therefore all the necessary technical and preclinical development required prior to clinical studies in man have been completed. While having a similar mechanism of action as ivermectin (potent microfilaricidal) it has shown a significantly different pharmacokinetic profile with a Ionger half-life. This has resulted in clear sterilising effect of adult female worrns as well as death of adults in some models. Following recent discussions with the commercial partner (American Home Products Corporation) it is foreseen to initiate phase I (pharmackinetic) studies in OCRC during last quarter 2000 and more advanced clinical studies during 2001. aa a a a ,, a JPC2I 4 Page 53 Annex X 4.3 Development of a standardised "DEC skin patch" test Following informal meeting with LTS Lohmann AG (a company specialising in transdermal delivery systems) the rationale for the needs to develop a standardised DEC skin patch test for oncho surveillance has been defined. It was agreed that a transdermal delivery systems could be applied towards optimising the currently utilised DEC skin patch test. If a Memorandum of Understanding can be signed between LTS Lohmann AG and WHO, a technical feasibility study could be conducted by LTS l.ohmann AG with the support of clinical evaluation by Filariases R&D (Macrofil). 4.4 Clinical examination of ivermectin "non responders" As part of the Ivermectin resistance detection tool project (see 3.1) the team has identified in Ghana, O. volvulus infected individuals that appear as non responders to ivermectin after having received multiple treafrnents with this drug. A study that will utilise clinical parasitological (skin snipping, nodule examination), entomological techniques (fly feeding) and pharmacokinetic methods in the above mentioned individuals will be initiated during the year 2000. The aim of this study is to define if the trearnent failures are due to ivermectin resistant parasite or other factors. This study will be conducted at the OCRC with participation of the Noguchi Memorial lnstitute for Medical Research (Ghana) and the Ministry of Health Ghana. The cost of these studies will be covered by the allocation to 4.1 4.5 Albendazole plus ivermectin or DEC for lymphatic filariasis Considering the need to integrate the LF elimination prograrnme with the onchocerciasis control programmes in order to provide further scientific basis the Filariases R&D (Macrofil) is conducting pharmacokinetic, safety and efficacy studies on the above mentioned combinations. These studies will be finalised during 2001. The clinical research development activities are fully supportd by TDR personnel with professional expertise in planning, pre+linical and clinical activities (including clinical trial expert and monitors). The total budget for clinical research activities is US$ 520, 000 (this includes costs of monitors for all clinical trials, pharmacokinetic determinations and histological examinations), in addition to the above figure US$ 115 000 for Dr Awadzi's consultancy fee is foreseen. 5. Meetings/Temporary Advisers Meetings on clinical drug screening and specific product development teams for macrofilaricides will covered from the Filariases R&D (Macrofil) budget. The costs of the Drug Discovery Steering Committee will be met from TDP/TDR central funds. The total costs of bringing temporary advisers to such meetings is estimated at US$ 70,000. 6. Operational travel The scientist employed to co-ordinate the Filariases R&D (Macrofil) activities will need to visit collaborating laboratories, screening and clinical centres, pharmaceutical companies, etc. and attend statutory meetings of OCP and APOC when required. A total cost of approximately US$ 25,000 is estimated. 1 i a JPCZI 4 Page 54 Annex X 7. Personnel Personnel requirements for the Filariases R&D (Macrofil) remains unchanged for 2001, namely one scientific post at the P5 level and one secre[ary at the G5 level. A total personnel cost of approximately US$ 285,000 (as in 2000). 8. Total budget It is ttrerefore proposed that a total budget of approximately US$ 1.7 million be allocated to the Filariases R&D (Macrofil) in 2001, in'this fourth year of operation. Filariases R&D Macrofil) SUMMARY BUDGET 2001 Item Approved 2000 Proposed 2001 DRUG DISCOVERY 1.-Screening 2.-Drug discovery grants* Sub total 400 000 425 W0 82s 000 299 000 120 000 419 000 DEVELOPMENT 1.- wM resistance** 2.-Clinical research Sub total 250 000 520 000 770 000 288 000 498 000 786 000 Consultants (Awadzi)**x I 15 000 115 000 Meeting/Temp Advisers*** 70 000 70 000 Operational travel*** 25 000 2s 000 Personnel*** 285 000 285 000 Misc. Supplies 10 000 0 TOTAL 2 100 000 1 700 000 Budget supported by APOC OCP TDR 700 000 700 000 700 000 s70 000 570 000 560 000 " In OCP and APOC document addressed as "Strategrc Research" ** In OCP and APOC documents addressed as "Technical Preclinical Development" *** Retained by OCP ($495 000) a a .t ) a gts EI E H H EI tPCzr.4 Page 55 ANNEX XI I J Fo troo(\t ,- (D o) o, U) lUJ =I I tu ot (L z o trfJ o ]U Foo(\ It o) C') - F ul lUJ lJ. lUJI I lU lJ. o z o Ff,J o TU a oI .9E o E .9lr .-E(E o oT' oI .9E .0, E o 0, .6' trE E,E(U(,o'= c o .12 .g tr o ..2g oE' og .9E{, tr ooo(\t G' ot o) og) (o o) o) l{, o,(n a o .Y(, = tso .9 E(I, o tr sf o, o, : o l{)oool,)oo ot o rr) C\l oo cf, o r.c,(, o saln3!q?^'qN / sals!r{a^'oN F' N t€ll.r I tlrr-lll,l Nl 6]6)lNl u:l I -t World Health Organisation Organisation Mondiale de la Sant6 Onchocerciasis Control Programme in West Africa Programme de Lutte contre l'Onchocercose en Afrique de l'Ouest Ouagadougou - Burkina Faso T6l6phone : (zza) s+ zs ss/ s9/ 60 T6lex : 5241BF trax : (zza) s4 28 i S a L : ; i : niu).r(,I, < I L* E-mai rt'p onrs.lrf <t , t \