Progress report: July - September 1978

l,{th R YrLLftRs :i. 'lt WORLD HEALTH ORGANIZATION ORGANISATION MONDIALE DE LA SANT6 oc?/?rv78,1 ORIGINAI: EBENCH ONCHOC'ERCIASIS CONTROI, ?ROGBA}T.IE IN [T{E VOITA RTVSR BASIN AISA Progress Report : JuLy - September 1978 I. INTRCDUCTION I. Ihe ain of the 0nchocerclasis Control Progranme is to control the blackfly vectors of the parasite by spraying insectieide on larra1 breedlng si.tes, to free populations from the disease, and to enable the Land aLor:gsltle the vlatercourses to be developed. 2. [he trnrtlcipating countries in IIIrest Africa are 3enin, Ghana,Ivory Coast, Mali, Iflger, Togo, antt Upper Yolta. The Y/orld Health Organlzation (\1H0) 1s responslble for the implennentation of the ?rograrnme. flhe other sponsorlng agencles are ttre Food and Agri- cuLture Orgauization of the Unlted Nations (FAO), the Uroited Natl.ons Development ?rogra.rnme (U,IDp) and the Woria Bank. It 1s fj-nanced by contrlbutlons from donor countrles and lnternatlonal agencies ttrrough a speclal fund aclm:Lnistered by the liforld 3ank. Merlical research and training activities are financed selnrately by UI{DP. uay ln stages. By June, 1977 the entire area of 700 000 hna uias under treafuent, The results of the entomological actlvities are aesessed by a nedical team, whll-e an econouic un:it keeps track of the econouic activities of the countries. 4. Up to ]O June, 19?8, tb 14 836 o29 had been spent, $ 29 779 ].47 of that for the flrst four years. Fron 1974 to 1977 the percentage breakd.oum of expendlture by nategouy tras as fcllows: vector control: 6l.8d/6t epiclemiolog:ica1 evaluation: 5.64fo, economic clevelopment : O.O4't, appliecl research, envirornmental sr:rreillance and tralnlngt 8,7.7%, Progra.nrme headguarters and administrative support at Ouagactougou: t5%, meeti.ngs: O.87i[t adnlnlsh:ative and techn:ica1 support from 1YII0 antl trlAO heatlquarters and fron the liaison office ai the Regional officez 7.55%t Joint caordlnating comittee: o.9flot 5. In earrylng out the aerial operatlons over ebout L4 000 hm of rivers, 14 600 helicopter hours and 24OO flxed-wing aircrsft hours were used, and some 420 OOO 3.ltres of i.nsecticitle were appJ.1ed, 6. The baslc epldenlologlcal evaluatlon earried out by the Progra,me covered 3]0 vlI.l,eges, ond e5 1$7 iirtlivlduals were exa&ined. -2- 7, rtrirty research contracts on vector ecolcgy, vector eontror andthe epicieniological, c1inical, parasitologi.cal antl chenotherapeutic aspects of the clisease, and i'iye contracts for tirc uonitoring of the aquatlc envirorurent, totalling {i 1 595 100, were signcd or rcnewed, with institutions and laboratorles in the Prngranne area ancl abroad. Ju1v - Septcnbcr 1978 B. Ihis ycar provided fresh confirmation that the third quartcr ofthe year is a pcriod of intense activi-ty for the Yector Contr.ol Unlt, which for the first ti;re extendecl its trcatncnt ci-rcuits to ti:e basins of the lIa:ahoud and sassantira in rvory coast, d:i1e continuirg its studies on reirnrasion, Entonologlcal surveillance revealcd most satisfaetory results overall. For the Epiclcrl:iological Evaluatlon Unit, on the other hand, th:is quarter is a period of retluced activity - it cannot visit the field becauso of the state of the roads and therefore mad.e use of the tlne to dravr up a plan of actkit-j.es for the n,Jrt seosono Ln the econonic field, attention vres trnid to public health probtens and to theinpact of the Progre,mnels activitles, while the adn:inlstrative sewices continuecl to provi<le support for the technical urrits, 9. Six i-raportant rieetings were helcl durlng the quarter. At the saneti-ue, evaluation of the entonologlcal ancl econonic activities of theProgranne cluring 1ts first four years yras continuerl, II. CURiiiINT ACTIVITIDS .4.. .iiSR}\I OTEBATIOI.TS Sprayirre 10. For the first tine the vector control activities covered not onlythe entire geographical area of the Prog:ernne but also the Sassancl.ra and hiarahoud basins J-n rvozy coast. The aerial operations weretherefore verTr consj.derable throughout the quarter. Because of the extremely imegurar flow of the treated. natercourses, the spraylng circults and the amounts of insecticide applied needed eonstanl adjusfuent. 11. rt was 1n Au6'ust and september that the fluctuations in rlyerflow were nost marked.. rn the west, in August, the frow of theKolodio and [onbe (rotir tributaries of tire lower xract vorL)l-trre TtZi, the Lrarahou6 and the lorver Bandama $as very close to the:-rdry season flow, but most of these uatercourscs Legan to flow copiously again in September. Treatments were undertaken at the end of September on some watereourses in the Bandlagara distrj_ct. rn the east, theriver flow yias more constant. Some watercourses zuch as the i/hite volta were in spate throughout August, and spraying uras conductedintensively in the lama-Kara and lrlatitingou clistricts. During the second., third and fourth weeks of August the Tapoa, the Dyamongou and the_Goroubi, all tributarles of the river }figer in ltriger, were graduallyinclud.ed in the treafuient circu:Lt. -1- 12. The excellent entomologieal results made it possible todiscontinue treatment on the Koul:pele, the Dougala-Iiondi and the[cherbo, all tributaries of the wnite volta in the centre ofUpper Vo].tap fron the beginning of August; on the other hand, exper:Lnental treaforent ue.s i"ntroduced for one nonth fror,r the endof August on the lower Ntzi and the lower como6 1n an atten:pt to recluce the increasing nr.mber of blaeHly caught at the Bui lorges. f'1. D"rring the quarter fi:ced-ring airc::aft were furly utirizedtttrerever and utrenever the river flow warranted.. [his accounts forthe fjxed-w:ing f1y:.ng hours of 448.2, conlnred w.ith 308.6 hours forthe eomesponding quarter in 1977. 14. The a,nounts of insecticide applied during the quarter, 95 DggIltres lncludlng 77 854.6 in septenuer, wre also much h:igh6r than inthe th:ird. quarter of l977 when 6? ZgO.2 litres were used. Althoughtreafuent $ias di-scontinued ln some areas yvh.ere flre entomologlcalresiilts were very good, treafuent uas undertaken for the first timeon a regular basis in the sassandra and Marahoud basins and on anexperimental basis on the lower lrlrZi and the lower como6. similarly soue rlver flows required partieularly large j.nsecticide applications:in september as much as r-2o u.tres on the sassandra, 40 bi;es on the1\[a::ahou6, 53 litres on the rlack volta and 48 ritres on the l,/trite voIta.[hese quantltles account for the extensi-ve use nade of fixed-w:ingaircraft. lhe two planes used for.treatments, one in the w.estem zoneand the other in the eastern zoner'between them appliea r€, ii-rrr trr"insecticide used in septerber, i.e. 26 284.3 lltrls. u." remainins.LL.570.7 litres were appried by the eight helicopters. L5. fhe breakclovnr of flying hours during the third quarter of rgTBis as fol].ows: Helicopters Jul.y August September Fixed-wine ai-rcraft Ju1-y August September SpravinE - +84.7 565.2 4L1.5 L 459.4 al6.4 ]-75.1 t56.7 448.2 ?rgsJlection 87.O 34.5 50.9 Adrninist::a- tion ol,s Total Guaranteed hor{ns 567.7 4p.A 597.7 4BO462.9 480 169.4 0.5 I 628.5 L 440 6.O 3.O t22.4 178.1 L62.7 463.2 100 100 100 700 16. fhe breakdov,i:a of the 95 598 }itresthe th-lrtl quarter of 19Tg j.s as fo].].ows: of insectlcide applied during Phase I 4 10 11 2 5 4 I 9 11 -4- Phase II L57.5 900.5 7-61.2 PlBse IIr-vr 7_42.4 989:2 294.3 Phase Phase II]-E IV fotal Jul-y August September 574.A 997;L 815.5 o25.7 06l..7 L77.9 356.7 598.9 445..7 196.1 547.3 854.6 2 4 1 5 6 9 22 35 77 70 746.6 10 1gg.O B 425.9 25 265.7 2L 36L.2 gn 5gB.O Other aeri.al operations l-7. Throughout the guaiter a totaL of 168.4 reconnalssance flights were flovvn by helicopter. Reconnaissance was conducted ln the n{arrahoud and' Sassandra basins to detert:ine the effectiveness of the la:srieidetreafuients. Simi].ar reconnaissance was conductecl on the Mole andSissili and in the Oudn6 and pencljarl basins. Reeoruraissance on theslrba in septenber showed no need for treatment. fhe flights inthe north-east were used to test the new conmun:ications pfoeedures with ltrigerr to check certain fuel depots in the bush, .rrd to perforrncontrol lnsect collections on sone rivers that are inaccessible fromthe ground at this tiaae of the year because of the state of the roads. 18. fhe staff provided by the air company at the end of the quarter amounted to eight helicopter pilots, two fixed-wing alrcraft pilots,a chief mechanic, eig'ht meehanics and a fierd project adrninjslraler.. 19. rn accordance w:rth the eontract, the company nade available tothe Progranune during the quarter a fleet of eilht hericopters and twofixed-w:ing airc::af t. AeTial operatj.ons Sontract 20, Following the agreements reaehed at the end of Ji:ne betweenrepresentati.ves of the canadi_an cornmspsl4l corporation (ccc), trr"viking company and the prograrmae, steps were tiken to transfer thecontract w:tth l\{obi1, w}rich zupplies the aircraft fueI, This contractis to be transfemed from the vlking company to the prrcgrame. The?rrcgranrme has agreed to take ru"porrsibility for the purchase andpa}maent of the fue1, wkuile Vilring would retain responsibility for thequallty gEx6 eleanliness of the second. hand drr as. 2l.. [he nerct discussions between r€presentatives of the ccc, vlkingand the Programe were planned for 1g-21 october in ottawa. rhePrograrmre Director sr.iggested that during these tarks the representatlveof I'{obil shoultl be lnrited to a trrree-party neeting to conclude thenegotiations on the transfer of the t{obil/viking contraet to the?rog::a,mre. tr 22. Ihe question of obtaining prior perrrission for overflights andlandings which was raised by Niger at the meeting in cotonorl ,asdealt w:ith in a letter dated 26 June in which the Prograrme Director sent the secretary of state for Health of iiiger a full report onthe complaints and a l1st of proposals intended to meet the requlrementsof the ltlger authoritles. Discusslons took place in ltla,:ney aur:.ng tirefirst week of July vcith the secretary of stale for I{ealth and vcithcivil aYiati.on officials. Ihe authorities noted with satisfaction theintended measures: (l) Before leavir:g on nlssi.on the pl1ot must always check thathls ::adlo equip:nent is worklng satisfactorily. sh;u1d it bedefecti-ve-l the pilot nugf, immsdiately infonn the base engineer so that the equ:itrment can be repaired before take-off ; (ii) Regular ::aclio cornmunlcation must be mai.ntai-ned betrryen theaire::aft ancl its base, at least every hour; (iii) As soon as they returu to base, pilots uust report tothe chlef pilot and the ch:ief engineer iny cor::nun:icationproblems encountered ciuring the fl.ight; (i"; Before enterlng the airspace of the l,iiamey eontrol tower,the pilot shou}l contact the tower to request plmrission to land.[h:is will genera]Iy be done by ]righ frequency::adio. rf it isnot possible, the pilot nust cu_mb to a sufflcient altitude toenable him to use the vezy lr-igh frequency vraveband; (") If for any reason the pilot does contact vuith the control tovrer, he mustleave }Iiger airspace, 23. However, the authorlties of Niger agreed that certain unforeseeableclreumstances mlght force the pilots to lind w"ithout pera:Lssion, andthey confirried that they w:tsheri to continue their "ooiu*tio"-*itr, trr"Prograrmne in a friendly spirlt. 21: Aerial operations in I'Iiger, which were discontinued in early Juneafter the talks in Cef,sper, ,"rr*"d on 11 July and have continuedregular].y since that tinxe. Insecticides 25- _[he Progranme received a yisit from ],ir K. ]/ettstei.n and [Ir T?g"I Martln, representatives of clenaaiid at Zfirich and ?ari.s respec-tively. [hey had ta]rcs with the oificials responsible for vectorcontrol, aerial operations, and administration. The talks covered.lnsecticide orders for 1979 and the heat stabirity and toxicity ofAbate. the two rrisltors then went to Bobo-Dloulasso to look at thespr€5dng equ:lpment. not manage to establish abanclon his risslon and -6- 26. By agreement with the Division of Veetor Biologgr and Control at heaclquarters, the ORSfOtrri hydrobiology laboratory and the OCCGE 0ncho- cerciasls Research Instltute at Bouak6, trials will be conducted on two sarnples of Dow insecticide, Reldan and Perimiphos methyl in capsules,in the Toukoto dlstrict of l*a1i durlng the third week in october. B. EPIDI&rIOI-:OGY 27. fhe rainy season and the state of the roarls did not provlde favou::able eonditions for field work during the quarter. Consequently, the members of the Epideniological E"ualuation Unit made use of tfu:isperiod to earry out certain work on the data collected dur:ing the year and to attend technlcal meetings. 28. As regards future activities, the medium-term objectives and the action plan of the Epidemlological Evaluation Unit should essentially be coneerned with: (") proced.ures for the processin6 and publication of flre datafed into the computer at heaclquarters slnce the start of eyaluation ; (O) the setting-up of a network for evaluating certain healthindices in collaboration with the Econor:-ie Development Unit ; (") establishu:ent of a tralnlng progra$me to neet the increasingly frequent demands; (a) dete:ni-nation of priorities for applied researeh in thefield for 1g78-Lg7g. 29. At the end of september the Prograrnme 'Jras visited by Dr K. y.Dadzier an ophthaJ-nologist recentry asslgned to Tamale hospital, vrho w:iII be working closely with the chemotherapy Research centre,Dr Dadzie had a lorlg discussion with the Prograrmre ophthalarologist.To enable Dr Dadzi-e to familiarlze himself rarith the techniques ofthe ?zogramte, J-n October they will together cafiy out the ophthalarolo-glcal ensminations for the second cietailed evaluation in the Upper Region of Ghana. 70. The Prograa:me ophthalmologist, wtro is to attend a meeting onthe preventlon of bllndness at Asilomar in californla from B to 15 october, has prep'ared the fo11ow:ing papers for presentation at the meeting: - trEpidemlological aspects of blindness statistics and assessment techniquestt - ttriethorls of ophthalmic scree:ui.tg progre.rr-est, - rrPrevention of blindness from onchoeerciasisrl 3l- [he unit arso put the finisking touches to the report ononchocerciasis in the ?rogremme ai'ea in Benin, and i: collabo:stionwlth an oBSTCI{ geog::apher prepared a docunent entj_tled rflevels ofendemiclty ln onchocerclaslstr (OCp/gpt/Zg, 3B)* for presentationto the neeting of the Scientific and 1'echnlcal Adviiory connftteein Bre.zzavil1e at the end of August. C. ECOI{OMIC DETEIJOH,,IHVT 32. rn conti.nuation of the mlssions that had been carz.ied out inseveral countries of the ?rograarme in [Iay, a visit uas mad,e from Bto 14 July to $iari: first to the sikassol Bougoun:i and segou-""ttor", and subsequently to the public health arttrorities in Barr:akor thepurpose of th:is visit vrias 1nrt1y to review the public health problemseonfronting llali, espeeially in the prog::a,mme area, ana partly toobtain infomation on the work of the nitionai Instltute for Researchon the ?haruacopoela and [raditional lUediclne. 33- ftre visits to the sectors and the tarks with the riationalauthorities at the General nirecto::ate for Hea1th prrovlrled lnfonnationon the cument sltuatlon of the health sen-ices anl made it possfUfeto evaluate the progress made j.n the last 15 years. 74. At the National Instltute for Research on the ?hanmacopoeia andTraditi-ona1 I\'ledicine, discusslons were hel-d on the activities of thernstlturte and its role in public health in Ma1i. 35- At the lnvitation of the Executive secretary of the ?ermanentlnterr-$tate comlttee on Droug.ht control in the sairei (cilis)l- ur"Progra,me took trmrt in the crr,ss/crub of the saher meeti4g on humanresources projects from 25 to 2T september in lfiamey. Th; purpose ofthis meeting vas to submit Z5 pro;ects of the CIISS hrman resourtesteam to arl the donor agencies and countr:Les for conside::atj_on andfinancing. tr"iim conlaifoients for 47 of these projects were obtainedf:rom the fi-nancing sources, of these +Z pr6jects, 25 are for ruralhealth. ??:*^.The Prograume also attended a coordination ueetirlg for thetAIilSI project orgarr:ized by the Afriean l"verop*"nt Bank in Abidjanon 27 september. [he ADB and the consultant in eharge of the i:::plenenta- :i:i of ll" gq;""t expressed a wish to attend tne n&t meeting of therrogra&mets Jolnt Coordlnating Conrmittee so as to sr:bnlt to it a docrment )E ocp/stAc ?.1 -8- reviewing the pr"ogress of the project and to obtain the opln:ion of the three countries concerr:.ed and of any other partlcipating countries in the Pro6gra.rnme which night be interested. f?rey lntend to submit this suggestion to the rndependent chalnuan of the ]cc. 57. fhe ?rogra.nrme soclologist had talks with lir Clss6 Saba Alpha, Head of the Constnrction ?roject of the Young tra:mners flrainlng Centrein Kambois6, Upper Yol-ta. I\tr Clssd is a member of the Assoclation torthe Natu::a1 Develotrnoent of Afri.ean Arclritecture and [own ?Iann.j.ng, one of the objectives of rrhich is to contribute through studies, research and practlce to the creation of a living enyironnent adapted to loca1 socioeconomic and eeological conditions. 38. Moreover, Dr Grant, who is responsible for lj.aison rarith the?rogra,rnrae in B]P.zzaville, prepared a d,ocr.iment entitled rrThe health caredelivery systen and the control of conmunicable diseases other than onchocerej.asis in the OCp cor:ntriesu..)+ [he docur.ent uas subnltted tothe Scientj.fie and [echnica]- Aclvisory Comm:ittee in Bre.zzavl;1e at the end of August. Another document entitlea rsome publie health problemsin the OCP areatt (OW/$CO/78) was pretrnred by Dr Masr:mbuko. D. NESARCH AJ,IN TNAruI}IG Research J9. - ,rhe ?rogra.nrme took lnrt in a I|DR working group in Geneva fnon Jto 6 July on fllariasesr during vfuich substaniiil attention uas paid to 9,. volrrul\rs, rhe trxlrticipants reviewed. the progress achieved in chemo-therapy slnce the meetir€ of the last vrorking gioup on the same subject18 months earlierr-together urith the research progra,me on new dnrgs setup at that tjme. Tkis programme deals with: (") the posslbj.]ity of selectirlg new drugs: five laboratorieshave been decrared suitable for selecting hundred.s of new compounds that are active against &itomosoides and otherfilariae in other hosts; (t) experi-mental pharmacology: studles on IEC, lenauisole ancl other prepa::ations are in progress i-n two laboratories; (") biochemistry: a project to study folate metabolism infilariae is read;,, for implementation; other studles on thebiochelrist:y of filarlae vri1l be considered in order of prlority; (a) seeond-leveI seleetion: trials on the chemotherapy ofOt eibFo{l:i. and 0. gutturosa in the ca1f, as an intermediate stage betieleen rodents and man, seem promising. [he effects of suramin and DEc in the calf are in fact yery comparable to those obsezved in manl x ocP/srac 7.5 -9- (") cooperation with the i.ndustry: encouraging progr€ss has'been made towards cooperation with the phamaceutieal industry.A large number of companies provide eonpouncls suitabLe for selectlon, and two industrial laboratories are arieady engagedln synthesizing and evaruating possible new drugs. .0.- sysiemfor safeguarding patent rights has been worked out; (t) assesffient of publicati.ons so far: an exhaustive studyhas been made of the literature on the cl:.emothe::apy of fllarlasesin order to help research workers determlne the cha::acterlstics required for new drugs; (g) cllnical trials: several centres capable of perfozuirrga rapid and objeetive clinical evaluation of new filarieldeshave been deslgnated; a workshop seminar aimed at standardizlngthe methods used ln clinieal tri.als on onchocerclasis nias heldlast year. 40- fhe working group also suggested new approaches in researeh onchemotherapy and reviewecl the work in progr-ss on i-munology, pathology and epidenloJ-ogy. fDR is preparing a detailed report on th:is meeting. 11. fhe Programne Dlrector had talks at headquarters on entrustingthe superrrision, adntnistration and financing of the Centre for Researchon the Chemotherapy of Orchocerciasis in [anale to the Specia] progr"a.rmefor Research and. [raining in Tropical Diseases. A clraft contract for{r_75 ooo i.n respect of the work of the centre has been dmwn up byIDR. 42- Dr. sal6s vislted rama]-e from rB to 21 July and prepared adocr.ment on the operation and scientific work oi the centre forpresentation at the STAC meeting.* 43. rn collaboration vrith an oRSToff entonologist, the ?rogrannaeprelnred a document entitled trThe laboratory naintenance ana rearingof sj-nuliup d.ampgsun complex species as a rlsearch tool for ocp*. 44. A research contract for $ I l5o was signed \^,:ith the Zoologicalrnstitute of Ki-el un:iversity; it concerns an eval-uation of theeffects of chlorphoxjm on non-target organisms. 45. A contract for $ 1 950 was signed uith Mrs. Brenda lfalsh, ahydrob5-ologlst at ouag3$ougou, for the suzveillance of the aquatic medium at Nangodi and p0 on the Red Vo1ta. x ocP/sIAC 7.6 -10- T{?inins 46. During the quarter seven cancliclates took a fourr-raonth trairring eourse in entomology at the OCCGE Onehocerciasis Research Institute in 3ouak6, Ivory Coast. They were: Ih Arsbne Gouenon Sagno of Guinea, biologist responsible for malariometrlc surveys, Preventi-on Department, I'talaria ?roject, Conakry; Mr Roger Topko Iema of Guinea, Professor of BioJ.ogy, trbculty of Natuxal Sciences, Conakry; Ivir Kabine Kaba of Guinea, assistant to the i,H0 entmologist for the onchocerciasj-s p1lot project in Gu:lnea; Ivlr Llaaedou Sarlfou 3alde of Guinea, Head of the Entomology Teamfor onchoeerciasis pilot project in Gulnea; IVIr Itramarli Adamou of l{1ger, laboratory assistant, Department of Hygiene and }iedi-clne, Iliamey; I'lr .Rahiou Iabo of Nlger, Deputy Head, Parasitology Section, f.rlvestock Breeding traboratory, l,Iiamey; illr Ketevi Kor.mouvi of Iogo, entomology asslstant, Department of l,'iajor Endem:ic Diseases and l,ialarla, lom6. 47. At the end of thelr training course the first four will perfo:m a month of practical vrork in the fj-eld. Ihe three others had carried out their field train:ing before they went to Bouak6. 48. One eandj.date, I[r. Gilbert lriensah of Benin, ]ryd.robiologist responsible for research at the i\linistry of Public Health in Cotonou,is undergoing six monthst trainlng in hyd.robiology at the ORSIOM Hydrobiology }aboratory in 3ouak6. 49. Iwo physiei-ans from Guinea, Dr Yaya Kasse, ophtha3mologist anclDirector of the Onchocerciasis Project at Kankan, and Dr Iah Dore, head of the eye lesion ease-finding team of the Onchocereiasis PilotProject, are taking a l2-lronth training course in ophthalaoology at the African Institute of Tropical Ophthal-mology in Ba.mako. 5A. A practlcal field training course J_n pazasitology, lasting elght weeks, is to be given by the Epidemlological Evaluation unit from October onuards for: -11 - - Dr Sekou Yalarrl Cama:ra of Guinea, Medical Offi.cer, Cona]r:qy School Medj-cal Inspectlon Depi rfuent, - I,Ir Anadou Dia[o of Gulnea, Head, Pa::asitology Sectlon of the Natiorral laboratoryr [ialarla ?roject, - lvjr siba Gba.mou of Gu:lnea, lnrasitology technician in theOnchocerciasis ?ilot Project for Gulnea. 51. Starting in Januaryt a979t four-nonth trairrir:g courses in entomology at the IR0, Bouak6 have been arranged for: - Dr sekou yalanl crmara of Guinea, vrho will already have taken a field training course ln pa::asitology, - Iir Baymond Koho Kone of Guinea, Head of the ?arasitology [eamin the ?revention Se:rrice, Ivialaria ?rojeet, - lir soule]mane Kourouna of Guinea, Head of the ?arasitologyfeam of the Onchocerciasis Pilot project for Guinea, - Mr Theoue Ou1are of Gui.nea, Assistant to the liHO Entomologlst,Onchocerciasis PiLot Project for Gulnea, - }lr Nicholas John l\taeoe of [anzarrla, ]istriet ],tedieal Offlcer at A:rrsha. 5_2. Sioreover, during the quarter the Prog:ume avriarded elght fellowshipsfor the acadeutc year 1978h979 to: - Dr Geraain Oussa_of -Ben-ln, Head, Medical and Paediatr:ic Servj.ces,?arakou Hospital, for speclahzed studies j.n ophthal-rnology at thetrbculty of }iedicine, Dakar Urrlversity, - Dr Djlkodjo clduent G1e1e of Ben:in, chief iliedical Offlcer,Djougou Medical Dj-striet, for specialized studies in epidemi-o1ory.The place of study is being arranged, - Ilir codjo Akogbeto of Berrln, teacher of biology and geology atthe lyc6e B6hanzin, Porto-Novo, for speciallzed studies in entomology with OnSfO}i at Bond.y, France, - I'ir Jaues samnan of Ghana, research asslstant at the rnstitute of Aquatle Biology at Achj-mota, ohana, for speciallzed studies inhytlrobiology at Salford Urriveri:.ty, Urrited Kir:gdon, - IYrr Joseph Serrrma Auelqre of Ghana, researeh worker for the Counellfor scientific and fndustrial Research, Accra, for speciaLized studles ln hydrobiology. fhe place of study ls being arranged, -l.2- - 1\1r leor:ard Abrahau l(wame Antwi of Ghana, research workerfor the council for scientlfl: and rndusirial Rcsearch, t"9or: for specialized studies on pestieides at MiamlUniversity, Ilorirla, and later at the Center for DtseaseUontrol, Atlanta, Georgla, - fr sanriel zanya Bugri of Ghana, I{edical Officer in c}rarge ofcomun:icable Disease. control, R.rblic Health Hospltal, r"iar"lfor specialized studies in pirasitology and public health. Theplaee of study is being aminged, - 11r I'Iichae]. D. lYilson of Ghana, entomologist, studies in parasitology at the London Schoo]'Tropical Medicine. for specialized of Hygiene and 531. .Qese eight fellowships are in addition to the one g::anted to Drtylle Fol1y Aboussa of [ogo, chief l,ledical officer of Aneho I{earthsubdistrict, for speclaliied studies in ophthalmology at the r,beultyof lliedicine of Dakar Un:iversity since l976, 54. Moreoyelr in view of the fact that the work of the vector Biologyand control Research unit at Karluna, Iligeria, *t i."t hitherto hasconcentrated on anopheles control, is shortly to U" redirected towardsthe study of the biology and control of utaclru.es, the prog::ammereceived a three-week fact-finding vj.slt from Mr tt.l. Lirthf", the Unitrsentomologlst. Drrlng his visit lvlr. Matir:is observed the work in one ofthe sectors, familiarized himself with our techniques of geographicalreconnaissance and entomol0glcal evaluati.orr, .rra learned about ournethods of treataent, planning and the calculatlon of operational eosts,Dr .Bishlkesh, who is in charle of the sa&e project, underwent a two-weekt::aining eourse _11 cytotaxonony r:nder tire progr;.me specialist in Tamale.A 4 - 6-week field training "oi,r"" :'or IvIr ,loiln clarte, entomologist withthe same projeet, is planned for October. 55. Again ln $igeria, Dr yJ. Gregory of the Nigeri.an Institute forTrypanosomiasi.s liesearch at Kaduna, who is resp6nsible for setting upan onchocerciasis contror progra,&mee made a fact-findlng visii lo tneProgra,r",rme area ln Jury, aitei visiting the Akosombo laboratory and thelamale sector 1n Ghana and the oachocerciasis Research centre in Bouak6,he had tal}s nrith Progrc.mme staff at Bobo-Dioulasso and ouagadougou onall aspects concerned with the planning ancl ,"trroo" of vector control andw'ith the organization of aerial operatj.ons, 56' Dr o: h, Prog:e,rme trnrasitologj-st, undervrrent an intenslve sjx-weekcourse in English at the University of Cfrana at legon. 57, tr{r Ido trbssena, nlrse urith the prog::anmers Epidemiological E\ral-ua_tion unit, underwent a th3se-month trainlrg eourse ln the ?arasitologySeetion of the OCCGE lhs;:c-.z Centre in Bobo_Dioulasso, L3_ E. ADI*INISTRAI]ON Budeet and finance 58. As at JO September 1978 expendlture during the third quarter amounted to $} 2 327 L77, bringinf the total expenc]lture since the start of the year to ti 7 824 067. Unliquldated obligations on 3O September amountecl to $ 2 680 837. Estimated expenditure for the last quarter of the year is {p I 579 747, i-ncluding the amounts already cormaitted. A breakdoum is given on page 14. 59, A draft revi.sion of docunent RAb/Z+/OO4/C/OLh4 has been prepared.this docr.ment dea].s with $ t 5Bo 140 of IrID? fr.urds prrcvided for applled researeh and t::alrring in tire period 1974-19T8. 60. Follouring a survey conducted in the countries of the Prog::arrone, the Director approved an increase in the travel allowance for gene::a} servlce staff of the Programme 1n Benin, Ivory Coast, Ghana, Upper vorta, Nlger and rogo. fhe applicatlon of the nerv rates, which camelnto effect on I September 1978e means an estirnated i-ncrease j.n ocpen,li-ture of $ zf ooo in 1978 and $ 64 ooo in 1979. 61. Ehe clerks of the l(orhogor/Sanako/famate sectors spent one weekin the Fir:ance Department of Programme headquarters j-n Ouagadougou to be brought up to date on the practi-ces and procedures of the Department.Iuring this period the Ouagadougou clerks replaced them in thelr sectors, Persor:ne1 Departnent 62. fu ,O Septemberr 19?B there were 673 staff ln the general serrices category for 771 establisheC posts, and 4l professional staff for the 5O established posts. 65. Mr tr. Tegetr who uras previously in charge of transport and buildings at the Regional 0ffice in Bm,zzavi11e, amived in ouagadougou earry 1n September and Lmrediately took up Lris duties. L[r traget is in charge of the ?rogre.rme I s [ransport Department and of the constnrction of the headquarters bulldiirg. 64" IINDP carried out a surrey in Togo to review the salaries of thegene:aI se]nrice staff. fhe new scales vrill be backrtated to t L{ay, 19?8. 65, D"rring the quarter the Persori.nel- Departnent issued 23 new contracts and renewed 85. Thirteen appointnents were terraj.nated, three on completion of contract, four by resignation and six for gross mlsconduct. 66. [he ?ersornnel Department also carried out an analysis of termina-tions of appoinfuent in the gene::aI service category fmm 1 January 1974 to 51 July 1978. Duri:ig that period, 2a3 appointments were ter-oinated. -L4- o\ .rd \o oLn €6(dr{ Ei .+ ..{ OJfa@ o ll +{ EfOO r{r- ..tr- r2 aP\O .rlrnc cO E) rl h, H4A 'rl =(l,o .q r{ -P r{ oSqrd -q 0) €.d € S.rOE -cl oqc F{ .rl cH -e.o\ol.r\ (acvrl .-t D-Ott{ GidD'-Or{|f\b0 <+ g+" 'rl .rrh I h(a (apho rl S!Uld'r{ 'rl gPoa)\O .rl Q,co{JE\O .rl a(f rd r.-- '(J HOdrd|c\6(DOlN "cl tr-H D.\ <*i tr-q{ ..+O t{rlo ho P "-?slF{ 'rr cJ Il5 5=d dElQ'4 rd .dsG ootoPOd @r--g.q 6 .rl P r{ *:.+t,q{ o o.-? -loll -l (aOd o()F{ r{ tr]oc) o oo .coP.PO(ao€coo oillr\() F{ ho-l+P{g .rl llo >H .c dtuH r2frl 02 -P 80'rlio .rl 'd >qrda)a4 C\ O O O t\ G O\oootr-t-c\totc\ o\ o c0 c\, r-- o c\J @ cr\ o -l t-- t\r{COnLn"+r{tr-!.\ cv r{ }.\ v rl rl \oo\o D'-o ta\ C\J O + r{ cs tr1Po+H i(, tl) Or{f -Pdcdga)A{O E 'rl .r{ P()P.rt .r{ .rl EPid EsE o4 c0 c.t Ln O |.\ ra\ fc\ -f t\ O O O t.\\R@O\oLc\or@r{OOc)\orl r{ r{ r{ '-l M\ @ rlOOOOtr"\oOOOOr\ooolc\|.-c\loLnoo\O O r.\ =+ O C\l D.- O l.- Or O 666GiC6i66G{A c{ O \O }r\ O @ l'- r{ CO N (\JC\, C\l CO Cn o'\ r{ tr\ C.- .+ O cr\Ln sj- rl \o cc c{ r{ r{ N 66tr'- r{ * -tc0 fa\o tc\ r{ r{ tr- O O\ Dc\ tc\ r-l f.-slOcVLnO-+|c\!r\ O r{ @ rc\ \O \OaG6^GGllll- €+ \O O .{ Lf\ ln t\ @O\N@C{r{tr\Olr\ r{ N -l o rlOl co 01(rl 00f--Ol ar{idcd^ O' ! + SI{,dOPt ,rd ..1 O .df(a 5alcf h00 .rl ,d rn r{ -{d€{,r)o(d oooooooooo aaao.aaaaao\S. o or r{ or o rl rn Lc\ u\ Lc\(\l fc\ r{ N <j' C\l C{ ('J r{ o ao C\, -1 tr--Otj.\N\OO\OL^Otntr-Nr--c\J\olnco(\Jtr- 6i-A^G6iGGtr\D-O\Nrll'-C{CVlrrA)N\oO.+nLn.+r{N\OI- rl r{ st r-t D.- fa\ co io @\o c! f P4q) a a2PO(rr o)goo ofD-@o\tr .r{5i .o cd oF) 'rlQr{ oooooooooo .t.aaaaataat \e. r{ I }c\ D'- clt C\l C\l Lc\ tr\ tr\ tn\O =+ r{ tn tn F- F- f.- F- N o o t-- rc\ N^\ .+ F- N r..\ \O O .+ lr\ |r\tr\Cr\Ntnr{\Otfr\Of.-Or('l + sr Lf\ \o \o c\l rn r{ f.\ 666G6G-hN l tr- o + t\ o co \o r.- -+o M\ Ln tc\ lc\ () c\l t\ l.- rt!-7+|.\+-l r{rlH G.itn r-l tr-\0o + cv @ t-- P e c)EcoPF-O Cf) r{ r{ r{ oooooooooooOOOOOtnOOlfTOO .:* O O O, sl- D'- tf\ O O C- o|\ O G66G6i6666 rJ\ O L.\ CV r{ Or O r{ @ C\l rnt..\ N D.- |J.\ .+ tf\ -+ tr- -{. O \O@ tr-- f.\ b'- r{ rl r{ r{ + G6O c\t oo LN rlrl 00 !c\ r{ AH og.r{lOO O f o+, d rl O '-l d. g t{ .-l r{ Fr+: e .- qq E .l-l \ o_tsqrc_pNilpr r.I fi Qa a N fuoHr{3-6&; f; gEr{qaJr{F{...ldFq.qo P( o o d og -l> () 83Sa&H> ESEB *O P{ O o OO a.q d d €P{ .-t ..1 d +) q0 OP H g Ok 5 S fi cr oo g oFJ Fl o- triO 02 O O .-l O(D .rl FiO P{P qd g r{ .r{t{ f g O O Olo O .rl O 9{ q.l.rl o Op{ & (3 OE fl ..$ '3 S 8a g E.E 5 E B r{ c\r l.\ -+ tn \o c'- o or 3 I ataaaoaloaa rl r{ rl r{ H rl r{ rl rl .-l r{ co D.- Ot -l 14pl EH P{ E'la or\ H a HI-!Opi H a E ?1 H 5{i/ g t'I C5aDrl @tr-o\ r'{ E4 6 i:) : H H H _15_ 67. the table on page L6 shows the reasons wlqr the appoinfuents were teminated, the cturation of e..plo3nnentl tle empJry"e"i-lraaesat the ti-ne of tennlnatlon of their-apilolndent, and the percentagesof teminated appolnfuents by urlt ana-py natlonarity. out of thetotal ot zo, tenntnatrons auitrig the period of four years and seven 19nt!!r M% were for r.rnsatlsfactory sersices ";-Ad;;;; ;il"" durrrurthe first tno years of serylce. TLe percentage of teruinatrooi G;ffiln gracle 01r mainry vector oollectors and lablurers, ls lovier than thepercentage of general serxri.ce staff in this grade (ig"), wtrlIe thepercentage of tennlnattons (u%) in grade oz] na::rry drivers, ls mr.rchhlgher than the percentage of gene::aL serrnie6 staff-enployed'in thisgrade 1zg/"). It wouLd "E", irrit staff employed as veetor collectorsare aore s@bLe than those employed as driveis. simiJ-arJ;r, i"*r*tioneof appolntment are proportionaJ.ly higher aeong the staff of theafullltstrative servlces than aeor€ t[e staff 6t tae techrrieal units. I Eilru:ff", s"ffi ilffi #l ff#ffi:':r :f":f *mx" yi:i"tm*'-is also hlgher,than the percentage of upper volta staff emltoyea by theProgra,me (lS/,). Geaeral senrlces 68' the constnrctlon of tun offlces and a store in the Bameko sectorhas now been coppleted. Ihe work url]-l have cost 4 328 326 $IaIi francsantl is nlthln the estlmates. 69. fhe simuLtaneous lnterpretation equipnent and the se:$:ices of aPrcgrame teebruician were loaned to uNrcEi ror a neeting in oragaclol€oufron rL to L5 septenber and to the o:agadougou Remote sEnsing centr:efor the conference of African p3-en:ipotEntiail."" on telecomuiicatlons,a6aln in Ouagadougou, fron 26 to 29- September. 70' so far thls equipuent has been loaned five times and the programehas also used it five tinres for lts owr3. meetlngs. rf the amouxt savedby the Progre'me on each of these meetlngs ls 6st:.mated at auoui 6 rooo,and if the fees charged for the loan of Irre equipment are added, thei''itlaL outray of tl 10 000 on this equlpnent dro oo* be regarcred ascovered. 7L. Durilg the quarter the travel delnrfuent process ed L34 travelauthorlzattons and obtainecl L5 air tickets and 59 yisas. Supplies - 72. Drlring the tirtrd quarter 206 inport licenees were requestect ) L64customs declarations- were clepositedr antl customs clearance uas grnntedfor L75 items- At the end oi the quarter 76 purchase orders and 15purchase guthorizations were being processed at neaoquartersr 77. In Septenber-the Prograrvme received fron 1.on6 the last conslgnmentof the L50 tons of cement that hacl been amited for weelcs. Cementboqght loca]-ly in o*agad.ougou has risen i:r prlce i_n one year from -16- TABT,E sHOTti"JNG lEnMrl{A[]oNS oF r[,{?royllmN[ At(D srAFF DEpARrunE SROM T}IE ?NOGBAJ\&M BETYTEEN 1 JA}IUANY 1974 AND '1 JUI,Y ].978 [e::mination of ' enplovment % of total general sern*ice staffNo. Percentage Beason Resignation Unsatisfactory service Non-renewal of contract(satisfaetory sewice) itietlicalJ.3' unfit Miscella,neous Death A.banclorunent oLpost 47 9O 20 14 L2 11 g 23 44 10 7 6 5 5Total 201 100 Dr:ration of emploment less than 4 months 4 to L2 monthslJ to 24 months 25 to 56 months 37 to 48 nonths 49 months 5L 72 42 27 10 1 25 76 2L t1 5 [ota]- 203 ]oo Qrade o1 a2 03 o4 05 O6-SRG 59 B9 10 10 5 10 29 44 L5 5 2 5 3e 29 16 5 5 7fotal 205 100 100 Uuit Veetor Cont::ol Admlrr.istration Epid em:iologlcal eval-uati on Mlscellaneous a14 +9 16 4 66 24 I 2 76 16 6 2lotal 203 100 Loo Nationa]-itv Upper Volta Ghana Cbte drlvoire B6rrin L{a11 Togo Iliger France 0ttrers 111 27 L7 11 11 11 5 5 5 55 t7 8 5 5 5 3 3 v 75 L5 t3 10 a7 11 2 I Iotal 207 IOO 100 _17_ 23 oao cFA francs per ton to 42 000 cFA francs per ton. [he cement bought by the Prograrmre 1n lon6 costsabout r0 000 CFA francs per ton after transport. 7+. Delivery was taken of four Saviem SG4 trucks and three fandrovers equipped with moblle workshops at the port of lom6. fransport 75. Durfng the quarter 199 raiscellaneous repairs urere carried out at the cenfulal garage. Fourteen engines and eight gear-boxes were eonpletely overhauled. 76. A tour of inspectlon uas made of the progra.nrmets ga::ages and workshops at Bobo-Dioulasso, Korhogo, Bouak6, 0tlienn6, Bougouni, Banako, lama-Ka::a, Kandi and l{atitingou. 77. E\raluation of the 17 Iandrovers that went into oper"atlon in ISTT revealed the followirrg facts: - the average distance recorded so far by these veLr:lcles varies between 40 OOO and 5O OOO h0; - five engines and seven gear boxes have had to be conpretely overhauled. Nine further engines haye had to be partially overhauled.. 78. An analysis of the work carried out on the irehicles has been sent to.headquarters to be passed on to British leylanrl. 79. f,he transport detrmrtment caried out cheeks on the veh:ic]-e logsfor the period April - Ivtay IgTBi 7B% ot the logs had been reeeivedl aad th:is percentage vras eonsidered satisfactorlr. 80. The bi1ls for petrol zupplied from comercial punps were cheeked agalnst the logs of the vehicles that had refue].led there. fhe bil1sproved to be iJI conformity with the recorded cons:mption. similar ehecks were eamied out on ilre petrol supp}ied from the progranme r s oyrn pwrps. [his check proved satisfactory. 81. The petrol conswption of 45 vehi.cles stationed at 22 differentplaces uas also checked. [he consumption of 6671 of these velclcles was w:i.ttr-ln norrnal lirnrtsr while Lfl' stpwed consi-mptlon exceeding the nom by LOf. fhe six ve]ulcles in this latter category have gone lntothe workshop for checkirrg and readjusfuient. 82. checks on fuel movements at the petrol station in the centr:algarage were also made at the end of July and throughout August. fhey showed a maxi&um shortfall of 6r litres and a ma:ri:mm surplus of 14? ritres; on average there $ras a shortfall of about 50 litres per cterivery of 4ooo lj.tres. [hese figures are within the accuptable -18- limitsr tahir:g into account the fluctuations due to the expansj_on and volatillty of petroll the approxinate nature of the rirr:.ng system at the depot, and possible differenees lietween the neters on.our pumps whlch are becoming ::ather aneient.. 87. Three accldents were notified ln September. They concez:eed, a w bus and a landrover in the Bobo-Dioulasso sector and a vlTbus in the Bolgatanga subsector. ido one. was hurt. The damgeto the vehicles v'Jas conparativety sligfut. ConstnrcElon of the heaclquarters brrilcline 84: The suppLy of cenent uBS a major problem throughout the quarter and ve.s not solved until the end of september. ylork on the officebuilding is now well ad.vanced,. However, not all the equilment neededfor the telephone installations and for connectint up the r,rater andelectricity to the mains has yet amj.ved. After that the finisS:ingtouches wili have to be attended to, and then we shal1 have to deal with aceess to the public highvm.y, iencing and outside lighting.Negotiations are under uiay for renting a piece of ]and to use as aparklng area. 85. _ steady progregs is beirlg mad.e on the conferenee haIl: flooring,roofing, tilir€, plumbir:g, septic tank, At the end of the quarterthe eleetrlcal ruirlng materials and underground cables ordered byhead.quarters were awalted. However, it seerqs nost u-kely that aetaysin-the derivery and foruarding. of the air-conditioning e[uiprnent ordered in July will hold up completion of the work. I1I. IIEEIIT,IGS i[e ofa for insec s forthe 1 iasls vectors P6. A workirig group consistlng of 12 members of the scientificAdvlsory Panel met in Geneva tiom 5 to T Jury to discuss research on insectieldes for the control of the onchocerciasi.s vectors.Th:ls meeting vras held in pursuance of the reeonrrnendati.on by theSeientlfie and fechn:ical Adv:.sory Conm;11sg that a stand-bylnsecticide should be sought. [i:irteen representatives of chemj.calfirts took part. Dr J.\if. Miles of the center for Disease control,Atlanta, Georgia, usA was appointed chairuan of the worklng gr3oupr 87- The agenda incruded the nature of the probren requiring thedevelotrment of a replacement lanrj-cide, the characteristics of thetarget, a cr:itical review of the procedures for evaluating insecti.cidesagainst target ancl non-target organ:ims, and results to dIte, andprob3-ems of insecticlde screerring and fomulation develotrment rebtedto specifications. - 10 - BB. One of the naj.n purposes of the meeting qras to draw the attention of the representatives of chemicaL companies to the urgency of the problen and to provide then with the arrailable infonmation to euable them to develop Larvicides sultable for !:nqliqq control. Some of those representatlves asked uirether the Programe would use a substitute for Abate if such a product were developed. the Dlrector stated that the Progna,nme llias prepared to give very serious conslderation to the use of ar\y new insectieide provided that it is compar^able ln effectiveness, sa{ety and cost to the product now being used. 89. [he working group revj-ewed: - vrhat industry would require to help it respond to the Prog::aumets needs for alternative products; - methods of testing the effect of new products on Sj^uulium; - methods for evaluating the effects on non-target organimsi - the operatlonal constraints. Reconrmendatlons rvere @.de on each of these poi-nts. 90, In its conclusion the urorking group stated its general opinion that it seemed unlikely that the eheuical conpanies would devote resources to the production of the new compounds for Sinulium cont:roI, but given the existence of a field evaluation seheme the industry woukl be pretrnred to submit sanples of compounds or fo:sru1a- tions for testlng and w?rere indicated, for further develotrment. 91. The report of the meeting, docr:nent WP/S'I[G/73.25, is avai]abIe on request. Sclsntlfic ancl Techn:ical, Advisory Conmlttee. seventh meetlng, Brazzavilte. 21-25 August 1978 92. The meeting uas opened by Ir Comlan A. A. Quenum, Regional Director. the Chairman uas Dr P. Haslre1l. It vras also attended by Dr IrI. Candau, Independent Chairnan of the JCC' and by llir S. Denr5:rgt Divisional Cirlef ot the liorld Bank. 95. I?re questlons put to YfIIO and the Cornrnittee by the Bank concerned: - lorrg-tem prcspects of the Prog::a,mre in its present forzt; - the lenel of vector control after 2O years, on the basis nology, to ach:ieve permanent that will have to be maintained of present la:owledge and tech- control of the disease; .20- - improvements in trnnowledge and technology that can reasonably be ocpected at present, and the i-mpct they would have on Progra,me st::ategy; - the prospects for lar,rnch-lng an intensive progralme to destroy the uigrating blaekfly at their point of d.etrnrture, the tj.ne this would take, and the cost of the operation in comparj-son to the cost of the cument ?rog::a.me; -"arlJr other str"ategles utrich n:ight be conslrler€ii. 94. fhe main agencla items were the study of the Progzamme evaluation report, the lor1g-te:m future of the Prngraune, consideratj-on of the report of the working group on insecticides and the report of the Ecological Panel, health lrrfrastn:cture in the Programners lnrticipating countries ancl the measures taken to control other coryunicable dlseases, chenotherapy, the research centre at fbnale, and the definitj_on of leveIs of endemj.clQ,, 9r. Duri.ng the discussions the members of the Comnittee nade recornrnenda- tions on: - the convqring of a working group to stucly rei.nrrasion and thejspact on this phenomenon of any extenslonsl - lije expectancy of persons blincled by onchocerciasls; - inclusion in the evaluation report of new }a:owledge about the epidenriology of the rlisease and. vector biorogy obteined sincethe ?rogra,me actlvitj.es began; - prorrj-si.on by the ?rogre.rnme of the necessary facilities for conducting trials of new insecticj-des and new formulati.ons when the uatercourse currently used for such trlals j.s no longer availablei - eontinuation of research on the possible use of adulticldes; - search for appropriate techniques that can be used at coronunlty Ieve1, wh:ich would facilitate the t::ansfer of responsibillties when the tj-ue comes; - r€search on ehemotherapy; - contlnuation orr soclo-demog::aptric studies; - collection of data on the nrmber of persons exposed in the reinvasion areas, l.ife enpectancy of blind onchocerciasis victims, their mortality compared with that of other bLlndpersons, distz:ibution and regresslon of onchocerciasis j-n chlldren and young adults after the interrr:ption of t::aasnrission. .2l-- 96. fhe Comittee v-*as also infomedthe basj-n of the Rlyer Senegal and inbasin. p3sliminary reports on thesethe meeting of the Joint Coordlnating Deeember. of the studies in progress in the }trlgerian part of the Niger studies will be presented at Conmittee ln trom6 next 97. The report on the seventh meet1rg of the Selentlfic and fechnica]Advisory Conmittee will be presented io the Joint Coordinatirag Conrnittee. Itiee on the uation on the econouic a t of the P 98. At the invitation of the Yiorld Bank the delegates of the seyenpartlcipating countries net ln ouagadougou to connent on the reportof the econolulc evaluation mlssion. Professor Berg, head of the uissi-on,was present at the meetlng, fhe meetlng r/ras opened by His ExcellencyDr ringa Douanba, iiinister of publie Health or uppu*yo1ta, and uesclosed by Ifls Excellency Ivlr Georges Sanogho, I,llnister of ?iar:::ing and C oope::ation. 99. tr'rom the corr:nents uade by the delegates it 1s clear that the0nchocerciasis contror prograrme area is coverecl by a systenaticdeveloprent plan, and that this plan could not have been conceivedmithout the actiyities of the progre,rnme to free the area fr.om onehoceF-ciasis. 1OO. the countries unanimously stressed that if the evaluation of theeconoule i::apact of the progranme is to be complete it must take into 3'ccount not only the crop-grovr"ing potential or tne areas to be reclaimedbut-also their pastoral, mir.dngz energy and tourist potential.Professor Berg conrmer:ted tirat IUe mi sslon report gaye procedure tocrop-growing because at present, anu for the corair:g decade, the cropgrowing seetor had to be regardecr as the prio;:ity sector. The quantityand quallty of the land wh-ich the Prog::ame would raake available forcrops and other forms of utillzation Ied to a very franl< discussionin which the countrles unani^lrously expressecl the wish for an upwardrevision of the estjmates in the report, 101. The countries vented the report to give a clearer picture of theirtrue develotrment potential by providing iulter and more recent datathan those selected by the nissj-on, so as to bring out more crearly thevery great economic j-upact of the prog::ame r s work, 102. Ihe delegates al.so sug.gested: - the firranelng of a cost/efficacy study on controlled mig::ationand spontaneous luigration; - that the part of the report dealing vrtth the analysls ofdevelopment policies and aetivities should be strlngthened. -22- th meetine of t Adviso PaneParis. It-l_3 September 1928 107. This meetfu:g uB,s held under the chaimanstr:ip of professor Guy caraus. rts purpose vras to colreet, at the request of the l,Iorld lar:t,the views of the Comnittee on the draft report of the eeonomic evalua-tlon mission so as to decide whether the report represented an adequate analysis of the iratrnct of the. onchocerclasis control ?rog:nnme on economlc development in the area. ?rofessor Berg, neaa of the evaluation mission, attended the neeting. 104' the dlraft report uas considered as a whole and sectlon by section. The members of the Panel felt that the report brought out very clearlythe extremely varied aspects of the Progranme area3 some distrlcts had coumon features and others showed enolmtous differences, and the implica-tions of this had to be taken lnto account in economic develotrrrent,They expressed reserrations about the parameters used to assess the econouie iarpact of the work of the ?rograume and felt that a broader analysis could have been rtade, taking lnto account spontaneous resettlement,the prospects for develotrment through imigation and livestock raising,the lmproveuent of crop yieId, and the industrial, mj.n:ing and energy resources of tkre area. Ihey dwelt at length on the sections conce*oirrg unused land, resettlement and migration, methods of crop growing andirrlgatlon, and the strategy and pranning for econonic developnent. 105. The comments of the Panel uril1 be lncluded in a report that is nowbeing prepared. for submissj-on to the JCC. The menbers of the panel agreed that the draft report of the mj_ssion had the merit of raising sone Yery important questions and formed an excellent background for a more thorough economic analysis. However, they expressed their convictionthat the draft subriittecl for thei.r considezatlon underestjsated the econouic potential of the area. Steerj-rrg Com:lttee. 23rd session. paris" 15-15 Seotenber 106, Tnmediately after the neeting of the Economj.e Development AdvisoryPanel, the Steering Committee helcl its 25rd session. The Chaiman vie,sllh S. Deruring, representative of the y/orld Ban-k. 107. The agenda items nrainly concerned the financing of the ?rogramneand the contributj-ons of the plrticipatirrg countries. The Committeealso consiclered some of the docr.urents that wou1cl be presented to theJoint Coordinating Comlttee in December: the report of the Sclentiflcand Technical Advlsory Cor,rnittee, the report of tLe Ecological panel,the anrrual report on the socioeconomic developnent aspects of theProgranmee the An::uar Report of the progra.mmel and trrl first lnrt ofthe e.raJ.uation zeport. -23_ 108. At its 24th session to be he1c1 in london from 11 to 13 october,the steering--comrittee was to cliscuss the report of the EconomicDevelopnent Advlsory Panele the second part of the evaluation report, and the report of lrtiO on studies on onchocerclasls outside theProgra,me area. #es!i9+o{ the WIIO Reglonal Comitt.. f.= Afri..,Kisal.i. 2C-27 September 109. the Progra.rnme Di-rector attended the 23rd session of the \fIIoEegional comittee for Africa and the discussions forlowing thepresentation of the Begional Dlreetorts Report on the regional progr€,ED[re of onchoeerciasis control, comments were made on thisitem by the delegates of_zaire, the congo, senegal, L[ali, Gui-nea, 9b*r^.Togor the Uai.ted Republic of Cameroon, triberia, Cfiaa, Benin,IIoIy Coast, Upper Volta and the Central African &mpire. The delegates of-Iflgerla, who had already left when this agenda item vras discussed,had had prevlous informal talks on the sub;ect. 110. Ihe resolution adopted on th:is agenda item, LTR/RCZB/R.8, endorsesthe action taken by the Regional Director to develop the activitles for onchoeerciasis control and to support the training of medical entomolo-8ists. It also recomnends seeking voluntary contributlons to supplementthe funds al].ocated for these actlvlties. IY OTH]]R ACTIVTTITS Erralqation of the pnrEramme 111. Dr Ab::am S. Benenson, Di-reetor of the Gorgas i\tenorial Labo::atory, Panama, vislted the Prog::anrme area as a WorlO fanf consultant duringthe first week of August. Ihe purpose of this visit vra,s to deternine on the spot whether the ?rogra.mre e',aluation report ua.s a sufficiently reliable basi-s for a decision to undertake the second phase of activitiesfor 1980-1985. Dr Senenson had been instructed to pay speeial attentionto: - the justiflcation for the technical methods used; - the rlsks incurred. - the long-term prospects of overcoming the disease; - the research prograrnae, 1n the light of the posslble risks; - the objectives to be pursued; - the 'irnmediate and rong-term options open to the prog::a,nrme. -24- 112. Dr Benenson was also expected to prepare a set of technicalquestions subnit to on the future of the programe, whi.ch the r{orrd Bank wourclrllio and the scientific *ne te"rrnicaL Advi"o=y-c*ittee. 113' Lir Derxris.tolror, Director of Regional progranmes at the usArDAfrlcan 0ffice i1 \strin€'ton, and head of the united states delegatlonto the ?rogra'nrmels Joint coordinating comlttee, uisited the rraoa-{a::asector in [ogo ln Ju1y. [he maln purpose of h:is rrisit vias to assessthe justifi.cation for a possible southuard extension of progra,nneactlvitles and to d.etenalne wtrether the helicopter rearly uas theappropriate lnstnment for rarvici.de treatmenti. ot uoaia a sp:eyinghericopter Mr- conroy irisited the source of the Biver Ka::a, in Benin,and flew up sevelar tributaries. He confiraed the effectiveness ofthe methods beir:g app].ied as compared with ground_leveI treafuent. Asregards the extension of the programne, he ielt trrat, as the bufuetestimates for the present Prog::aune were on the increase donors wereunlikely to agree to ortenstoi r:nless a cast-iron entomological justi-fication 1s put forue.rd. }14. DLlxing the quarter, letters of**T- s.^4r5 ur.s g .r,{' rer, r 'uters remi.nder were again sent to those|]|+:1!?tir€ corxrtries ti:at were not up to date with their Da.vmenrs^lnSnoents. T :"., :: y*, ol^:"1:Fld i,,s " o"t"iu" ti;; " T" ;" t;; ";" ;i;li ibTi:rfi {'IfiJi"* " to 105 104 OO0 CFA franes. Th:is matter was discussecl at the neetlng "-1;i+ "'J ;; ,,ro,,o,,{r 1O7A i,n^^-^ !r ^ h13"1e]Lg:1 the prosrra^ncr" *" ;;*";i-;;i;;;il;" :";;r;";:made pronptly. 115. d.ate, .considered at present to be p::actj_cat1y up tothe data should be completed iy Novembei, i.nd it Data stor:age and processirlg hta storage is Screening of should be possible to proeess then tovrards the end of the yui=. 116. Steps have been taken to recruit a statistlclan to deal w:ith theentomological and also been made to epidealologlcal d.ata. prelirninary apprrraches havethe,Un:iversity of Salford in the b"ii6a fingdo; ::.'+*ili:y-.T1"] l3siytan"" "orid be given to t#-p"oI;;;1;-;il"collection and arralysis of Lqrdrobiolotieat Oata. I17. Mr logy Unlt take up a to prepare T' F' de c. L.arshall, statistician in the fropical Epiderolo-of the ,onclon schoor of Hygiene and fropieal ,lredicine, vur11eonsultantskrip 1n November-at Headquarters and in ouagado,gouthe data analysis prograxtrte. rt _25_ Yisitors 118. rn september the prograruo? ,,a: visited by r)e. Talaat zagtrloulean entomologlst in tfre Preventive Liedicine Defurfuent of the tuin:.stryof llealth in Kuuait. During his visit Dr zaiirtoul met the Ministerof Health of Upper Volta. He was able to trave ta::<s with the staffof each of the technlcar units in oragadougou on the nethods andtechnlques of control and evaluation. He also learned about theadministrative and ElarElgement actlvities. the second trnrt of 11;is visitwas spent in the fleld in the Tarnale sector, where he observed theentonologlcal suzrrelllance, control and evaiuation activlties, l1g. Pg Prog:enne uas also vlsited by }ir 1\[6ise ]tensah of the fnterna-tional tr\rnd for Agri-cultlrzal Developnlnt, accompanied by lrir Ahed raJrfour.&ir- Mensah explaj-ned the objectives, stnrctures and operation of the tr\.mdand the dlfferent types of loan granted by it. Iir }iensah agaln expressedhis interest in the work of the ir*rgr.*". Documents 120. Dl4ing the quarter the Programe prepar.ed and distributed worglngdocuments for the seventh meeting of the sclentiflc and. [echnical aavlsoryCornrnif,f,ss in BrazzaVl,le. 121. fhe fin:ishing touches were put to the report of the second neetingof the l[atiorial Cornrnt 11sss ln Cotonou. Th-ts report was di-stributed,as vlas the report of the twenQr-second session of the Steering Commillss,held in Rome from 28 to 5O June. 122. *te drdt annexes to the Prog::a.r',me evaluation report were in pr€para-ti-on, and material uias collected ior the Aru:ua1 neporl. 123' By the end. of the quarter, preparation of the docr.rments for subm:isslonto the Joint Coordlnating Courcittee ,aias well advaneed, lciork 11lgs beingdone on the final presentati-on and on the transration of the plan ofaction antl budget for A9T9t the annual report of the Scientific and[echn'ica1 Advisory Comalttee, and ttre annua] report for 19Tg on thesoeloeconomic de.yelotrNcent aspects of the programne. The report on thework of the 0rgani-zation in 19zB and the t:.rit lnrt of ttre ?rog::ammeeyaluation report were brought up to date. Inforyatlon 124' The Programme contributed to a seminar on |tDevelopment managementttorganized by the Institute of International Cooperation of tire Universltyof ottaua for l-7 Canadians working in technical, political and econoralcfields and a group of about 25 people fron the ivorv coast, lliger, Beninand upper volta.who were making a study tour under irre ".rsp:""ei of theCouncil of the Entente, An aeeount of the work of ttre ?rolraamre was alsogi-ven to a group of 18 Amer:lcan teachers on a study tour oiganizerl bythe vfestern Carolina Un-iversity under the auspi-ees of the rtrftrigiit ta d -26- Foundation. An information meeting on the programre \las organ:Lzedfor 23 A.meriean Jgacherg f,gking part in a stud! tour under theauspj.ces of the Phelps Stokes tr\rnd. These prelentatlons, fi:ich Y?""_glven by Prog::anme staff, were follo*a ly questions ancl filmCisplays. 125' fwo.f}h!, trOnchoeerclasistt and rrHurcan onchocerciasis in African,were sent to Dr lindsay, canadian representative at. the JCC, whoshowed them to participants at the annual meeting of'the canadiannntomological soclety in ottawa fron 20 to 23 August. 126. The Bamako sector assisted in the cerciasis and other eye dj-seases madeCentre of lvla1i. 127 ' ltte Division of Public rnfomation at headquarters, in coLlabora-tlon vuith the Programre, has bulIt up a collectlon or r*iaio recordingscontaiuing a series of interviews with the Director and some of the l:og*T*" staff, and with severar of the particilnnts at ure meetingof Natlonal Comrlttees ln Cotonou 1ast June. [his collection alsoeontains statements on the ?rogramne nade by the L{inisters of publicHealth of Guinear'i!1a11, [ogo aia l{iger at tire []:-trty-first tforld Hearthassembly Jast May. fhise iecoroingEr-:."i-"4"a*ior ihe use of broadcastingselices, are obtaj-nable on request. shooting of a fiLrr on oncho- by the National Cinematographic /