Onchocerciasis Control Programme in West Africa: Committee of Sponsoring Agencies, report of the forty-third session, Washington, 4 – 6 April 1990

RESTRICTED ocP/csA/43 ENGLISH ONLY ONCHOCERCIASIS CONTROL PROGRAMME IN !{EST AFRICA COMMITTEE OF SPONSORING AGENCIES Report of the forty-third session 4-5 April 1990 I I I i ocP /csA/43 page 2 ANNEX I: ANNEX 2: A B c D E F G H I J K L CONTEI,ITS OPENING OF THE SESSION ADOPTION OF THE AGENDA APPROVAL OF THE REPORT OF CSA.42 MATTERS AR]SING FROM THE REPORT OF CSA.42 PREPARAT]ONS FOR PHASE IV EXTERNAL REVIEW OF OCP DONORS' MEETING FUTURE 0F oCT FRoM 1992 oNWARDS NOMINATIONS FOR EAC MEMBERSHIP LAND SETTLEMENT REVIEW ANY OTHER BUSINESS DATES AND PLACES OF FUTURE CSA MEETINGS Page 3 3 3 3 3 4 5 5 5 5 5 7 PARTICIPAI{TS MEMBERS OF THE EXTERNAL REVIEW TEAM 8 9 B2 ocP /csA/43 page 3 A. OPENING OF THE SESSION 1. The forty-third session of the Committee of Sponsoring Agencies was held in Washington D.C., U.S.A. during 4-6 April 1990 under the chairmanship of Mr Florent Agueh. In his opening remarks the Chairman gave a special welcome to Mr Andreas Papasolomontos, Director, Agricultural Services Division, Agricultural Department, FAO, who r,i,as attending the session on behalf of FAO for the first time. ADOPTION OF TTIE AGENDA The agenda, as presented in the contents list of this report, r^,as adopted. C. APPROVAL OF THE REPORT OF CSA.42 3. After agreeing upon a few small changes, the report of CSA.42 was formally approved D. MATTERS ARISING FROM THE REPORT OF CSA.42 4. Exchanses between WHO /AFRO and OCP (item 8.5): it was reported to the Committee that an epidemiologist assigned to the WHO/AFRO Sub-regional Office in Bamako to liaise with OcP, had been briefed by OcP on epidemiological surveillance activities and r^ras currently participating in an ivermectindistribution progremme. 5. With regard to the recruitment of professional staff for the Progranme, the Committee recalled the importance of ensuring that only the best qualified candidates were selected. In this connection, the Comnittee noted that in a recent case, selection had been made which did not appear to comply with established WHO procedures. The Committee decided to approach WHO on this issue. E. PREPARATIONS FOR PHASE IV 6. The Committee congratulated the Programme on the excellent first draft Plan of Ope rations for the Fourth Financial Phase (L992-t997) which had beendistributed to CSA Members in a very timely way. 7. In concluding a detailed discussion of the draft Plan of Operations it was agreed that greater emphasis should be placed upon the strategic aspects andimplications of the most important issues facing the Programme. This applied especially to the subjects of macrofilaricide development and the sustainability of the devolution process by national health services. 8. The Comnittee agreed that before decision-making discussions of budget options for Phase IV could be held, it would be necessary for the Progra.mme to carefully double - and cross check the technical and administrative statistics which had formed the basis for making budget forecasts. This should receive timely attention so that a second draft Ptan of Operations would be availablefor review by the Expert Advisory Committee (11-15 June, 1990) and during the 44th session of the CSA. ocP/csA/43 page 4 F. EXTERNAL REVIEW OF OCP 9. The Committee was informed that a 7-nan Bxternal Review Team had been assembled and that the Team was, at the time of CSA.43, gathered in the WorldBank, Washington for briefing by Bank officials and by the QCP ProgrammeDirector. Team Members are listed in Annex 2. 10. The Committee commended the World Bank for its efforts in putting together such an impressive team of experts and urged that the earliest attention begiven to all the administrative and travel arrangenents which had to be completed before the Tean Members could visit the different countries of the Programme area (scheduled to commence in earry-mid May 1990). see arsopara 13. 11. 0n I April the External Review Team met with the Committee so that their respective members could be introduced to each other, and in order to giveindividual Team Members the opportunity to discuss the areas of the review to be covered by them and to present tentative timetables for their various activities. L2. In welcoming the External Review Teem, the Chairman of CSA stressed thegreat inportance of the External Review for the future of the Progranme and expressed his appreciation to the individual Team Members for making the effortto be available as a complete team to meet the members of the CSA to discuss thekey issues of the Review. 13. In his reply, the Tean Leader, thanked the CSA for the confidence it hadbestowed upon the Tean Members and for the arrangements which had been made forthen to visit Washington for discussions with World Bank officials and with theCSA. He also expressed the Tean's gratitude for the briefings it had receivedfrom the OCP Progrnmms lfpsctor. He then proceeded to outtine the tinescale ofthe Teams' activities, viz: - positioning of nost Team Menbers in the Programrne area by 11 May, - briefings in OCp/He, Ouagadougou, 1!-16 May, - field visits to Participating Countries, mid-May to early June, - meeting with the Expert Advisory committee in Ouagadougou,17-tj June, - further field visits, until the end of June, - report-writing throughout JuIy and August so that a first draft report could be available for review by the csA in early Septenber, - finalization of the report by nid-september (at which time the Team would be disbanded), so that it could be distributed to Donors in advance of the Donors' Meeting scheduled for 1J-18 October. 14. Team Members then, in turn, described their individual fields of competence, outlined the roles they foresaw themselves playing in the Review, and' expressed their views on sections of the Terms of Reference of particularpertinence to them. During these presentations and the ensuing discussions, special attention was addressed to devolution, to oncho surveillance andtreatment during post-0CP, to socioeconomic development and to analysing the keyfactors which have contributed to the success of OCp. ocP/csL/43 page 5 G. DONORSI MEETING 15. The Committee reaffirmed the importance of a Donors' Meeting being held during 1990, to provide Donors with previews of the Plan of Operations for thefourth Financial Phase (L992-L997), of the Report of the External Review and of the Land Settlement Review (this latter to be introduced by a verbalpresentation based on the conclusions from a seminar for ParticipatingCountries, co-sponsored by the World Bank, UNDP, FAO and OCP, and arranged to beheld in Ouagadougou from 2J Lo 2J September). It was agreed that the Chairman of the CSA would present a verbal report on the Donors' meeting to JPC.11. 16. It was agreed that the Donorsr meeting would be held in the lr,orId Bank,Paris during 17-18 October. It would be preceded, on 15 October by the 45th session of the CSA. H. FUTURE 0F oCT FRoM 1gg2 oNWARDS 77. The OCP Programme Director informed the Committee that, he had recently haddiscussions on the future of OCT with Director TDR and Project Manager 0CT.With regard to a possible merger of OCT and TDR/FIL, various options were being exanined for the institutionalization of a nerger, for the apportionment offinancial support costs and for reporting to the peer committees of OCP and TDR.Possible neasures for ensuring that the search for an onchocerciasis macrofilaricide renained the highest priority within any future OCT/TDR chemotherapy project, had also been given consideration. 18. The Comnittee considered that it would be premature to attenpt to formulate any realistic proposals for the future of OCT, based on the information currently available. The Committee therefore agreed that OCP/OCT/TDR dialoguebe continued and that the views of the Expert Advisory Committee be obtained. I. NOMINATIONS FOR EAC MEMBERSHIP 19. The Committee h,as informed that in February 1990 an ophthalmologist and apublic health administrator, both from Participating Countries, had been invitedto participate in the 11th session of the EAC. Unfortunately, it had been necessary to postpone the invitation extended to the public health administrator, as he had subsequently been recruited as a member of the External Review Tean. The appointnent of the ophthalmologist as an EAC menber !r,as approved by the Committee. 20. The Chairman of the CSA urged Comnittee members to give increased assistance to oCP in the identification of potential candidates for EAC membership, with emphasis upon persons originating fron Participating Countries OCP would establish an EAC membership roster, complete with curr'icula vitae and other biographical data, which would be reviewed at subsequent CSA meetings. J. LAND SEITLEMENI REVIEI{ 21. Prior to this session of the CSA copies of a draft Final Report of the Land Sett,lement Review (prepared by the Institute of Development Anthropology, New York, in February 1990) had been circulated to Conmittee members for their comments, and some suggestions had already been received by the Vrtorld Bank. TheCommittee noted that the deadline of receipt of additional conments by the authors of the report was l0 April 1990. The report would then be finalized and made available to participants of the seminar on socioeconomic development, scheduled to be held from 2J to 2/ septenber 1990 (see para 1!, above). ocP/cs^/43 page 6 22. Three nembers of the review consultant tea:n, Dr Thayer Scudder (Director), Dr De1la McMillan and Dr Thomas Painter, were invited to attend this session of the CSA to present their report and to receive the comments of CSA members. In welcoming the consultants, the Chairman CSA explained that this session of the CSA was a good opportunity for them to neet the CSA, as CSA nembers had already reviewed the draft final Report of the Land Settlement Review and were therefore prepared for constructive discussion with the consultants. 23. Dr Scudder introduced the draft report and gave a short overview of the social artd economic aspects of land settlenent, with special reference to the situations in Burkina Faso, Ghana, Mali and Togo. To further assist in placing the Land Settlement Review in its true perspective, each of the consultants explained the bases for and the inplications of ten major recommendations contained in the report. Finally it was explained that in finalizing the report, CSA comments would be taken into account, greater enphasis would be placed on the relationship between the Land Settlenent Review and the Hunting Reports, an annotated bibliography would be incorporated and various annexes would be added. 24. In opening the general discussion which foIlowed, the Chairman of CSA complimented the review team on the quality of the draft report and on the timely manner in which it had been made available. The World Bank would be sending written comments on the draft report to the authors but in the neantimeit was useful for CSA menbers to air some of their views individually. In this respect, the review tean was requested to take note of the following suggestions: - ensure consistency of terminology and provide definitions of some of the technical terms used, - give more information and clarification on some of the key issues, e.g. on land tenure systems and on the rationale for advocating rain-fed agricultural practices, - make the report more operationally orientated and provide specific guidelines which could be operationalized for tand developnent by the Participating Countries, - place nore emphasis on the control of diseases other than onchocerciasis (both human and aninal), - approach the subject of mechanized farming (including ox tractionpractices) with greater caution, - expand upon the exploitation of mineral resources especially with regard to gold-mining, - enlarge upon the environmental issues associated with land settlenent and the role of wonen in settlement-related activities. 25. In concluding these very informative discussions, the Committee agreed that during its 44th session attention should be given to defining the future role of the CSA in national development programmes and to the environmental aspects of land settlement and developnent. K. A}.IY OII{ER BUSINESS 26. The Committee was informed that representatives of seven non-governnental organizations (NG0's) and of the Mectizan Committee would attend a meeting in OCP/HQ, Ouagadougou on t April to discuss ways and neans of improving the t ocP/csA/43 page 7 delivery of ivermectin to individuals and comnunities outside the sphere of the Programme's joint distribution activities with national health authorities. The Connittee was impressed by the number of NGOrs attending this meeting, but urged that efforts be continued to attract other NGO's and private voluntary organizations (PVO's) into the ivermectin delivery progremmes. 27. It was was again brought to the attention of the Committee that funding for the devolution plan of Burkina Faso was still not forthcoming even though sone of the Programmers Donors had expressed interestl a problem nrhich was obviously not confined to Burkina Faso. 28. lrlhile acknowledging that the responsibility for securing devolution funding rested with the Governments of the Participating Countries concerned, the Conmittee agreed that it had an obligation to identify some of the fundingbottle-necks and to give appropriate advice. In this connection the Committee considered that Governments might be able to secure funding nore rapidly if they were to: - Adopt more forthright approaches to external fund-raising and to clearly demonstrate to potential donors that devolution was considered as a high priority. - Provide potential donors with precise information on national contributions and on proposals for the continuation of devolution activities beyond the period covered by the initial devolution plan. Ttrese would denonstrate continuing commitnent on the part of the Government. 29. Ttre Comnittee noted with great interest the initiative taken by the QCp Progremme Director and the LINDP Resident Representative to Burkina Faso in exploring funding for Burkina Faso at the local level using IJNDP as the focalpoint to attract funding from the in-country offices of Donors, as an alternative to considering direct funding by IJNDP and other potential donors.Negotiations would continue on the mechanisms for UNDP to take the coordinating role in such joint funding arrangements and on the possibilities for LJNDp toprovide sone funds. 30. Before closing the discussion of devolution funding the Comnittee agreedthat every opportunity should be tal<en for the CSA to discuss funding p*oblems with participating governments. Ttre forthcoming meetings of NationalOnchocerciasis Committees, of the Donors and of the Joint Programme Comnitteeprobably presented the best opportunities for such discussions. L. DATES AND PLACES OF FUTIIRE CSA MEETINGS 31. Ttre Connittee tentatively agreed upon the following schedule of CSA neetings for 1tt0: - csA.44 - csA.45 - csA.45 - csA.47 London Washington Paris Conakry early July 1990 5-5 Septenber 1tt0 16 0ctober 1990 2 and J December L99O. ocP /csA/43 page 8 ANNEX 1 Members Secretariat: - World Bank . I'NDP - FAO - [lIHo PARTICIPAI{TS Mr Florent Agueh (Chairnan) Mr Bruce Benton Mr Jorgen Lissner Mr Andreas Papasolomontos Dr Ebrahim M. Sanba Dr C.-H. Vignes Dr David Baldry, Chief, OCP Liaison Office, WHO, Geneva (Secretary) Dr Ole W. Christensen, OCP Consultant, WHO Geneva Dr Scott Guggenheim, Anthropologist, Agricultural and Rural Development, World Bank, l{ashington Dr Bernhard Liese, Principal Tropical Disease Specialist, Population and Human Resources Department, !{orld Bank, Washington Dr Tijan M. Sallah, Economist, Onchocerciasis Unit, Population and Hunan Resources Division, Sahelian Department, World Bank, Washington Ms Elizabeth Skinner, Research Assistant, Population and Human Resources Departnent, World Ba.nk, Washington Mr Jean-Baptiste Zongo, Chief ECO, OCP, Ouagadougou MEMBERS OF THE EXTERNAL REVIEW TEAM Dr Gerald Webbe, Sub-Dean Head, Department of Medical Helminthology London School of Hygiene and Tropical Medicine St Albans United Kingdon Dr Basile S.F. Adjou-Moumouni Project Associate Harvard Institute for International Development at the Zaire School of Public Health Kinshasa Zaire Mr Lawrence A. Dash Retired, former econonist with USAID Nesquehoning United States of America ocP/csA/43 page 9 ANNEX 2 Tean Leader HeaIth Administrator Econonist Epidemiologist Tropical Disease Specialist Institutional Management Specialist Executive Secretary Dr PauI Lechuga Directeur du Centre d'Epid6miologie, de Statistiques et d'Information OCCGE Bobo-Dioulasso Burkina Faso Dr Steven Smits Royal Tropical Institute Amsterdam The Netherlands Mr George Tsalikis Associate Professor of Public Administration, specializing in health administration University of Ottawa 0ttawa Canada Mr John Wilson World Bank consultant in health anthropolog:y Washington, D.C. t a