Onchocerciasis Control Programme in West Africa: Committee of Sponsoring Agencies, report of the thirty-eighth session Washington, 13 and 14 April 1989

l!- RESTRICTED ocP/csA/38 ENGLISH ONLY ONCHOCERCIAS]S CONTROL PROGRAMME IN !{EST AFRICA COMMITTEE OF SPONSORING AGENCIES Report of the thirty-eighth session ldashington, 13 and 14 Apr il lg8g ocP/csA/38 page 2 Page 3 3 3 3 4 4 5 5 5 6 6 7 7 B B B A. B. c. D. E. F. G. H. I. J. K. L. M. N. 0. P. OPENING OF THE SESSION ADOPTION OF THE AGENDA APPROVAL OF REPORT OF CSA.37 MATTERS ARISING FROM REPORT OF CSA.37 FINANCIAL STATEMENT FOR 19BB TRANSFER OF FUNDS WITH]N PROGRAMME ACTIVITY MODIFIED BUDGET FOR 1989 DEVOLUTION SOCIOECONOMIC DEVELOPMENT ARRANGEMENTS FOR NOC MEETING PROGRESS REPORT AND FUTURE STRATEGY OF DONORS' CONFERENCE EVALUATION OF OCP AS PROPOSED IN JPC.9 DATE AND PLACE OF NEXT CSA SESSIONS ANY OTHER BUSINESS APPROVAL OF REPORT OF CSA.3B ANNEX 1 PARTICIPANTS 0cP 9 2ocP/csA/38 page 3 A. OPENING OF THE SESSION 1. The thirty-eighth session of the Committee of Sponsoring Agencies was held at the World Bank, Washlngton, on 1l and 14 April 1989 under the chairmanship of Mr Florent Agueh. B. ADOPT]ON OF THE AGENDA The following agenda was adopted: 1. Approval of Report of CSA.I/ 2. Matters arising from report of CSA.I/ 3. Financial Statement for 19BB 4. Transfer of funds within programme activity 5. Modified budger for 1989 6. Devolution 7. Socioeconomic development B. Arrangements for NOC meeting 9. Progress report and future strategy of OCp 10. Donors' Seminar 11. Evaluation of OCp as proposed in JpC.9 12. Date and place of next CSA session 1J. Approval of report of CSA.3B c. APPRoVAL 0F REPoRT 0F CSA.37 3. The report of CSA.I/ was formally approved. D. MAT"IERS ARISING FROM REPORT OF CSA.37 1. The 1et!er-from-Mr w.!{. Furth (item E.6) was discussed at the StandingCommittee of TDR and it was agreed that there was already a cross-representationof certain EAC members in TDR committees which would meet requirements regarding appropriate flow of technical inforruation from one programme to the other. ocP/csA/38 page 4 5. Future of OCT activities (item E.J): The committee endorsed the need for research to continue towards finding a macrofilaricide which, according to recent reports and current projections, may not now be available until after7997. By L992, responsibility should be transferred entirely to TDR but in thatprogremme a nechanism must be found to maintain appropriate emphasis. The JpCshould be advised that the Participating Countries will need a macrofilaricideto accomplish the task of onchocerciasis control more effectively and that aftera certain date OcP would stop funding Ocr and TDR would 1ikely ai"rrreresponsibility. In light of projected needs, the OCT budget for the remainder ofthe third Phase should be redefined. Thereafter, a smaller Fmount should beretained in the OCP budget in support of this activity, as an indication of theProgramme's interest and commitment, 6- The Committee was informed that four contractors were preselected in Januaryto bid for the next Aerial Spraying Contract (item F.9). -One had since droppedout, but three bids were expected to Ue opened on 22 lttay L)g). 7, EAC membership (item G.1l): The Committee agreed that a list of Africansinvolved in drug distribution systems should be prepared with individualbackgrounds' as a source from which future EAC mlmblrs may be drawn. Managerswith experience in population-based chemotherapy from other countries may be added to the list. The Committee also "pprorred- the invitation of Dr A. Davis,retiring Director of the WHO Parasitic Diseases Programme, to attend EAC.10(scheduled for 12 - 16 June 1989). B. The Committee accepted that it was more appropriate that Donor Visits (itemH.1!) be coordinated between WHO and the Bank ratner ttan co.,si.aeiEdE CSe sessions. E. FINANCIAL STATEMENT FOR 1988 9. The Comnittee noted that the expenditure for 1p8B anounted to US $27 9ZL 273indicating savings of US $1 544 727 in the approvei buaget of uS $29 466 oo0. F. TRANSFER OF FUNDS WITHIN PROGRAMME ACTIVITY 10. The committee was informed that, in its 1!BB statement, there wereexpenditures in four ProgrFmme activities exceeding the 10 I allowed by WHO.The Connittee concurred with these over-expenditures pending fornal approval bythe JPC; it agreed that, in future, any new activity or increase in activityresulting in any impending increase of expenditure of more than 10 I above thatin the approved budget wirr be referred to the chairman of the cSA forappropriate clearance. ocP/csA/38 page 5 G. MODIFIED BUDGET FOR 1989 11. According to WHO financial regulations any "contribution in kind" must be valued and recorded in the budget. In line with WHO regulations the donation of ivermectin to the Progrnmme would require modifying OCP's 1989 budget. The Conmittee considered it counterproductive to reflect the j.vermectin which had no true cost value to the Programme in the budget, and recommended that to meet WHO's requirements, the record of such supplies should be shown in a supplementary line below the OCP budget total each year, EIn explanatory note being appended. H. DEVOLUTION 72. The availability of ivermectin. has changed the concept of devolution and national participation in ivermectin distribution is progressing actively. The countries themselves have been involved in this activity from the start and by 1997 should be sufficiently experienced operationally to assume responsibility for whatever maintenance activities remain thereafter. However, some structure must be in place for this to become a reality. 11. The Committee agreed that emphasis should continue to be given in the first instance to Mali, Niger and Ghana to prepare project proposals, similar to that for Burkina Faso, for presentation at the Donors' Conference and JPC.10. AIso, guidance should be given to Burkina Faso to help it to obtain the funding necessary to put its proposal into action. In this respect, UNDP would contact its representative in Ouagadougou. 14. The Committee considered it prudent to develop and test institutional mechanisms and activities to support devolution in these countries, which could then form the basis for similar structures later in the other countries of the Programme. There should be a clear distinction between implementing the control strategy, which is the responsibility of the Programne, and preventing recrudescence which will be the responsibility of the countries, and which is thus devolution. L5. It was agreed that Bank and WHO personnel would visit MaIi and Ghana in May and early July respectively in relation to devolution. I. SOCIOECONOMIC DEVELOPMENT t5. tfre Committee was informed that since CSA.37 an SED mission had been conducted in C6te d'Ivoire. Plans were on hand to comptete the first round of such consultations by July 1989 with visits to Sierra Leone, Guinea, and Guinea-Bissau. It was felt that second visits to certain countries where missions were held prior to release of the Hunting Report might be useful to ensure l-ocal-follow-up to the development proposals and initiation of National Oncho Zone Development Studies (N0ZDZ). The Hunting report has now been distributed to all Agency Representatives in the Participating Countries and to the Donors. ocP/csA/38 page 5 17. The Committee was also informed that the Inception Report from the Institute for Development Anthropology had just been received. Each Agency was requested to review and comment on it by 30 April, taking into consideration the requirements set out in paragraph 6.4 (b) of the Terms of Reference. 18. FAO and the krlorld Bank were asked to prepare a stocktaking document for the next CSA which would review the results of the first round of SED consultations. A principal objective of such an exercise would be to deternine whether the consultation missions have proved useful in catalyzing development activities in the oncho zones within the overall framework of national development strategies, and whether these consultatj.on missions should be continued. The stocktaking document would also consider alternative mechanisms for monitoring and promoting SED follow-up at the national 1eve1 within the oncho areas, including the possibility of selective visits to the beneficiary countries. J. ARRANGEMEI{TS FOR NOC MEETING 1!. Consequent to the indication at the Conakry NOC that the next NOC meeting should be amongst the Participating Countries' representatives without the presence of CSA members, the Committee agreed that a technical meeting should be arranged accordingly on 6 and 7 June. OCP will, as usuaI, be responsible for all the organization. 20. The meeting would discuss Devolution and Socioeconomic Development. OCP would be responsible for the input to the item on devolution. For socioeconomic development, Mr Zongo of OCP would coordinate the programme based upon suggestions for the agenda from the CSA agencies. K. PROGRESS REPORT AND FUTURE STRATEGY OF OCP 21. The Committee was informed of the decision, followj-ng clearance of ivermectin for large-scaIe distribution at a joint TDR/OCP meeting in January and a review of activities at a recent Progrnmme seminar, to expand the role of this drug in the Programme operations. fn 65 I of the 0riginal area CMPL is virtually zero and rapidly reducing to that level- in another 25 /,, Vector control in the Southern Extension area r^ras proving very effective and, consequent to the epidemiological mapping of the hlestern Extension, seasonal and selective larviciding is being implemented in that area as far as Sierra Leone. 22. T}:e Committee recommended that the future strategy of OCP should be presented to the Donors in a manner which will emphasize continuity and stability and should address the following: - the possibility of attaining the objective of OCP through vector control complemented by judicial use of ivermectin; - the implications of the strategy on the timefrane of OCP; - management requirenents related to the introduction of ivermectin; - financial schedules. ocP/csA/38 page 7 L. DONORS' CONFERENCE 23. The Donors'Conference will be held in Paris on 18 and 19 October 1989. 24. ttre following proposed agenda was discussed. 1. Progranme status report on operations 2. Progress report on devolution (Burkina, Ma1i, Niger, Ghana) l. Progress report on socioeconomic development (Land Settlement Review) 4. Financing for remainder of Phase Three !. Phase Four: - objectives - strategic framework - approximate costs - preparation arrangements (schedule for preparation, discussion, and approval of Phase Four Plan of Operations) 6. Terms of Reference for external evaluation of Programme 2J. The Committee considered it appropriate to readjust the order of the agenda items and to add an additional item after (1) above which would address the latest developments in the strategy of combining the use of ivermectin and vector control through the remainder of the third Financial Phase. 25. With regard to Phase Four the Committee recognized the difficulty at this stage of indicating approximate costs for the six-year period and noted that any detailed costing should be deferred until a later Donors' meeting. Even by October 1!!0, with changes in the mix of the two control tools, it could be difficult to present precise figures, but it was emphasized that to secure long- range Donor commitments, some order of magnitude projection for the entire Phase would be essential by then. Some consideration was given to dividing the Plan of 0perations for the fourth Phase into two parts, in order to enable greater precision to be given to the Donors during the first part of the Phase. This will be reviewed in greater detail at a later CSA meeting. M. EVALUATION OF OCP AS PROPOSED IN JPC.9 2J. The suggestion at the ninth session of the JPC was that I'an external evaluation be conducted before the end of the third Financial Phase to assess progress towards achieving Programme objectives and towards devolution and socioeconomic development." It was agreed that the evaluation would take place under the auspices of the CSA, with the !rl<.lr1d Bank responsible for amanging financing which is expected to be available from various sources within the ocP /csA/38 page 8 cument Donor community. The evaluation would consist of an exercise of assessing progress to date in each of the above areas (Programme objectives,devolution, SED) and in projecting what is required to achieve the irogramne's objectives by the end of the 1990's, to sustain them thereafter, and tocapitalize on development opportunities resulting from disease control. USAID would be contacted by the Bank and informed of CSA decisions regarding theexternal evaluation. 28. Given the time constraint the CSA recommended that a consultant be appointedto prepare the Terns of Reference and the profiles of the five to six experts who will be required on the evaluation team. The draft TORs, expert profiles, and the covering transmittal letter to the oCP Donors will be tabled at CSA.39in Ju1y. The Donors will be invited to submit candidates for the team leaders and expert posts. The final- TORs, the expert team, and the work plan wil1 bedistributed to the Donors for consideration at the october 1!B! Dtnors;Conference. Final approval for the review woutd be given by JpC.10 in December7989. 29. The expert tean will undertake field visits in January - February 1!pO andthe team leaders will complete the first draft for presentation to the CSA atthe end of April 1!t0. N. DATE AND PLACE OF NEXT CSA SESSIONS 30. CSA.39 will be held in London on 26 and ZJ JuIy 1999.to be held in Paris on 14 and 1! September 1!B!. CSA.40 is scheduled O. ANY OTHER BUSINESS J1. The problems related to recruiting a replacement for the OCp Chief ofAdministration and Management were presented to cSA with a request torepresentatives to assist in finding a suitable candidate. 12. The Conmittee considered the need for an updating of the ,,Mara" film toinclude the use of iveruectin. ocp will fol1ow this up with Merck and co.and an independent film naker and report to the next session of csA. P. APPRoVAL 0F REPoRT OF CSA.3g 33' The report of CSA.38 will be circulated to those present and formal approval-given at CSA.39. t, ocP/csA/38 page 9 ANNEX 1 Members PART]CIPANTS Mr Florent Agueh (Chairman) Mr Bruce Benton Mr Jorgen Lissner Mr Cyril Groom Dr Ebrahim M. Sanba Dr C.-H. Vignes World Bank I'NDP FAO t'JH0 Secretariat: Ms Nicole Glineur, Economi.st, Onchocerciasis unit, popuration andHunan Resources Division, Sahelian Department, World Bank,Washington Dr Bernhard Liese, principal Tropical Disease Specialist, population and Hunan Resources Department, World ganL, Washi"Sto" Mr J.D.M. Ma*, chief , ocp Liaison ,ffice, wH,, Geneva (secretary) Mr charres Pharand, chief, Administration and Management, ocp,0uagadougou Ms Elizabeth skinner, Research Assistant, 0nchocerciasis unit,Popuration and Human Resources Division, Sahelian Depa*tment, worldBank, Washington a