Consideration of national onchocerciasis control plans and project proposals (CDTI vector elimination and headquaters support) approved in 2003

JOINT ACTION FORUM Offiee of the Chairman t20 too 1997 JAF-FAC: NINTH SESSION Gatineau, -1-5 Deeemtrer, 200'1 -.a---_ 16 --a FORUM D'ACTION COMMUNE Bureau du Pr6sident l.-r I ,,. j l/ t-_,African Programme for Onchocerciasis Control Programme africain de lutte contre I'onchocercose i- -, 8o 60 40 19S 12 1S9 2000 2001 20,02 107 427 20vJ a 20 o 'tl 1 1996 CONSIDERATION OF NATIONAL ONCHOCERCIASIS CONTROL PLANS AND PROJECT PROPOSALS (CDTI. \TECTOR ELIMINATION AJ\[D HEADOUATERS SUPPORD APPROVED IN 2OO3 JAF 9.7 ORIGINAL: ENGLISH Senfemher 20O3 - t - Prolects approved Peryear --{-Cumulative total 80 69 63 57 45 29 ! I JAF9.7 Page i I 2 2 2 2 5 6 6 7 9 F B. I A. INTRODUCTION Table of contents ivermectin project of North Ubangui, DRC ivermectin project of South Ubangui, DRC ivermectin project of Tshuapa, DRC.......... ivermectin project of Lualaba, DRC........... NEW NATIONAL PLANS AND CDTI PROJECT PROPOSALS......... ANGOLA 1.1. Rapid epidemiologicalmapping of onchocerciasis (REMO) in Angola... 1.2. Community-directed treatment with ivermectin (CDTI) project of Cabinda, Angola.. 1.3. Community directed treatment with ivermectin project of Moxico, Angola" 2. CAMEROON............... 2.1. Rapid epidemiological mapping of onchocerciasis (REMO) in Cameroon.......... 2.2. Community-directed treatment with ivermectin (CDTI) project of Adamaoua 1, Cameroon.... 2.3. Community-directed treatment with ivermectin (CDTI) project of South Province, Cameroon.. 2.4. Community-directed treatment with ivermectin project of East Province, Cameroon.. 2.5. Community-directed treatment with ivermectin project of Far North Province, Cameroon.. 3. CONGO 3.1. Rapid epidemiological mapping of onchocerciasis (REMO) in Congo 3.2. Extension of Congo Community-directed treatment with ivermectin project 4. DEMOCRATIC REPUBLTC OF CONGO (DRC) 4.1. Rapid epidemiological mapping of onchocerciasis in DRC....... 4.2. Community-directed treatment with ivermectin project of Equateur-Kiri, DRC....... 4.3. Community-directed treatment with ivermectin project of Mongola, DRC......... 1l 4.4. 4.5. 4.6. 4.7. Community Community Community Community directed directed directed directed treatment treatment treatment treatment with with with with 4.8. Community directed treatment with ivermectin project of North Katanga, DRC.............26 4.9. Community directed treatment with ivermectin project of South Katanga, DRC............. 28 5. ETHIOPIA ...............29 5.1. Rapid epidemiological mapping of onchocerciasis (REMO) in Ethiopia-. .....29 5.2. Community directed treatment with ivermectin project of East Wellega, Ethiopia..........29 5.3. Community directed treatment with ivermectin project of West Wellega, Ethiopia-........ 32 5.4. Community directed treatment with ivermectin project of lllubabor, Ethiopia-................ 33 5.5. Community directed treatment with ivermectin of Gambella, Ethiopia...........................35 5.6. Community directed treatment with ivermectin project of Jimma, Ethiopia....................35 5.7. Community directed treatment with ivermectin project of Metekel, Ethiopia..................37 6. SUDAN ...................39 6.1. Rapid epidemiological mapping of onchocerciasis (REMO) in Sudan..... .....39 6.2. Community directed ffeatment with ivermectin project of East Bahr El Ghazal, Southern Sector, Sudan 4t 6.3. Community directed treatment with ivermectin project of West Bahr El Ghazal, Southern Sector, Sudan ...............43 6.4. Community directed treatment with ivermectin project of East Equatoria, Southern Sector, Sudan......... .........44 6.5. Community directed treatment with ivermectin project of West Equatoria, Southern Sector, Sudan 6.6. Community directed treatment with ivermectin project of Upper Nile, Southern Sector, Sudan......... .........47C. REVIEW OF PROGRESS REPORTS (TECHNICAL AND FINANCIAL) AND BUDGETS FOR SUBSEQUENT YEARS FUNDING....................................48 D. OVERVIEW OF BUDGETS SUBMITTED TO TCC AND APOC 46 L MANAGEMENT IN 2OO3 5l l5 JAFg.7 Page ii ACRONYMS APOC African Programme for Onchocerciasis Control Community d i rected distributors Commun ity-directed treatment w ith ivermectin Committee of Sponsoring Agencies Democratic Republic of Congo Government of Sudan Hellen Keller International Healthnet International International Eye Foundation Lions Club International Foundation Ministry of Health Non Governmental Development Organization National Onchocerciasis Task Force Organisation pour la Prdvention de la C6cit6 Rapid Epidemiological Mapping of Onchocerciasis South Nations Nationalities and Peoples Regional States Sudanese Peoples Liberation ArmY Sight Savers International Technical Consultative Comm ittee Ultimate treatment goal r, CDD CDTI CSA DRC cos HKI HNI IEF LCIF MOH NGDO NOTF OPC REMO stnlPR SPLA SSI TCC UTG 1 JAF9.7 Page 1 A. INTRODUCTION From 1996 to 2000, the Committee of Sponsoring Agencies (CSA) approved 63 projects proposals recommended by the Technical Consultative Committee (TCC). The approvals were ratified by the Joint Action Forum (JAF) at its second session in December 1996 (4 projects), third session in December 1997 (25 projects), fourth session in December 1998 (16 projects), fifth session in December 1999 (12 projects), sixth session in December 2000 (6 projects) and seventh session in December 2001 (6 projects). ln 2002, the Management of APOC, in line with the Memorandum of the Programme for Phase II and the Phasing-out period, has approved I I projects. This approval was ratified by the Joint Action Forum (JAF) during its eighth session in December 2002. [n 2003, the Programme Management on behalf of the Joint Action Forum, has approved 27 new project proposals recommended by TCC at its various sessions. The approval of these twenty-seven (27) project proposals in 2003 is herewith submitted to the Joint Action Forum for ratification. Furthermore, after review by TCC and APOC Management of technical and financial reports of fifty five (55) projects in their first, second, third, fourth and fifth year implementation, the Management of the Programme has also approved subsequent years funding of these projects. This approval is also submitted to the JAF for ratification. CAR CDTI=1CDTI=1CDTI=27 NOTF HQ=l Sudan CDTI=6 NOTF HQ=| CDTI=9 NOTF HQ:l CDTI=I4 NOTF HQ=l Uganda CDTI=4 Vector-2 Liberia CDTI=3 Burundi CDTI=1 Tanzania CDTI=7 Vector-1 NOTF HQ =1 Malawi CDTI=2 Gabon ..Qpf[rt=l Congo CDTI=2 Angola CDTI=3 NOTF HQ=l R.D. Congo CDTI=I4 NOTF HQ=l Eouatorial Gfiinea CDTI=1 Vector-1 Geographical distribution of the (107) approved projects (CDTI, Vector, HQ) as at September 2003 JAF9.7 Page2 B. NEW NATIONAL PLANS AND CDTI PROJECT PROPOSALS 1. ANGOLA 1.1. Rapid epidemiological mapping of onchocerciasis (REMO) in Angola Fie. 1-1: Community-directed treatment with ivermectin (CDTI) areas in Angola Lrgrnd I rorc ! nocon ! n"rrarcon rcfinc /ft. anrroe"ra4 KM 0 1m m 1.2. Community-directed treatment with ivermectin (CDTI) project of Cabinda, Angola The province of Cabinda (7270 km2; is the smallest province of Angola. It represents less than lo/o of the country (1,246,7 00 km2). The borders of the province of Cabinda are in the West the Atlantic Ocean, in the North Congo (Brazzaville) and in the South and East the Democratic Republic of Congo (DRC). 1.2.1. Background information The proposed project is partnership between the Ministry of Health (MOH) and the NGDO partner MALAL (ltalian NGDO). It seeks to introduce for the first time ivermectin in the province of Cabinda and to treat yearly 112 onchocerciasis endemic communities (62 meso endemic and 48 hyper endemic) with a total population of 379,873 persons. Census exercises will be carried out prior to the implementation of CDTI activities in order to determine the population figures and the project ultimate EEU A I crbindr Ir JAFg,7 Page 3 treatment goal (UTG). In this counqr, which has experienced more than 20 years of civil war, rapid epidemiological mapping of onchocerciasis (REMO) was the first countrywide survey, which provided data on communities. As schistomiasis is endemic in the province of Cabinda, the National Onchocerciasis Task force (NOTF) intends to integrate this regional public health problem to onchocerciasis control activities. Figure l-3 shows the detailed REMO results in the province of Cabinda. Table 1-l: General information 1.2.2. Summary budget Table 1-2 summarizes the fiveyear budget as submitted by the NOTF of Angola and Figure l-2 shows the trend ofthe cost per person to be treated between 2004 and 2008. ][ablel2: Five-year summary budget as submitted by the NOTF of Angola, Cabinda CDTI project *Pers: person W: Trend of the cost per person to be treated from 2004 to 2008 of Cabinda CDTI project 30.20$0.32 Total s400 $3.60 $.m 6 o3 E 3250 t oi rr'*t o 3 i 31.60c ct $1.m 00.50 00.00 ([oHe NGDO) t053 N4 2@S2006 Administrative units Total 4 municipios (districts) CDTI tarset 4 rnunicipios Population Total of the province 379,873 persons Target for CDTI 319,063 persons Communities Total in CDTI areas I l2 communities Tarset for CDTI I l2 communities Year Persons to be treated (A) Total Cost (B) CosUpers Total(C)=B/A Contributionof APOC (D) CosUpers* APOC(E)=D/A 1 58,374 $205,519 $3.s2 $l14,605 $1.96 I 82,389 $132,524 $1.61 $44,574 $0.s4 3 300,747 $194,919 $0.6s $94,855 $0.32 4 309,769 $146,194 $0.47 $53,686 $0.17 5 319,063 $169,567 $0.s3 $63,541 $0.20 TOTAL 319,063 $848,723 $2.66 $371,261 $1.16 t1.56 APOC 2005 2007 x .\er ' . s0.65 Partnars s0,47 I $l tAF9.7 Page 4 Fie.l-3: REMO results in the province of Cabinda, Angola Fie.l-4: REMO results in the province of Moxico, Angola I"* ! r.con ! o"aror"cou rcirc ffi nwop,rlo5 KM 500 Congo R.D. Congo LOgende lr."',H'*I le-e-' !1,-, rtlorlrr 9t Porteu13 nodulo! I .19 .39 - 100 Oo O l- Olo o20 O40 Angola Cabinda (Angola) Moxlco Lmbal6 N'G'imbo 1m \.c-. (( a 'tf Y1n-^./ ) -t I t tl l.jltltl 3l 3l \ ti to7 Luil Crcdo OWim ,J liroxbo JAFg.7 Page 5 1.3. Community directed treatment with ivermectin project of Moxico, Angola 1.3.1. Background information Table l-3: General information The proposed project will be implemented in the province of M-oxico, which is the least populated @41:524 personsin 2003) and the largest province (223,023 Km21 of Angola. Located in the East of Angola, the province of Moxico is limited in the east by Zambia, in the north by Democratic Republic of Congo, and the province of Lunda Sul (Angola), in the west by Bie province (Angola) and in the south by Cubango Cubango province (Angola). Moxico province comprises 9 municipios (administrative levels 2 equivalent to districts) which are Alto Zambeze, Kamanongue, Lumege (or Kameia), Luacano, Luau, Luambala N'Guimbo, Luchazes, Luena, and Leua. Rapid epidemiological mapping of onchocerciasis is partially completed in the province of Moxico (figure l-4) because of mine lands, broken bridges and poor roads. The REMO partial results enable the NOTF to delineate ivermectin mass treatment areas in 8 districts (municipios). The proposed project is a partnership between the Ministry of Health and the NGDO GOAL (lrish NGDO) already involved in other public health interventions such as HIV/AIDS prevention in the province of Moxico. The submitted project aims to treat 158,748 persons in 28 hyper endemic and 214 meso endemic communities by its fifth year of CDTI implementation. The population figures and the number of CDTI communities will be updated in due course on completion of the REMO. 1.3.2. Summary budget Table 1-4 summarizes the five-year budget of Moxico CDTI project as submitted by the NOTF of Angola and Figure l -5 shows the trend of the cost per person to be treated between 2004 and 2008. Table 1-4: Five year summary budget of Moxico CDTI project as submitted by the NOTF of Angola Administrative units Total 9 municipios Target for CDTI Meso and hyper endemic zones in 8 municipios Population Total 447,824 (year 2003) Persons to be treated in year 5 158,746 people Communities Total 315 communities CDTI communities 242 communities Year Persons to be treated (A) Total Cost (B) CosUpers Total ( C ):B/A Contribution of APOC (D) CosUpers APOC (E ): D/A I 132,104 $268,148 $2.03 $100,393 $0.76 1 138,313 $206,562 $1.49 $42,868 $0.31 3 144,814 $203,357 $t.40 $36,547 $0.2s 4 151,620 $205,058 $1.3s $41,236 $0.27 5 158,746 $206,829 $1.30 $40,922 $0.26 TOTAL L58,746 $1,089,954 $6.87 $261,966 $1.65 JAFg.7 Page 6 Fis.1-5: Trend of the cost per person to be heated from 2004 to 2008, Moxico CDTI project proposal $2.50 $2.00 $0.60 $0.00 2004 2005 2006 2007 2008 2. CAMEROON 2,1. Rapid epidemiological mapping of onchocerciasis (REMO) in Cameroon [!4!=1: Community-directed treatment with ivermectin areas in Cameroon ao Et tt.so oa o c o bAb $1.00A ot si.as - ' $1 .27 $1 18 $1 05 sr35 $r.30 t Tpt"I Partncrs 0utoH & ilGDo) ,76 $0.25 $o.27$0.26 Lcgcnd ! r,o..t Tlt Frr"ludrd ur t rcFrnc ! nocdd ! dcflnltccaa KM 0 100 200 JAF9.7 Page 7 2.2. Community-directed treatment with ivermectin (CDTI) project of Adamaoua 1, Cameroon The Province of Adamaoua comprises five departments (administrative level 2) subdivided in 13 health districts. The departments of the province are: Faro-Deo, Djerm, MayoBanyo, Mbere, and Vina. ln 1997, a CDTI project named Adamaoua 2 was approved for APOC Trust Funds support. This project, which launched CDTI activities in 1998, includes the meso and hyper endemic areas of the health districts of Meiganga, Banyo, Bankim and Tignere. The current CDTI project proposal of Adamoua I will complement the CDTI project of Adamaoua 2 by covering three health districts, which are Ngaoundere (Vina), Djohong (Mbere) and Tibati (Ndjerm). 2.2.1. Background information The current project proposal is a reorientation to CDTI of an ivermectin distribution programme initiated in 1996 by the Ministry of Health and Sight FirsUlions'Club. Figure 2-2 shows the number of persons treated between 1998 and 2002 by the initial ivermectin treatment programme. }[!g.!jl: Generalinformation The project of Adamaoua l, partnership between the Ministry of Ilealth (MOH) and the NGDO International Eye Foundation (lEF), seeks to implement ivermectin mass distribution based on CDTI strategy in 154 hyper endemic and 294 meso endemic communities of three health dstricts (Ngaoundere, Djohong and Tibati Ndjerm). It will treat 213,977 people by its fifth year of CDTI implementation. 2.2.2. Summary budget Table 2-2 summarizes the five-year budget as submitted by the NOTF of Cameroon and Figure 2-3 shows the trend of the cost per person to be treated. Table2-2: Five year summary budget of Adamaoua I CDTI project as submitted by the NOTF Administrative units Total 8 health districts in 3 "ddpartements" Target for CDTI 3 heath districts in 3 "d6partements" Population Total 258,972 persons in the 3 health districts concerned (year 2003) Persons to be treated in year 5 213,977 persons Communities Total CDTI communities 448 communities (154 hyper & 294 meso) Year Persons to be treated (A) Total Cost (B) CosUpers Total(C)=B/A Contributionof APOC (D) CosUpers APOC(E)=D/A I 145,000 $258,1 14 $1.78 $124,475 0.86 2 170,000 $203,440 $1.20 $64,515 0.38 3 188,630 $204,242 $1.08 $59,1 l 5 0.31 4 200,812 $205,590 $1.02 $52,700 0.26 f, 213,977 $208,529 $0.97 $50,250 0.23 TOTAL 213,977 $1.079,915 $5.0s $351,055 1.64 JAF9.7 Page 8 Fis.2-2: Number of persons treated between 1998 and 2002 in Ngaoundere, Djohong and Tibati, Adamaoua province, Cameroon 123602 19!t9 2m0 2001 200;t Fie.2-3: Trend of the cost per person to be treated, Adamaoua I CDTI project $2.00 i10m0 tarno lmmo enfl, frIno 10000 aIno ! t t c EA c E -a a 0 1998 $1.80 $1.50 6 $t.aoo3 ! * st.zoo! o i ot.oo c o I so.eo Loc! to.so C' $0.40 $0.20 I11?,)6 I!,lro6tsIac4ra 29737 Totdt I $1.08 s1.02 s0.97 sl so 'oPartners (MOH & NGDO) $0 82$0.86 APOC $0.3e $0.31 $0.23 ilu.zb $0.00 Year 1 Year2 Year 3 Year 4 Year 5 JAF9.7 Page 9 2.3. Community-directed treatment with ivermectin (CDTI) project of South Province, Cameroon 2.3.1. Background information Administratively, the South Province is divided in four departments (Mvila, Vallde du Ntem, Ocean and Dja-Lobo), which comprise 21 subdivisions (arrondissements). Table 2-3: General information The project is a reorientation to CDTI of an ivermectin distribution programme initiated in 1992 in two health districts (Sangmelima and Zoetele) by the Ministry of Health (MOH) in partnership with the NGDO International Eye Foundation (IEF). Despite the withdrawal of IEF in 1994, the MOH pursue ivermectin distribution in the districts of Sangmelima and Zoetele and treated in 2001 a total of 43,000 people. The current CDTI project proposal is a partnership between the MOH and IEF. It aims to treat I 15,695 persons in 274 meso endemic and 137 hyper endemic communities in its fifth year of CDTI implementation. The 411 CDTI communities are located in five health districts, which are namely Ambam (departement of Mvila), Djoum, Meyomessala, Sangmelima and Zoetele (departement of Dja and Lobo). Figure 2-4 shows the detailed REMO results in the South Province. 2.3.2. Summary budget Table 2-4 summarizes the five-year budget as submitted by the NOTF of Cameroon and Figure 2-5 shows the trend of the cost per person to be treated. W: Five year summary budget of South Province CDTI project as submitted by the NOTF Administrative units Total 21 "arrondissements" (all South Province) in 4 "d6partements" CDTI target 5 arrondissements in 2 d6partements Population Total in CDTI area 258,81 7 persons (year 1) CDTI tareet I I 5,695 persons (year 5) Communities Total (hypo,meso,hyper endemic) 684 communities CDTI target (meso & hyper endemic 411 communities Year Persons to be treated (A) Total Cost (B) CosUpers Total(C)=B/A Contributionof APOC (D) CosUpers APOC(E)=D/A 1 rss 623 $ss0 746 $3.s4 $401 330 $2.s8 2 161 680 $320 409 $1.98 $195 s79 $1.21 3 166 370 s290 774 $1.7s sr48 843 $0.89 4 169 558 s2s0 204 $1.48 $t0s 700 $0.62 5 t74 475 $266 ls0 $1.s3 $102 202 $0.s9 TOTAL 174 475 $l 678 283 $9.62 $953 654 $5.47 JAF9.7 Page l0 Eig.24: REMO results in the South Province, Cameroon l{odules (*) t H'""' ! rc{rl ! a"tro"rt - RInn o0 o t-9 o 10-19 o 20-39 o 40-100 0 100 Fie.2-5: Trend of the cost per person to be treated, South Province CDTI project IA !o Eo o! c Ec oIg b4 o o(J t1Il0 1350 13.oo 02.50 12.00 lr50 lr .00 f050 TOTAL l$2.58 $'r.98 $1.75 $'r.53$1.48 11.21 ---- t0.94tu.of $0.96 00.8510.77 00.59 $0.00 Year I Year 2 Year 3 Yeall Year 5 XM 50 2.4 JAF9.7 Page 1 1 Community-directed treatment with ivermectin project of East Province, Cameroon 2.4.1. Background information Ivermectin distribution was initiated by the Ministry of Health, Sight Savers International (SSI) and the Lions Club International Foundation (LCIF) in the health district of Bertoua since 1996. From 1998 to 2001, the performance of this vertical ivermectin distribution programme, which does not involve the communities, dropped from 55Yo in 1998 (12,873 persons treated out of 23,369 people) to lgYo in 2001 (3463 treated out of 18 065 persons). The current project proposal is a partnership between the Ministry of Health and Helen Keller Intemational(HKI) and a reorientation to CDTI. The proposed project area will cover five health districts, namely Bertoua, Betane Oya, Garoua Boulaye, Abong Mbang and Lomie. In 2003, the total population of these health districts is estimated at373,013 people living in 33 8 hyper endemic, 450 meso endemic and 337 hypo endemic communities. Figure 2- 6 shows the REMO results of the East Province. Table 2-5: General information The project seeks to treat292,74l persons in 788 meso and hyper endemic communities in its fifth year of CDTI implementation. 2.4.2. Summary budget Table 2-6 shows the five year budget as submitted by the NOTF of Cameroon. Figure 2-7 shows the trend of the cost per person to be treated annually during the five years of the implementation of the project. Table 2-6: Five year summary budget of East Province CDTI project as presented by the NOTF Administrative units Total CDTI tareet 5 health districts Population Total in CDTI area 373,013 persons (year 2003) CDTI target 292,7 41 persons (year 5) Communities Total (hypo,meso,hyper endemic) 1125 communities CDTI target (meso & hyper endemic) 788 communities Year Persons to be treated (A) Total Cost (B) CosUpers Total ( C ):B/A Contribution of APOC (D) CosUpers APOC (E ): D/A I 261 109 s482 074 $1.8s $323 014 $1.24 ,, 268 681 $256 41 8 $0.9s $1s6 379 $0.58 3 276 472 $22s 930 $0.82 $127 640 $0.46 4 284 491 $212 021 $0.75 $120 438 s0.42 5 292 741 sl97 208 $0.67 $lo4 667 $0.36 TOTAL 292 74t $1 373 65r $4.69 $832 138 $2.84 JAF9.7 Page 12 Fis.2-6: REMO results of East Province, Cameroon Trend of the cost per person to be treated, East Province CDTI projectFis2-7 12.oo 11.80 11.60 1r.40 $r.20 t1.00 10.80 t0.60 t0.40 1020 l0-00 $1.86 ,n Et o oa o c o E4 be I Ysar I Lcgcnd zonce hhelltx rrfnc no crld dcirtle cild Noduler (it) o0 o l-9 o l0-t9 o 20-39 . 40-100 50 100 ll1.2l \\ tn oE $0-75 $0.82APOC $0.61 10.16 30.36 $0.32$0.37 $0.36 Year 2 Year 3 Year I Year 5 ErtrJr alI I -J( _1\- H JAFg.7 Page 13 2,5. Community-directed treatment with ivermectin project of Far North Province, Cameroon 2.5.1, Background information The Far North Province is divided in six departments (administrative level 2). The current project proposal will be implemented in three health districts (Mokolo, Roua and Koza) of the departement of Mayo-Tsanaga. The three health districts have a combined total population estimated at 499,825 persons in 2003. Table2-7: Generalinformation Fis 2-8: Rapid epidemiological mapping of onchocerciasis results in Far North Province I I Legend refine no cdti ileftfte cdti Arrondissements Nodules (*) 0 l-9 I0-19 20-39 40-100 o o o o o Administrative units Total I "d6partement" concerned by CDTI CDTI target 3 health districts in Mayo-Tsanaga "d6partement" Population Total in CDTI area 499,825 persons (year 2003) CDTI target 179,413 persons (year 5) Communities Total (hypo,meso,hyper endemic) 281 communities CDTI tareet (meso & hyper endemic) 90 CDTI communities KM 50 1000 JAFg,7 Page 14 The proposed project is a partnership between the Ministry of Health and the NGDO HKI. It plans to treat I 79,413 people in 25 hyper (total population of 51,559) and 65 meso endemic (127,854 persons) communities in its fifth year of CDTI implementation (figure 2-8). 2.5.2. Summary budget Table 2-8 summarizes the five year budget of Far North CDTI project as presented by the NOTF of Cameroon and figure 2-9 shows the trend of the cost per person to be treated between year I and year 5. Table 2-8: Five year summary budget of Far North CDTI project as presented by the NOTF Fie 2-9: Trend of the cost per person to be treated, Far North Province CDTI project Year 2 Year 3 Year,l Year 5 IA ! ot6 o! 0 C o o bB E a 6(J $.m t2.50 32"m 1r.50 lr.m 10.50 $.m Year I Year Persons to be treated (A) Total Cost (B) Cost/pers Total(C)=B/A Contributionof APOC (D) Cost/pers APOC(E)=D/A 1 t60 024 s389 783 $2.44 $27s 054 $r.72 2 164 665 $234 684 s1.43 $140 s0l $0.8s 3 169 440 $210 76s $1.24 $1 19 199 $0.70 4 174 354 $201 747 $1.16 $1ll 562 $0.64 5 179 413 $196 463 $1.10 $103 482 $0.s8 TOTAL 179 413 st 233 442 $6.87 s749 798 $4.18 TOTAL $1.24 3't.16 $1.10oc $0.70 $0.85 $0.54 p"rtnac4rlroui -r.reoff' - JAF9.7 Page 15 3. CONGO 3.1. Rapid epidemiological mapping of onchocerciasis (REMO) in Congo Fis.3: REMO/CDTI results of Congo as at September 2003 L.i.nd ! conrrrrrry- Arlu I Flr !rconI '/,.:.; SEr|ql. !ur- IhE Nodul6 (t) In 2000, the Joint Action Forum (JAF) approved a CDTI project for Congo. The project was launched in 2001. This project covers three districts of the capital city (Brazzaville),8 districts in the Pool region, 9 districts in Bouenza, three districts in Niari and one district in Kouilou. CDTI activities are being implemented in four of the l0 regions of the country. The new proposal will extend CDTI to two districts (figure 3): Devenie (Niari) and Sibiti(Lekoumou) 3.2.1. Background information The current extension of the Congo CDTI project is a collaborative effort of the Ministry of Health and the NGDO "Organisation pour la Pr6vention de la Cecite" (OPC). lt plans to extend CDTI activities to 12 meso and hyper endemic communities in which 14,000 persons will be treated by the fifth year of the extension project. 3.2.2. Summary budget The National Onchocerciasis Task Force of Congo presented a first year budget of 20,048 US $ for CDTI activities in the extension area. This representsT4%o of the total budget(27,236 US $) forthe extension of Congo CDTI project. The Ministry of health will contribute for l0%o and the NGDO partner for 16%o of the total budget. The NOTF is expected to submit to APOC Management the plan of action and budgets for each of the remaining four (4) years. o o o o o 0 1.9 llLt9 2G39 40tlD R/L.ro EhrtlL. 3.2. Extension of Congo Community-directed treatment with ivermectin project JAFg.7 Page 16 4. DEMOCRATIC REPUBLIC OF CONGO (DRC) 4.1. Rapid epidemiological mapping of onchocerciasis in DRC Fis.4-1: Rapid epidemiological mapping of onchocerciasis (REMO) results in DRC Hodules (%) R!frtu o o o o o 0 l-9 l0-19 20-39 40-100 KM r-_10 lm2m Fis..4-2: Community-directed treatment with ivermectin (CDTI) areas in DRC ffi ,-** ! nocnn I Dcf,nirc CDTI KMr-t0 1m2m Kahgo Srfrhrd JAF9.7 Page 17 4.2. Community-directed treatment with ivermectin project of Equateur-Kiri, DRC 4.2.1. Backg!:ound information The province of Equateur is divided in five districts, which are Equateur, Mongola, Nord Ubangui, Sud Ubangui and Tshuapa. The district of Equateur (proposed CDTI project area) comprises 7 health zones: Basankusu, Bikoro, Bolomba, Bomongo, Ingende, Lukolela, and Mbandaka. Table 4-1: General information The proposed CDTI project (figure 4-3) will cover 5 health zones in the district of Equateur (Province Equateur) and one health zone (Kiri) in the district of Mai-Ndombe (Province of Bandundu). The project plans to treat I ,029,295 persons in 1940 communities in its fifth year of CDTI implementation. 4.2.2 Summary budget Table 4-2 summarizes the five budget of the CDTI project in Equateur Kiri as presented by the NOTF of DRC and figure 4-4 shows the trend of the cost per person to be treated between 2003 and 2007 . Table 4-2: Five year summary budget of the Project of Equateur-Kiri as submitted by the NOTF Administrative units Total 2 districts CDTI target 6 health zones in 2 districts Population Total in CDTI area 914,517 persons (year 2001) CDTI tarset 1,029,295 persons (year 5) Communities Total CDTI target 1940 communities Year Persons to be treated (A) Total Cost (B) CosUpers Total(C)=B/a Contributionof APOC (D) CosUpers APOC (E ): D/A 1 484 683 $202 90s $0.42 $159 193 $0.33 2 677 342 $133 337 $0.20 $82 214 $0.1 2 3 970 210 $120 820 $0.12 s76 922 $0.08 4 999 316 $83 43s $0.08 $s3 13l $0.0s 5 t 029 29s $83 419 $0.08 $s8 619 $0.06 TOTAL I 029 295 $623 916 $0.61 $430 079 $0.42 JAF9.7 Page l8 Fis.4-3: REMO results of Equateur-Kiri Eg.a.:l: $0.42 00.{5 t0.10 10.35 g 1030 !ot E lo25 o! o 5 so.zoo E e E no lo.r5cU 30.r0 $0.05 10.00 2003 isala mo Legend ! nocon Ba: Rcfrc ! uennircon l-l s".rnro* MI c TOTAL $0.33 \\ \ \*, \ $0.12 t0.12 an io t0.08 00.09 $0.08 rs 10.02$0.05 200{ 2005 2006 2007 Trend of the cost per person to be treated between 2003 and 2007, Equateur-Kiri CDTI project mba )v \Befale IBoende lngende ngu lkelakol Kiri n lo MiN ioki ush JAF9.7 Page 19 4.3. Community-directed treatment with ivermectin project of Mongola' DRC 4.3.1. Background information Mongola (58,141 km2; is one of the five districts of the Province of Equateur in Democratic Republic of Congo. Mongola district (1,327 ,460 inhabitants) is divided in five health zones, which are Pimu, Yambuku, Buma, Binga, Lisala. }[!eu!-3: General information on Mongola CDTI project The proposed CDTI project of Mongola aims to treat 1,494,068 persons in 2817 communities meso and hyper endemic by its fifth year of implementation. Figure 4-5 shows the REMO results in the district of Mongola. 4.3.2. Summary budget Table 4-4 summarizes the five year budget as presented by the NOTF of DRC and figure 4-6 shows the trend ofthe cost per person to be treated. Table 4-4: Five year summary budget of Mongola CDTI project as presented by the NOTF [!111[1!: REMO results in Mongola district in Equateur Province, DRC Administrative units Total 5 health zones CDTI target 5 health zones Population Total in CDTI area 1,327,460 persons (2001 ) CDTI target 1,494,068 persons (year 5) Communities Total CDTI target 2817 meso & hyper endemic co!q!qu4{!gq Year Persons to be treated (A) Total Cost (B) CosUpers Total(C)=B/A Contribution of APOC @) CosUpers APOC(E)=D/A I 68s 341 sl87 305 $0.27 $148 126 $0.22 2 I 245 390 s122 209 $0.1 0 $70 938 $0.06 3 l 408 302 $122 r99 $0.0e $76 9s9 s0.0s 4 I 450 551 $76 323 $0.05 $46 e3s s0.03 5 t 494 068 $74 960 $0.0s $51 684 s0.03 TOTAL I 494 068 $s82 996 $0.39 $394 642 $0.26 Lisala Binga Mongala Businga Lrg.nd Ir* ! rrcon n!r ! o.u.con Bumba Basankusu Befale JAFg.7 Page20 Fie.4-6: Trend of the cost per person to be treated of the CDTI project of Mongola, Equateur Province, DRC $o.30 $0.27 $0.2 APOC $0.10 5.2$o I a+ I m.zo t ! o 10.15 a o A t $0.10 a o o $o.o 5 io.oi r rr r 6 at - - I fo.0 5 $0.05 i0.0 3 , 90.02 2007 Partners (MOH & iIGDO) ro.oa 2003 2004 fo.0 3 10.00 2005 200 6 Fie.4-7: CDTI areas in the districts of North and South Ubangui, Equateur Province, DRC tvlbaya Lisala Blnga I Parkc I NoCDTI Drfrdtc CDTI Legend R.fini EI Buslnga Akeli Bumba Basankusu KMBefale JAF9.7 Page2l 4.4. Community directed treatment with ivermectin project of North Ubangui, DRC 4.4.1. Background information North Ubangui (56,644 Km2) is one of the five districts of the Province of Equateur. It is limited in the east by the district of Bas Uele (Province Orientale), in the west by south Ubangui district, in the north by the Central African Republic (CAR), and in the south by the district of Mongola. Ig!!q!i!: General information The proposed project plans to initiate community directed treatment with ivermectin in 2301 meso and hyper endemic communities of 7 health zones, which have in 2001 a total population of 1,084,227 people. In its fifth year of implementation the project aims to treat I ,220,308 persons. Figure 4-7 shows the details of CDTI areas in the concerned district. 4.4.2. Summary budget Table 4-6 summarizes the five year budget of the CDTI project of North Ubangui as presented by the NOTF of DRC and figure 4-8 shows the trend of the cost per person to be treated from 2003 to 2007. Table 4-6: Five year summary budget of North Ubangui CDTI project as presented by the NOTF Fis.4-8: Trend of the cost per person to be treated, North Ubangui CDTI project,2003-2007 lor0 1035 t030 lo:5 lo20 t&r5 iLl0 ioJr5 $0.00 o e EItt o Tl E a t0.r8 $0.07 ,0.o7 glIl2 2001 P.rh.rr (MoH & sonl 200{ 2005 Administrative units Total 7 health zones CDTI target 7 health zones Population Total in CDTI area 1,084,227 persons (2001 ) CDTI target 1,220,308 persons Communities Total CDTI target 2301 meso and hyper endemic communities Year Persons to be treated (A) Total Cost (B) CosUpers Total(C)=B/A Contributionof APOC (D) CosUpers APOC (E ): D/A I 520 708 $r84 824 $0.3s $142 147 $0.27 2 785 341 $129 240 $0.1 6 $76 893 s0.10 3 | 150257 $124 tsg $0.1 I $76 175 $0.07 4 1 184765 $79 018 $0.07 947 984 $0.04 5 t 220 308 $79 665 $0.07 $53 950 $0.04 TOTAL r 220 308 $s96 906 $0.49 $397 149 $0.33 APOC so.1 I 30.08 2003 2006 10"07 JAFg.7 Page22 4.5. Community directed treatment with ivermectin project of South Ubangui, DRC 4.5.1 . Background information The concerned CDTI project area (figure 4-7) shares boundaries with Central African Republic in north, Congo in the east, North Ubangui in the north east and Mongola in the south east. The district of South Ubangui (550,603 km2) is divided in t health zones with an estimated population of 1,523,352 people in 2001. Table 4-7: General information The proposed project intends to introduce CDTI activities in 2402 meso and hyper endemic communities of 6 health zones. These CDTI health zones are namely Budjala (total population of 112,279 persons in 2001), Bwamanda (117,000), Gemena (310,688), Libenge (220,775), Tandala (298,327), and Zongo (72,837). The project aims to treat by its fifth year of implementation 1,273,969 persons. 4.5.2. Summary budget Table 4-8 reveals the five year summary budget of South Ubangui CDTI project as presented by the NOTF of DRC and the figure 4-9 indicates the cost per person to be treated between 2003 and 2007 . Table 4-8: Five year summary budget of South Ubangui CDTI project as presented by the NOTF of Democratic Republic of Congo Administrative units Total t health zones CDTI target 6 health zones Population Total in CDTI area 1,13 1,906 persons (year 2001) CDTI target 1,27 3,9 69 persons (2007) Communities Total CDTI target 2402 meso and hyper endemic communities Year Persons to be treated (A) Total Cost (B) Cost/pers Total(C)=B/A Contributionof APOC (D) Cost/pers APOC(E)=D/A 1 641 102 $186 3r7 $0.29 $143 227 $0.22) | 081 722 $130 719 $0.12 s77 6s9 $0.07 3 1 200 838 $1 l9 985 $0.1 0 $74 189 $0.06 4 t 236 863 $76 828 $0.06 $46 869 $0.04 f, t 273 969 $7s 831 $0.06 $s2 001 $0.04 TOTAL | 273 969 $s89 680 $0.46 $393 945 $0.31 @: JAF9.7 Page23 Trend of the cost per person to be treated, South Ubangui CDTI project,2003-2007 Jo35 $0.30 a to25 o Eo E ooro t o Eg Itrsoa oo b6e 10.10 t{r,05 J0.lt{t 20042003 20062005 2007 E!g[;10: REMO results in the district of Tshuapa, Equateur Province, DRC ttoz8 \** $0.r2 $0.10 $OII7 $0.06 t0.06$0.06 30.04 30.05 $0.04 Prrtn.rt (MOH & NGDO) Lisala I r*r" ! nocon ! o"at con Legend R!ffrc Lomela Bosobe Dekese *\\ ' ' looz Bumba Befale il Ubundu lngende Opala lkela Kiri KM 0 100 KoleBagata JAFg.7 Page 24 4.6. Community directed treatment with ivermectin project of Tshuapa, DRC 4.6.1 - Background information Thsuapa is one of the five districts of the Province of Equateur. It is composed of 6 health zones, which are namely Befale, Boende, Bokungu, Djolu, Ikela, and Monkoto. The six health zones have a combined total population of 1,346,046 persons in 2001 . Table 4-9: General information The proposed project plans to treat 1,511,762 persons in 2850 meso and hyper endemic communities by its fifth year of CDTI implementation. Figure 4- l0 shows the ddails of the CDTI areas in Tshuapa. 4.6.2. Summary budget Table 4-10 summarizes the five year budget of Tshuapa CDTI project proposal as submitted by the NOTF of DRC and figure 4-11 indicates the trend of the cost per person to be treated from 2003 to 2007. I&L10: Five year summary budget of Tshuapa CDTI project as presented by the NOTF Fie.4-11: Trend of the cost person to be treated of CDTI project of Thsuapa between 2003 and2007 loJs to30 10.25 io20 t0.r5 l&r0 to05 lo00 TOTAL Eof6!t o C6 hn 3 ao0 10.07 i0.05 2fr720042003 !0.06 10.05 Partncr3 (MOH & NGDO) 3llJ5 10.03 t0.0/t t0-02 Administrative units Total 6 health zones CDTI target 6 health zones Population Total in CDTI area 1,346,046 persons (year 2001) CDTI target 1,511,762 persons (year 2003) Communities Total CDTI target 2850 meso and hyper endemic communities Year Persons to be treated (A) Total Cost (B) CosUpers Total(C)=B/A Contributionof APOC @) CosUpers APOC (E ): D/A I 640 693 $193 861 $0.30 $148 083 $0.23) 1 172 450 $r38 649 $0.1 2 $81 694 $0.07 3 1 424981 $130 140 $0.09 $80 443 $0.06 4 1 467 730 $80 632 $0.0s $48 883 $0.03 5 1 511 762 $78 sl9 $0.05 $s3 426 $0.04 TOTAL I stt 762 $621 801 $0.41 s4t2 529 $0.27 $0.23 s0.'12 2005 2006 JAF9.7 Page25 4.7. Community directed treatment with ivermectin project of Lualaba, DRC 4.7.1. Background information The district of Lualaba is one of the five districts of the Province of Katanga. It covers a land square of 800,026 km2 and has an estimated total population of 726,645 people in 2001. The district comprises 6 health zones which are namely Dilolo, Kasaji, Kapanga, Sandoa, Kafankumba and Kalamba. &!!q!:11: General information The proposed CDTI project seeks to treat 311,405 persons in 570 meso and hyper endemic communities of three health zones (Kapanga, Kafankumba and Kalarnba) in its fifth year of CDTI implementation. 4.7.2. Summary budget Table 4-12 summarizes the five year budget of Lualaba CDTI project as presented by the NOTF and figure 4-12 indicates the trend ofthe cost per person to be ffeated between 2003 and2007. Table 4-12: Five year summary budget of Lualaba CDTI project as presented by the NOTF Fi*4-12: Trend of the cost per person to be treated, Lualaba CDTI project,2003-2007 $or3 to.18 3r:0 Itill toJll t0.60 toao l0:0 toD a xI I 5lI E $22 to.ra Partn.tr(MOHtNODO)'., - . - - to.r0 to.tt 10.05 TOJE 200t Administrative units Total 6 health zones CDTI target 3 health zones Population Total in CDTI area 281,975 persons (year 2003) CDTI tareet 31 1,405 persons (year2007) Communities Total CDTI target 570 meso and hyper endemic communities Year Persons to be treated (A) Total Cost (B) Cost/pers Total ( C ):B/A Contribution of APOC @) CosUpers APOC(E)=D/A I tgt 799 $t77 593 $0.e8 $l l3 153 $0.62 2 284 980 $75 408 $0.26 $47 198 $0.1 7 3 293 s29 $63 737 $0.22 $41 242 $0. l4 4 302 33s $51 019 $0.1 7 $33 33s $0.1 I t 3l I 405 $56 791 $0.1 8 $4 I 995 $0.13 TOTAL 311 405 $424 548 $1.36 $276923 $0.89 20t a5 20lr tgJS . . JAF9.7 Page26 4.8. Community directed treatment with ivermectin project of North Katanga, DRC The Province of Katanga has an area of 531,080 km2 (10% of the country) and a total population estimated at 8,000,000 persons in 2002. Administratively, the province is divided into 4 districts, which are Haut-Katanga, Haut Lomami, Tanganika, and iualaba. The North Katanga (367,150 km2) consists of the districts of Haut Lomami and Tanganika. The South Katanga is made up of the districts of Lualaba and Haut-Katanga. 4.8.1. Background information The current proposal aims to initiate CDTI in two health zones of the districts of Haut Lomami (total population of 1,597,105 persons in 2000) and in three health zones of Tanganika (181,269 persons in 2000). Figure 4- 13 shows the REMO results in the province of Katanga. p[!ez!-li!: General information The project plans to treat in the districts of Haut Lomami and Tanganika 1,124,642 persons in 2058 communities by its fifth year of CDTI implementation 4.8.2. Summary budget Table 4-14 summarizes the five year budget of the CDTI project of North Katanga as presented by the NOTF of Democratic Republic of Congo and figure 4-14 shows the yearly cost per person to be treated from year I to year 5 of the project implementation. Table 4-14: Five year summary budget of North Katanga CDTI project as presented by the NOTF Administrative units Total 20 health zones CDTI target 5 health zones Population Total in CDTI area 941,87 1 persons (year 2001) CDTI target 1,124,642 persons (year 5) Communities Total CDTI target 2058 communities (year 5) Year Persons to be treated (A) Total Cost (B) Cost/pers Total(C)=B/A Contributionof APOC (D) Cost/pers APOC (E ): D/A I 3s6 3s9 $176 278 $0.49 $140 794 $0.40 2 t 029 207 $122 094 $0.12 s7t 079 $0.07 3 l 060 083 $102 411 $0.1 0 $64 321 $0.06 4 l 091 885 $72 371 $0.07 $44 430 $0.04 5 I 124 642 $68 783 $0.06 $48 301 $0.04 TOTAL I 124 642 $541 937 $0.48 $368 925 $0.33 JAF9.7 Page27 [!g!1!!: REMO results in the province of Katanga Fie.4-14: Trend of the cost per person to be treated by North Katanga CDTI project between 2003 and2007 ql50 10.51! 9r.10 00.30 00.20 lio.lo $0J0 ut !o Eo O € o cc E r E4 6 Kon0olo KaJanea SJcoir Dctulrr CDTI tufiru KM 0 lm 200 Legend I ItcDrI TOTAL APOC $0.12 $0.10 !0.0610.10 Partsrcrs (MOH & NGDO) IOJI5 $0.06 $0.01 tiu.oz 2003 m04 2005 2006 2007 Lu.bo K.b.lo Anko ro KaEimbaNl a mbi M ob. P*to X.p.ne. LDmtaba Dilolo JAF9.7 Page 28 4.9. Community directed treatment with ivermectin project of South Katanga, DRC 4.9.1. Background information The South Katanga (163,930 Km21 has an estimated population of 3,607,888 people (2002 estimate). The proposed CDTI project will cover 3 health zones (Kampemba, Kansenya and Mufunga-Sampwe). These health zones have a total population of 7 18,296 persons in 2003. Figure 4- I i shows the REMO results in the province of Katanga. Table 4-15: General information The project plans to treat 790,547 persons in 1447 meso and hyper endemic communities in its fifth year of CDTI implementation. The number of communities and persons to be treated through ivermectin mass distribution will be updated by community census in all CDTI areas of the Province of Katanga. 4.9.2. Summary budget Table 4- 1 6 summarizes the five year budget of the CDTI project of South Katanga as submitted by the NOTF of Democratic Republic of Congo and figure 4-15 shows the trend of the cost per persons to be treated during the five years of the implementation of the project. Table 4-16: Five year summary budget of South Katanga CDTI project as presented by the NOTF Eig.4-.15: Trend of the cost per person to be treated between 2003 and 2007, South Katanga TOTAL t0.30 l015 ozr 10.t5 10.t0 10ff llro II I I I t Partncn fiOH & NGDO) ----IP----- '--- 40.m lt0.05 Administrative units Total l8 health zones CDTI tareet 3 health zones Population Total in CDTI area 718,296 persons (year 2003) CDTI target 790,547 persons (year 5) Communities Total CDTI target 1447 meso & hyper endemic communities Year Persons to be treated (A) Total Cost (B) Cost/pers Total ( C ):B/A Contribution of APOC (D) Cost/pers APOC(E):D/A 1 546 093 $1s4 882 $0.28 gt22 539 $0.22 a 723 462 $121 89s s0.r7 $75 449 $0.1 0 3 745 166 $90 673 s0.1 2 $s7 0s1 s0.08 4 767 521 $68 306 $0.09 $42 30s $0.06 5 790 547 $66 078 s0.08 $46 898 $0,06 TOTAL 790 547 $501 834 $0.63 s344242 $0.44 30.'17 APOC so.12 10.10 10.08 10.06 2m3 Z)(]{ z!05 zn6 2007 JAF9.7 Page29 5. ETHIOPIA 5.1. Rapid epidemiological mapping of onchocerciasis (REMO) in Ethiopia Fie.S-l: Results of Rapid epidemiological mapping of onchocerciasis (REMO) in Ethiopia Legend ! r**tycDTlanes ! mcthiersas KM bbc nfnarl urselccted ertas Riwtle Nodules (11) o0 o l-9 o 10-19 o 20-39 (D 40-100 0 100 200 5.2, Community directed treatment with ivermectin project of East Wellega, Ethiopia 5.2.1. Background information Oromia Regional State is one of the 9 National Regional States in the Federal Democratic Republic of Ethiopia. This State is located in the western part of Ethiopia. East Wellega is one of the 12 zones of Oromia Regional State. It has a land square of 21,980 Km2 with an estimated total population of 1,488,001 persons. l-,4 :...,- 't_ .t_ a-'a ia, .t it: r: :rj .a. :a 'a' r. 'J r :rj .a: ?i .a, :.. .. a t,.l tl ..1 .. ,., r'! o ... '.a. .a: rl: '-t. t ? r: :.: t: r: t:? '.!. ,a tot.." '.':r :t':':ffi.!.l_:*. t:x:...:i ?al.q'J tll.j r i.l :+:;+.: la: :r: .a:i, :.. , s,.r. :.1 :.::.; ',i b. tt" ,"tl u :. :.. :.: t. 'i JAFg.7 Page 30 }[!q!11: General information Figure 5-2 indicates the CDTI areas in Wellega. The proposed project plans to treat 798,813 persons in 162 meso and hyper endemic communities of East Wellega in its fifth year of CDTI implementation (year 2007). 5.2.2. Summary budget Table 5-2 summarizes the five year budget of East Wellega CDTI project as submitted by the NOTF of Ethiopia and figure 5-3 shows the trend of the cost per person to be treated from 2003 to 2007 . Table 5-2: Five year summary budget of East Wellega CDTI project as presented by the NOTF @!3!: REMO results in East and West Wellega, Ethiopia Administrative units Total 2l districts (wereda) CDTI target l0 districts Population Total in CDTI area 1,488,000 persons (year 2002) CDTI target 798,8 1 3 persons (year 2007) Communities Total 291hyper, meso, hypo endemic communities CDTI target 162 hyper and meso endemic communities Year Persons to be treated (A) Total Cost (B) Cost/pers Total(C)=BiA Contributionof APOC (D) Cost/pers APOC(E)=D/A 1 712 498 $384 333 $0.s4 s246 813 $0.3s 2 733 t6l $284 019 $0.39 $100 046 $0. l4 3 754 422 $257 09s $0.34 $61 822 $0.08 4 776 301 $244 sts $0.31 $30 9l I $0.04 5 798 813 $289 r 8s $0.36 $9 273 $0.01 TOTAL 798 813 $1 459 146 $1.83 $448 864 $0.s6 Legend ! raoatrcnn** ! xocrums ! trcnarcr [l rccbctdmt - RTIGB o0 o l-9 o 10-19 o 20.9) o /10-100 Nodules (*) l I :!, :q ( \. \ .!: \\ l+. ..j 1 3; l') ,.j Fie.5-3 JAF9.7 Page 3 1 Trend of the cost per person to be treated between 2003 and 2007, East Wellega mo0 2005 2006 2001 2004 2005 2006 2007 $u60 t&50 $rla0 gt30 to20 l&t0 se00 o? ET et o E t Tt 2003 I!s.5-.4: Trend of the cost per person to be treated between 2003 and 2007, West Wellega $0.60 10.50 to.40 $0.3r! 1020 30.r0 $0,00 6 o =t To!tI E gl no 2003 $o.34 lG35 so.3l - - -9t25 30.20 t0.14 $0.19 P.rtn.r! (MOH) loJl $0.39 $0.35 $0.33 1030 Partn.rs (MOH) $0.25 $0.27 30.14 1020 JAFg.7 Page32 5.3. Community directed treatment with ivermectin project of West Wellega, Ethiopia 5.3.1. Background information West Welle ga (23 ,980 Krn'), composed of 20 districts, has an estimated population of 1,941 ,430 people (year 2003) out of which 90o/o live in rural areas. Partial rapid epidemiological mapping of onchocerciasis results (figure 5-2) reveal that onchocerciasis is meso or hyper endemic in 6 woreda. Refinement of the REMO maps of Wellaga will be carried out in 6 other woreda which may be eligible for ivermectin mass distribution. Table 5-3: General information The proposed CDTI project of West Wellega aims to treat in its fifth year of implementation 893,501 persons in 160 hyper endemic (population of 496,390 persons) and 105 meso endemic communities (397,1 I 1 persons). 5.3.2. Summary budget Table 5-4 summarizes the five year budget of West Wellega CDTI project as presented by the NOTF of Ethiopia and figure 5-4 indicates the trend of the cost per person to be treated between 2003 and 2007. Table 5-4: Five year summary budget of West Wellega CDTI project as presented by the NOTF Administrative units Total 20 districts (wereda) CDTI target l2 districts Population Total in CDTI area 1,167,533 (vear 2003) CDTI target 893,501 (year2007) Communities Total 722 communities CDTI target 265 meso and hyper endemic communities Year Persons to be treated (A) Total Cost (B) Cost/pers Total(C)=B/A Contributionof APOC (D) CosUpers APOC(E)=D/A 1 722 767 $394 679 $0.55 $247 033 $0.34 2 839 844 s330 97s $0.3e $l l7 938 $0. l4 3 843 848 $296 470 $0.3s 966 432 $0.08 4 868 329 $286 464 s0.33 $33 216 $0.04 5 893 50r $333 780 $0.37 s9 96s $0.01 TOTAL 893 501 8t 642 369 $1.84 $474 583 $0.s3 JAF9.7 Page 33 5,4. Community directed treatment with ivermectin project of Illubabor, Ethiopia 5.4.1. Background information Illubabor CDTI project area is located in Illubabor zone in the south western part of Oromia Regional State, in Ethiopia. It shares boundaries with Gambella Region in the west, West Wellega Zone in the north-west and East Wellega in the north-east, Jimma Zone in the south and southeast and Kaffa- Sheka Zone inthe south. I[ubabor Zone (15,870 Km2) has a total population estimated at 1,053,151 persons in 2003 out of which 9l%o live in rural areas. Table 5-5: General information The proposed CDTI project will cover 6 wereda with an estimated population of 641,773 persons in 2003. The CDTI wereda are namely Mettu, Darimu, Alge Sache, Yayu-Hurumu, Alle Dido, and Bedele Dado. The project proposal seeks to treat7,719,52l people in2567 meso and hyper endemic communities by its fifth year of CDTI implementation. Figure 5-5 indicates the detailed REMO results in Illubabor. The proposed project is partnership between the Ministry of Health and the NGDO GRBP Carter Center. 5.4.2. Summary budget Table 5-6 summarizes the five year budget of Illubabor CDTI project and figure i6 indicates the trend ofthe cost per person to be treated between 2003 and2007. Table 5-6: Five year summary budget of Illubabor CDTI project as presented by the NOTF of Ethiopia Administrative units Total I I wereda (districts) CDTI tareet 6 wereda Population Total in CDTI area 641,773 persons (year 2003) CDTI target 719,521 persons (year 2007) Communities Total 3800 communities CDTI target 2567 meso and hyper endemic communities Year Persons to be treated (A) Total Cost (B) CosUpers Total(C)=B/a Contributionof APOC (D) CosUpers APOC(E)=D/A I 641 773 $380 182 $0.se $257 754 $0.40 2 660 384 $266 460 $0.40 $1s4 6s2 $0.23 3 679 536 $179 087 $0.26 $80 464 $0. l2 4 699 242 sl38 655 $0.20 $40 232 $0.06 5 719 521 $lll 4s3 $0.1 s s12 070 $0.02 TOTAL 719 521 $1 07s 837 $1.s0 $54s 172 $0.76 JAFg 7 Page 34 Eg.5-5: REMO results in Illubabor, Gambella and Jimma, Ethiopia Fis.5-6: Trend of the cost per person to be treated between 2003 and 2007, Illubabor CDTI project proposal, Ethiopia 30.70 ioro 0050 30.40 3030 1020 l&10 $0I,0 o c E E t o tl Ent6o zm Legend ! raoavcon.r"." ! Nocatanes f, tbc rannci fi rrrrscbctld;rnrn - IUrrB o0 o l-9 o 10-19 o m49 o 40-100 ilodules (lt) o XM 0 50 100 \ TOTAL $0.& APOC 10.23 t020 gr.r1 s0.l{lo.rs 30.r7 30.02 2004 2005 ano m7 :+j ?l g o o .r, a o ,+, 't! }] r o irj .!. .a. :t aj .9 .(.. o'1,..,a. .t, g '.r) '.J :+li ?. s1l t:' c o ,'f, .., !. '!. g :.. ia t'- ?' ?" o '! - iil t i.. :a ,. tt' ,,' :c- II t 't!/ g '.t_ ..1. l. _ a.3l :'l !. :.1 ...: r JAFg.7 Page 35 5.5. Community directed treatment with ivermectin of Gambella, Ethiopia 5.5.1. Background information GambellaNational Regional State (25,274.88 Km2) is one of the nine Regional States of the Federal Democratic Republic of Ethiopia. It is located in the western part of Ethiopia. 82.4% of the total population (228,593 persons in 2003) are living in rural areas. GambellaZone is divided in 9 wereda which comprise 914 communities. The proposed project will cover 4 wereda, which are namely Gambella, Godere, Dimma, and Abodo. Table 5-7: General information The proposed project of Gambella plans to treat I13,034 persons in242 hyper endemic and 161 meso endemic communities by its fifth year of CDTI implementation. Figure 5-5 shows the detailed REMO results in the concerned project area. 5.5.2. Summary budget Table 5-8 summarizes the five year budget of Gambella CDTI project as submitted by the NOTF and figure 5-7 shows the trend of the cost per person to be treated between 2003 and2007. Table 5-8: Five year summary budget of Gambella CDTI project as presented by the NOTF 5.6. Community directed treatment with ivermectin project of Jimma, Ethiopia 5.6.1. Background information Jimma Zone(19,316.18 Km2) is located in the south western part of Oromia Regional State. It shares borders with West Shewa in the North, South Nations Nationnalities and Peoples Regional States (SNNPR) and Illubabor Zone in the east and East Wellega and Illubabor zone in the west. Jimma Zone is divided in I I wereda, which comprise 7982 communities. Administrative units Total 9 wereda (districts) CDTI tareet 4 woreda Population Total in CDTI area 100,821 persons (year 2003) CDTI target I 13,034 persons (year2007) Communities Total 914 communities CDTI target 403 meso and hyper endemic communities Year Persons to be treated (A) Total Cost (B) CosUpers Total(C)=B/A Contributionof APOC (D) CosUpers APOC(E)=D/A I 100 821 $142 526 $ 1.41 $92 szs s0.e2 2 t03 744 $79 968 $0.77 $31 107 $0.30 3 t06 753 $75 204 $0.70 $25 923 $0.24 4 109 848 $63 027 $0.s7 $ 12 961 s0.12 5 l 13 034 $s3 974 $0.48 $3 888 $0.03 TOTAL 113 034 $4r4 700 $3.67 $166 404 $1.47 JAF9.7 Page 36 Fie.5-7: Trend of the cost per person to be treated between 2003 and 2007, Gambella CDTI project 2004 2005 axr6 2lJ07 tr.60 tr.40 llro 1r.00 10.00 t0.60 30.10 1020 t0.00 o a E6 E65 o! o Ell u6(J 2003 Fie.5-8: Trend of the cost per person to be treated between 2003 and 2007, Jimma CDTI project t0.60 30.50 Itr40 31t30 tn20 t0.10 10.00 o Eo E o t o E Tl zU 2003 TOTAL \ x co rT $0.70 i0.57 9,.46 $0.48 t0.44 Partn.r. (MOH) $0.30 J0.24 $0.03 $0.47 $0.28 10.26 io.23 $0.2r $o.r7 $0.19 10.i7 Partncru (MOH & NGDo)$0.19 $0.02 2004 m05 zto8 2007 Administrative units Total I I wereda (districts) CDTI target 3 wereda Population Total in CDTI area 735,698 persons (year 2003) CDTI tarset 824,824 persons (2007) Communities Total 7982 communities CDTI target 2943 meso and hyper endemic coqqu4tigq JAF9.7 Page 37 Table 5-9: General information on Jimma The proposed CDTI project will cover the wereda of Mana, Dedo, and Sekachorsa. It is a partnership between the Ministry of Health of Ethiopia and the NGDO GRPB Carter Center. It aims to treat 824,824 people in 1324 communities hyper and 1619 meso endemic at its fifth year of CDTI implementation. Figure 5-5 indicates the detailed REMO/CDTI areas in Jimma. 5.6.2. Summary budget Table 5-10 summarizes the five year budget of Jimma CDTI project proposal and figure 5-8 shows the trend ofthe cost per person to be treated between 2003 and2007. Table 5-10: Five year summary budget of Jimma CDTI project as presented by the NOTF of Ethiopia 5,7. Community directed treatment with ivermectin project of Metekel, Ethiopia 5.7.1. Background information Metekel Zone (25,993 Km2) is located in the north western part of Ethiopia. It has an estimated total population of 247,831 in 2003. Rapid epidemiological mapping of onchocerciasis reveals three meso and hyper endemic wereda (Pawi, Dangur, Guba) and a refinement exercise should be carried out in three other wereda (Dibati, Bulen, Wombera) to clarifu onchocerciasis endemicity level. Table 5-11: General information Figure 5-9 indicates the detailed REMO results in Metekel Zone. The proposed project plans to 134,800 persons in 20 communities hyper and 56 meso endemic treat in its fifth year of CDTI implementation. Year Persons to be treated (A) Total Cost (B) CosUpers Total(C)=B/A Contributionof APOC (D) CosUpers APOC(E)=D/A I 735 698 $379 368 $0.s2 $zss 239 $0.3s 2 757 033 $352 130 $0.47 $208 427 $0.28 3 778 987 $203 20r $0.26 $67311 s0.09 4 80r 578 $187 900 $0.23 $40 3s0 s0.0s 5 824 824 $174 052 $0.21 $16 663 $0.02 TOTAL 824824 $1 296 6s1 $1.s7 $s87 990 $0.71 Administrative units Total CDTI target 3 wereda (districts) Population Total in CDTI area 232,538 persons (year 2003) CDTI target I 34,800 persons (y ear 2007) Communities Total 992 communities CDTI target 76 meso and hyper endemic communities JAFg.7 Page 38 Fie.5.9: REMO results in MetekelZone, Ethiopia Eg.5-1Q: Trend of the cost per person to be treated between 2003 and 2007, Metekel CDTI project, Ethiopia .55 TOTAL tr.oD t0.88 t0.88 io.E $0.77 io.z Plrtners (MOH) 3t.80 3'r.00 11.10 tr20 11.00 $0.80 10.60 t0.10 3tL20 30.00 am3 Legend ! r"tarrcon*." f xocrlumr ! rorcntmr ffi mcbcnrtenre - RIEE ilodules (%) o o o o o 0 t-9 l0-19 2It-39 40-100 $0.64 APOC zm4 IG32 arc5 30.fi zn6 mo7 o a E E t c E t 5A Eu r. .1, .4, I r !, I, su !l J, .a- l!- .a, .a, .a, A :.: :! .9, '.: i. Ia -.1 . iq- !i .'; .t- s, ., .a, .a- ,a- JAFg.7 Page39 5.7.2. Summary budget Table 5-12 summarizes the five year budget of Metekel CDTI project as submitted by the NOTF of Ethiopia and figure 5-10 reveals the trend of the cost per person to be ffeated between 2003 and2007. Table 5-12: Five year summary budget of Metekel CDTI project as presented by the NOTF, Ethiopia 6. SUDAN 6.1. Rapid epidemiological mapping of onchocerciasis (REMO) in Sudan Es.Gl: Rapid epidemiological mapping of onchocerciasis results in Sudan Year Persons to be treated (A) Total Cost (B) CosVpers Total(C)=B/A Contributionof APOC @) CosUpers APOC(E)=D/A 1 t20 234 s186 s3s $l.ss $1 l0 160 $0.92 2 t23 721 $13s 3s7 $ 1.09 $40 ls8 $0.32 3 t27 309 $1 l2 548 $0.88 $14 4l s $0.1 1 4 13l 001 $1 r4 859 $0.88 $7 208 s0.06 t 134 800 sllz204 $0.83 $2 162 s0.02 TOTAL 134 800 $661 504 $4.91 $174 103 $1.29 Legcnd ,n Erlu&duu R!68 ! cotrroa,r*- I nocDrtmu iffi *or..*. KMr--l0 200 JAF9.7 Page 40 Eig@: REMO results in Southern Sector of Sudan Fie.6-3 CDTI areas in Southern Sector of Sudan 1\/) I I 1 ') L ) Nodules (*) o o o o e 0 l-9 l0-19 20-39 40-100 l(M ---------T 1m m Lagend 'fu rnt*t'*u tuiru ! conr*av** ! rocnn*- ffi nuuoeo'dry - rur,lE '1. '.; !. 3. :!j '!, 'p?- t !, g .+, i. Legend '4 *r *u fuftr! ! connaoatr** ! nocorr*- ffi nmrop",urry i...j c'-t"" 0 100 zfi .r, t. !. r. L .!, r,.!; Klt JAFg.7 Page 33 5.4. Community directed treatment with ivermectin project of lllubabor, Ethiopia 5.4.1. Background information Illubabor CDTI project area is located in Illubabor zone in the south western part of Oromia Regional State, in Ethiopia. It shares boundaries with Gambella Region in the west, West Wellega Zone in the north-west and East Wellega in the north-east, Jimma Zone in the south and southeast and Kaffa- Sheka Zone in the south. Illubabor Zone (15,870 Km2) has a total population estimated at 1,053,15 I persons in 2003 out of which 9lYo live in rural areas. Table 5-5: General information The proposed CDTI project will cover 6 wereda with an estimated population of 641,773 persons in 2003. The CDTI wereda are namely Mettu, Darimu, Alge Sache, Yayu-Hurumu, Alle Dido, and Bedele Dado. The project proposal seeks to treat7,719,521 people in2567 meso and hyper endemic communities by its fifth year of CDTI implementation. Figure 5-5 indicates the detailed REMO results in lllubabor. The proposed project is partnership between the Ministry of Health and the NGDO GRBP Carter Center. 5.4.2. Summary budget Table 5-6 summarizes the five year budget of tllubabor CDTI project and figure !6 indicates the trend ofthe cost per person to be treated between 2003 and2007. Table 5-6: Five year summary budget of Illubabor CDTI project as presented by the NOTF of Ethiopia Administrative units Total 1 I wereda (districts) CDTI target 6 wereda Population Total in CDTI area 641,773 persons (year 2003) CDTI target 119,521 persons (year 2007) Comrnunities Total 3800 communities CDTI tareet 2567 meso and hyper endemic communities Year Persons to be treated (A) Total Cost (B) CosUpers Total ( C ):B/A Contribution of APOC (D) Cost/pers APOC(B)=D/A 1 64t 773 $380 182 $0.s9 $2s7 7s4 $0.40 2 660 384 $266 460 $0.40 $154 6s2 $0.23 3 679 536 $179 087 $0.26 $80 464 $0.1 2 4 699 242 $138 6ss $0.20 $40 232 $0.06 5 719 521 $ll1 4s3 $0.1 s s12 070 $0.02 TOTAL 7t9 521 $1 075 837 $1.s0 $545 172 $0.76 JAFg 7 Page 34 Fis.5-5: REMO results in Illubabor, Gambella and Jimma, Ethiopia Fis.5-6 Trend of the cost per person to be treated between 2003 and 2007, Illubabor CDTI project proposal, Ethiopia o Et o I € t l t noI tom i0.60 $050 to,to l0.ar t020 lol0 30r,0 mo3 Legend ! rroavcon.r"., ! Nocauenas lo bG ,rfnri - Ilirttr rcGliclcil arEE Nodules ft) o0 o l-9 o 10-19 o 20-39 o 40-100 KM 0 50 100 TOTAL i0.40 APOC $0.23 $0.20 $o.t4 i0.r6 10.14 $0,19 $0.17 $0.02 2004 2005 2006 20(J? ) :.: I/ ill \\l 'g '_t. .l .\ F -\ rrrdr \ to.z6 JAF9.7 Page 35 5.5. Community directed treatment with ivermectin of Gambella, Ethiopia 5.5.1. Background information Gambella National Regional State (25,274.88 Km2) is one of the nine Regional States of the Federal Democratic Republic of Ethiopia. It is located in the western part of Ethiopia. 82.4% of the total population (228,593 persons in 2003) are living in rural areas. Gambella Zone is divided in 9 wereda which comprise 914 communities. The proposed project will cover 4 wereda, which are namely Gambella, Godere, Dimma, and Abodo. }[!q!/: General information The proposed project of Gambella plans to treat I13,034 persons in242 hyper endemic and l6l meso endemic communities by its fifth year of CDTI implementation. Figure 5-5 shows the detailed REMO results in the concerned project area. 5.5.2. Summary budget Table 5-8 summarizes the five year budget of Gambella CDTI project as submitted by the NOTF and figure 5-7 shows the trend of the cost per person to be treated between 2003 and2007. Table 5-8: Five year summary budget of Gambella CDTI project as presented by the NOTF 5.6. Community directed treatment with ivermectin project of Jimma, Ethiopia 5.6.1. Background information Jimma Zone (19,316.18 Km2) is located in the south western part of Oromia Regional State. It shares borders with West Shewa in the North, South Nations Nationnalities and Peoples Regional States (SNNPR) and Illubabor Zone in the east and East Wellega and Illubabor zone in the west. Jimma Zone is divided in I I wereda, which comprise 7982 communities. Administrative units Total 9 wereda (districts) CDTI target 4 woreda Population Total in CDTI area 100,821 persons (year 2003) CDTI target 1 13,034 persons (year 2007) Communities Total 914 communities CDTI target 403 meso and hyper endemic communities Year Persons to be treated (A) Total Cost (B) CosUpers Total(C)=B/A Contributionof APOC (D) CosUpers APOC(B)=D/A I 100 821 $142 s26 $1.41 $92 szs $0.92 2 103 744 $79 968 $0.77 $31 107 $0.30 3 106 753 $7s 204 $0.70 szs 923 $0.24 4 109 848 $63 027 $0.s7 $12 961 $0.1 2 5 I 13 034 $s3 974 $0.48 $3 888 s0.03 TOTAL 113 034 $414 700 $3.67 $166 404 $1.47 JAF9.7 Page 36 Eg.5-7: Trend of the cost per person to be treated between 2003 and 2007, Gambella CDTI project o !6Io I o a T T u6u fi.60 1r.40 lr20 tr.00 30.80 10.60 10.10 10.20 10.00 2003 2001 2005 2006 2007 Fie.5-8: Trend of the cost per person to be treated between 2003 and 2007, Jimma CDTI project tt Eto t o t T bc a6(J 10.00 t0.50 i0.40 10,30 3(t20 tor0 t0.00 2003 TOTAL a6 77 10.57 t0.44 $0.48 flr.46 $0.30 $0.24Partn.r. (MOH) $0.03 $0.47 $0.28 $0.26 $0.23 s0.21 $0.r7 Partncri (MOH & NoDOI$0.17 $0.19 $0.02 2004 2005 2006 2007 \, Administrative units Total I I wereda (districts) CDTI tareet 3 wereda Population Total in CDTI area 735,698 persons (year 2003) CDTI target 824,824 persons (2007) Communities Total 7982 communities CDTI target 2943 meso and hyper endemic communities JAF9.7 Page 37 }[!g!2: General information on Jimma The proposed CDTI project will cover the wereda of Mana, Dedo, and Sekachorsa. It is a partnership between the Ministry of Health of Ethiopia and the NGDO GRPB Carter Center. It aims to treat 824,824 people in 1324 communities hyper and 1619 meso endemic at its fifth year of CDTI implementation. Figure 5-5 indicates the detailed REMO/CDTI areas in Jimma. 5.6.2. Surnmary budget Table 5-10 summarizes the five year budget of Jimma CDTI project proposal and figure 5-8 shows the trend ofthe cost per person to be treated between 2003 and2007. Table 5-10: Five year summary budget of Jimma CDTI project as presented by the NOTF of Ethiopia 5.7. Community directed treatment with ivermectin project of Metekel, Ethiopia 5.7 .1. Background information Metekel Zone (25,993 Km2) is located in the north western part of Ethiopia. lt has an estimated total population of 247,831 in 2003. Rapid epidemiological mapping of onchocerciasis reveals three meso and hyper endemic wereda (Pawi, Dangur, Guba) and a refinement exercise should be carried out in three other wereda (Dibati, Bulen, Wombera) to clarifu onchocerciasis endemicity level. Table 5-11: General information Figure 5-9 indicates the detailed REMO results in Metekel Zone. The proposed project plans to 134,800 persons in 20 communities hyper and 56 meso endemic treat in its fifth year of CDTI implementation, Year Persons to be treated (A) Total Cost (B) CosUpers Total(C)=B/A Contributionof APOC (D) Cost/pers APOC(E)=D/A I 135 698 $379 368 $0.s2 $2ss 239 $0.3 s) 757 033 $3s2 130 $0.47 $208 427 $0.28 3 778 987 $203 201 $0.26 $67311 $0.09 4 801 578 $187 900 $0.23 $40 3s0 $0.0s 5 824 824 $174 0s2 $0.21 $16 663 $0.02 TOTAL 824 824 $1 296 651 s1.57 $s87 990 $0.71 Administrative units Total CDTI target 3 wereda (districts) Populatiorr Total in CDTI area 232,538 persons (year 2003) CDTI tareet I 34,800 persons (year 2007) Communities Total 992 communities CDTI target 76 meso and hyper endemic communities JAFg.7 Page 38 Eg.5.2: REMO results in MetekelZone, Ethiopia Fie.S-10 Trend of the cost per person to be treated between 2003 and 2007, Metekel CDTI project, Ethiopia TOTAL ir.09 i0a8 $0.83 t0.77 ioz Partncr! (MOH) $0.88 .55 1r.80 1r.60 1t,40 tr.20 tr.00 10.00 10.60 10.{0 30.20 10.00 o E E I c t t g EU 2003 Legend ! naoarrcorr** ! rvocatertr n trcntrer [f.jl wcbcurume - RtrEB l{odules (11) o0 o l-9 o 10-19 o 20-39 o ,i0-100 $0.64 APOC 2004 $o32 2005 l0.r r 2006 2tot g I I p, I{r4 1., .a, 5tl I t ) I, \ .4, g, )( )t t g .} \ a1\ i{ ' JAFg.7 Page 39 5.7.2. Summary budget Table 5-12 summarizes the five year budget of Metekel CDTI project as submitted by the NOTF of Ethiopia and figure 5-10 reveals the trend of the cost per person to be treated between 2003 and2007. Table 5-12: Five year summary budget of Metekel CDTI project as presented by the NOTF, Ethiopia 6. SUDAN 6.1. Rapid epidemiological mapping of onchocerciasis (REMO) in Sudan Fis.6-l: Rapid epidemiological mapping of onchocerciasis results in Sudan Year Persons to be treated (A) Total Cost (B) CosUpers Total(C)=B/A Contributionof APOC (D) CosUpers APOC(E)=D/A I 120 234 $186 s3s $1.s5 sl l0 160 $0.92 2 123 721 $l3s 3s7 $1.0e $40 158 $0.32 3 127 309 $l 12 548 s0.88 sl4 415 $0.1 1 4 131 001 $l 14 859 $0.88 $7 208 $0.06 5 134 800 $t12204 $0.83 $2 162 $0.02 TOTAL 134 800 $661 s04 s4.91 $174 103 $1.29 Legend /f, rnx,;,,a*u R!6rE ! courrtrtr* I nocDlrcu ittt *or"*," KMI-l 0 200 JAFg.7 Page 40 Fie.6-2: REMO results in Southern Sector of Sudan Fie.6-3: CDTI areas in Southern Sector of Sudan I I / ,/- {n I ) Nodules (1t) o o o o (l 0 l-9 l0-19 20,.39 /t0-100 KM 01u0zJ/J Legend 'fu, rnr*trnu R!tru ! conrttrrr** ! rocon*o $fiH nrrrop""a'3 _ IliEn LeEend /4 tonnt*u tunru ! conrtroav*o ! xocor*- ffi nuvropcnar4 i...j c"-u." l(M ---------t 0lm2m I JAF9.7 Page 4l 6.2. Community directed treatment with ivermectin project of East Bahr El Ghazal, Southern Sector, Sudan 6.2.1. Background information East Bahr El Ghazal region is the north central part of southern Sector. It comprises 6 counties (administrative level 2), which are namely Awerial, Cueibet, Mvolo, Rumbeck, Tonj, and Yirol. The Southern Sector Onchocerciasis Task Force (SSOTF) headquarters will be based in Rumbeck. The population of Bahr El Ghazal is not ivermectin narVe. In 1995, the Government of Sudan (GOS) and the Sudanese Peoples Liberation Army (SPLA) declared a ceasefire to allow humanitarian aid into the Southern Sector of Sudan. This enables many NGDOs, coordinated by Healthnet International (HNI) to initiate ivermectin treatment in Southern Sudan. Table 6-1: General information The proposed project aims to treat in its fifth year of implementation 669 meso and hyper endemic communities with an estimated population of 666,024 persons. The number of CDTI communities and the number of persons to be treated will be updated prior to ivermectin mass distribution in all the CDTI areas when feasible. Figures 6-2 and 6-3 revealthe details of the REMO results in East Bahr El Ghazal. 6.2.2. Summary budget Table 6-2 summarizes the five year budget of East Bahr El Ghazal CDTI project as submitted by the Southern Sector Onchocerciasis Task Force (SSOTF) and figure 6-4 indicates the trend of the cost per person to be treated between 2004 and 2008. !: Five year summary budget of East Bahr El Ghazal CDTI project as presented by the SSOTF Administrative units Total 6 counties CDTI target 6 counties Population Total in CDTI area 1,477 ,098 persons (year 2003) CDTI tareet 666,024 (vear 5) Communities Total 2648 communities CDTI target 669 meso and hyper endemic communities Year Persons to be treated (A) Total Cost (B) CosUpers Total ( C ):B/A Contribution of APOC (D) CosUpers APOC @)=D/a I 159 913 $l l5 730 $0.72 $ll4 880 $0.72 2 228 447 $88 I 80 $0.3e $77 130 $0.34 3 326 352 $r00 705 $0.31 $68 200 s0.21 4 466 217 $13 600 $0.03 $8 600 $0.02 5 666 024 $13 600 $0.02 s7 100 s0.01 TOTAL 666 024 $s31 81s $0.50 $275 910 $0.41 JAFg.7 Page 42 Fie.6-4: Fie.6-5 Partners (MOH & 10.80 10.70 10.60 10.50 10.40 1030 t020 t0.r0 l0r0 o tf,o t 0 t g g aop Trend of the cost per person to be treated between 2004 and 2008, East Bahr El Ghazal CDTI Project, Southern Sector Sudan .72 $0.31 NGDO) 2004 2m5 2006 20lJ7 2008 30.30 o t 10.2566 e! to.zo o oa E t0.r5 E6U $.r0 $0.40 30.35 10.05 10.00 Trend of the cost per person to be treated between 2004 and 2008, West Bahr El Ghazal CDTI Project, Southern Sector Sudan 2005 2006 2007 an8mu \; \ s0_09 APOC t0.02 \; \ \ $0.18 t0.13 io-00 i0.06 Partners (MOH t NODO) JAF9.7 Page 43 6.3. Community directed treatment with ivermectin project of West Bahr El Ghazal' Southern Sector, Sudan 6.3.1. Background information The West Bahr El Ghazal region shares borders with Dafur (under GOS control) to the North, East Bahr El Ghazal to the East, West Equatoria to the South east and Central African Republic to the West. West Bahr El Ghazal is administratively divided in 7 counties: Aweil West, Aweil East, Aweil South, Gogriel, Raja, Twic and Wau. Table 6-3: General information The proposed project is a reorientation of an existing ivermectin distribution programme assisted by many NGDOs coordinated by Healthnet International in areas not under GOS control. The National Onchocerciasis Task Force (NOTF) carried out ivermectin treatment in areas accessible to GOS. The current proposal plans to treat in its fifth year of implementation an estimated population of 1,508,733 persons. On completion of the rapid epidemiological mapping of onchocerciasis and community census, the exact number of CDTI communities will be determined. Figures 62 and 6-3 reveal the detailed REMO results in West Bahr El Ghazal. 6.3.2. Summary budget Table 6-4 summarizes the five year budget of West Bahr El Ghazal CDTI project and figure 6-5 reveals the trend ofthe cost per person to be treated between 2004 and 2008. Table 6-4: Five summary budget of West Bahr El Ghazal CDTI project as presented by the Southern Sector Onchocerciasis Task Force, Sudan Administrative units Total 7 counties CDTI target 7 counties Population Total in CDTI area 2,670,676 persons (year 2003) CDTI target 1,508,733 persons (year 2008) Communities Total 3219 communities CDTI target More 105 communities Year Persons to be treated (A) Total Cost (B) CosUpers Total(C)=B/A Contributionof APOC (D) CosUpers APOC(E)=D/A I 362 247 $130 254 $0.36 $l 12 230 $0.31 2 517 495 s93 654 $0.1 8 $71 420 $0.1 4 3 739 279 $92792 $0.1 3 $60 s38 $0.08 4 l 056 l13 $95 394 $0.0e $sl 3s0 $0.0s 5 l s08 733 $96 374 $0.06 $37 320 s0.02 TOTAL I 508 733 $s08 468 $0.34 $332 8s8 $0.22 a JAFg.7 Page 44 6.4. Community directed treatment with ivermectin project of East Equatoria, Southern Sector, Sudan 6.4.1. Background information East Equatoria region is the south eastern region of Southern Sector of Sudan. It shares boundaries in the south with Democratic Republic of Congo (DRC), Uganda and Kenya, in the south east with Ethiopia, to the north with Upper Nile and East Bahr El Ghazal, and to the west with West Equatoria. East Equatoria is composed of eight counties, which are namely Juba, Terekeka, Yei, KajoKeji, Magwi, Torit, Budi, and Kapoeta. Table 6-5: General information Figures 6-2 and 6-3 indicate the detailed REMO results in Equatoria region. The proposed project seeks to cover five counties in Southern Peoples Liberation Army (SPLA) areas and it aims to treat 424,261 persons by its fifth year of implementation. 6.4.2. Summary budget Table 6-6 summarizes the five year budget of East Equatoria CDTI project as submitted by the Southern Sector Onchocerciasis Task Force and figure 6-6 shows the trend of the cost per person to be treated. Table 6-6: Five year summary budget of East Equatoria CDTI project as presented by the Southern Sector Onchocerciasis Task Force Administrative units Total 8 counties CDTI target 5 counties Population Total in CDTI area 940,818 persons (year 2003) CDTI target 424,261persons Communities Total CDTI target 438 meso and hyper communities Year Persons to be treated (A) Total Cost (B) Cost/pers Total(C)=B/a Contributionof APOC (D) Cost/pers APOC (E ): D/A I 101 865 st70 s42 $l.67 $149 788 $1.47 2 145 522 $t}t 222 $0.70 $89 s08 $0.62 3 207 889 $l l3 8s4 $0.5s $78 928 $0.38 4 296 983 s23 864 $0.08 $9 s00 $0.03 5 424 261 $2s 864 $0.06 $8 000 $0.02 TOTAL 424 261 $435 346 $1.03 $33s 724 $0.79 I Fis.6-6: Fis.6-7: $r.80 3r.60 $r.40 3't.20 tt.00 gr80 tn60 gL40 $020 to00 o e E Eo!tI E0 E T ao(J o E o Eo t o c o g e Eu JAF9.7 Page 45 Trend of the cost per person to be treated between 2004 and 2008, East Equatoria CDTI project proposal, Southern Sector Sudan .67 2m5 2006 2007 2008200.1 t060 to50 $0.{0 $030 lo:0 to.r0 fluD Trend of the cost per person to be treated between 2004 and 2008, West Equatoria CDTI project proposal, Southern Sector Sudan 2@{ .-\'. TOTAI \ \ \ APOC lGN TA $0.70 $0.08 t0.06 P.rtn.E (MOH & NGDOI TOTAL t0.46 00.34 i0.23 APOC Prrtnarr NCDOI(MOH m6 2006 zlJ/Jl 2000 a & JAFg.7 Page 46 6.5. Community directed treatment with ivermectin project of West Equatoria, Southern Sector, Sudan 6.5.1. Background information West Equatoria is the south western region of Southern Sector of Sudan. It shares boundaries with the Central African Republic and the Democratic Republic. The project should look at a cross border collaboration with these neighbouring countries to control onchocerciasis as a public health problem. West Equatoria is made up by five counties, which are namely Ezo, Maridi, Mundri, Yambio and Tambura. In these counties ivermectin distribution, as a vertical programme, is going on since l995.In 1998, total of 47 , 7 47 persons received ivermectin in the five counties. This number increased between 1998 to 2002, when 173,385 received ivermectin. }[!9..1[;/: General information The proposed project aims to treat by its fifth year of implementation 422,351 persons in 401 meso and hyper endemic communities. Figures 6-2 and 6-3 show the detailed REMO results in West Equatoria. 6.5.2. Summary budget Table 6-8 summarizes the five year budget of West Equatoria CDTI project as submitted by Southern Sector Onchocerciasis Task Force and figure 6-7 indicates the trend of the cost per person to be treated. Table 6-8: Five year summary budget of West Equatoria as presented by the Southern Sector Onchocerciasis Task Force Administrative units Total 5 counties CDTI target 5 counties Population Total in CDTI area 908,069 persons (year 2003) CDTI target 422,351 (year 2008) Communities Total CDTI target 401 communities Year Persons to be treated (A) Total Cost (B) Cost/pers Total(C)=B/A Contributionof APOC @) Cost/pers APOC (E ): D/A 1 255 519 sl30 s3s $0.s 1 $109 265 $0.43 2 268 968 $80 095 $0.30 $63 395 $0.24 3 283 124 $127 2s8 s0.4s $98 438 $0.3s 4 298 025 $99 880 $0.34 $68 390 $0.23 5 422 751 $98 600 $0.23 $44 080 $0.1 0 TOTAL 422 751 s536 368 $1.27 $383 s68 $0.91 iJAF9.7 Page 47 6.6. Community directed treatment with ivermectin project of Upper Nile, Southern Sector, Sudan 6.6.1. Background information The proposed project area is located in Upper Nile region in the north eastern part of Southern Sudan along the Ethiopian highlands. The Upper Nile is composed of 30 counties. The project area is limited to six counties, which are namely Pibor, Pocholla, Akobo, Latjor, Renk and Kangor (part of Blue Nile region). Pibor, Pocholla, Akobo, Latjor and Kangor are accessible to Southern Sector Onchocerciasis Task Force; other counties are partially or totally accessible because of the war going for more than 20 years. Table 6-9: General information Figures 6-2 and 6-3 show the detailed partial REMO results in Upper Nile region. Ivermectin distribution has been carried out in Upper Nile since 1998. 5458 persons received ivermectin treatment in 2002. The current project proposal is a reorientation to CDTI. The project aims to treat in its fifth year of implementation 131,862 persons. 6.6.2. Summary budget Table 6-10 summarizes the five year budget of Upper Nile CDTI project as submitted by Southern Sector Onchocerciasis Task Force and figure 6-8 reveals the trend ofthe cost per person to be heated. r@10: Five year summary budget of Upper Nile CDTI project as presented by Southem Sector Onchocerciasis Task Force Administrative units Total 30 counties CDTI target 6 counties Population Total in CDTI area 131,862 persons (estimated population of the accessible areas CDTI target 58,084 persons (year 2008) Year Persons to be treated (A) Total Cost (B) CosUpers Total(C)=B/A Contributionof APOC (D) CosUpers APOC(E)=D/A I t3 946 $l 1s 730 $8.30 sl 14 880 $8.24 2 t9 923 s88 180 $4.43 $77 130 $3.87 3 28 461 $100 70s $3.s4 $68 200 $2.40 4 40 659 $lll s40 $2.74 $73 394 $1.81 5 58 084 $124 930 $2.1 s $6s 202 $1.12 TOTAL s8 084 $541 085 $9.32 $398 806 $6.87 JAFg.7 Page 48 Fie.6-8: Trend of the cost per person to be treated of Upper Nile CDTI project, Southern Sector, Sudan .TOTAL (MOH & NOOO) ) l9.m 38.00 l7.m t8.m I5.m g.@ 33.00 t2.00 $l.m 10.00 o ctto I c f,l T E zt04 2m5 2006 2007 2m8 REVIEW OF PROGRESS REPORTS (TECHNICAL AND FINANCIAL) AND BUDGETS FOR SUBSEQUENT YEARS FUNDING After a technical and financial review by the TCC and APOC Management of first, second, third, fourth and fifth year progress reports and proposals for subsequent years funding of fifty.five (55) APOC-funded projects, APOC Management upon recommendation of the TCC during its l6'n and l7'n sessions, has approved in 2003, the second, third, fourth, fifth and sixth year funding of the projects summarized by tables Cl-C3. C $4.43 APOC 12.1C Table C-1 JAF9.7 Page 49 Annual technical and interim technical reports submitted to TCC and APOC Management in March and September 2003 t Country Year I Year2 Year 3 Year 4 Year 5 Total Annual technical Reports submitted to TCC Cameroon 2 2 2 4 l0 Chad I I Congo I 1 DRC 3 1 I 5 Ethiopia I I Liberia I I Malawi I I Nieeria 2 9 9 5 25 Sudan 3 5 Tanzania I I I J Uqanda I 2 2 2 7 subtotal 6 8 l5 t7 t2 58 Interim technical reports submitted to APOC Management Cameroon I I I 2 5 CAR 1 I Chad I I Conso I I 2 DRC 2 I I 4 Ethiopia 2 I aJ Nigeria I I 2 ) 7 Uganda 2 1 ) subtotal 6 5 4 4 7 26 Grand Total t2 13 t9 2L t9 84 JAFg.7 Page 50 }[!9-.1}2: Financial reports reviewed by APOC Management in March and September 2003 }[!9-.1}1: Budgets reviewed by APOC Management in March and September 2003 ) Countlry Year I Year2 Year 3 Year 4 Year 5 Total Cameroon 2 I 5 I 9 Chad I 1 Congo I I 2 DRC 1 1 Liberia I I Niseria 1 I J J 8 Tanzania 1 1 2 Total 4 3 3 9 5 24 Country Year I Year 2 Year 3 Year 4 Year 5 Year 6 Total Cameroon I I I 2 5 Congo I DRC 3 2 5 Ethiopia 2 1 5 Liberia 1 I Malawi I 2 Nigeria I I 6 6 2 l6 Sudan I I Tanzania I 2 J Uqanda 4 1 5 Total 1 5 2 l4 11 9 42 I - JAF9.7 Page 5l OVERVIEW OF BUDGETS SUBMITTED TO TCC AND APOC MANAGEMENT IN 2OO3 }[!g}1: Budget (US $) per country Table D-2: Breakdown per project and per country of the total budgea (6,4L4,676 US $) as submitted in 2003 D a ll $214 998$214 998 $1 430 872s79 724$r 208 164 s62 778 $80 206 $20 477 s20 477 sr 308 879$920942 $187 86r $200 076 $866 032$866 032 s858 039$8r0 054 $47 985 $57 506$s7 s06 $r82 031 $93 s80 $548 403$272 792 $760 077$760 077 $s0 s36 $128 228$77 692 $192 939 $221 165$28226 $l 241 002 $r44 116 s6 414 676$2s0 639 $156 417 $610 098$4012 404 (burrtrt' Artgola (l:rntcrooll (iongrr t)tt(l lirl (i uinca Iithiopil l,iberia Nigcria Surlurr 'I'unzanil [Jgantla 't'o'l'Al, Ycur I Ycar 2 Yctr 3 Ycitr { Year 5 \'citr (r 'l'rltal $l l4 605I Angola Cabinda* $100 3932 Moxico* $133 8l I3 Cameroon Adamaoua I * $431 4304 South Province* $347 2405 East Province* Far North* $295 6836 $80 206Centre I7 $62 7788 Centre Il 9 North West $79 724South West II10 $20 477l1 Congo Extension* SN Countn' I)r'oject Ycll I Yeitt'2 \'cltl'3 Year { \'c:tI'5 Ycitr'6 a * budget to be reviewed and scaled down Equateur-Kiri $14s 778t2 DRC Katanga-North $116 701l3 Katanga-SoLrth $100 223t4 Lualaba $104 222l5 Mongala $l l0 64116 17 Ubangi-North $111 057 $l l4 874l8 Ubangi-South $117 446l9 Tshuapa $r04 29020 Sankuru Bandundu $83 5712t NOTF^{Q $l l9 52022 $80 ss6Kasai23 $39 91024 Eq Guinea Bioko CDTI s826 12225 Vect Elimination $47 98526 Ethiopia East-Wellega* $lss 39s $160 s9827 West-Wellegat $165 21s28 Illubabor* 29 Jimma* $170 468 30 Meteke*l $71 460 $86 9183l Gambella* 32 NOTF/HQ $s7 s0633 Liberia Lofa Bong $93 s8034 Nigeria NOTF/HQs $62 12035 Niger $64 07036 Bauchi 37 Ekiti $44 410 $71 29338 Borno st4 70239 Zamfara $42 sl040 Gombe Edo/Delta $58 8764t $43 97242 Ondo $37 16043 ovo $ls 71044 Kebbi SN Country l)rojcct Ycar I Ycar 2 Ycnr 3 Yenr .l Ycrtr 5 Ycar 6 JAF9.7 Page 52 @l: Breakdown per project and per country of the total budget (6,414,676 US $) as submitted in 2003 (continued) D * budget to be reviewed and scaled down @,!: JAF9.7 Page 53 Breakdown per project and per country of the total budget (6,4L4,676 US $) as submitted in 2003 (end) * budget to be reviewed and scaled down t rt 45 Sudan West Equatoria* $t44 423 $170 s4246 East Equatoria* $112230 47 West B. El Ghazal+ $2t7 15248 East B. El Ghazal* $l l5 73049 Upper Nilet $77 69250 Tanzanie Tunduru* s34 1645l NOTF/HQs st6 37252 Mahenge $2822653 Uganda Mpamba Vect El. $100 10s54 Phase II $92 83455 Phase III Ycar I YcuI'2 Year'3 \'citl'{ Ycar'5 Yctr 6 lll0l2.l04 $i2.s0(,19 Sl56-ll7 56l009ti 5il24l(X)2 llil44 ll(rt'o'IAl. SN* (llrrntry l)r'o.icct a t