Plan of action and budget for the Special Intervention Zones (SIZ) 2006: Bénin, Ghana, Guinée, Sierra Leone et Togo

African Programme for Onchocerciasis Control (APOC) Programme africain de lutte conffe I'onchocercose JAF-FACJOINT ACTION FORUM Office of the Chairman JOINT ACTION FORI-IM Eleventh session Paris. France. 6-9 December 2005 FORUM D'ACTION COMMUNE Bureau du Pr6sident JAF1 I/INF/DOCI (Cont'd) ORIGINAI: FRENCH October 2005 PLAN OF ACTION AND BUDGET FOR THE SPECTAL TNTERVENTTON ZONES (SIZ) 2006 (B6nin, Ghana, Guin6e, Sierra Leone et Togo) October 2005 12 3 4 5 6 TABLE OF CONTENTS INTRODUCTION ........ WHO SZ PERSONNEL TRAVELS AERIAL OPERATIONS ............... LARVICIDES ............. ACTTVITIES OF ENTOMOLOGICAL EVALUATION, HYDROLOGICAL SURVEILLANCE AND EPIDEMIOLOGICAL EVALUATION ................... CDTI ACTryITIES ... I .,.2 2 2 J J 47 8 9 ANNUAL SZ SPECIAL CONSULTATIVE COMMITTEE AND ACTIVITY PLANNING AND REVTEW MEETrNGS............... ...............4 VEHICLE, MOTORBIKE, GENERATOR MAINTENANCE AND PIIRCHASE OF LABORATORY AND FrELD EQUrPMENT............... ........................4 OPERATIONAL RESEARCH (SOCIO-DEMOGRAPHIC, CDTI, DNA, ENTOMOLOGY) 4 TRAINTNG/RE-TRATNTNG (CDTr + ENTOMOLOGY) 5 OPERATIONAL EXPENSES ADMINISTRATIVE SI-IPPORT OF APOC RECAPITULATION OF THE PROVISIONAL BUDGET FOR 2006 10. 11. t2. 13. T4, ..5 ..5 ..5 JAFl 1/lNF/DOC1 (Cont'd) Page 1 Plan of Action and Bud et 2006 (Benin, Ghana, Guinea, Sierra Leone and Togo) 1. INTRODUCTION Onchocerciasis control activities in the SIZ were carried out under good conditions in 2005. Thus, vector control activities, coupled with enhanced ivermectin distribution in the Oti basin and its tributaries: Kara, Keran and Mo in Togo and Benin, as well as on the Upper Oueme in Benin were satisfactorily conducted. No transmission was noted during the period of May 2005 in all the basins. Available CDTI results for 2005 in the SIZ indicate that in Guinea, the geographical coverage rate is 99.2yo, and the therapeutic coverage is 79.1% at the time of the first round of treatment. lt is must be recalled that these results are similar to those of 2004. On the other hand, for the second CDTI round, only 41.60% of villages with 192% of persons in the SIZ area were treated due to the fact that ivermectin was out of stock, which was caused by the under-estimation of needs. ln Benin, the results of the first CDTI round in 2005 indicate g4% of geographical coverage and 81% of therapeutic coverage. ln Togo, the first round of CDTI activities is in progress. ln Sierra Leone however, the reorganisation of health services and the re- settlement of communities are undenryay after the civil war. The reorganisation of CDTI activities is ongoing so as to allow communities to not only have access to the drug, but also own the CDTI strategy in the various provinces of the country, where entomological and epidemiological parameters indicate that onchocerciasis is still a public health problem. To this end, a workshop was organised in Freetown by the SIZ Management, under the auspices of the Ministry of Health, from 19 to 21 April 2005. Discussion centred on the CDTI Strategic Document, written up by the APOC/SIZ Management. After this workshop, a Plan of Action and Budget was drawn up, with the collaboration of partners: SSl, HKl, World Bank and the Government, for a sustainable establishment of CDTI in Sierra Leone before the end of SIZ activities in 2007. A timetable for implementing CDTI activities, in accordance with the recommendations of the above-mentioned workshop, has been drawn up. ln order to find a solution to the poor management of activities and resources, and to give a greater chance of success to the CDTI reorganisation effort, the Ministry of Health appointed a new coordinator since 15 February. The epidemiological evaluations conducted indicate a downward trend of prevalence rates, with rates still above the 5% threshold. The Plan of Action and Budget (PAB) for 2006 is the fourth of the Special lntervention Zones (SlZ), which will be submitted for the approval of the World Bank and WHO. With this new PAB, continued efforts will be made to improve entomological and epidemiological parameters up to levels which will be easily maintained by participating countries. Details of the 2006 budget for reinforcing planned activities are presented below JAFl 1/lNF/DOC1 (Cont'd) Page 2 2. WHO SIZ PERSONNEL The budget earmarked for personnel (16 employees) with WHO status, involved in StZ activities will be maintained in 2006. The amount provided for is $US 349 000. Technical assistance (international level) is also planned for to assist in the plannrngl training/re-training, supervision and analysis of CDTI activities. An amount of $US 26 250 is earmarked for this. The total amount budgeted for WHO/SIZ staff is $US 375 250. 3. TRAVELS The intensification of prospections and additional ground larviciding (necessitating several travels by employees of this component), instead of the use of the helicopter (due to the high cost of the flight hour), and accompanying of pilots for maximum efficiency of larviciding, are the essential element of this budget item. This budget category also takes into account the organisation of meetings between the SIZ team and SIZ countries and the travels of the logistician (TLMO) for addressing on-the- spot problems or conducting routine follow-up/supervision missions. The travels of the CDDT, as part of the supervision of CDTI activities, as well as those of focal points for consultative meetings with other programmes, superyision and intensive monitoring in the countries will be maintained. Supervision travels of the DTL ant the CVCT will be limited to selective interventions in order to address specific problems. To this end, the amount projected for this item is $US 45 000. 4. AERIAL OPERATIONS Due to the high cost of helicopter use, the appropriate period of accessibility to the breeding sites are utilized for conducting ground larviciding. The number of guaranteed flight hours in 2006 that would be similar as 2005 is 636 hours. The negotiations in progress for the extension of aerial contract in 2006 and 2007 indicate a possible increase in flight hour price of $US 1 225lhour. A maximum cost of $US 1,332.5/flight hour has been estimated and taken into account in the establishment of the budget 2006 for aerial larviciding of about 2835 km of rivers in Togo and Benin (Kara, Keran and Mo) and on the Upper Oueme in Benin. Only one fully operational helicopter will be used for the operations. The amount earmarked for this, including the cost of fuel, (Jet Al ) is $US 890 400, taking into account the fact that aerial spraying on the Upper Oueme will be relatively reduced. JAFl 1/!NF/DOC1 (Cont'd) Page 3 5. LARVICIDES ln order to prevent the development of any resistance, the larvicide rotation strategy, which was put in place by OCP, will continue to be applied. However, particular emphasis will be placed on the use of B.t.H-14, the biological insecticide whose performances has been improved before the closing of OCP. For 2006, larvicide orders will consist of 10 000 litres of temephos at $US 174 400, and a container of Teknar at $US 79 300. The total amount to be provided for is $US 288 305, including 15o/o of PFl. This order, in addition to the projected larvicide stock at the end of 2005, will enable vector control operations to be carried out efficiently in the basins in question. 6. ACTIVITIES OF ENTOMOLOGICAL EVALUATION, HYDROL O GICAL SURVEILLANCE AND EPIDEMIOLO GICAL EVALUATION Epidemiological evaluation activities will be conducted in control villages of each intervention area in order to evaluate the impact of activities undertaken. These evaluations will cover as many villages as possible in each of the SIZ countries and will be preceded by active geographical prospecting surveys with a view to possibly discovering new villages. Standard parasitological methods will be used in these epidemiological evaluations. The teams will use vehicles that OCP transferred to the countries for the smooth conduct of these activities. An amount earmarked for the five SIZ countries in 2006is $US 45 000. The entomological evaluation network (11 regular catching points) of CDTI activities, coupled with vector control, will be maintained in Togo and Benin. The network will enable surveillance of the trend of blackfly densities, and the transmission situation to be conducted in the area under larviciding. Eight technicians (4 entomological technicians and 4 laboratory technicians) distributed over the Kara and Parakou bases will conduct the entomological evaluation of vector control activities. The catches will be ensured by village catchers (2 catchers/catching point). Entomological activities in Sierra Leone will be carried out mainly in the northern part of the country, as part of the study of blackfly movement on the points of Arfanya, Yirafilaya, ltrlusaia and Kaba Ferry, in addition to the sites in Guinea (Yalawa and Morigbedougou) and in tt/ali (l\4adina Diassa). The amount projected for entomological activities in 2006 is $US 199 593. ln order to ensure maximum efficiency of larviciding, while avoiding overdosing and under-dosing of larvicides, it is necessary to maintain the water gauges in the area in good working conditions. To this end, the maintenance activities of the hydrological network (17 water gauges in Togo and I in Benin) will be maintained by national hydrologists in these two countries. The cost for maintaining the hydrological network is$us 3 781. The total amount for entomo-epidemiological and the hydrology surveillance is$us 248 374. JAFl 1/lNF/DOC1 (Cont'd) Page 4 7. CDTI ACTIVITIES CDTI activities cover sensitisation and mobilisation of communities and the decision makers, training of health workers and CDDs, drug administration, supervision, data collection, management and analysis and feedback. At the end of each CDTI activity, an evaluation is conducted in order to ascertain progress made, especially through the evaluation of geographical and therapeutic coverage rates. The reinforcement of these activities will continue in all the SIZ areas. The total cost is estimated at $US 188 229 in 2006, to take into account of specific activities to be conducted for the establishment of the CDTI strategy in 12 districts in Sierra Leone. 8. ANNUAL SIZ SPECIAL CONSULTATIVE COMMITTEE ANI) ACTIVITY PLANNING AND REVIEW MEETINGS The special intervention team benefits from technical advice given by a six (6) members group of experts, who make up the Special Advisory Committee (SAC), on surveillance/evaluation, control (distribution of ivermectin and vector control), as well as environmental issues. An annual activity review and planning meeting is organised with the 5 SIZ countries, the other ex-OCP countries and the partners, such as SSl, HKI and OPC. The total amount of these meetings organisation is estimated at about $US 66 105, i.e. $US 41 706 forthe annual meeting of the SAC, and $US 24399 forthe annual review and planning meeting. VEHICLE, MOTORBIKE, GENERATOR MAINTENANCE AND PURCHASE OF'LABORATORY AND FIELD EQUIPMENT 9. ln 2006, provision is not made for the purchase of new vehicles, motorbikes or computers. The actual vehicle fleet will need a good maintenance. On the other hand, the renewable laboratory and field material stock needs to be replenished. The total amount projected for the purchase of laboratory and field equipment is $US 24 882. The cost of spare parts, tyres and batteries amounts to $US 33 244. 10. OPERATTONAL RESEARCH (SOCIO-DEMOGRAPHTC, CDTr, DNA, ENTOMOLOGY) Studies will be conducted to evaluate the success of activities, or improve the control process for better results. ln some areas, KAP, socio-demographic and other specific studies will be conducted to determine the factors to be taken into account in the control activities. ln the area of entomology, research activities will be limited to those aiming at ensuring better understanding of the situation in the zone. This will centre basically on continuing and finalising studies on the migratory movements of blackflies and JAFl 1/lNF/DOC1 (Cont'd) Page 5 identifying parasites per the DNA probes, initiated by OCP. This last activity will entail the provision of resources for supplying the needed products and the collaboration of the molecular biology laboratory of the Multi-Disease Surveillance Centre of AFRO. An amount of $US 30 000 is earmarked in the budget for these activities. 11. TRAINING/RE-TRAINTNG (CDTI + ENTOMOLOGY) This is one of the essential components of the Oncho control strategy in the SlZ. It will be built on specialised training with a view to enhancing the national capacity for carrying out operations. This will have to do with the training/re-training of community distributors and health personnel, as well as health authorities at the district level, health centres and intermediary staff (agricultural extension workers, social workers, teachers, etc.). This will involve the re-training of entomologists and entomology technicians, computer training, and data collection, management and analysis. This training will include sessions on ground larviciding and post-larviciding entomological evaluation activities. An amount of $US 23 000 is earmarked for these activities. 12. OPERATIONAL EXPENSES An amount of $US 23 404 is reserved for operational expenses in 2006 which covers the procurement of office supplies and possibly computer consumables, supplies and minor materials for day-to-day activities, as well as utility expenses (telephone/fax etc.) 13. ADMINISTRATIVE SUPPORT OF APOC The Management of APOC gives an important administrative and technical support to SlZ. This support will go on in 2006 and a symbolic lump sum of $US 20 000 is provide for this support. 14. RECAPITULATION OF THE PROVISIONAL BUDGET FOR 2006 The total amount of the budget 2006 is 2 256 193 $ US as indicated in the following table. JAFl 1/lNF/DOC1 (Cont'd) Page 6 OVERVIEW TABLE OF 2006 PAB F'OR THE 5 SIZ COUNTRIES (Amounts in $ US) ACTIVITIES/Budget item APPROVED BUDGET 2003 APPROVED BUDGET 2004 APPROVED BUDGET 2005 PROPOSED BUDGET 2006 WHO-status staff 312 830 444 000 375 250 375 250 Aerial operations 842700 922 200 803 620 890 400 Larvicides 371 100 815 190 310 375 288 305 Travels 33 023 67 400 53 000 45 000 CDTI activities 237 002 143 822 211 189 188 229 Operational expenses 198 112 110 120 37 976 23 404 Entomo-epidemiological 245 682 286 660 276 611 248 374 Operational research (socio- demographic, CDTI, DNA, entomology) 8 555 51 025 48 092 30 000 IEC materials 0 0 20 000 0 Training/Re-training (CDTI + Entomology) I 290 30 000 40 000 23 000 lt/aintenance & equ ipment (vehicles, motors, generators) 105 180 30 000 27 814 33 244 Field and Lab equipment 9 OBB 5 000 26 598 24 882 Meetings 29 407 35 000 35 000 '66105 APOC support 0 0 20 000 20,000 Mid-term evaluation of activities in the SIZ 0 0 131 533 0 TOTAL 2 401 969 2940 417 2 417 058 2 256 193