,r I RESTRICTED OCP/APOC-CSA9: THE ONCHOCERCIASIS CONTROL PROGRAMME IN WEST AFRICA (OCP) AND THE AFRICAN PROGRAMME FOR ONCHOCERCIASIS CONTROL (APOC) COMMITTEE OF SPONSORING AGENCIES (CSA) Report of the ninety-seventh session World Bank office in Brussels, 27 March2002 tiI( ;, Dratt23.04.02
) I A. OPENING OF THE SESSION 1. The ninety-seventh session of CSA was held at the World Bank office in Brussels on27 March 2002 with Bruce Benton in the Chair. He stressed the importance of the session as the first during Phase II and the Phasing-out Period of APOC, the first with representatives of Merck & Co., Inc. and of the NGDO Group as full Members and the first to be held in the World Bank office in Brussels. He particularly welcomed Georges Koulischer, Member and co-secretary of the OCP External Evaluation Team. ADOPTION OF THE AGENDA The proposed agenda (13.02.02) as reflected in the present report was adopted. OCP MATTERS EARLY IDEAS CONCERI\ING "EVENTS'DURING JPC23 4. As this would be the last session of JPC to be held a few weeks before closure of the Programme, particular efforts should be made to enhance its importance. Invitations to the Executive Heads of the four Sponsoring Agencies should be sent by the Chair of CSA within a not too distant future while Heads of States of Ghana, Mali, Niger and Burkina Faso would be invited by the Chair of JPC22. Also, invitations should go to President Carter and Raymond Gilmartin as well as to the former Directors of OCP. Consideration might be given to a field visit, although the logistics and practical alrangements could very well be of a magnitude that would make such a visit impracticable. 5. In order to provide the session with an insight into the "down-to earth work" that had been going on in the field for more than a quarter of a century, it was agreed that the Programme would invite one or two vector collectors and Community-directed Distributors (CDDs) to recount to participants the work they have been carrying out day-after-day near to rivers or distributing ivermectin within communities. 6. It would be important that any arrangements made be coordinated with the Burkina Faso authorities. D. ELC ud ftoc SESSION (11- 15 March) 7. This agenda item was introduced by Boakye Boatin who stressed the focus of the ad ftoc session on post-OCP onchocerciasis control in the four "special Intervention Zones" and the structural alrangements for this control. The session had also discussed in some details the future activities of Macrofil. E POST-OCP CONTROL 8. Much of the discussion was based on the recommendations made in the report of the EAC ad ftoc session and particular attention was given to the future role and structure of the MDSC as it related to post-OCP onchocerciasis surveillance activities. Antoine Kabor6 reassured the Committee that the Centre was now fully prepared to fulfil its mandate and to fully commence its operational role, immediately following the closure of OCP. Staff was being put in place taking into consideration possible transfers from OCP. The Bouak6 molecular laboratory had been moved B. 2. C 3to the OCP headquarters building since 1997; and provision for the Centre to cover the activities of the molecular laboratory in2002 and 2003 had been made in the AFRO Regulpr Budget. 9. The principal activity of the Centre would be to collaborate with, and support, Participating Countries in epidemiological surveillance. It was stressed that the MDSC had no mandate to be directly involved in vector control (larviciding) activities and ivermectin distribution. The Centre would support entomological surveillance. Expectations were justifiably high but the building up and functioning of the Centre should rest on realistic grounds. Also, coniideration would need to be given to the extent to which APOC might be involved in post-OCp activities i.e vector control and ivermectin distribution. In any case, a coordinating body would be required. 10. Special consideration was to be given to post-OCP control activities in the four "special Intervention Zones" (SIZs) given that JPC22 had requested CSA to prepare for consideration of the Donors' Conference to be held in October and of JPC23, a report on the planning of these activities. Furthermore, EAC at its recent ad hoc session requested the Director of OCP to work out "a special inter-country unit for risk management" or some other appropriate mechanism for consideration at the September session of that Committee. 11. During the discussion on post-OCP control and its institutional arrangements, a series of issues were brought up. It was stressed that aerial larviciding in the Upper Oti (Togo) - Ou6m6(Benin) basins and its monitoring would fall outside the TOR of the MDSC. [n so far as aerial larviciding operations would be conducted in two counffies, an inter-country project would need to be worked out by the two Participating Countries, WHO and the World Bank for approval as soon as possible. 12. As to the institutional arrangements for the Special Intervention Unit (SIU) (f. e. the above "Special inter-country unit for risk management"), responsible for conducting aerial larviciding and providing support to reinforced CDTI programmes in the four SZs, it was agreed that WHO with OCP, APOC, MDSC and the World Bank would prepare a description of a proposed SIU, including budget estimates and propose the most cost-effective administrative arrangements. The Unit would have a few international staff, supplemented by national staff and operate within the allocation from the Reserve of the OCP Trust Fund. One possibility would be for AFRO to situate the unit in Ouagadougou and for it to share administrative and other services with APOC and,/or the MDSC. It was recognized that this was an administrative issue to be handled WHO with a view to finding the most cost-effective arrangement. 13. The OCP Donor community, although no longer constituted as such, would be regularly informed about the operations in the four SZs and the use of the funds allocated from the Reserve of the OCP Trust Fund. Such reports would be provided by the APOC CSA. This was in order to satisfy the Donors that their investment was safeguarded. 14. A meeting would be held early in May in AFRO at which a plan of operations for the MDSC would be discussed among all those directly involved. At that occasion a draft of the description and proposal referred to in para. 12 above would also be available. Copies of the two papers should be made available to Members of the Extemal Evaluation Team 15. Other issues brought up concerning post-OCP control in the SIZs included the urgency of discussions with Evergreen which would find itself in a strong negotiation position. Furthermore, the 4F expected contributions to reinforced CDTI programmes by NGDOs already working in the countries concerned and their expected contributions should be reflected in the final document to be presented to the Donors. The point was also made that if funds remained available in the Contingency Reserve after commitment to post-OCP control in the four SZs (including its research component) and to closing-down costs, such funds would be transferred to the MDSC and/or to the Macrofil project provided approval was granted at the Donors' Conference. It was agreed in this connection that allowance should be made in the document for operational research and monitoring of the proposed post-OCP control activities. CONTROL IN SIERRA LEONE 16. The World Bank Mission to study, and recommend on, the development of the health infrastructure in Sierra Leone, including two OCP staff members concerned with the onchocerciasis control component, would now visit the country in April. The findings of the OCP special study on transmission in Northern Sierra Leone would only become available at a later date. Should aeial larviciding be included in onchocerciasis control in the northern part of the country the current estirnated US$ 10 million would not be sufficient. It was pointed out that a possible aerial contract would be negotiated directly by the country which would have full control of the utilization of the grant money. G SUPPORT TO SOCIOECONOMIC DEVELOPMENT 17. The Committee was informed that FAO was trimming down the regional aspect of its programme for support to socioeconomic development in onchocerciasis-freed zones and that the programme would be connected with the FAO Special Programme for Food Security. Three to four sites would be selected in the oncho-freed zones in each of the Participating Countries to reformulate projects together with the countries concemed. FAO was looking forward to the confirmation of the proposed Belgium funding totalling US$ 1.1 million. Progress would be reported to CSA at its July session as well as to the Donors' Conference. 18. A joint World Bank-FAO study on the socioeconomic impact of onchocerciasis in oncho-affected zones of APOC countries was envisaged. It was mentioned in this connection that itching caused by the infection reduced work capacity and school attendance. A draft terms of reference would be submitted to CSA at its next session. WEST AFRICAN FRESHWATER BIODIVERSITY CONSERVATION AND ECOSYSTEM MANAGEMENT PROJECT 19. No nerv developments were reported. CLOSURE OF OCP 20. The winding-down process continued. Dr Ebrahim M Samba had circulated C.V.s of OCP staff to WR offices and agencies and programmes within the UN system. It was planned to maintain some staff members, mainly administrative, for 2 to 3 months after closure of OCP to deal with outstanding matters and unforeseen claims post-OCP. Appropriate administrative alrangements would need to be made by WHO to continue the necessary staff in function during this time.. The last meeting of the AFRO-OCP-APOC Committee concerned with the closure of OCP would take place on 16-18 Apr1l2002 and would deal with this matter.. H. I. 5J 21. CSA was informed about certain specific issues. As to the future use of the OCp garage, it was suggested that the IFC assess the different options from a cost-effectiveness point oi vieiv. Regarding the OCRC, a decision would be taken by AFRO. All operational data were in the process of being computerized for transfer to Participating Counhies. River beacons might be sold to those Participating Countries which would find them of use. 22. Directors, OCP and APOC, would work together to compare their respective lists of staff to identify those that could be maintained for closing-down activities on the one hand and to be transferred to APOC on the other hand. They would report their conclusions to the 16-18 April meeting. Also, non-renewal of contract notices would be sent to all OCP staff within the near future. 23. With regard to obtaining donor approval for use of the OCP funds remaining after the closure of the Programme for (i) post-OCP activities, (ii) maintenance of a contingency reserve for closing-down costs and (iii) employing OCP staff in 2003 for final closure of the programme, Bruce Benton agreed to obtain an opinion from the Bank Legal Office on the nature of the approval from the Donors which would be required by the Bank in order to enable the remaining funds to be us for the specified purposes. EXTERNAL EVALUATTON (2002) 24. The evaluation exercise would essentially consist in providing a strategic outlook for post-OCP activities and would, in this connection, take account of the recommendations of EAC. The draft report of the Evaluation Team would be presented to CSA at its July session. 25. Georges Koulischer informed the Committee about the progress made by the Evaluation Team including the methodology to be followed such as interviews in Ouagadougou where the Team met with the Members of the ad hoc EAC session; the identification of evaluation tasks into six categories; and a few visits to Participating Countries. The Team was sheduled to meet early in June to exchange information about the progress made at that point and decide on the fufure course. 26. In referring to Annex 5 of the report of the ad hoc session which enumerated the m points that came up during an exchange of views between Members of EAC and of the External Evaluation Team, Georges Koulisher. particularly stressed the historical aspect of OCP as a vertical programme moving towards integration within the national health structures. He referred to the managerial aspects and the way to capitalize on, and maintain, the knowledge acquired by Participating Countries through OCP. The need for a post-OCP coordination body had been underlined as had the importance of identifying the role and modalities of the AFRO Multidisease Surveillance Centre (MDSC). 27. CSA was informed that the European Commission had expressed the wish to have the findings of the Evaluation available on the Web site as well as the results of the ongoing APOC self-sustainability study. 6APOC MATTERS K. JAFT 28. The session and that of the Joint JPC-JAF session had profited from a high-level attendance. Several OCP National Coordinators stayed on after closure of JPC. The main event was the approval of the Programme Document for Phase II and the Phasing-out Period and the signature of the corresponding Memorandum. During the session the reports of Participating Countries , including the sustainability aspects, were well received. Particular attention was given to CDTI programmes in conflict zones; to the utilization of the ComDT approach for the control of public health problems other than onchocerciasis; to the need for reliable forecasts to MDP for ivermectin requirements; and to the future collaboration between the AFRO Multidisease Surveillance Centre and APOC headquarters in Ouagadougou.. 29. It was agreed during the CSA session that, although APOC only provided direct financial support to sixteen of the Participating Countries as onchocerciasis was onlyhypo-endemic in three of the nineteen APOC countries (Kenya, Mozambique and Rwanda), all nineteen countries would remain within the APOC "family'' as a matter of precaution, should new or imported cases occur to the extent that CDTI programmes would be justified, L. TCCl4 30. This first session of the Committee under the new procedures approved by JAF proved their effectiveness in leaving sufficient time for TCC to deal fully with programmatic and operational issues and operational research. The project reviews by TCC were now confined to annual reports and new project submissions. The recommendations of the Committee are summarized in the table on the following two pages. 31. TCC paid particular attention to, and made recommendations on, such matters as reporting on the receipt and utilization of ivermectin tablets; CDTI activities in Southem Sudan; onchocerciasis control in Loa-loa areas; procedures for preparation and submission of research proposals; the definition of operational indices; the registration (census) of villages and their population; and technical support by APOC to the control of onchocerciasis in Yemen. MENTBERSHIP OF TCC CSA agreed to recommend as follows: - to end membership after TCCI5 (September 2002): Mamoun Homeida, Bertha Maegga, and Basille Kolo (thank you letters from the DG) and Frank Richards (thank you letter from CSA) - to be extended: Adenike Abiose (three years as from 01.01.03 as expert/scientist and no longer in her capacity as OCP EAC Chair) and Michel Boussinesq (3 years as from April 2003) M. 32. 7- ne\y appointments: Deborah McFarland and Peter Enyong - new appointees pending receipt of C.V.s:Danny Haddad and Moses Katabarwa at the next CSA session. SUMMARY OF PROPOSALS SUBMITTED BY THE NOTFs AND REVIEWED BY THE MANAGEMENT OF APOC IN MARCH 2002 Number of project concemed by the review 42 Number of document reviewed 74 Number of project with subsequent year budget Reviewed for consideration in 2002 budget 24 Number of project review in 2001 for 2002 budget 05 Country Project Year Submission Amount approved Difference US$ us$ 1 NIGERIA Akwa-lbom 1 137,517 137,517 S/TOTAL 137,517 137,517 2 CAMEROON Centre 1 2 140,514 105,430 3s,084 3 ETHIOPIA HQ Support 2 141,440 22,520 118,920 4 CAMEROON Haute Sanaga 2 63,022 63,022 SffOTAL 344,976 190,972 5 CAMEROON South West ll 3 129,126 92,819 36,307 6 NIGERIA Ekiti State 3 107,680 68,780 38,900 7 TANZANIA Tanga 3 89,383 70,131 19,252 I TANZAN!A Tukuyu Focus CDTI 3 38,277 31,790 6,487 9 NIGERIA Ondo State 3 125,628 80,582 45,046 10 oRc HQ 3 112,470 88,400 24,070 11 DRC Kasa'i' 3 174,235 97,650 76,585 S/TOTAL 776,799 530,152 12 NIGERIA Borno State 4 91,073 69,830 21,243 13 NIGERIA EdoiDelta States 4 112,489 73,223 39,266 14 NIGERIA Jigawa State 4 18,220 18,220 0 15 UGANDA Phase lV 4 82,289 70,205 12,084 16 UGANDA Phase lll 4 82,123 6s,286 16,837 17 N!GERIA Adamawa 4 76,453 65,143 11,310 18 N!GERIA Oyo State 4 93,060 56,645 36,415 19 UGANDA Phase ll 4 68,004 68,004 S/TOTAL 623,711 486,556 20 CAMEROON South West I 5 106,261 85,710 20,551 21 NIGERIA Enugu/Anam./Ebon 5 167,674 126,617 41,057 22 NIGERIA lnroiAbia States 5 77,904 67,348 10,556 823 NIGER!A Kano State 5 33,045 33,765 -720 24 NIGERIA Plateau/Nasarawa 5 63,625 u,443 9,182 25 NIGERIA Cross River 5 76,250 56,800 19,450 26 NIGERIA Yobe State 5 23,740 23,740 0 27 SUDAN Southern 5 397,506 241,757 155,749 28 NIGERIA Kaduna State 5 35,556 35.556 29 MALAWI Thyolo/Mwanza 5 161,517 161,517 NIGERIA HQ (augmentation) 5 23,000 23,000 SffOTAL 1,166,079 910,253 TOTAL 29projects+lamended 3,049,081 2,255,450 793,631 LEGEND Reviewed by the Management of APOC and approved pending submission by the NOTFs of detailed Plans of Action and Budget Justification Reviewed and approved in 2001 but funded by APOC 2002 budget New CDTI Proposats reviewed and recommended by TCC 14for approval No Countries Project First year budget as Gost for 5 years funding Submifted by NOTFs as submitted by the NOTFs I ETHIOPIA North Gondar us$ 127,575* us$ 330,487 2 ETHIOP!A Bench-Maji us$ 283,469. us$ 86s,660 3 LIBERIA Southeastern us$ 178,780. us$ 485,5s0 4 LIBERIA South West us$ 183,000" us$ 439,635 5 DRC Tshopo us$ 104,410. us$ 307,652 TOTAL us$ 877,233 us$ 2,429,994 LEGEND Amount to be revised according to TCC 14 recommendations* N. 33. 34. OCP-APOC MATTERS THE DONORS CONFERENCE The dates of the Conference, to be held in Luxembourg, had been tentatively fixed at7,8,9 or 8,9,10 October. The following issues were proposed for inclusion in the provisional agenda: - institutional arrangements for post-OCP onchocerciasis control and approval of the OCP Reserve to meet the cost of these activities; - approval to maintain a portion of the OCP Reserve as a contingency fund for a lin'rited time to meet possible liability claims arising in connection with the closure of the Programme; Reviewed by the lVla of APOC and the approval 9- approval to use a portion of the OCP Reserve to employ a limited number of former OCP staff in 2003 for final closure of the Programme; - rapid epidemiological mapping of Loa-loa (RAPLOA) and management of SAEs in APOC countries; - progress report on implementation of the APOC Phase IVPhasing-out Period work plan. o. FINANCING OF OCP AND APOC 35. Bruce Benton confirmed that OCP was fully financed with a Reserve of US$ 8.0 -8.7 million at its closure. APOC was so far US$ 36 million short in indications of contributions while US$ 43 million was already pledged. ELECTION OF CSA CHAIR FOR THE REMAIIYDER OF 2OO2 Bruce Benton was elected to hold the Chair until the end of 2002. VENUES AND DATES OF CSA SESSIONS FOR TIIE REMAINDER OF 2002 - CSA98 would be held on 15-16 July, possibly in London. - CSA99 would be held in Washington on l0 and I I September. - csA would meet to prepare for, and draw conclusions from, the Donors' Conference (if the Conference opened in the afternoon of Monday 7 October, CSA would meet during the moming of that day and after closure on Wednesday 9 october; if the Conference opened in the morning of Tuesday 8 october, CSA would meet morning and afternoon of Monday 7 October and after closure of the Conference on Thursday l0 October). - csA100 would be held in conjunction with the JAF-JPC sessions in Ouagadougou meeting on Sunday I December. P 36. a. 37. Members: Attending in ex officia capacity: Specially invited: Secretariat: l0 Annex I List of participants World Bank: FAO: WHO: Merck (MEC): NGDO Group: Bruce Benton (Chair) Bernhard Liese Moise Sonou Antoine Kabor6 Allen Foster Pamela Drameh Boakye Boatin Azodoga S6k6t6li Georges Koulischer, (Ext. Eval. Team) Tom Topping Ole Worm Christensen (Secretary)
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. ll Annex 2 Conclusions Invitations to Executive Heads of the four Sponsoring Agencies to attend JPCZ3 to be sent by Chair, CSA within the near future (para 4). Invitations to Heads of States to be sent by Chair, J?CZZ (para 4). Invitations to be sent also to President Carter, Raymond Gilmartin and former OCP Directors (para 4). Arrangements for attendance by vector collector(s) and cDD(s) (para 5). Coordination with Burkina Faso authorities (para 6). wHo in collaboration with ocP, APoc the MDSC and the world Bank to prepare a description of the "Special Intervention Unit" etara l2). APOC CSA to keep the Donor community informed about the utilization of the Reserve funds for post-OCP activities (para l3). copies of the "Special Intervention Unit" document (para 12) and the MDSC plan of operations to be discussed at meeting in AFRo early in May. Also, copies of the two documents would be made available to the OCP External Team (para l4). Unused funds of the Reserve to be transferred to the MDSC and/or Macrofil with approval by the Donors' Conference (para l5). FAo to report to the Donors' Conference on progress in its programme for support to socioeconomic development in oncho-freed zones (para l7). Economic impact of onchocerciasis in APOC countries to be studied (para l8). Possibility of post-oCP "mopping-up" team to be employed for a limited time in 2003 (para2}). Possibility of IFC assessment of options for the future use of the oCp garage(para2l). Bruce Benton to seek the opinion of the Bank regarding donor approval of use of the remaining OCP funds (pan23). Possibility of findings of the OCP External Evaluation Team on the web site (para 28). The original list of APOC Participating Countries to remain unchanged Qtara2g). Recommendations of membership of TCC (see para 32). Issues proposed for inclusion in the provisional agenda of the Donors' Conference (see para 34). Bruce Benton to hold the CSA Chair throughout 2002 @ara36). CSA98 to be held on l5-16 July, possibly in London (para 37). 13. 14. 15. 11. 12. 16. 17. 18. r9. 20.