tocP/rAcfi'.L ONCHOCERCIASIS COI\ITROL PROGRAMIIIE IN THE VOLTA RIVER BASIN AREA REPORT of the FIRST MEETING of the TECiTNToAL ADvrsoRY coMMriTEE Geneva 18-19 Decenber 1974 ! I oce/rac/ts.r page 2 INTRODUCTION CONTEI.IIS 1. Page , 3 1.1 Opening of meeting L.2 Election of Officers . . l,1.3 Adoption of the Agenda 3 3 3 3 4 5 5 IL.4 General information on the I 2. PRSSEI.IT STATE OF PROGRESS OF TIM I 3. RESEARCH AND TMINING ACTIVITIES I 3.1 Research on the v€ctor, on implementation of the Programme PROGRAMIM ASSOCIATED WIIII T}M PROGRAMIM its control, and on the protection of I environment I 3.2 Epideniological Evaluation and Research I3.3 Training I 4. NEXT MEETING OF TAC AND VISIT TO T}M ONCHOCERCIASIS CONTROL PROGRAMIM AREA ANND( ANND( 1: List of menbers of TAC 2: Terms of Reference of TAC l4lHO Secretariat: I Dr A. BUCK, Senior Medical Officer, Epideniological Methodology and Clinical Pathology, Headquarters I Dr J.IHAMON, Chief, Vector Biology and Control, Headquarters I Dr J.rD. M. MARR, Enttmologist/eiofogist, Onchocerciasis Control Progranme, Headquarters 'l I or C.IQUELENMC, Entomologist/Chenist, Onchocerciasis Control Progranme, Headquarters l Secretary of the meeting: IDr A. BELLERIVE, Director-Consultant, Onchocerciasis Control Programme, Headquarters J oce/rac/zs.r page 3 1.. IMRODUCTION 1.1 Opening of meeting Dr L. Bernard, Asslstant Director-Genera1, on behalf of the Director-General of the World Health Organization (WHO), opened the meeting and welcomed the members of the Conmittee (Annex 1). In his introductory r€marks, he explained the roles of the various bodies involved in the Onchocerciasis Control Programme (OCP). After outlining the disciplinary representation of the_Technical Advisory Committee (TAC) and defining its terms of reference (Annex 2), Dr Bernard emphasized that menbers should act individually wfth complete independence, and collectively play a dynamic role in the Onchocerciasis Control Programme; not merely by serving as a catalyst between the Scientific Advisory Panel, WHO and the Steering Committee, but also by initiating necessary recommendations on matters ranging from evaluation criteria to training. ' The Chairman of TAC (elected At each meeting of the Committee without prejudice to future eligibilitl) or his representative will attend meetings of the Joint Coordinating Comittee. L.2 Election of Officers Dr.P. G. Janssens was elected Chairman, Rapport€urs. 1.3 Adoption of the Agenda and Dr J. Mouchet and Dr M. Laird were elected , . While the Agenda was adopted without modification, TACrs initial designation was not felt to be fu1ly descriptive of the Conmittee's role. It was considered, and is so recommendedr that a better title would be rrscientific and Technical Advisory Committee" (STAC). L.4 General information on the implementation o:E_j!,tre Elegrgsae Dr A. Bellerive described the organizational pattern developed to guide the direction and i inplementatlon of the Programme, from the specialized programme units in ouagadougou to WHO head-quarters. He stressed the importance of the NatlonaL Onchocerciasis Conmittees in, .for exanple, such matters as training needs, which will obviously vary from country to country. 2. PNESENT STATE OF PROGRESS OF THE PROGNAMME Dr G. Qu6lennec presented a detailed review of ope"at:.ona1 aspects, the stite of personnel recruitment, the n€thods adopted for treatment and surveil-lance and interactions between the two latter activities. Announcing that the actual operational progrn-me was initiated(following unusually prolonged rains) as recently as IO Decexober, he sketched out the support arangements. These include a telecommunications network which will be fully operatlonal by March 1975. The Committee expressed its appreciation of the quality and totality of the conc€pt and background documentation prepared by the Preparatory Assistance to Governments Mission and provided to its members by WHO. It also recognized that these papers comprise a good example of how such a vector control programe should be approached, and that they will long be vaLuabLe not only for the Onchocerclasis Control Programme but also for all who are interested in the advancement of the area concerned. " It was strongly felt by the Comnittee that the epideniological evaluation should be comprehensive and include both the nedical and entomological aspects. With regard to the latter, it was agreed that the capturing of adult sinuliids at present affords the best means of monitoring the vector population and of detecting possible gaps in the operational progremme. 3. oce/rac/zs.t i The Cormittee recognized the virtual inpossibility of obtaining exhaustive and consistent entomological baseline data before initiating a project on such a scale as the Onchocerciasis Control Programme. It nevertholess urged that maximum use be made of all the relevant information that has been accr:mulated over the past quarter of a century in considerable areas of the zone now under treatment, and all the data rvhich will be collected, to develop - as comirlete a picture as possibl.e of the ecosystem of the Programme ar€a and the disease problem, as an essential background to a1I aspects of the Prograrnme. 'rd" Conmj.ttee requested WHO to prepare a preliminary draft of the syst€m to be used for data storage and analysis for the next meeting of TAC. It recommended that the need for rapid field analysis of data for operational purposes should be balanced with the storage of I The Committse concluded that there was no evidence that Abate was toxic to man in the doses proposed for the control of S. damnosum. Nevertheless, it was recommended that other organophosphorus compounds should not be used in the chemotherapeutic treatment of personnel involved in handling concentrated insecticide. t RESEARCH AIID TR.AINI}IG ACTIVITIES ASSOCIATED WITH THE PROGRAMMN l 3.1 Research on the vector, on its control, and on the protection of the environment I Mr J. D. M. Marr presented a status report and subsequent to discussions, the Committee nade the following recommendations: i - (a) because the lack of self-sustaining laboratory colonies of simuliids (especially vector strain of Simulium damnosum) is a major impediment to the study and control of onchocerci".is tnE-e-Eiifi--L?ffificient funding assured for research aimed at ""t"b1i"t irrg "l'(b) because, at present, cytotype determinations rely entirely on the examination of the Iarval forms, it is desirable to find methods of determining cytotypes in adult S. damnosum. Cytogenetic, biochemical, immunological and morphological and other methods should be investigated; ,,(c) because retiable means of sampling populations of adult sinuliids are basic to the proper conduct and surveillance of the Onchocerciasis Control Programme, e-[{!;as possible a range of methods should be explored; I 'I (d) because species and individual host attractiveness is a highly variable factor, e effort should be made to dete:mine the actual basis of such variabilit 1 (e) because it is essential to ascertai-n where adult simuliids rest, particularly while incubating their eggs following a blood neal, the early gaining of such knowledge as regards Simuliu4 damnosum, should be ,"€eld"g_3g tant; I(f) because more is known about sinuliid larval ingestion than nutrition, and because ingestion of particulate matter is important in relation to the efficiency of insecti- cides, Iarval fitter-feeding behavj.our should be investigated in detail. _l"l To implement some of the reconmendations made by TAC, it will be necessary to identify institutions and indivicluars to carry out the work. The comnittee therefore suggested that meDbers of the scientific Advisory panel should be asked for their advice in this respect ind on thd scientific proposals made' in this report. The committee noted the interest of the united Natlons Envirorunent Progranme (UMP) in the onchocerciasis control programme and recommended that this Agency be more closely involved in maiters concerning the envirorulent. oce/rrc/zs.t page 5 3.2 Epi.demiological Evaluation and Research This subject was reviewed by Dr A. A. Buck but in view of the limited tine available it was not possible to discuss it fulty or include recormendations. It was agreed that considera- tion of these matters would be given priority during the next meeting. 3.3 Training Dr G. Qu6lennec explained the training component of the Prograrome and in particular what had been accomplished in l-974 at the Centre Entonologique de ltOnchocercose, Bouak{ in training entomologists and technicians. The Comnittee suggested that more attention be paid river ecology. Further discussion on this was defemed in the training course to the global until the next meeting. COIVTROL PROGRAMIIIE AREA4. NE)(T IlIEETING OF TAC AND VISIT TO TIIE ONCHOCERCIASIS The Conrnittee decided to hold its next meeting from 3 to 5 June 1975. Before that date certain members will visit th€ Programme area in groups of three to four for a period of approximately one week. The necessary arrangem€nts will be concluded by the secretariat in association with the Programme Director.
Dr Colvin GIBSON Dr Peter HASKETL Dr Pieter c. JAI.ISSENS Dr Herman.KNUTTGEN Dr Friedrich KUHIOW Dr Marshall IAIRD Dr Christiann LUCIASSE Dr James MILES Dr Jean MOUCI-TET Dr ceorge S. NELSON Dr Letitia E. OBEIG *Dr F61ix SERIE ocv/rrc/zs.t page 1 ANNEX 1 MEMBERS OF THE TECHNICAL ADVISORY COMMITTEE Assistant to the Director for Conrnissi.oned Officers National Institute of Health BETHESDA, Maryland, United Stdtes of America Director, Centre for Overseas Pest Research I4@,. United Kinsdon Director, Prince Leopold Institute of Tropical Medicine AMWERP, Belgium Director, Institute of Tropical Medicine University of TUbingen, Ttlbingen, Federal Republic of Germany Director, Liberia Research Unit IITIQNBOVIA, Liberia Research Professor (Parasitology), Department of Biology Memorial University of Newfoundland ryj, Newfoundrand, canada Chief, Ye11ow Fever Research and Production Unit Institute of Tropical Hygiene, Department of Microbiology AMSTERDAM, Netherlands Chief, Pesticides Branch, Vector Biology and Control Division Bureau of Tropical Diseases, Center for Disease Control p[l{T$, Georgia, United States of America Inspecteur g6n6ral de Recherche, Office de Ia Recherche Scientifique et technique outre-mor, Services scientifiques centraux, @, France Director, Department of Medical Helminthology London School of Hygieno and Tropical Medicine IONDON, United Kingdom (Director, Institute of Aquatic Biology, Ghana), c/o Unitea Nations Envi.ronment Programme, MIROBI , Kenya Directeur g6n6ra1 de la Sant6 pubtique, MinistBre de 1a Sant6 publique, ABIDJAN, C6te dtlvoire l. Dr Serie was unable to attend the meeting.
ocP/r^cfis.L page I _ ANND( 2 Introduction TIRMS OF REFERII.ICE OF THE IECHNICAL ADvISoRy CoMMTTTEE The Governments of Dahomey, Ghana, Ivory Coast, Ma1i, Niger, Togo and Upper Volta concluded, on I November 1973, an Agreement with'th6 WorLd Health Organization for the implementation of the twenty-year Onchocerci3sis Control Programme in the Volta River basin aroa, and.agreed to the Organization serving as S<ecuting Agency. It was agreed that the Organization would bo assisted in that endeavour by a'specially established Scientific Advisory Panel (SAP). Twe1ve members'of.the Panel, specialized in the main scientific and technical fields concerned by the Progranms activities,-wilI be appointed by the Organization to forn the. Onchocerciasis Control Programme Technical Advisory Corrmittee (OC?/TiAC). The Onchocerciasis Control Programme fecnnicaf Advlsory Committee is establj-shed to assj.st.the Organization in the pemanent.scientific and technical evaluation of the plans and operations of the Programe and its associated training and research activities. The menbers of the OCP/TAC are speiialists who undertake to contribute without renumera- tion, each in his,own fieldrrto the evaluation of the progrnmme. ' ^,1 ' .r ' i t ! v , , Purpose and Functions of the Technical Advisory Conmittee ri.: Tho purpose and functions of the Conmittee shall be: -;,-..,rto review ths latest knowledge and scientiflc information available in all fieLds related rrJ:." t9- !-he.Onchocerciasi.s Control'Progrnmme and to nake it available to the Organization; 3''air::' .!, :- . I '. -..' '. to analyse and coment on the technical and scientific reports of th€ Progremme and plans of action; - to make recommendations designed to improve the planning of the Programme and the implementation of its activities. The Conmittee shall not advise the Organization on questions of administrative policy and its conclusions and recommendations on technical and scientific matters shall not conmit the Organization. The menbers of the Comittee shall be selected by the Director-General from qmong the members of the OCP/SAP on the basis of their abllity and.experlence. In view of the great flexibility required in the planning and operations of the Programme, tEembers of the Committee shall be appointed for a period of two years without prejudice to reappointment. ALl menbers of the Comnittee shal1 be convened in consultation with the Chai:man of the TAC to attend the periodic meetings iryhich wilL be held at least twice a year. The Organization may organize additional meetings. The Organization will mak€ arrangements for members of the TAC to visit the Programme area if necessary. ocnfucfts.r paget2 I I Annex 2 , I I In accordance with the administrative regulations of the Organization, a member of the OCP/TAC attending the periodic meetings of the Comnitteer or any working group session of the OC//SAp to which ne miy have been convened, sha1l be entitled to a refund of travelling expenses necessitated by their attendance and also to a daily living allowance during such meetings and sessions. l lInteinational Status of Members ,- Itn tne exercise of their functions the members of the OCPfTAC shall act.as international 'l .*p."t" serving the Progrenme exclusively; in that capacity they nay not request or recej-ve instructions from any goverDments or other authority. ] tn.y shal1 enjoy the privileges and inmunities envisaged in Article_67 (b) of theConstitution of the Organization and set forth in the Convention on the Privileges and Inmunj.ties of the specialized Agencies and in Annex vII thereof. I ' I lm" OCn Support Unit at the Organization Headquarters'shall'provide the Secrbtarj.at at a1l Coumittee meetings and shall arrange the tine and place of each session and shall convene the nembers. ll lRt eacfr session"the Connittee'shalt elect a Chairman from its'members to direct its debates, and one (or two) rapporteur(s). The chairman lnay be reappointed. Theworking1anguagesoftheocP/TAcsha11be.Errg1ishandFrench."., At each session the Conmittee shal1 draw up a report setting forth its findings, observations and recommendations. Such reports shall be forwarded by ltllHo, with i.ts cooments thereon, to the'steering Committee. The Steering Committee shall transmit the reportsi with its observations, to the Joint Coordinating Committee (JCC)I not less than, thirty. days before the'Joint Coordinating Conmittee's annual meeting. :l , ' tn" Joint Coordinating Comnittee is composed of representatives of the'seven participating Governments of all Contributing Parties and of the four Sponsoring Agencies. ,i