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Request for supplementary budget for 1987 as authorized by CSA on 30 July 1987

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Onchocerciasis Control Programme in West Africa Programme de Lutte contre I'Onchocercose en Afrique de I'Ouest. JOINT PROGRAMME COMMITTEE Office of the Chairman JPC .CCP COMITE CONJOINT DU PROGRAMME Bureau du Pr€sident JPCB.5 (A) September ltBJ JOII'IT PROGRAMME COMMITTEE Eighth session Rome. 30 November - 3 December 1987 Provisional agenda item 13 - REQUEST FOR SUPPLEMENTARY BUDGET FOB 1987 OnchocercLasLs Control Progranune as authorLzed by CSA on 30 July 1987 INTRODUCTION Purpose The purpose of this document is to seek approval for a supplementary budget of US $4 538 000 over and above the 1987 budget of US $29 934 OO-O approved by the Joinr Progrsmme Committee (JPC), thus proposing a modified budger of US 934 472 OOO, asdetailed in Tables 1 to 5. This document further provides justifications for ttre additional funding requirements to meet the Progranme forecasts of expenditure rerated to ocP essential operational needs up to the end of the year. Background The PIan of Action for 1987 aimed at naintaining activities in the original area of the Programme, and to progress towards achieving the set objectives in the Western and Southern Extension areas as specified in the Plan of operations. Technical difficulties as wetl as cost overruns prevented Onchocerciasis Control Programme (OCP) from achieving these objectives. The spread of resistance to temephos throughout the Prograrnme area in early 1986 was rapidly on its way to becoming widespread in late 1986 and early 1987, and even reached Guinea in the WesternExtension before any treatment had been made. This required an appropriate modification in larviciding strategy towards the rotational use of more expensivelarvicides and the consequent increase both in terms of quantitative requirements and costs, in addition to more expensj.ve aerial spraying operations. At the ssme time, a significant budget shortfall was developing in the Programme. As early as l1 March 1987, the budget approved by rhe JPC for 1987 of US $29 934 OO0 was already largely committed with an unobligated balance for the remainder of theyear of only US $6 754 6p2. This balance was reduced further by US $2.5 million dueto the necessary purchase of additional and more expensive larvicides in order to overcome the spreading resistance. I t JPCB.5(A) page 2 The Committee of Sponsoring Agencies (CSA) was made aware in early April t)Bl of the immediate situation facing the Programme j.n relation to the rapid spread of resistance to temephos and subsequent costs. The Programme also reported that there was an overrun of US $1.9 mitlion in 1!86 over and above the US $2.1 millionpreviously authorized by the CSA and approved by JPC. The CSA acknowledged the urgent and continuing need for additional larvicides and suggested that the Programme use available unobligated funds pending an in-depth review of the Programme situation by rhe cSA in lare July 1987. 0n the 30 June 1987 the unobligated balance which incl-uded US chemotherapy research contracts about to be committed stood at US $1 $1 .4 million of 653 732. Additional funding requirement To cope with the above-mentioned difficulties in meeting the essential operatj-ona1 needs, the Progranme's requirements of additional funding anounted to US $5 479 382 as follows: - Personnel cost and 1oca1 subsidies - Cost to overcome resistance - Cost of participants attending meetings of experts - Over-expenditures of 1pB6 - Cost of ivermectin trials 8t 33 $ $1 $ US US US US US $ 350$2 842 282030 500 570 000 63 9 4 A review of the entire Programme to eliminate or reduce non essential- activities resulted in savings of US $941 382 mostly through reductions of applied researchprojects, fellowships and training and the freezing of capital cost projects. These reductions decreased the requirement for additional funding to US $4 538 000 for a total revised budger of US $34 472 OOO for 1987. The summary of increases and decreases for the revised budget for 1p8/ isdetailed in Table l. tifications for additional The following elements contributed to the budget shortfall in 1987: - The high cost of overcoming the spreading of resistance; - The increased costs of personnel, operations, larvicides, equipment, supplies and other services; - An over-expenditure of US $1 879 570 in 1985, over and above the approved supplementary budget, which must be carried over to the 1987 financialperiod; and - The ivermectin field trials ot 7987 Resistance The cost of utilizing replacement larvicides has considerably increased asillustrated in the following cost analysis of various larvicides to treat the Sassandra/Boa River for one year: I JPc8.5(A) page 3 Temephos B.t. H-14 versus temephos Chlorphoxim versus temephos Alternation of chlorphoxim and permethrin versus temephos Carbosulfan versus temephos US US US US US L5 6 3 10 $ 205 116$ 370 oo8$ 255 583 $ 218 482 s 278 256 0 factor7 1 1 1 1 B0* 24 06 35 * (equivalent effective at L.2.nE,/l at a price of US $3.50 per litre). The comparative cost of alternative use of larvicides graphically displayed inthe following tables shows clearly the significant cost increases: Table 6. Comparative cost of B.t. H-14 2x and 4x versus temephos. Table /. Comparative cost of carbosulfan-chlorphoxim-permethrin versus temephos. 0f the alternative larvicides, B.t. H-14, can be used year-round at considerabl-e cost despite recent improvements. 0f the compounds that would have to be used in wet season (permethrin and carbosulfan), permethrin would undoubtedly provoke resistancein a few seasons, and carbosulfan is too toxic and expensl.ve. The costs of larvicides per litre in US do11ar (cost-insurance and frelght) have averaged as fol-lows: 7985 1986 t9B7 Temephos (France) B.r. H-14 (US) Chlorphoxim (Germany) Permethrin (England) Carbosulfan (US) Temephos B. r. H-14 Chlorphoxim Permethrin Carbosulfan 1B 5t 11 4 5.72 14.00 77.72 $2$4$B 11 .41 4.so 25 0B (435 0OO lirres) Jan 1987 90 (226 000 litres) Mav 1987 4o5 14 79 94 .L2 30 4.tl 0. 84 The quantities of larvicides purchased to overcome resistance in llBJ have alsoincreased as shown in litres below: 1985 L9B6 Lg87 130 200 10 5 5 000 000 000 000 000 92 381 20 10 7 65 ooo 14 Boo 21 000 000 000 000 000 000 725 6st 000 000 The total cost of purchasing rarvicides in the last three years was: 1985 1986 666 ooo 277 936 071 000t987 Furthermore the aerial- treatments with larvicides other than temephos necessitate more surveillance of the breeding sites, more monitoring of larviciding to detect resistance both resulting in greater mileages of vehicles and in increased dutytravel. US US US t JPCB.5(A) page 4 Increased costs Personnel costs have increased durin9 L9B7 bV 5.5/. for the Professional staff anrl J\'/" fot the General Service staff. While the basic salaries of the Professionals remain stable, the post ajustments increased in West Africa by L7% from 1 January to]0 June 1!BJ, mostly due to currency fluctuations and statutory step increases. The salary of the General Service staff increased bV 35'l as a result of significant upwards revision of some countries salary scales as decreed on the United Nations procedure of salary survey with effective dates of two years in severalAfrican countries. The retroactivities have to be absorbed in the current year's budget in conformity with liHO financial regutations. A price analysis of material of some 100 items revealed that costs increased on average by L2% from 1985 to 1987. The cost of temephos increased between 1986 and 1987 by 27f,, B.t. H-14 2O,/", chlorphoxin 75/., permethrin 4l and carbosulfan 7.9 l. However it is to be noted that the price of the last order of B.t. H-14 cane down by 43%. Depreciation of the US dollar The significant decline in the rates of exchange of the US doIlar has resulted in cost increases that cannot be determined with accuracy. However from the date the 1987 budset was prepared in July 1!86 to l0 June 1987, the US dollar has declined asdetailed by the rates of exchange shown below: Rates July 1pB6 Rates June 1987 Decline FCFA French Franc Swiss Franc t Sterling Deutchmark 5.95t.5r 0.61 1 .80 77 5.4 L7 90 345 73.6 !3.6 298 6. 1. 0. 2. B2 64s t7 The fluctuation in the rates of exchange of the US dolIar influenced 67.5"1 of the budget in 1986 and it is estimated that it will perturb 64.2% i.n 1987. Slightly over US $12 million will be disbursed in US dollar while the other expenditures of about US $22 million wilt be carried out in a number of other currencies, as shohrn in Table 8. 1985 Over-expenditures In the course of 1986, the Programme committed expenditures of US $1 879 570 over and above the approved modified budget of 1!85. This was due to the fact ttrat obligations of large amounts to be paid in currencies other than the US dollars were not updated systematically as they ought to have been to fo11ow the trend of the US do1lar fluctuation. llhile reviewing the commitments at the year end closure of accounts, it was disclosed that to pay these commitments another US $1.$ million would be required over and above the additional US $2.3 mitlion approved by the JPC due to non-availability of funds in the 1986 provision. The WHO accounting procedures do not permit deficits over approved budgets. Therefore, when the approved budgetfor 1t85 of US $25 495 JJ2 was exhausted, US $1 798 29O of obligarions were transferred from 1tB6 records. Further commitments amounting to US $581 280 entered I JPc8.5 (A) page 5 ln 1!86 were made directly against the 1987 budget. Considering that the expenditures were strictly justified by operational requirements, OCP had no other option than to carry them over as a charge against 1987 Uudget. However, better systems have nowbeen established to improve the management of commitments and stricter controlsimplemented to avoid over-expenditures. Ivermectin field trials Since its inception in 7975, OCP has had to rely solely on vector control throughlarviciding as the only feasible method to achieve its objective of putting an end to onchocerciasis as a dj.sease of public health and socioeconomic importance. However,important advances have recently been made in chemotherapeutic research for onchocerciasis and it is hoped that ivermectin, which is an effective microfilaricide, will be registered before the end 'ot L9B7 and be available forlarge-scale use from 19BB onwards. Because of this prospect, the oCp has startedpreparations for the operational use of ivermectin in the Programme area. An OCpj-vermectin committee has been established which has developed detailed plans for community studies of ivermectin which will have to precede the introduction ofivermectj,n as an operational tooI. Two field trials will be conducted in 1987 and itsprojected costs have been included in the budget j.ncreases of VCU and EpI. Thedetailed costs appear in Tab1e 9. Reduc on in activities To offset the overall increased costs, OCP has tightly reduced planned activitiesfor 1tB/ by: - Freezing the recruitment of all vacant positi-ons (11 Professional and40 General Services posts); - cancelling consultancy contracts or reducing duratl-on; - Reducing overtj.me; - Reducing fellowships and training; - cancelring and postponing the purchase of new vehicles; - Cancelling renovation to buildings; - Reducing the procurement of supplies, furniture and equipment; - Reducing per diem for General Service personnel bV Z5%. Revisqd Budset 1987 The supplenentary funding requirements of the revised Budget L)BJ are summarizedin the following Tab1es: Table 1. Proposed revised Budget 1987, Budget performance as of 30 June 1!g/ Table 2. Revised 1987 Budget by programme Activity Table J. Revised 1987 Budget by Category of Expenditure page JPCB A Table 4. Programme Revised 1!87 Budget - Summary by Activity and Category of Expenditure Table 5. Summary of increases and decreases of revised Budget tor L9B7 The following Tables provide further information or justification related to the request for additional funding: Table 5. Comparative cost of treatment B.t. H-74 2x and 4x versus temephos. 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Informations clés
Type de document Technical Documents
Date d'adoption
Source Organisation mondiale de la santé