Steering committee for onchocerciasis control in the Volta river basin area : report of its seventeenth session, Geneva Geneva 17-19 June 1976

\ ltA /t rRnurt RESTRICTED STEERING COMMITTEE FOR ONCHOCERCIASIS CONTROL IN THE VOLTA RTVER BASIN AREA REPORT OF ITS SEVENTEENTH SESSION Geneva 17-19 June 1976 2 AB C D E F G H I J 2 CONTENTS Opening of the session Election of Chairman'. Adoption of the agenda OCP Plan of Action and Budger for l97l Aerial contract - Invitation to Bid Insecticide Bui lding Drug development Ecological Panel : Report of the third meeting of the Scientific and Technical Advisory Conurittee Economic development (i) Economic Development Advisory Panel (ii) Economic Development Unit Progress Report on the Onchocerciasis Control Programre Other matters Arrangements for the third session of the Joint Coordinating Conmit tee Arrangements for the next session of the Steering Comrittee Adoption of the report Closure of the session Paragraph .1 ,5 .6 .7 .L6 ,T9 .22 .24 .28 31 Page 3 3 3 4 5 5 5 6 6 I K 7 7 7 7 7 8 L M 34 36 39 42 N o P 43 44 45 46 8 8 8 8 -3 ! I I A. OPENING OF THE SESSION 1. The seventeenth session of the SEeering Corrnittee was opened at WHO Headquarters by Mr M. Bazin, former chairman, Dr L. Bernard, Assistant Director General of IIIHO, addressing the Couunittee, expressed his appreciation of the role played by the Steering CormniEtee in the development of the Onchocerciasis Control Prograuune. Referring to the departure of Dr Bellerive on reEirement, Dr Bernard informed the Cournittee that the Director-General of hlHO had decided not to replace Dr Bellerive by a full time Director, but had appointed Dr T. Lepes, Director of the Division of Malaria and Other Parasitic Diseases, to act as focal point for Ehe Prograrmte. The Progranrme would, of course, benefit from the expertise of the various members of that Division in addition to the existing support team, and he himself would con- tinue to be closely associated with its work. 2. Dr Bernard regretted Dr Lepes I inability to attend the session until the following day, due to previous commitments. 3. The members of the Cournittee paid tribute to the work and personality of Dr Bellerive and expressed their regret at his departure. Mr Bazin, speaking on behalf of his colleagues, referred to Ehe close collaboration that had existed over the last four years and reca1led, i-n particular, the breadth of Dr Bellerivers experience, his diplomacy and his sensitivity to human relationsl he was glad to learn that Dr Bernard would continue his association with the Prograrrne and thanked him for his support. The Conrnittee extended its best wishes to Dr Bellerive on his retirement. 4. Dr Bellerive thanked the members for their good wishes and said that of the t8 years he had spent in the different services of WIIO, one of the things he would value most \"rould be the opportunity afforded him to know each one of them personally, ELECTION OF CHAIRMAN Dr A. Bellerive was elected Chairman of the session ADOPTION OF THE AGENDA The following agenda was adopted: Opening of the session Election of chairman Adoption of the agenda OCP Plan of Action and Budget for 1977 Aerial contract - invitation to bid Ins ecti cide Bui lding Drug development Ecological Panel Report of the fourth meeting of the panel Composition of the Panel B 5 c 6 I 2 3 4 5 6 7 8 9 9.L 9.2 10 11 L2 13 Report of the third meeting of the Scientific Economic Development Advisory Panel Progress Report on the Onchocerciasis Control Other matEers and Technical Advisory Comittee Progranrne 13.1 Arrangements for the third sessi.on of the Joint Coordinating CoruniLtee Arrangements for the next session of the Steering Committee Adoption of the report Closure of the session L4 15 16 4- D. OCP PI.AN OF ACTION AND BUDGET FOR 1977 7. In introducing the Plan of Action for L977 and the gIobal 1977 Budget Esrimates, WHO stressed that the former rtas a draft, requiring refinement, on which the Corrnitteers cotrEtrents were requested. The final document would contain staff figures for each Prograrune Unit with details of their functions, as shown for the Vector Control Unit, and a sunmary table of the total staff by Unit. 8. It was recalled thaE at the sixteenth session the Bank had asked WHO to provide an indication of the order of magnltude of the budget requi.rements for L977;l this global estimate stood at approximately $ 14 million. WHO pointed out thaE 1977 was the first ful1 year of operations over the entire Prograrme area; Ln L976 certain activities in Phase III had begun only in May. Accordingly, the global estimate reflected higher requirements in mary'months of staff, vehicles, alrcraft, etc. A firm figure could not be given until, amongst other things, the cost of the second aerial contract was known, and a decision was taken by the Conmittee regarding a Progranure Headquarters building. The main increases in 1977 were relaEed to general service salaries, a rise of at least 407. in numbers of flight hours and their cast, a larger quantity and increase in Ehe price of insecticide and a substantial increase in vehicles for reserve and replacement. It vras anticipat.ed that there would, of course, bemi.nor modifications berween nour and September, when the Committee would review a more complete and detailed budget submitted by WIIO. WHO confirmed that it.s budget estimate for 1976 would total approximately $ 10 mi1lion, as indicated to the second session of the Joint Coordinating Cormrittee; its treasury requirements for L976 would also remain as stated in the 1976 budget document. 9. With regard to budgetary presentation, Ehe lndependent Chair:nan of the Joint Coordinating Conmrittee stated that the expenses relaEed to the JCC would appear as a separate item. 10. Concerning the funds required in 1976 atd L977 for applied research and training, IINDP informed the Cotrmittee that the temporary ceiling for 1976 (US$ 465 OOO) would be confirmed in mid-July, and UNDP was doing its utnost to make a similar amount available io L977. 11, The Bank reviewed the state of financing of the Programne and reported on its endeavours to interest other donors over the last six months. Amongst the Scandinavian countries, Norway was considering a contribution and a reply was awaited from Finland. Once a more definite estimate of financial requirements for L977 was available, the Bank would again approach other potential donors. FAO suggested that, in particular, contacE might be made with the OPEC countries. L2. The Independent Chairman stated that he would be at. the disposal of the Bank tc assist in contacEing possible sources of finance. 13. The Conrnittee reviewed the text of the draft Plan of Action and expressed satisfaction with the document, however, greater precision was required and there were a number of Points that needed clarification. It was suggested Ehat, in each section, the Prograumers require- ments in terms of staff, services and equipment should precede a description of the work. L4. With regard to the Vector Control Unit, the Bank felt thaE a compari-son should be made with the situation Lt 1976, in particular, in relation to flight hours, insecticide and dis- tribution points for fuel and insecticide. With regard to vehicles, WHO \ras request.ed to incorporate justification in the text for the numbers required and to Present a costf compari.son analysis of alternatives. 15. It was agreed that FAO and LINDP would forward their coments on the draft Plan of Action to WHO in early July, including a revised text for the Economic Development Unit, and that a meeEing would take place between the Bank and WHO in the second half of July to consi-der the amended document. AE that time WHO would provide revised and detailed budget estimates for L977, it being understood that, if necessary, the figures would be modified at the third session of the Joint Coordinating Cormrittee, following approval by the Steering Cormtittee' 1 sixt"errth session report, paragraph 9 t I t I 5- I I I I E. AERIAL CONTRACT - INVITATION TO BID 16. WIIO reviewed the action taken with regard to the aerial spraying conEract and recalled that an advertisement had been inserted in three international aviation journals, as a result of which 51 companies had indicaEed interest. At the beginning of April a SelecEion Connnittee had considered the replies received, and had drawn up a short list of 24 contractors who were sent the Invitation to Bid; five of these had since withdrawn. 0f the remainder, only 13 had attended the briefing sessions arranged during the weeks beginning 26 April and 17 May, and the Selection CouulitEee would have to determine whether, according Eo the terms of the Invitation to Bid, they were Ehe only eligible bidders. L7. A few queries had been received on certain aspects of the Invitation Eo Bid, in particular, three companies had raised questions concerning the Performance Bond: Ostermanns, Sweden, and Viking Helicopters, Canada, enquired whether the bondrs value would be progressively reduced over Ehe latter part of the contract; BEAS Helicopters, UK, had asked if the bonds would be acceptable in sterling. WHO had been approached on several occasions by represen- tatives from one country regarding the bonds, and had been requested either to reduce the level of the bonds, or to postpone the date of bid opening for two weeks. WHO explained that- the Performance Bond \^ras established at a 25% levei of the bid price to permit the Organiza- tion to hire alternative services, during the minimum period required to inviEe fresh tenders. should the contractor be in default. At this late date, WHO could not legiEimaEely defer the bid opening without inconvenience and unfairness to other bidders. 18. The deadline for the receipt of bids was 5 p.m., l"londay 21 June. A public opening of bids would take place at 3 p.m. on 22 Jwe, and the Selection CouunitEee would meet thereafter to consider the bids and select a conEractor. F. INSECTICIDE 19. WIIO informed the Comnittee that of the 210 0OO litres of Abate 20% emulsifiable concen- Erate required for the control operations in 1976, 150 O0O litres had been received so far and 60 OOO remained to be ordered, It was recalled that at the fourteenth sessionl it had been decided, in view of the high cost of Abate, to a\^rait the results of the evaluation of another candidate insecticide (chlorphoxim) before ordering the remaining quantity. WHO stated thac the preliminary observations of a three month field trial conducted with chlorphoxim seemed to indicate a higher toxicity to non-target organisms than Abate. A fu11 report was expected in July and subsequently a large-scale trial would be carried out in the Prograrme area. Although it had been indicated that chlorphoxim could be provided ar half the Abate prlce theOrganization had had to purchase the 1200 litres required for the rrial at US$ 7.13 a litre, compared with US$ 5.45 a litre for Abate. So far chlorphoxim had not been conrnercialized and Bayerts production capacity was not knorm. 20. With regard to other candidate insecticides, the risk of cross resistance between DDT and meEhoxychlor was recal1ed, and the Couunittee was informed that research was continuing on other Products and formulations including small-scale trials with microencapsulated methyl- dursban. 2L. In the light of Ehe information provided, the Steering Cournittee agreed that WHO should proceed with the purchase of the remaining 60 OO0 litres of Abate required for t976. G. BUILDING 22. The ConrnitEee reviewed the five option.2 p."""rrted by I^IHO concerning the construction or lease of a building(s) Eo house Prograrme Headquarters in Ouagadougou. WHO explained that, at Present, four buildings are rented for the different Prograume units and a fifth for the I FourteenEh session report, paragraph 17 Annex 2.2 6- Ouagadougou sector and sub-sector office. RecaIling that aE the sixteenth sessionl the Bank had suggested that a detailed proposition should be put forward to the nexE session of the JCC concerning the Prograrmne Headquarters, WHO requested the views of the members on the various options so that a decision could be reached for inclusion in Ehe text of the Plan of Action. 23. FAO and UNDP indicated their preference for the second option, i.e. the construction of light units and a store at a cost of US$ 323 7OO. The Bank r,ras requested to send its vi-ews to WHO as soon as possible. H. DRUG DEVEI,OPMENT 24. The Committee vras informed of the latest developments in the field of chemotherapeutical research. Trials with diethylcarbamazine plus levamisole, levamisole alone and nifurtimox, were being carried out at the OCCGE,2 Centre Muraz, Bobo-Dioulasso in Upper Vo1ta. Investi- gations on the first group of patients, wi-th the participation of the OCP ophthalmologist, were already in progress. 25. With regard to the establishment of the Chemotherapeutic Research Centre at Tamale, . northern Ghana, WHO had experienced difficulty in obtaining the services of a pharmacologistf clinician as a consulEant to undertake the planning, conduct and coordination of the drug trials. As an alternative, WHO had investigated the possibility of pharmacological and toxi- cological studies being carried out in a laboratory outside the Progranune area. The Liverpool School of Tropical Medicine, United Kingdom, had been contacted by IiHO and had indicated its interesE in participating in this project. The agreement of the Ghana Government to the association of the Liverpool School with the Tamale Centre had just been received. 26. WHO informed the Conrnittee of the action taken since the last Steering Conrnittee session to encourage pharmaceutical companies to undertake research for the development of suitable products for use in mass campaigns against onchocerciasis. The OrganizatLot was considering whether to contact pharmaceutical industries not only for Ehe development of antifilarial drugs but also for products needed for other imPortant parasitic diseases. 27. The Bank, while recognizing the value of a concerted approach, expressed concern that this might result in a delay in finding a suitable drug for the Prograrrne. I. ECOI,OGICAL PANEL 28. The Steering Comittee noEed the report of the joint meeting of the Ecological panel (EP) and the Scientific and Technical Advisory Cortrnittee (STAC), and accepted in principle the proposal that a representative of STAC should attend future meetings of the EP and vice versa. It was considered that cross representation should also be extended to the Economic Development Advisory Panel (EDAP). 29. The Comnittee reviewed the report of the fourth meeting of the Ecological Panel and requested the representaEi-ve of the Bank to discuss particular asPects with the convener of the Panel. 30. Recalling that the term of service of the Ecological Panel members was due to expire on 30 June L976,3 the Cosmittee requested its Chairman to hrrite to each of the members to inform him of this fact and to congratulate him on the valuable task he had performed. IJNEP should also be advised, Each organization would then appoint a nominee. The Comnittee felE Ehat, with participation of a representative of STAC and EDAP at EP meetings, the membership of the Ecological Panel could be reduced to five. I Si*te..,th session rePort , paragraph 27. 2 O.g..ri".tion de Coordination et de Coop6ration pour la lutte contre 1es grandes endemi-es. 3 Forrtt.errth session rePort, paragraph 32. , 7- I J. REPORT OF THE fiIIRD MEETING OF THE SCIENTIFIC AND TECHNICAL ADVISORY COMMITTEE 31. The report of the third meeting of the Scientific and Technical Advisory Comnittee was presented to the Committee, which expressed appreciation of its detailed content. The Bank, requesting information on how the research prograuune was defined, was informed by WHO that it is formulated according to the requirements indicated by the Programme operational personnel, the recommendations of the Scientific and Technical Advisory Cormtittee and sugges- rions from members of the Scientific Advisory Panel (SAP). The proposals are considered by a WIIO Research Coordinating Corunittee, set up specifically for OCP, which meets twice a year. This Conurittee reviews the overall prograrnme, assists in identifying personnel and insti- tutions who may be able to undertake the different activities, and ensures that there is no duplication of interest with other divisions of WHO. 32. WHO explained to the Bank its procedure for establishing research agreements, defining the protocols and deEermining the leve1 of financial assistance granted. The size of this assistance depends on the research priorities of OCP, the locaEion of the instiEutions and the facilities available for carrying out the proposed research. At the request of the Bank, I^IHO provided a list of the conLracts already established with different institutions and their cos t. 33. In reply to a query from the Bank on the increased budgetary estimate for research i-n 1977, WHO explained that as well as continuing much of the present prograrune, some ner^r activi- ties were foreseen in connexion with the reinvasion problem, e,g. study of the wind-movement of S. damnosum. K. ECONOMIC DEVELOR,IENT (i) Ecgnoqrlq Developqe4t {!v1egry Pa4el (EDAP) 34. It was confirmed that EDAP is an independent body, but, as indicated by its Chairman, members of the sponsoring agencies were welcome to participate in its meetings. 35. The Cormnittee agreed that Mr Paul Marc Henry, Chairman of EDAP, would be the focal point for reports on economic development. (ii) Economic Development Unit 36. Referring to discussions which took place during the first meeting of the Economic Development Advisory Pane1, WHO requested that the role of the Programme economist be c lari fied. 37. The Cormnittee agreed that the terms of reference as detailed at the eighth session of the Steering CotrElitt""l ,"." valid. In this respect the importance of maintaining an up-to- date record of all development actions planned at nat.ional and regional level within the Prograume area \^ras emphasized. It was also mentioned that one of the functions of the economist was to assist the Prograrrne Director by receiving visitors to the Programme concerned with economic development, 38. FAO informed WHO that after consulting the official documents relating to the Programe, the channels of courmunication betr^7een the Economist and FAO would be defined and submitted to the Steering Comittee. L. PR0GRESS REPORT ON THE 0NCHOCERCIASIS CONTROL PROGRAI'{ME 39. The Prograrnme Director informed the Corunittee that insecticide treatment which had previously been suspended on certain rivers in the Phase I area had now been resumed, and in Phase II all Ehe.rivers were flowing and under treatment, A11 sectors and sub-sectors were now oPerational, with the exception of Niamey: the Country Protocol having been signed by the Government of Niger on 10 June, this base would come into operation in about 1O daysr time, 1 Eighth session report, paragraph 46 8- 40, The Conmittee was informed that the 1976 reinvasion was following the same pattern as that in 1975. The research programre initiated for the study of this problem had already indicated that at least some of the invading females originated from the forest area. It had been decided to Ereat the lower Bandama below Lake Kossou, where there were a number of pro- ductive breeding sites, on an experimental basis for a period of four t,o five weeks to check the impact of such treatment on the Simulium population in the zone under rei.nvasion. 41. In the field of epideniological evaluation, basic evaluation work had been almost com- pleted in selected villages in Ghana, Ivory Coast, and Upper Volta. Surveys had begun in eastern Mali.. M. OTIIER MATTERS 42. Dr A. Bellerive introduced Dr T. Lepes who would represent WHO on the Steering Cornmittee. On behalf of the Coururittee Mr Aribisala welcomed Dr Lepes who att.ended the second day of the session. Arrangements for the third session of the Joint Coordinatins CouuriEtee 43. Dr M. G. Candau informed the CormiEtee that he had r,rritten to the Government of Upper Volta regarding their invitation to hold the third session of the Joint Coordinating Corunittee in Ouagadougou, He reconmended that any decisions regarding the arrangements should be deferred until a reply had been received. N. ARRANGB,IENTS FOR TI{E NEXT SESSION OF THE STEERING COMMITTEE 44. It was agreed thaE the nexE session of the Steering Conoittee would take place in Geneva on 28-29 September 1976. O. ADOPTION OF TIIE REPORT 45. The Comnittee reviewed and adopted Ehe present rePort. P. CLOSURE OF THE SESSION 46. In closing the session Dr Bellerive thanked the mernbers for the help he had received in carrying out his duties, and hoped that the exceptional spirit of cooperation r^rhich had always prevailed in the conrmitEee would continue in Ehe future. I i I 9PARTICI PANTS Members of the Steering Conunittee I,Ir T MrM DrA MrG S. B. Aribisala, FAO Headquarters, Rome Ls. Bazin, IBRD Headquarters, VJashington Bellerive, WHO Headquarters, Geneva Pennacchi-o, UNDP Headquarters, New York ANNEX 1 I I Secretariat FAO Headquarters Mr C. G. Groom, Senior Officer, (Policy and Planning) Agricultural Services Dlvision Mr M. J. Sharpston, Econooist, Western Africa Dr P. ZLegLer, Progranrme Director World Bank Headquarters Onchocerciasis Control Prograuune Headquarters, Ouagadougou WHO Headquarters Mr A. Groenendijk, Director, Division of Budget and Finance Mr A. Imbruglia, Chief, Budget Unit Mr C.-H. Vignes, Chief, Constitutional and Legal Matters, Legal Division Mr J. D. M. Marr, Entomologisr/Biologisr, 0nchocerciasis Control Prograrure Dr E, Onori, Epidemiologist, Onchocerciasis Control Programme Dr G. Qu6lennec, Enromologist/Chemist 0nchocerciasis Control Prograrrre Miss R. Villars, Administrative 0fficer, Onchocerciasis Control Prograrme Dr M. G' Candau, Independent Chairman of the Joint Coordinating Conrmittee, and Mr E. P. 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