Plan of action and budget 2006

JOINT ACTION FORUM Office of the Chairman JAF-FAC: Eleventh session Paris / France December 2005 FORI.]M D'ACTION COMMUNE Bureau du Pr6sident t African Programme for Onchocerciasis Control Programme africain de lutte contre I'onchocercose 18 000 000 16 000 000 14 000 000 12 000 000 10 000 000 8 000 000 6 000 000 4 000 000 2 000 000 I 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 Plan of Action and Budget 2006 Item 22 ofthe provisional aeenda World Health Organisation JAF 11.6 ORIGINAL: French October 2005 0 JAFl1.6 Page i JAF 1 1.6 AIzuCAN PROGRAMME FOR ONCHOCERCIASIS CONTROL PLAN OF ACTION AND BUDGET FOR2OO6 WORLD HEALTH ORGANISATION JAFl 1.6 Page ii 2 2.1 2.2 J 3.1 3.2 J.J 3.4 3.5 3.6 3.7 3.8 3.9 4 4.t 4.2 4.3 4.4 4.5 4.6 4.7 TABLE OF CONTENTS 1 INTRODUCTION: Context and previous activities Context....... Recall of 2005 activities and overview of national projects oBJECTIVE ................ Recall of overall Programme objective Specific Objectives of the Plan of Action and Budget of 2006....... 2006 PLANNED ACTIVITIES ............. CDTI Activities IEC Materials ............ Evaluation and monitoring of Programme activities... Vector Elimination Initiating disease mapping (REVIO) Initiating the mapping of loa loa (RAPLOA)........... Activities of long-term impact assessment of operations........ Research Programme management and administration........... FORECASTING BY PROGRAMME ACT[VITY............ ...... 10 Activities, Expected outcomes, Indicators and projected costs for 2006..................... 10 Costs by activity and by country... ...18 ,.,20 ...2t ...22 ...23 ...24 LIST OF TABLES AND FIGURES Table l: National Projects...... Table2: Activities by country in 2006....... Table 3: Operational Costs by country in 2006 Table 4: Proposed 2006 Budget in relation to that of 2005 and2004.... Table 5: Proposed 2006 Budget by category of budget line item as compared to that of 2005 and 2004........... Figure 1: Graph representation of2006 budget by category ofbudget line item Figure 2 :2006 administrative and operational costs .......... Figure 3 : Trend ofnumber ofapproved projects from 1996 to 2006 Figure 4 : Trend of budgets from 1996 to 2006....... LIST OF ANNEXES 1.1 t.2 I i 1 6 6 6 6 6 8 8 8 8 8 9 9 9 2006 Budget in relation to that of 2005 and2004 2006 Budget by category of budget line item in relation to that of 2005 and2004 ... Graph representation of 2006 budget by category of budget line item Budget Breakdown by major budget category items ......... Evolution/trend ofnumber ofprojects approved and the budgets approved or submitted from 1996 to 2006 ANNEX 1: AVERAGE LTNIT COSTS USED FOR BUDGET CALCULATIONS ANNEX 2 : ORGANISATION CHART OF APOC PROGRAMME............ 2l 22 23 24 24 25 26 .5 18 ...19 ...20 JAFlI.6 Page I 1 INTRODUCTION: CONTEXT AI\ID PREVIOUS ACTMTIES 1.1 Context This Action Plan and Budget for 2006 (PAB 2006) is the eleventh of its kind to be presented by the African Programme for Onchocerciasis Conhol (APOC) for review and approval by the Joint Action Fonrm (JAF). As obtained under the previous plans, the fifttr year of Phase [I of the Programme will be characteraed by the implementation of activities of Community-Directed Treatment with Ivermectin (CDTI) of five new projects distributed over South-Sudan (l), Democratic Republic of Congo (2) and Angola (2), as well as the consolidation of the six-year gains under Phase I, and the first four years of Phase tr involving 96 projects in Malawi (2), Uganda (4), Nigeria (27), Tanzania (7), Sudan (4), Cameroon (15), Chad (l), CAR (l), Equatorial Guinea (l), DRC (15), Liberia (3), Ethiopia (9), Congo (2), Burundi (3) and Angola (2). Activities will also include vector elimination through entomological surveillance in project areas in Uganda (2),Tanzarria (l) Equatorial Guinea (l). Seven central secretariats of National Onchocerciasis Control Programmes (NOCP) will benefit from technical and financial assistance for the implementation of projects in Cameroon, DRC, Tanzaniq Nigeria, Sudan, Ethiopia and Angola. Overall, one hundred and five (105) CDTI and vector elimination projects and seven NOTF (National Onchocerciasis Task Force) secretariats support projects, distributed over 15 countries will benefit from scheduled activities in line with the 2006 specific objectives set hereunder, by virtue of the mission assigned to the Programme. The year 2005 was marked by the following major activities. 1.2 Recsll of 2fi15 activities and overview of nationel proiects o The activities conducted under CDTI projects in 2005 are summed up as follows: (i) Implementation of first year activities of fourteen (14) new CDTI projects (4 in Angola,2 in Burundi, I in Uganda, 4 in DRC and 3 in Sudan). (iD Continuation of activities in sixteen (16) CDTI projects in their second year of implementation (2 in Angol4 5 in Cameroon, I in Burundi, I in Congo,2 in Sudan, 3 in DRC, I in Liberia and I in Tanzania). (iiD Intensiffing implementation of twenty (20) CDTI projects in their third year of implementation (1 ) in Angola (1) in Cameroon, (9) in DRC, (6) in Ethiopia, (1) in Liberia,(l) in Nigeria, and (1) in Tanzania), and a reinforcement project of the NOTF secretariat in Angola. (iv) Continuing implementation of six (6) CDTI projects in their fourth year of implementation (1 in Cameroon, 2 ln Ethiopia, 3 in Equatorial Guinea). (v) The completion of reinforcement activities under the implementation of ten (10) projects in their fifth implementation year, of which 9 are CDTI projects: I in DRC, I in Nigeria, I in Tanzania,2 in Cameroon, I in Congo, I in Malawi, I in Uganda and 1 in Liberia), as well as I reinforcement project for the NOTF secretariat in Ethiopia. The results obtained are significant, and have to do with training and re-training of 161 503 community distributors (CDDs), 15 651 health workers, and capacity building of 500 nationals on tools and facilities used in CDTI activities. A supervision rate of more thanTSYo was also recorded, with respect to the CDDs and health workers trained, and 85%o of 86 377 communities benefited from sensitisation on CDTI. Other achievements are, among others, the organisation of 212 sessions of mobilization, sensitisation and advocacy conducted in 45%o of the districts/LGAs; the development of IEC materials/strategr to ensure compliance with JAFI I.6 Page2 treatment in almost 60% of ongoing projects; the management of 85% of identified/reported SAE (Severe Adverse Events) cases; and the conduct of KAP studies for the integration of reproductive health and Vitamin A Supplementation into CDTI. Overall, the number of persons teated, which was 37 307 000, is gone up to about 41 407 000 in 2005. CDTI sustainability evatuation exercises, Iong-term impact assessments of Programme operations enabled the following actions to be taken: (vi) On the basis of plans drawn up by the countries, support was given to reinforcement activities for enhancing CDTI sustainabitity in forty-five (45) CDTI projects in their sixth, seventh and eighth year of implementation (6 for Cameroon, I for Equatorial Guineq 1 for Malawi,25 for Nigeria, 3 for Ugand4 I for Sudan" 4 for Tanzania, I for CA& I for Ethiopia, I for DRC and I for Chad). The enhancement of CDTI sustainability was mainly done through extensive integration into health systems, and through the use of the Community-Directed Treatrnent (ComDT) approach so as to take up the challenges thrown by other health interventions, such as Vitamin A distribution campaign, the bilharzias control campaign, the distribution of treated bed nets under malaria control, the fight against sexually transmitted diseases and HIV/AIDS, for instance in "Oncho" zones. (vii) On the basis of country plans, sustainability enhancement activities were carried out in five (5) projects to strengthen secretariats of NOTFs in their sixth, seventh and eighth years of implementation (Cameroon, Nigeri4 Sudan, DRC and fqnzqnia). This is mainly done through the covering of costs of the secretariats and support of their activities of coordination and supervision of onchocerciasis control, by the Ministries of Health (MoH) of APOC participating countries. The impact study data collected on 12 sites were analysed and used in articles submitted to various scientific journals for publication. (viii) o Vector elimination activities continued through: (ix) The consolidation of entomological evaluation activities in four foci of vector elimination projects (two in their sixth implementation year in Uganda (Itwara and MpambaNkusi) one in its seventh year of implementation in Equatorial Guinea (Bioko island) and another in its eighth implementation year in Tanzania (Tukuyu focus). The results recorded show that vector biting rates are nil everywhere, except in the Tukuyu focus. a Other activities undertaken in 2005 Continuation of assistance to NOTFs for drawing up their sustainability plans, on the basis of evaluation results. (xi) Continuation of training of field technical staff on the technique of developing and conduct of operational research, and the use of the results in decision-making. (xii) Continuation of coordination by APOC Management of REMO (Rapid Epidemiological Mapping of Onchocerciasis) surveys in the following APOC member countries: Burundi, DRC, Angola, Sudan, Liberia, CAR; continued refinement of these REMO surveys in the countries concerned, and the integration of survey data into the Geographic lnformation System (GIS). (xiii) Continuation of coordination by APOC Management of the mapping of Loa loa in: Congo, DRC, Cameroon and South-Sudan to determine areas of onchocerciasis/Loa loa co- endemicity, where the risk of SAEs after treatment with ivermectin is likely to be high. o (x) JAFI I.6 Page 3 (xiv) Continuation of the Phase tr long-term impact assessment of APOC operations on the major indicators of the endemicity of onchocerciasis, on the epidemiological, dermatological, ophthalmologic and entomological levels. (xv) Continuation of participatory follow-up/monitoring of ivermectin distribution projects by independent scientifi c experts. (xvi) Continuation and enhancement of self-monitoring of CDTI implementation by community members (xvii) Management of possible severe adverse events (SAEs) in areas that are co-endemic for onchocerciasis/Loa lo4 and support for operational research proposals aimed at shedding light on all SAE-related issues. (xviii) Continuation of advocacy, Information, Education and Communication (IEC) activities, through the production of a guide on the stratery of developing IEC messages adapted to the local context as well as the production of tools for underpinning the IEC activity. (xix) Continued consolidation of the scientific bases of the Programme through operational research, in close collaboration with the special prograrnme of Research and Training on Tropical Diseases (mR).. (xx) Continuation of collaboration between Programme Management WHO Regional Oftice for Africa, WHO countr5r offices in participating counffies, the World Bank Oncho Unit in Washington, the WHO Administration and Finance office in Geneva, and the Programme for the Prevention of Blindness and Deaftress (PBD) of WHO Headquarters in Geneva, which, as obtained in the past, will see to liaison and coordination with the group of NGDOs. (v.xi) (xxii) Support for the AFRO/APOC liaison office based at WHO Headquarters in Geneva. Covering of consultant costs, of half of the operational costs of the office of the NGDO coordinator based in Geneva, including half of the cost of a secretary of the office based in Genevq and travel costs, as well as the cost of office supplies. (xxiii) Continuation of support for the search for a macrofilaricide in close collaboration with TDR. (xxiv) Continuation of vector elimination-related activities in identified foci in three APOC member countries: Equatorial Guine4 Uganda" and Tanzania. (xxv) The implementation of a policy of support and follow-up of treatment of Oncho patients living in hypo-endemic areas not eligible for CDTI. (xxvi) Continuation and enhancement of the collection of statistical data on ivermectin distribution and progress in CDTI implementation in APOC member countries. To this end, the Programme will continue training national top-level statistics personnel for data collection, analysis and interpretation. (xxvii) Covering salaries/emoluments of Programme staff based in Ouagadougou, follow-up missions, evaluation and coordination missions in participating counffies by Programme staff and by consultants. JAFI I.6 Page 4 (xxviii) Participation of APOC Management in sessions of the Committee of Sponsoring Agencies (CSA), as well as missions of advocacy and fundraising organised by the World Bank (prix) Preparation and holding of two TCC ordinary sessions in Ouagadougou @urkina Faso), and the l lh JAF session of the Programme in Paris, France. As part of scheduling of activities to be undertaken in 2006, the overview of projects is as follows: \oocGI E \oliardUO tE E CJc o rr Glo E \o a) 9>, .!99EL.l!qtr ;FOE Y->?EES!c!,9oo 6;lEso -. (,TEE = >E 'Eo,l u; .l= oee€R 9Es =>-EE EE 9E EE: sE i .EEE;.t E EHE1i50 ED >r atEErrr =-. cJ o AA? 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(!(,) ri o 6I! tro -o(l o Q& o cg ! o) -o r.l (g ro rq o b0 oU 1,tr lito rO o b0 tr JAFI I.6 Page 6 2 'OB.IECTTVE 2.1 Recatl of overall Programme objective The 2006 Plan of Action and Budget is centred on the overall Programme objective as follows: "To establish, within a period of 12 to 15 years, effective and self-sustainable, communitydirected ivermectin treatment throughout the endemic areas within the geographic scope of the Programme, and, if possible, in selected and isolated foci, to eradicate the vector by using environmentally safe methods. The attainment of this objective is expected to contribute towards the elimination of onchocerciasis as a disease of public health and socio+conomic importance throughout Africa and so improve the welfare of its people." Given this overall objective, and the progress chalked by the Programme for the past ten years, it plans achieving in 2006 the 16 objectives listed hereunder: 2.2 Spccific Objectives of the Plan of Action and Budget ot2U0,6 a) Implement l0l CDTI projects and treat, at least, 45 507 000 persons; b) Conduct entomological evaluation in 4 onchocerciasis vector elimination project areas; c) Support and reinforce 7 central NOTF Secretariats; d) Evaluate the sustainability of six (6) projects e) Conduct independent monitoring of l0 CDTI projects, and the monitoring of implementation of l0 sustainability plans; f) Conduct selGmonitoring of l0 projects; g) Conduct REMO/REA exercises in 4 countries, and RAPLOA exercises in two; h) Support four countries in managing severe adverse events (SAEs) i) Publish the results of the long-term impact assessment of APOC operations, and conduct treatnent compliance surveys in three countries; j) Support a review meeting on the situation in the four vector elimination foci; k) Continue Operational and Macrofilaricide Research activities; D Continue giving administrative and technical support to projects; m) Build institutional capacity of countries in several areas (CDTI stratery, GIS, Finance,...); n) Continue administrative collaboration with WHO/Genev4 WHO country offices and NGDOs; o) Provide Programme with adequate materials and equipment; p) Bear overhead costs of Programme headquarters. 3 2006 PLAI\NED ACTTVTTIES 3.1 CDTI Activities They will be centred on the following: JAFI I.6 PageT (i). Implementation of five new first-year CDTI projects: (1) in South-Sudan, (2) in DRC and ' (2) in Angola. (ii) Continuation of activities of twenty-two (22) CDTI Projects in their second year of implernentation: Sudan (3), Cameroon (3), DRC (9), Liberia (1), Burundi (3), Congo (l) and Angola (2) (iii) Enhancing the implementation of thirteen (13) CDTI projects in their third year of implementation: Nigeria (l), Tanzania(2), Cameroon (2), DRC (l), Liberia (1), Ethiopia (6). (iv) Continuation of the implementation of seven (7) CDTI projects in their fourth year: Malawi (l), Nigeria (l), Cameroon (1), and DRC (2), ETHIOPIA (2)- (v) Continuation of reinforcement activities under the implementation of six (6) CDTI projects in their fifth year of implementation: Nigeria (l), Tanzania (2), Cameroon (l), DRC (2). (vi) Giving limited financial support from APOC Trust Fund towands the reinforcement of forty- eight ASl projects in their 6^ ,7* or 86 year in the following countries: Malawi (l), Uganda(4), Nigeria (24), Tanzania (3), Sudan (l), Cameroon (E), Chad (1), CAR (l), Equatorial Guinea (l), DRC (l), Liberia (l), Ethiopia (l) and Congo (l). (vii) Training and re-training sessions of CDDs will be organised in the form of workshops in ten CDTI projects in Nigeria, Congo and Cameroon with a view to addressing the low CDD- treated population's ratio. Meetings and training sessions will also be organised to: (viii) lmprove data collection and processing competence, and the statistical data processing of CDTI and other health projects for ease of decision-making; (ix) Enhance the popularisation of the APOC philosophy through workshops that bring all stakeholders to the implementation of CDTI; (x) lmprove knowledge on modalities and recording of statistical data on CDTI in Congo, DRC and Ethiopia; (xi) Harmonise the content of messages to be delivered to learners, and enhance the skills of trainers / training of trainers (health workers, primary health nurses) in four countries: Cameroon, Malawi, Tanzaniu and DRC. (xii) Training of managers and Oncho control activity coordinators in four countries on operational research and on EPI-INFO so as to promote and attain a l5o/o increase in operational research proposals; (xiii) Identiff and involve local NGDOs in new CDTI projects in three countries (DRC, South- Sudan and Ethiopia) and ensure enhancement of ownership of projects through communities in Cameroon, Chad, Liberia and Equatorial Guinea. (xiv) To better share with national partners the APOC stratery and philosophy, two workshops to be organised in Burundi, South-Sudan and Ethiopia. (xv) Ensure transfer of skills in statistical data analysis and follow-up of financial management of projects, computer skills of nearly 90 persons in 5 countries for better interaction. JAFI I.6 Page 8 (xvi) Provide technical assistance to NOTF central secretariats through CDTI project rcview meetings with a view to improving the performance of 20 CDTI projects in six countries: DRC, Sudan, Nigeria, Cha4 Angolq CAR. (xvii) Bring together top decision-makers of the health, finance and planning sectors, NGDO and donors to brainstorm on the approach of integrating neglected diseases at the national health level, namely through the integration of Oncho control per CDI (Community-Directed Interventions) into the PRSP (target countries: DRC, Malawi, Ethiopia). 3.2 IEC Materials (xviii) IEC materials will be improved and illustrated for use by illiterates, and pre-tested in four countries (Cameroon, DRC, South-Sudan and Uganda) in a bid to improve comrnunication with the communities and facilitate data collection. 3.3 Evaluation and monitoring of Programme activities (xix) Six CDTI projects will be evaluated on the basis of sustainability indicators with a view to measuring progress made, and facilitating the phasing out of the APOC Trust Fund. The projects selected are in Ethiopia, DRC, Liberia and Uganda. (pr) Ten projects will conduct independent monitoring exercises of CDTI. These are projects in Angola, Burundi, Cameroon, Congo, Tanzania, South-Sudan, Liberia and DRC- (xxi) Ten other projects will conduct monitoring of the implementation of sustainability plans, with the participation of members of their governments in order to build the capacities of their top- level health officers. These exercises will lead to taking appropriate action towards the effEective implementation of for onchocerciasis contnol integrating other community-based programmes in Cameroon, Nigeria, Tanzania, Congo, Malawi and Sudan. (:orii) Summary studies will be conducted by non-NOTF' nationals so as to detennine the geographical and therapeutic coverage rates of l0 projects in 5 countries: Nigerig Cameroon, DRC, Ethiopiq Uganda 3.4 Vector Elimination The following will be organised: (xxiii) Entomological surveillance/evaluation in the vector elimination project areas in Bioko @quatorial Guinea); Tukuyu (Tanzania); Mpamba-Nkusi & Itwara (Uganda)- (xxiv) A review meeting on vector elimination projects to assess their progress, and put in place practical modalities for the cessation of surveillance activities, especially in the foci of Uganda. 3.5 Initiating disease mapping EEMO) (prv) Refining activities will continue in four countries (Sudan, Liberia, Angola, DRC) so as to establish updated data on the number of infected persons, and develop last DCTI projects. 3.6Initiating the mapping of loa loa (RAPLOA) (xxvi) RAPLOA surveys will be conducted in two countries, and maps made available for CDTI projects suspected to be co-endemic for onchocerciasis/Loa loa in the DRC and Sudan. JAFI I.6 Page 9 3.7 Activities of long-term impact assessment of operations (xxvii) The outcomes of the long-term impact assessment of APOC operations will be published in scientific journals. (xxviii) Longitudinal studies will be conducted on treatnent compliance. A hundred thousand (100 000) persons will be involved in these studies in three CDTI projects in Cameroon (l), Nigeria (l) and in Tanzania (l). 3.8 Research (ptix) Collaboration between TDR and the Prograrnme will be pursued so as to take stock of the progress made on the research on integrating CDTIC into health systems; the attainment and maintenance of high treafinent coverage rates, and Oncho treatnent compliance; the use of the "community-directed treatment" approach for other health interventions (Malaria, Tuberculosis, Vitamin A Supplementation), and for the development of treatment strategies in areas co-endemic for onchocerciasis/Loa loa. (xxx) Programme's continued support for the search for a macrofilaricide. This will have to do with the pre-clinical and clinical development of macrofilaricides against onchocerciasis, and also the development of diagnostic methods capable of detecting molecular resistance to ivermectin n O. votvulus. (:o<xi) The Programme could support six (6) rpsearch initiatives under the subventions granted by the Director of the Programme, and ten (10) operational rcsearch proposals submitted by the NOTF to the TCC for its appraisal and funding by the APOC Trust Fund. 3.9 Programrne management and administration (xxxii) Continuation of collaboration between APOC Programme Managemen! the WHO Africa Regional Office, the WHO county offices in participating countries the Oncho Unit of the World Bank in Washington, the WHO administrative and finance offrce in Genev4 and the Programme for the Prevention of Blindness (PBD) of the WHO Headquarters in Geneva, which, as in the past will ensure coordination with the NGDO goup. (xxxiii) Continuation of Programme contribution to the maintenance of the AFRO/APOC liaison office based at the WHO Headquarters in Geneva. (xxxiv) Covering of costs of consultants, a greater percentage of operational costs of the office of the NGDO coordinator based in Geneva, including: half of the cost of a secretary, and travel costs as well as the cost of office supplies. (xxxv) Payment of salaries and emoluments of staff of the Programme based in Ouagadougou (see organisation chart in annexe 2), follow-up, evaluation and coordination of activities in participating countries by Programme stafi consultants and temporary advisers. (mxvi) Participation of APOC Management in sessions of the Committee of Sponsoring Agencies (CSA), as well as in advocacy missions and fundraising organised by the World Bank. (xxxvii)Preparation and holding of two TCC ordinary sessions in Ouagadougou (Burkina Faso) and the 126 JAF session in a participating country of the Programme. JAFI I.6 Page l0 4 , FORECASTING BY PROGRAMME ACTTVTIY 4.1 Activities, Expected outcomes,Indicaton and projected costs for 2fi)6 Ac'tivities Expected Results Indicaton Estimsted costs $us l. CDII activities a Training of Community Distributors (CDDs) a Training of Health workers a Ilealth education a Production and distribution of IEC materials - 185 000 CDDs trained/retrained to maintain a therapeutic coverage rate of70Yo. - List of projects with low CDD/treated population ratio drawn up. * Number of CDDs trained/re- trained increased qualitatively and quantitatively, i.e. more than 100 personVCDD, ild workshops organised in at least l0 CDTI projects in three countries: Nigeri4 Congo, Cameroon * Number of projects with low ratio of CDD/population treated l 400 000 - l8 000 local health workers trained/re-trained, i.e. an increase of llYo of workers that learnt skills on CDTl-related statistical data collection and processing and that of other projects, to enable decisions to be made, namely in Congo, DRC and Ethiopia. - Capacity of health workers improved in the field of advocacy and community participation in at least three countries (Nigeria, Congo, Cameroon) - APOC philosophy reinforced and popularised with parhers through three workshops in Ethiopia, South-Sudan and Burundi * A number of local health workers trained/re-trained : - on statistical data collection and processing - on advocacy and community participation - on the popularisation of the APOC philosophy and CDTI strategy 700 000 - 65% of communities (nearly 95 000) reinforced and benefited from health education. * Number of sessions conducted and communities reached 514 000 - IEC materials improved, illustrated for use by illiterates, pre-tested in DRC, South-Sudan, printed and distributed in nearly 50oh of implemented projects, and 75 000 CDDs trained on the use of these materials, namely in Congo, DRC and Ethiopia * Format of IEC materials improved, illustrated and pre- tested + Number of CDDs trained on the use of IEC materials * Quality and number of IEC materials distributed, used and quality/number of reports _ 772 000 JAFII.6 Page ll Activities Erpected Results Indicators Estimsted costs $us received on communication with communities. a Supenision and training of CDDs treiners - 60% of CDDs trained / supervised for better assistance in primary health care in Cameroon, Tanzanig Malawi and DRC + Number of supervisors CDDs on the increase 354 000 o o Mobilisation, sensitisation & advocacy Management of Serious Adverse Events (SAEs) - Nationals and local partners sensitised on CDTI stratery and APOC philosophy; 170 mobilisation and advocacy sessions organised in districts and LGAs in DRC, South-Sudan, Ethiopia, and six local CBOs and/orNGDOs taking part in CDTI activities in target countries: Cameroon, Chad, Liberia, Equatorial Guinea * Number of mobilisation/sensitisation and advocacy sessions organised; Number of local NGDOs identified and involved in new CDTI projects, and the number of meetings organised on CDTI stratery in three countries: DRC, South- Sudan and Ethiopia 669 000 - 85Yo of SAE cascs are quickly identified and brought under contnol by better informed, well trained and equipped medical teams in DRC and Angola * Number of Severe Adverse Event cases (SAEs) decreasing and better managed 257 000 a Capecity building of, and skill transfer to projects - 400 nationals trained in various areas (APOC strategy and philosophy, GIS, Finance,...) 90 persons at least, of these are trained on statistical and spatial analysis, and produce statistical reports * Number of persons trained on the analysis of geographicaUstatistical data, and the follow-up of project financial management; expertise availab le for implementing and owning CDTI. s 14 000 a Integration of CDTI and other intenentions (Vit d Reproductive EeaIth, Hfv/AIDS, Malaria...) - 15 pilot experiments and/or surveys conducted on the integration of CDTI and other disease control interventions (in Cameroon, DRC, Tanzani4 Nigeria) - Eighty (E0) high-level decision- makers in health, frnance, planning, NGDOs and donors meet on the approach of integrating neglected diseases into the national health development plans, in Malawi and Ethiopia. Number of projects that carried out the integration exercise, and lessons leamt available. * Reports and recommendations made on the integration of onchocerciasis control per CDI into the PRSPs approach 360 000 2. SuoporUassistance to Central Secretariats of NOCPs - Seven more dynamic NOCP Secretariats on the field working toward the sustainability of CDTI in Angol4 Burundi, Cameroon, * Number of central secretariats of NOCPs active in the coordination of activities of the Programme 326 000 JAFI I.6 Page 12 Activities Expected Results Indicetors Estimeted costs $us Ethropia Nigeria, DRC, South- Sudan, Uganda Chad and Tanzania - Ten managers and coordinators of onchocerciasis activities trained on EPI-INFO in order to develop operational research proposals in Cameroon, Nigeria DRC and Uganda - Five accounting, computer and financial review training sessions organised in the countries: Nigeria, Cameroon, DRC, Ethiopia and Uganda Technical assistance made available to central secretariats of NOTFs during CDTI project review meetings and NOTF meeting minutes available; CDTI project performances improved for 20 projects in at least six countries: Burundi, Sudan, Nigeria, Chad, Angola CAR. + Training held, and l0 operational research proposals submitted and approved a Rate of technical and financial reporting and the rate of CDTI projects using the APOC Website and standard computer software in the follow-up of funds and real estate of APOC is higher thanTOYo of funded projects a * Number of professionals, TCC members, and temporary advisors taking part inNOTF review meetings + Number of projects that improved their performance 3. Monitorine rctivities - Independent monitoring exercises conducted in ten CDTI projects in Angola, Burundi, Cameroon, Congo, T arvani4 South-Sudan, Liberia and DRC - Monitoring exercises of implementation of l0 sustainability plans completed for Cameroon, Nigeria, T anzania, Congo, Malawi, and Sudan Number of ls year monitoring reports available *Number of sustainability plan monitoring reports available +Number of districts and areas contributing financially to CDTI activities 160 000 JAFI I.6 Page 13 Activities Expected Results Indicators Estimated costs $us 4.Vector Elimination Entomological surveillance activities carried out in vector elimination project areas for all target areas: Bioko/ Equatorial Guinea, Tuku5nr/Tanzanix, Mpamba-Nuksi & Itwara / Uganda Vector elimination project review meetings organised, and data of targBt proj ects examined. + Vector biting rate. * Annual Potential Transmission rate in all the areas * Number of progress reports received, and recommendations on entomological surveillance available. -Report on s&atus of control in each focus - Recommendations on the duration of entomological surveillance 98 000 2. Evaluption of sustrlnebility - Six CDTI projects TIDC evaluated, and sustainability indicators of CDTI projects and support structures developed to facilitate the gradual financial pullout of APOC in four countries: Ethiopia, DRC, Liberia, Uganda - Report and status of sustainability of projects and feedback made to projects 100 000 6.Lone-term jlqplg! assessment of APOC operatlons Phase 2 of impact studies completed on 12 sites in eight countries. Longitudinal studies on treatment compliance conducted in three CDTI projects, and a hundred thousand persons (100,000) surveyed in Cameroon, Nigeria and Tanzania. Reports of entomological dermatological, socio- demographic and ophthalmologic studies produced on the data of long-term impact study of APOC operations (phase 2') and articles published in scientific reviews. Data on treatment compliance are collated and report written up for each ofthe countries. 95 000 7. Disease manpinq - REMO surveys conducted in Sudan, Liberia, Angola and DRC to bring to 94Y, the rate of completion of mapping of APOC Completion rate of disease mapping in APOC countries Number of infected persons 165 000 JAFI I.6 Page 14 Activities Expected Results Indicators Estimated costs $us countries, and providing updated data on the number of infected persons in Programme anea. updated. Ultimate Treatment Objective drawn up per country - RAPLOA surveys conducted in two countries (Sudan and DRC) for 100% of the CDTI project areas suspected to be co-endemic for onchocerciasis/loa loa to be mapped. Co-endemicity mapping completion rate in APOC countries and mapping of priority CDTI updated in three countries. E. Technical supnort to national oroiects bvPrognmme units - Permanent technical assistance provided for ll2 operational projects; support to countries in the drawing up of project proposals, implementation, follow-up and evaluation of ivermectin distribution projects and vector elimination; liaison with the NGDO Soup, and necessary support for statutory bodies of the Programme (TCC and JAF) a Sustainable drug distribution Unit (7-members staff, including one proposal of a Temporary Staff Position (STP4) and a new regular Fix-Term Staff Post (Pa) of " Science Specialist" a Epidemiolory and Vector Elimination staff ( I 2-member staff, including two Temporary Staff Positions (STP3 and STP4) and a new regular Fix-Term Staff Post (P3) of " Information and Communication Technology Officer" Reports available, and external views given by temporary consultants and advisors recruited on a regular basis. + Number of missions an other technical services ensured by APOC staff to national projects and other auxiliary activities of the Programme * Quality of submitted project or research proposals + Quality of presentations made by projects during statutory meetings. Reports of services of temporary consultants and advisors produced for the Programme. l 705 000 JAFI I.6 Page 15 Activities Expected Results Indicaton Estimeted costs $us Consultant and advisor services accessible to Programme and projects. - Temporary professionals identified and recruited to assist in Programme implementation. - Recruitnent of temporary consultants and advisors to facilitate meetings, missions to projects, and brainstorming workshops on subjects of ooilrmon interest for the Programme. External expertise available and involved in technical support and assistance to projects and Programme. 9. Grent for the seerch for e pecrolilericide Continuation of support for the search for a macrofilaricide so as to ensure pre+linical and clinical development of macrofi laricides against onchocerciasis, and also the development of methods for detecting any possible resistance of O. volvulus to ivermectin. Report made to statutory bodies of Programme. Reports on activities conducted. 700 000 10. Oncrational Reseerch Report written up, and JAF I I participants infonned of research on the integration of CDTI into health systems. The attainment and maintenance of high therapeutic coverage and treatnent compliance rates; the use of the "Communit5r-Directed Treatment" approach for interventions in other health areas (Malariq Tuberculosis, Vitamin A Supplementation...) and the development of treatnent strategies in areas that are co. endemic for loa loa./onchocerciasi s ( in DRC, Cameroon, Nigeria, Uganda) Collaboration with TDR continued, and results of CDI studies (Phase 2) presented at JAF 12. 430 000 10 relevant areas under operational research. Number of operational research schemes initiated by NOTFs on the increase by 15-20% SUBTOTAL -I (OPERATIONAL COSTS) 9 319 000 JAFI I.6 Page 16 Activities Expccted Results Indicetors Estimated costs $us ll. Proerrmme Manasement Programmc statutory meetings * TCC sessions to be held in March and September 2005 to examine new project proposals, and to take cognisance of progress made in project implementation. + Twelfth JAF session prepared and held, including translation of related documents. Statutory meetings well organised: * Two TCC session reports. * JAI] 12 final communiqu6 and report. 180 000 a Iflenrgement end administration of the Programme Managernent and coordination of administrative and fi nancial services carried out by 46- member staff, made up of: - The Director and his direct secretariat (6 members) - Office of the Coordinator of Programme Director (40 members, including two Temporary Staff Positions (STP3) and a new regular Fix-Term StaffPost (P4) of *Budget & Finance Officef' - Temporary staffhired, and overtime hours regularly paid. tHuman and financial resources available for fulfilling mandate of Programme. - Number of advocacy and sensitisation visits - Number of internal audit missions Number of additional projects implemented - Number of recruitment dossiers of temporary staff processed - Number of materiaUequipment orders processed. - Number of letters of agreement managed - Number of personnel dossiers managed Man/month of temporary staff. No. of overtime hours of general services stafftaken care of by Programme l 260 000 a Collaboration with WIIO/AFRO \ilHO/Geneva and the NGDO coordination office - Administrative assistance taken care of by WHO and NGDOs at international, regional and national levels. - Number of fund transfers facilitated by WHO/AFRO (via WHO country offices and WHO/Geneva - NGDO reports Number of mission travel authorisations and plane tickets for European and American collaborators of Programme 315 000 O JAFII.6 Page 17 Activities Expected Results Indicators Estimated costs $us o Olficial Missions and travels for assistance to projects - Training carried out with technical, administrative and financial assistance on the field from Management. APOC Management represented at statutory meetings of Progarme partners. * Number of support visits conducted to countries (training, re-training, review) * Number of participations of Management in statutory meetings of Programme partners. 30 000 a Meintenance of equipment & and computer networ*of APOC headquarters Maintenance work on equipment carried out. * l0 vehicles in good running statet Buildings and equipment well maintained. * Security outfit in place.t Utilities (water, electricity and telephone bills settled on time. 130 000 a Equipment, supplies, logistics, Printing and oIfice consumables Computer network managers trained on routine interventions, and Management computers are connected to system network and operating normally; all incidents are detected on time. Office materials and supplies and miscellaneous consumables, and computer equiPment; maintenance of computer network. Statutory documents produced on time. Temporary staff hired, and overtime hours regularly paid. a Guaranteed electronic information system. Quality of routine interventions. a * Materials and offrce furniture in good state, and consumables available. * Number of materials and equipment operational. * Number of out-of-stock cases reduced. * Number of documents produced and distributed to Programme partners. Mar/month of temporary staff. No. of overtime hours of general services stafftaken care of by Programme 15 000 SITB.TOTAL . II (ADMIMSTRATTVE COSTS) I 930 000 OVERALL TOTAL: SUB-TOTAL (I) + (II) 11 249 000 at(u 't .E (Jd .o o crl okq-i o tro HEE '.=9'5 (1)O tdEB(! t(!oo o€(D6 Lr . i-.4b0- €€ EE ftl Li .sEHOEa < 6il!? ho oCtc)r?OO-H6t-Z 9l0. -rdori> .EOU irt'E .g €3t ':l'E > o9E 20),a I I XX XX I I XX XX I XX XX XX I I ooo o\\o\o € o oGe t4EitEEI.QO (1)t.):, HE'Z Ua'95 X X X X I I X X I I I t X X X X ooo \oGI(a !=oer li(:= o Bi€EE\J EH I I X I I t X X I I I I X I X I ooo o\o(r) (t hog 'E ooaH.E Fo.t.= EEE XXx XxX XXX X xX I Xxx XXX XX X a X X XxX XXX XXX Ooo =la -d oo!Ea)E EHE .8.# t -ta XX X XX X X X XXX XX I X X X XX X XX X to(r)\o sBgt XX X XX X X X XXX XX I x X X XX X XX X o o GI!la .9 RI 'tr o) frl E otrl I I XXX XXX XXX XXX I I I I I XXX XXXx ooo 6lF.F EO)0Esl s#ET XXX I X I I I XXX I I I a I XXX I I 6o F roGI Ao od8 5 ts e:P oo9 iE.= (D . 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O ad ql oo ril tro -oclo rdt)tr () +E] al C)D J .E ct d qt o u) z tr(lt (n d cql N Et- tc(t ol) o 6 tr J36oU \oo cl ti oI oq) I N (l) EcH L e oq) & c () 6l E arl o,o(J cl $ 5= Ego <cl -;A I fi .E o 6d Eo o .9+1 6tq 6) .EI E.E hI EEElE. .6 EI EE ,l(r qt ?l 3€Eto tr ., EIgE .91 rrlr: s?EI!I E.E '3Zl q EElslE IIlrl E t slelu s iISEE :l El ..gl lae o d() .o rrl rd() XX X XX X X X XXX XX I X X X Xx X XX X o ! ro E- o9 EH E.E rE oLo rd z I X I X X X I X I X I X X X I X I I I X t X I X X X X X X X ooa o('tt ooo t. dlOY >E rrl <&& X I I I I XX I I I I XX I o6o Y)\o (t c,ora E E E€ i,gE Ho.r o o.ta 6Yd I I X I I I I I I I X X I ooo ta o\ r<baii= a-OXct art G, =.nge rrl I I I I I a X XXX t I X t I X oo oo ?€>o x- 'B'g'€.E.E =adrana EEEs€E EO I I I I I I a I X I I I I X XX oo a o\ b{ -r L o.= cht o 2 I I X I X I I I I I I X X X X I ot o € E OI)IDE 'o'trEEo.'=rD= sz X X X I X t X I I I X I I X X I o e € r, oI 6t o ootr ! L rD ooE() E6l CJ € clsr) o@ o od. (.) ad, (, ao rI] o -o Et() El C)tr ao dtI] d 'tr op J B6t CI 2 d o60 z E € a .cc s E F< 6,E d o0 (h Do EI 6 ooO I I a I Fl E(t o(, oE(D d o B o oO aa E tto ll rt E' i.)oo o\ o o u, e C'' C 0qD p.!, ip N D, F' cac o-p z oaoFt A, g 8oI rr 6o p rn € p hE t, tD F' o A)dI rfJ o!p UFo o F o o oa o o tea o to o o o TDt d o. 0ao F) o o E' 'I o 5 { (, t\){ t\) (, I \o -t t\) t, (r) 5 o E'FlE 5 t) I FI -{ I tro \o(, \o € { L,Ttj) osUr L,Io\t Lar -t\o o\6o UJ N) \o5{ \o(,rro 5i.)5 o5 s6{ otrt\o s5o{ UJ N) I tJt L,I(+) (,l o\ o\ o a\oo 5 { -I\o t, @(+) o -t\o srrt(rr \055 oN)@ o5 u) L'Io5 (.J t/J rrt(rr @ o\5 o\ o + a (t) .to -c,eo s -o o)s -gr orC's -{(.,{s IPN{s -|o,os -or C' o,s .5{os -oc,os Po6ts -I5 o)s -5 gr s -5 TD5s I 5s -(rr5{s -oro o,s s :9>6E(!- \o o\ JAFI1.6 Page 20 4.3 2006 Budget in relation to that of 2fl)5 and 2004 Table 4: Proposed 2006 Budget in relation to that of 2005 and 2004 Amount Proposed Approved ApprovedBudget line item 20,}6 2005 2004 RECTIRRENT CHARGES I 257 000Personnel services I 260 000 t 257 000 Consultants and technical assistance I 53E 000 1792000 I 734 000 Travels 163 000 200 000 200 000 700 000Macrofil Project 700 000 700 000 Contracts (research and others) (i) PBD - forNGDO liaison (ii) TD& APOC countries and other institutions (iii) cDs (REMo/Grs) 430 000 589 000 619 000 140 000Operational costs 145 000 148 000 40 000 62 000 20 000Supplies 180 000 170 000 170 000Statutory meetings National CDTI Projects, including in some cases other health activities in the form of pilot projects. 6 066 255 7 119000 6 675 854 460 000National vector elimination projects s8 000 s57 000 Training, Workshops, Mobilisation, Advocacy 220 807 485 000 450 000 390 000 Administative support : WHO/AFRO/HQ Geneva, NGDO and WHO offrces in APOC countries 386 000 390 000 Subtotal tt 1E2062 13 466 000 12923854 Fixed assets Office equipment 36 000 39 000 45 000 Computer equipment 29 000 15 000 l5 000 Technical equipment I 938 24 000 30 000 Subtotal 66 938 78 000 90 000 TOTAL 11249 000 13 s44 000 t2 913 854 JAFI 1.6 Page 2l 4.4 2006 Budget by category of budget line item in relation to that of 2005 and 2004 Table 5: Proposed 2006 Budget by category ofbudget line item in relation to that of2005 and 2004 $US Amount ApprovedProposed Approved 2005 2004 Budget line item 2006 RECTJRRENT CHARGES WHO/APOC staff l 80 000 232 400 232 400Director and Secretariat l 080 000 1 024 000 l 024 000Office of the Coordinator of Programme Director's office 1 260 000 | 256 400 t 2s6 400Sub-total 1 s38 000 | 792 600 t 734 600Consultants and technical assistance (fromsustainable drug distribution Unit and epidemiology and vector control Unit) 200 000 200 000Travels 163 000 700 000700 000 700 000Macrofil Project 148 000140 000 145 000Operational costs 619 000430 000 s89 000Contracts (research and others) (i) PBD - for NGDO liaison (ii) TDR, APOC countries and other institutions (iii) cDS (REMO/GrS) 106 938 140,000.00 1 10 000Supplies and Equipment 6 675 854National CDTI Projects, including, in some cases other health activities in the form of pilot projects 6 066 255 7 119 000 460 000National vector elimination Proj ects 58 000 557 000 220 807 485 000 450 000Training, Workshops, Mobilisation, Advocacy 170 000Statutory meetings 1 80 000 170 000 390 000Administrative support WHO/AFRO/HQ Geneva,NGDOs and WHO offices in APOC countries 386 000 390 000 TOTAL 11249 000 13,544,000.00 12 913 854 JAFl 1.6 Page 22 Kev: statutory Meetings 2% Administrative support WHO/AFRO/HQ Geneva NGDO WHO Offices in APOC countries 3o/o Travels 1% Supplies and Equipment 1% Gontracts (research and others) 4Yo Operational Expenses 1% Macrofil Project 6Y, Personnel Services 11% Training Workshops Mobilisation Advocacy 2o/o Consultants and Technical assistance 14Yo Budget by category of budget line item ( $us) oh National project (CDTI * Vector elimination +HQs) Consultants and technical assistance Training, Workshops, Mobilisation, Advocacy Personnel services Macrofi laricide Proj ect Contracts (research and others) Administrative support WHO/AFRO/HQ Geneva WHO Offices in APOC Countries Statutory Meetings Travels Supplies and Equipment Operating costs 54,440/o 13,670/0 1,960/0 11,200/o 6,220/o 3,820/o 3,430/0 1,600/0 1,450/o 0,95% 1,240/0 6 124 255 1 538 000 220 807 1 260 000 700 000 430 000 386 180 163 106 t40 000 000 000 938 000 Total 11 249 oool 1oo, oo% 4.5 Graph representation of 2006 budget by category of budget line item Figure I : Graph representation of 2006 budget by category of budget line item National Projects (CDTI + Vector Elimination) 55o/o JAF11.6 Page 23 4.6 Budget Breakdown by major budget category items Figure 2 : 2006 Administrative and operational costs ADMINISTRATIVE COSTS 17.160/o OPERATIONAL COSTS 82.84o/o L- JAr'1 1.6 Page 24 4.7 . Evolution/trend ofnumber ofprojects approved and the budgets approved or submitted from 1996 to 2006 Figure 3 : Evolution of number of approved projects from 1996 to 2006 -+ Number of approved projects per year --r- Total of approved projects 140 120 100 80 60 40 20 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 Figure 4 : Evolution/trend of budgets approved from 1996 to 2005 and submitted for 2006 18 000 000 16 000 000 14 000 000 12 000 000 10 000 000 8 000 000 6 000 000 4 000 000 2 000 000 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 ttv 64 H--{ -rby'ag IA tnl ,1 1 \{ar 6 JAFI I.6 Page25 a ANNEX 1: AVERAGE TINIT COSTS USED FOR BUDGET CALCULATIONS I 2fi)6 2005 2004 2003 2002 2001 Steff Professionals -PGD2 190 000 170.000 170.000 155.000 rs5.000 15s.000 - P4-P5 165 000 145.000 145.000 145.000 145.000 145.000 - P2-P3 I 10 000 I15.000 I15.000 I15.000 I 15.000 -STP4-STP5 l2l 000 90.000 90.000 E5.000 85.000 85.000 STP2-STP3 90 000 65.000 65.000 65.000 - General scrrices 22 000 18.000* 18.000 14.000 20.000 20.000 . STG 8.800 8.800 8.800 6.000 4.000 - ConsultanVmonth 7 000 7.000 7.000 7.000 7.000 7.000 - Temporary staff (General services) 800 800 800 800 800 E00 Dollar equivalent - CFA Francs 505 560 550 600 550 550 - Euros 0 .770 0.847 0.849 1.55 5.50** 5.50+* - Swiss Franc l.l8 l.3l 1.30 1.42 1.42 1.42 - Pound sterling 0.554 0.584 0.610 0.58 0.58 0.58 - Canadian dollar t.23 1.35 1.38 1.38 1.38 1.38 - Japanese Yen I l0 r 12.00 118.00 l12.00 I12.00 112.00 * Average cost raised in relation to 2005 costs, taking into account reality of expenditure incurred ** French Franc eo Eooo oo .u,E-1r-<E a FEJoE €Eo €5 ,: -o9.ECa6 AE lll 6ao doEE>9a-bts<aab:3EE:toe oo{, .,a oa dE G[lIlrILo o =o.o. = .t E EoI 3 cl tg(, oo(, o o, e6 Eo6o a c CL .E FE:o(, c-a-EPtlLOEtr.= €a JE!" E6 Ea t o(, o .rT?aEEroout oE b3q5 EEr H=U Ed- allE"E .>o EEgaatio. =; -bE5< ao D E o at6 tg(, ErtIILl! o - UIFo al, a5o ooo E, ulI TLl!o UJ 9a <trzo L- .t F u.t(9 o) fo Elrl(, ltt!o6i ul lr(r-z 2 tr .i!aoao SE o!El!oo .t !E €g -ro!aa .t € oa(,c(,E <5 -o a aa aIaa(, E ac:o .,o !ao € a, u,t za)Ou-El!20 9aP5Qo =d-o=(,6 ulF co Ea Poo6 o EDCoaao = tt a ?I dE b3 o(, oo !a5 <E Eh Eb :€ eEoo EoF^<6J<odzts EF xG .Lo CT u,l t a d EAo oFt!o tIo EtIt ah 8 o- d.oF(,[tc o G c9of,hur^ =ERct=odv(J8U- o trEo airEo,tdSa €;oo oocooto - b s E(, oo g ooI g o o .t tl o3r,g o Eo o .: Q EI C' Ea o ooo CDE Eio o o o F .J !a.Qo .fo .d, Ett o o o .z o .Jt E = doo o eE P(, oo R3 o fi TEoo6Q =ggr' zI 2E -ur^ EH? =Ev =oo o L o !i# COEga EEOE2EEOg8 0f E,o lI a0 2 =Folg, r c!Eo E2D zo F , eE Io o c,(, aEIr;E :6<r LOgo- coo to.iiEs!t D6 Eto -o gEfe afo<a lrlI t I trlra a, tsaa il u oil Fr U o nr Irr o tr& FIrlU z oEF atstz (, & ? ol\o.^ x;X Erlio Z3S 1 I I I I I I