Plan of action and budget for 1993

0nchocerclasis Contro'l Prograrme in West Afrlca Prograrme de Lutte contre 'l'Onchocercose en Afrlque de l'Ouest JOINT PROGRAM},IE CO},II.IITTEE off 'lce of the Chalrman JOINT PROGRAI,II'IE COI,IMITTEE Thirteenth sesslon Geneva. 8-11 December 1992 Provislona] agenda item 11 JPC.CCP COI.IITE CONJOINT DU PROGRA},IME Bureau du Pr6sident JPC13.4 (ocP/e2. 1 ) Orlg'lnal: ENGLISH September 1992 I : PLAN OF ACTION AND BUDGET FOR 1993 a t t rtI Ia ocP /92 .1 ONCHOCERCIASIS CONTROL PROGRAMME in West Africa PLAN OF ACTION AND BUDGET FOR 1993 ) a WORLD HEALTH ORGANIZATION ucPl92.l Page I t t a 1 2 3 4 ONCHOCERCIASIS CONTROL PROGRAMME IN WEST AFRICA PLAN OF ACTION AND BUDGET FOR 1993 TABLE OF CONTENTS INTRODUCTION OVERVIEY{ OF THE PLAN OF ACTION GENERAL CONSIDERATIONS ON THE PROPOSED BUDGET FOR 1993...... ESTIMATED COST BY PROGRAI,IME ACTIVITY. . Vector Control Unit..... . Epidemiological Evaluation Unit.... . Biostat'istics and Information Systems Unit . Devo'lutlon Unit..... . Onchocerciasis Chemotherapy Project . Office of the Director. . Adm'in'istration and Support Services Unit.. . . Adm'inistrative support'in Geneva . Statutory meetings.. 0. Capital Costs 5. RESEARCH PROGRAMI'IES. . . . . . ANNEXES I. OCP ORGANIZATIONAL CHART II. AVERAGE COSTS USED FOR BUDGETARY CALCULATIONS.. III. RATES OF EXCHANGE OF THE US DOLLAR 1983-1992.. IV. NUMBER AND PERCENTAGE OF OCP STAFF MEMBERS BY NATIONALITY AND SEX AS AT 31 MAY 1992.. Page 3 5 7 18 18 24 30 34 39 43 45 47 50 51 53 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.1 55 56 57 V. VI. VII. VIII IX. X. COST OF PERSONNEL FROM 1983 TO 1993. AERIAL OPERATIONS FROM 1983 TO 1993. MAP - PROPOSED VCU PLAN OF OPERATIONS FOR 1993... VCU ENTOMOLOGICAL EVALUATION NETWORK - 1993 MAP - LARGE-SCALE IVERMECTIN TREATMENT PLAN FOR 1993. 58 59 60 61 62 64 65 'a VEHICLES IN OPERATION FROI,I 1983 TO 1993. 0cP/92. I Page 2 LIST OF TABLES TABLE 1. BUDGET BY PROGRAT,IME ACTIVITY... TABLE 2 BUDGET BY CATEGORY OF EXPENDITURE... BUDGET FOR 1993 - SUMMARY BY PROGRAMI,IE ACTIVITY AND CATEGORY OF EXPENDITURE... TABLE 3 a TABLE TABLE TABLE TABLE TABLE TABLE TABLE TABLE TABLE TABLE TABLE TABLE TABLE 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. VECTOR CONTROL EPIDEMIOLOGICAL EVALUATION. . . . BIOSTATISTICS AND INFORI.IATION SYSTEMS. . . . DEVOLUTION. . . . ONCHOCERCIASIS CHEMOTHERAPY PROJECT. . . OFFICE OF THE DIRECTOR. ADMINISTRATION AND SUPPORT SERVICES. . . ADMINISTRATIVE SUPPORT GENEVA. ADMINISTRATIVE COSTS - CONSOLIDATED TABLE. STATUTORY I,IEETINGS CAPITAL COSTS. BREAKDOWN OF CAPITAL COSTS BY PROGRAMME ACTIVITY.. RESEARCH PROGRAI.IMES. . . . . . Page 13 15 17 23 29 33 38 42 44 46 47 48 50 52 52 54 t a I !ocPl92.1 Page 3 1. INTROT'I'CTION 1.1. The Plan of Action and Budget for 1993 is in 'line with the budget estimates of the Plan of Operations.for the fourth Financla1 Phase (1992- 1997) which was approved by the JPCI at lts twelfth sess'ion (Riyadh, 1-4 December 1991), and 1n conformity wlth the Long-Term Strategy. The amount, US$ 29,739,000, is lower than that approved for 1992. 1.2. The safeguard'ing and strengthening of the Programme's achievements depend on the way the Participat'lng Countries will be able toprevent, detect and control recrudescence. For this reason, the lmplementation of the devolutlon plans of the countries wil'l remaln one of the main concerns of OCP 1n general and bf its Devo'lution Unit in particular, which has therefore heen strengthened by the redeployment of a greater number of workers from the other OCP units. OCI wl'11, maln'ly through its Devo'lutlon Unit, play the role of coordinator, advlser and catalyst through technlcal support to the Partlc'lpating Countries as regards lnformation, education and cormunlcatlon, epldemlologlcal surve'il'lance and lvermectin treatment of patients. The Programme wl'll alsolend lts support to operatlonal research, particularly on lvermectlndlstribut'lon, migratory movoments in the onchocerclasis-freed zones, lmpact of blackfly nulsance, resettlement and socioeconomic development of these zones and actlve conmunlty partlclpatlon 'ln onchocerclasls control. With }{HO and the other Sponsoring Agenc'les, OCP will see to lt that these actlv'ities are integrated into the natlonal health systems of the countries concerned. The implementat'lon of this strategy necessarl'ly lmplies adequatetraining of nat'lonal personnel at al1 leve'ls. OCP y111 therefore continue togive hlgh prlority to such training. Final'ly, stil'l through lts Devolutlcn Unit, OCP will help the countriesprepare or update their devo'lut'ion plans and mobillze the financ'ial resources requi red for thei r implementation. 1.3. In the spirit of devo'lution, OCP is endeavouring, rather thanhiring permanent staff, to resort wherever possib'le to consultCnts or short- term professiona1s who are,nationals of the Participatlng Countrles. This enables nationa'ls to acquire theoretical and practlcal knowledge 1n dlfferent OCP f ie1ds. Following the staff rotat'lon thereby establlshed, an increased number of persons can thus be trained in OCP. Furthermore, intercountry exchanges'ln the Prograrune area are facllitated by the sendJng of qualtfteitstaff of a given country to coordinate a speciflc operattoi, such as anivermect'in distribut'ion campalgn, in another country. This favours experience shari ng and awareness of a corrlnon work for whi ch a] I the countrles arelnterdependent, maklng possible a serles of exchanges beneficial both to the Programme 'ln genera'l and to the part.les concerned. 1 JPC : Joint Progranme Committee 2 OCP : Onchocerciasis Control progranne a ocPl92.l Page 4 1.4. l{htle devolution is proceeding towards its obJective, attention ls also belng paid to the continuation of the activit'ies whlch should brlng the Programme to a close. Larviclding, which 'is on the way to completion in the initial Prograrme area, wi I l be cont'lnued in certain parts of the southern and western extensions - where they were started between 1986 and 1990 depending on the areas - at the same rate as in previous years. Wherever poss'ib'le, larvicide spraying wil'l be se'lective and seasona'1. A new aerial contract has been signed for a period of three years (1993-1995) with a specialized company after an internationa] invitation to tender. 1.5. Ivermectin distribution will continue unabated, particularly in the cormunities exposed to the risk of onchocercal bllndness. The inittal investment, in the form of censuses, epidemiological surveys and preparation of simple and detailed maps, has led to a cons'iderable decrease 1n the dlstr'lbution cost. The distribution is now carrled out by national teams of the Participat'ing Countries, assisted by local health centre workers, or, 1n certain river baslns, by non-governmental organizations (NGOs). OCP coordinates the dlstributlon schedules, supervises treatments and glves techn'lcal and loglstlc support. Special attentlon continues to be given to education and public awareness campaigns. While seeklng improvement of the treatment coverage and efficacy in the operat'ion'ln general, it can be said that the foundations of the mechanism have been wel'l establlshed. 1.6. In view of the 'lmpact whlch an effective macrofilarlcide could have in bringing onchocercias'ls contro'l to a timely conclusion, and lts future usefulness to national health care systems, the Onchocerciasis Chemotherapy Project (OCT) has been encouraged to accelerate its activltles 'in drug discovery and deve'lopment. 1.1. Socioeconomic deve'lopment remains the ultimate purpose of OCP's work. However, socioeconomic deve'lopment act'ivities themse'lves do not form part of its mandate. They are coordinated under the responsibility of the Committee of Sponsoring Agencies (CSA) which cooperates 'ln specific proJects and studies with the governments of the different countries in the Prograrme area as well as w'ith FAO and international and national agencies. Wtth'ln the framework of thts structure put 1n p'lace between the various partners, OCP will no longer need a fu11-time officer for these activities. Thus, OCP vlll mainta'ln close contact with a]l the parties concerried and may, through the services of consultants, strengthen the work undertaken as required. 1.8. The fourth F'inancial Phase ls based on year-by-ysar decreasing budgets. To this end, firstly, only projects essentlal for the achievement of the Programme's obJectives have to be reta'lned. Furthermore, every effort will be made to keep improving the admin'istratlve and financlal management' fields 1n which OCP'ls re1y'lng on the experience acquired during the thlrd Financia'l Phase, backed by an increasing recourse to data processing. aucP192.1 Page 5 2. OVERVIEH OF THE PLAI' OF ACTI(r{ 2.1. The various units will continue their duties of larvlcidlng and related activities, of ivermectln distribution, of research and of data processing support, without any notible change. The Devolution Unit, which was created in 1991, is fulIy playlng the role assigned to it by graduallyputting the Participating Countries in a position to safeguard the programne's achievements and seeing to it that they could prevent, detect and control recrudescence. Z.Z. The rlver bas'lns where aerlal larvlciding will be carried out will essentially be the same as in 1992. The treatments of the Banifing IV, in the western zone, as well as the Mekrou and the main Oti in the eastern zone, were interrupted in 1992 as a result of the good epidemlologlcal results. A rapid decrease in prevalence has been noted on other bas'lns but 'it is wise to malntain them under 'larvicidlng up to 1994. Final ly' in southern Sierra Leone, the larvlciding boundary wi'll be maintained as in 1 992. Z.g. The reduction of the VCU entomological evaluatlon network is be'ing continued with the cessatlon of larviclding in the inltlal area. After the closure of the subsectors of Niamey and Bougouni in 1991 and of Sikasso and Natit'ingou in 1992, the Ouagadougou subsector, which has been reduced to only one catching team today, may be removed from the VCU network in 1993 after the post-contro'l studies. 2.4. The post-control studies went on as planned and gave excellent resu'lts on the whole, the blackfly infectlvity rate having become negllglble. The opening of a DNA-probe laboratory in 1992 for the identiflcatlon of Onchocerca will henceforth make it posslble durlng these studies to separate human Onchocerca from anlma] Onchocerca. 2.5. In the vector control field, applied research wlll mainly cover the fie'lds of lnsecticides, identification of vectors and parasites, hydrology and hydrobio'logy. These research activities wi'll henceforth be carried out a'lmost exc'lus'lvely by OCP personnel. 2.6. Epidemio'logical eva'luations and ophthalmologica1 follow-up wlllbe conducted in the zones under larv'iciding. Furthermore, ln-depth epidemio1ogical surveys will be carried out to help ln declsion-maklng concern'lng places where larviciding 'is to be stopped. 2.7. Large-scale ivermectin dlstribution wi I 1 be undertaken ln al I the OCP areas where the epidemlological map reveals the presence of a high rlsk of onchocerca'l blindness. Less rigid criteria will be used, thus extending the zone to be treated. OCP wlll supervise and support the natlonal teams that w'lll undertake this activlty wh'lch, in certain zones, wl1l be carrled out by non-governmental organizations. Other means of d'lstrlbutlon wi'll be sought, lnvolving cotnmunity participation in treatment, fixed centres, or mobi'le services (e.S. combined with expanded programmes of immunlzation). The studies in the Mako focus in Senegal as well as in the Rio Corubal tn Guinea- Blssau wlll be continued: these studies relate to the possible lmpact of p1ur1-annual treatment on transm'ission. a wPl92.t Page 6 2.8. The processing and analysls of entonological and epidemlological evaluation data wi'll be continued. Efforts will be made to develop a cmputer system to be put 'in place in the Participat'lng Countrles. This system wlll make possible the estab'lislment of a data base ln each country, allowing their analysis to be made on the spot. 2.9. The Macrof i'l Chemotherapy Project, jointly admlnlstered by OCP and the t{HO Special Progranme for Research and Training in Tropical Diseases(TDR), will increase 'lts drug screen'ing and development prograrme, in an attempt to produce a macrofilaricide by 1997. This will mainly involve expanslon of the prec'linical and cllnical facilities to a'llow a more rapid eva'luation of lead compounds such as Ul,lF 078. 2.10. The administration and management will continue its duty of support to the other OCP units, As in previous years, cooperation of these units will be enllsted in an endeavour to use the avai'lable resources optimally while maintaining rigorous management. Furthermore, the administrat'ion will work on organizing the transfer of part of the OCP staff to the governments of the countrles in the initial area, or give such staff a status based on natlonal - and no longer OCP - employment conditions. These measures should take effect on 1 January 1993. t I 0cPl92.l Page 7 3. GEI{ERAL COilSTDERATTOi{S Ot{ THE PROPoSEo BU0GET FOR 1993 lrs$ 29,739,000 3.1. The Plan of Action and Budget for 1993 is presented, according to the pattern of prev'ious years, by "Programe activity" (sections 4.,l to 4. 10). The Programe activities correspond essential ly to the ma'ln subdivlsions of OCP's organizational chart (Annex I). 3.2. Table 1 presents a synthesis of the costs by Progranmre actlvity.It contains a sumlary of the third Financial Phase (19E6-1991), the budget approved for 1992 and that proposed for 1993. Flgure 1 presents graphical'ly the proposed budget for 1993. 3.3. Each Programme activity comprises a series of categories of expenditure. Table 2 presents a synthesls of the costs per category of expenditure (sunmary of the third Financial Phase, budget approved for 1992 and that proposed for 1993). Figure 2 presents graphical]y by category of expenditure the budget proposed for .l993. 3.4. Table 3 combines Tables 1 and 2 for 1993: summary by Programme activity and category of expendlture. General renarks 3.5. As in previous years, in preparing the budget, each activity hasbeen reviewed as well as each personnel post so as to maintain only wnit is essential to the executlon of the progranme. 3.6. The budget proposed for 1993 amounts'to usl 29,239,000. The average costs used for calcu'lating the budget appear in Annex rr. 3.7. The budget approved for 1992 is usg 32,4s3,000. From 1992 to1993, there is therefore a decrease of us$ z,T14,ooo, i.€., gt. The savings expected are due mainly to a decrease in the budget of some items (personn6l services, Duty travel, Adrial operations, operating costs, Larvicides,Techn'ical equlpment), as will be explained later under the respectlve categories of expenditure. Annex III shows the evolution of the rates of exchange of the US dollar, in percentage, from 19g3 to 1992. CATE@RIES OF EXPEIIDITURE 3.8. The categories of expenditure are the components of the programmeactivlties. A study by category therefore gives an account of the viriousfactors which, in addition to the assumed rale of the do]1ar, have an effect on the budget'level. The order followed in the rev'iew hereunder is that ofTable 2. a ocP/92.1 Page 8 Personnel services 3.9. Hitherto, the staff worklng for the Onchocerciasis Control Prograrme in t{est Africa has been composed of: - WHO/OCP staff in the initial Prograrme area and southern extension (Benin, Burkina Faso, C6te d'Ivo'ire, Ghana, l,lali, Niger, Togo); - government employees put at the d'isposa'l of the Prograrrne in the western extension (Guinea, Guinea-Bissau, western l.{a'li, Senegal, Sierra Leone). 3. 10. Ef fgrts wi 'l 'l be made, as f rom 1 January 1 993, to extend the western extensidn employment system gradually to the initial Prograrme area: At the time of preparat'lon of this budget, negotlations were in progress for the transfer of part of the OCP general servlce staff to the various governments of the countries in the initia'l area. In some cases, the staff will not be absorbed by the governments but will be given a new status as close as possib1e to nationa'l employment cond'itions, and no longer WHO/OCP. Such measures, announced at the last two sessions of the Joint Programmq Conm'ittee, are due to four factors: progress of the Programme, devolution, budgetary restrictions and standardization of employment conditions 'in the western extens'ion and 'initia'l area, The staff affected by these measures wi'l'l cease to belong to OCP, wi'll therefore be paid statutory end-of-service grants, and will be entitled to claim their United Nations Joint Staff Fension Fund benefits. It should be noted that, as long as OCP continues toexist, some of its staff, wlth OCP status, both in the professlonal and inthe general service categor.lss, w.i'll be needed for the runnlng of its headquarters in Ouagadougou and for several operationa'l and research centres (Bamako: Mali; Od'lenne, Bouake: COte d'Ivoire; Kara: Togo). 3.11. In view of the foregolng, the staff working for the Programme will be distributed as follows in 1993: a - OCP staff - Staff with nationa'l status 221 612 Total There is a substantial decrease in OCP staff and a concomitant increase 'ln national staff. The national staff wil'l therefore henceforth comprise the western extens'ion staff, staff in the initial area transferred to the governments as from 1 January 1993, and staff under any other national status. 833 aocP/92.1 Page 9 OCP staff 3.12. The fo]1ow'ing tab'le presents the total number of OCP posts approved in previous years and what is proposed for 1993. The fo'llowing table presents a breakdown of the posts 'into professiona'l andgeneral service posts: Unit Total number of posts 1988 1989 1990 1991 i1 992 1993 Proposed vcu 493 147 112 112 379 124 EPI 37 27 28 2T 25 20 BIS 4 4 4 4 3 3 DEV 5 7 ECO 3 1 t,5 1 5 ocT 2 2 2 2 2 2 DrR/ADtl 120 110 108 106.5 100 65 TOTAL 659 591 555.5 553 514 221 lJiit Professionrls &ncrul Sanlcc Itt8 rgt9 1090 l09l t032 t993 Proposd t9tt t9t0 rtc0 rt9 I re92 Itet Propsad YCU 30 2t 22 22 It il r03 fi9 390 tr0 3il il0 tPI { 5 { 2 2 32 2t 23 2t ?3 It trs 3 2 2 2 I I 2 2 2 2 2 0rY I I I 2 tc0 I I I I 2 0.5 0,5 0cT I I I I I I I I I I I 0rR/rut t2 il t2 t2 I E t0t 9g 96 9t.5 0t 5I I0Iil. 52 {I {l 12 35 lt 60t 5{{ 5 r2.I 5il tIe tt0 a 5 t I 0cP/92. r Page I0 ThEdecrease in 1993, compared to 1992, is therefore 293 posts (572), 1.€.,4 profess'ionals and 289 general service staff members (112 and 60I respectively). Following these reductions, the cost of OCP personnel services tn 1993 w'lll decrease by USi 2,700,000, compared to 1992. 3.13. The number and dlstrlbution, in terms of percentage, of OCP staff by sex and country of orlgin as at 31 l.lay 1992 are presented in Annex IV. Annex V shows the trend of the cost of personnel services from 1983 to 1993, excl udl ng consultancy serv'ices. llatlonal staff 3.14. The national staff is therefore on the increase as explained above. In the western extension, the salaries and allowances are paid by the respect'lve governments. During the fourth F'inanc'la1 Phase, OCP will pay the salaries and allowances of the nationa'l staff 'ln the initial Programme area, making substantia] savings, compared to what this staff would have cost under the OCP status. In the whole Programme area, OCP will pay to the national staff individual lump sums according to each person's function (0CP will also pay them dai'ly subsistence allowances when they are on duty travel). The summary tab'le of national staff 1s as fo1'lows: ACTIVITY YEAR 1 988 1 989 1 990 1 991 1 992 1 993 Proposed VCU EPI DIR/ADM Total 319 351 338 78 255 78 240 104 467 111 34 319 351 416 333 344 612 Consultancy servlces 3.15. These serv'ices include, firstly, consultants used by OCP,part'icularly for activities re'lated to'ivermect'ln distribution, and experts who contrlbute to research work in the fields of 'lnsectlcldes, entomology, hydrology, hydrob'lology and cytotaxonomy. Included also are short-term professionals (16 planned for 1993) and a United Nat'ions Volunteer in the fie]d of ep'idemiology. The p'lanned expenditure is greater than that of 1992by US$ 596,000, due mainly to the increased number of short-term professi ona'ls. I c ocPl92.t Page ll Ooeratlonai travel 3.16. Strict measures continue to be taken as regards operational trave'|. There is an expected decrease of USg 121,500, compared to 1992. Contracts 3.17. This category covers research and servlce contracts signed with companies, universit'ies and other institutions in support of specific OCP activit'ies, €.9., aquatic monitoring, Argos teletransmission, maintenance of hydrological stations. A1so included are contracts signed as part of the Onchocercias'is Chemotherapy Project on which a special emphasis has been laidby the Joint Prograrme Conmlttee; in view of the evolution of the chemotherapy project, the planned expenditure, under this category, isgreater than that of 1992 by US$ 845,000. Aerial operations 3.18. A new aerial contract has been signed for the period 1993-1995.It provides for spraying by helicopter alone (the Turbo Thrushes and the 'lia'ison aircraft have been cancelled). Following the new contract, the cost of f]ight hours (including fue'l) has decreased by 3.St compared 1o 1992. The estimated total number of flight hours is 7,405, compared to 7,800 for 1gg2.This has brought about a decrease of USg 55O,OOO (including fuel), comparedto 1992. A diagram show'ing the trend in the costs of aerial operations from 1983 to 1993 ls given in Annex VI. Operatins costs 3.19. These are costs related to the logistic needs of the prograrune(e. g. , vehic'le fuel , spare parts) 'and io inf rastructural servlces(electricity, water, te'lephone). Everything possible wil'l be done to maintainthe operating costs with'in the 'lowest possible lim'its compatible with the smooth running of the operat'ions. Despite the 'increase in the prices of fuel and services, the amount required for 1993 is USg 2S2,0OO less than that of 1 992. Larvicides 3.20. During the first three years of the fourth F'inancia'l phase (1992-1994), 'insecticide requirements w'l'l'l be close to those of 199b and 1991.Larviciding operations w'i'll sti I I cover some zones in the initia'l prograrune area. In the who'le of the southern extension, the larvic'lde applications willbe select'ive and seasonal. In two western extens'ion countries, Sierra Leone and Guinea, larvicid'lng has to be continued with a sufficient intenslty andduration on the permanent rlvers, which have a high rainy-season discirarge and correspond to hyperendemic foc.i. As regards the chem'ical 1arvicides, the safety margin expected at the end of1993 is less than that envisaged at the end of tgge. For B.t. H-14, lt isimperative that a safety margin of about 6Ox of the expecte?-consumption be mai ntai ned. The amount required for 1993 is USg 560,000'less than that of 1992. ocP/9?.r Page 12 Suppl les 3.21. This concerns the procurement of recurrent ltems as opposed to capltal costs. The est'lmated amount is US$ 15,000 more than that of 1992. Statutorv rBetlnss 3.22. The budget has been increased by USi 1E,000, compared to 1992, because of the increase ln air-fares and related costs. Fellorshlps and tralnlns 3.23. This category w{ll continue to cover current fellowshlps, ne}, ones, and fleld training, all actlvitieswhlch are fundamental to devolutlon. Following increased tralning efforts, the est'lmated amount exceeds that of 1992 by US$ 86,000. Iestern extenslon natlonal teams 3.24. As explalned above, under the "Personne'l services" category, the governments of the western extension countries put at the disposal of the Programre national teams whose salarles and allowances they pay. In addition to lump sums, OCP pays them per diem when they trave'l on mission. The teams work under the technical supervislon of OCP which a'lso provides the vehicles and fuel and other equ'lpment. The amount required for 1993 has decreased by US$ 115,000, compared to 1992. Othor catesories 3.25. Administratlve support in Geneva and cap'ltal costs will be dealt w'lth under Prograrme act'lv'lties. Budset sumarv 3.26. The proposed budget requirements are surTmarized ln the following tables and figures: Table 1 - Budget by Programme Actlvity Figure 1 - Budget by Prograrme Actlvity Tab'le 2 - Budget by Category of Expenditure Flgure 2 - Budget by Category of Expenditure Table 3 - Budget surmary by Programne Actlvity and Category of Expendlture Further details are given in Tables 4 to 15 for each Programme activity. Table 16 is a synthesls of the costs of the research work undertaken by OCP(these costs are a'lready lncluded'ln the budgets of the respective progranme activitles). ocPl92.l Page 13 IAELE I BUOCEI BY PROGRA}|I|E ACIIYIil (us t) P }l A S E III PHTSE IV Programc Activity turependiEr Expend ure 1 ,328,7{7 t Proposcd r 980/ r 990 l99t 21,363,798 2 ,105 , 602 I 993 Ycctor Control Epideriologicrl Evaluation Biostatistics I Info. Systols Sociocconoric Oevel oprent Dcvolution Chcrothcrrpy Project Office of the Dircctor Adrinistrution I Support services Adrinistrativc Support costs Genevr Strtutory lleetings Capitll Costs (l) t0l,703,00{ 5,555,210 790,088 511,782 5,788,220 l2,ll0,{ll I ,313,709 I,1t7,085 18,173,000 0 2 I 3 , 679 ,000 5 2,3n, 3 3 79 79 000 000 000 000 000 000 000 000 189,2 105,2 88 {{ 10,589,37{ 06 0 08 t n 1,153,5 33 3 3 3 I 38 79 00 3 288 I 6,85708 2 tpplied Rcserrch rnd EnvironnEntrl llonitoring 3,925,395 TOTAL llt,821 ,125 32,513,300 29 , 739 ,000 (l) Crpital cost expenditures for 1986 t0 tg89 are included in the cxpenditures of thc Programe rctivities above. Ihe rnount of USf 1,080,857 in thc 1980/1990 colurn therefore reprrsents the expenditures in tgg0 alone, llote Ivernectin: 3,000,000 tablets, vrlued rt USI 3 r tablet, rill be provided free of chrrgc by llerck Sharp rnd l)ohre. a lttttri lotal I tpproved i tll rtt i r980/r9er i reez ittl t--r-ltttttt | 1 26 ,066 , 802 1 22 , 365 ,000 | rtttrl| 6,883,957 | I,803,000 |ttllrl i 985,9i6 i 288,000 ittl rtt| 617,026 i ittttlti I e6r,00o itttttt I lt,l{2,910 | 2,tgo,o0o IltttttI 7, t 39,736 1 727,000 itttttt| 11,5t6,013 | 2,558,000 |tttttt I I,703,01I | 3{0,000 ittrttl I I,750,999 i 305,000 ittlttt| 2,039,23{ i 907,000 itttttttlrtttlrttttttrtttI 3,925,385 i Ittt I ----_-- I -__-_-_-_ |tttltt | 177,37t,085 132,153,000 iltt I -_-____ r ______ I ocPl92.r Pase 14 FIGURE 1 BUDGET BY PROGRAMME ACTIVITY. 1993 g9 10 4 (us $) (Yo) 5 1 Vector control 2 Epldemlologicalevaluatlon 3 Blostatlstlcs & lnformatlon Systems 4 Devolutlon 5 Chemotherapy ProJect 6 Office of the Director 7 Admlnlstratlon & support servlces 8 Admlnlstratlve support costs - Geneva I Statutory meetlngs 1O Capltal costs Total 18,I 73,OOO 1,679,OOO 279,OOO 1,438,OOO 3,679,OOO 579,OOO 2,347,OOO 36O,OOO 323,OOO 882,OOO 61.10 5.65 o.94 4.44 12.37 1.94 7.89 1.21 1.O9 2.97 a 29,739,OOO 100.oo 7 rl 3 2 il ocPl92-l Page 15 IIBLE 2 BIJOGET 8Y CAIEOORY OI EIPEIIDIIUf,E (us 91 Gatcgory of erpenditure RECURREIII COSIS Pcrsonnel services Consu I tants 0pcrational trrvel Contracts(rescrrch t others) Aerirl operrtions Operating costs Lrrvicides Suppl ies llcctings Fellorships and trrining llationrl tears Adrinistrativc support costs - Genevr Sub-tota I CAPIIAT COSIS Office furniture l)rtr proccssing equipmnt Yehicles Tcchnicrl cquipmnt Euildings Sub-toto I i tureExpend r 980/ r 990 {0, {98,908 3,878 ,8 1 2 1,860, I ll 12,051,058 25 ,000 ,093 10,765, l3l 20,703,713 2,112 tt66 I ,105 , 393 I , 290, 310 2,617,113 I ,3{3,709 t39,312,890 596,330 2,0I7,571 t2 217 52 050 09r 5,511,815 P l{ A S E III turrExpend 10,917,078 l99r 0,299,151 2,220,810 102,567 t97 912 5810 12 08 85 33 I I 0 { 3 70 35 880 2 I 3{ I30 I I I 398 I25 57, 08 00 I 9{ ,9 359 129 59 38 6 I395 305t32 0IOTAI l1l,82l ,125 l7I,37l,085 32,{ 000 29,1 000 ApprovedTotrl r e80/ r 99r 57,{15,98C r 992 I t0,939,000 I I I t,2t7,000 I I I I,167,000 I I I 2,{89,o()o I I| 0,500,000 I I| 2,512,000 I I 09 56 12 735 ,0 985 882 258 {, 5, 13' 3l ' 12, 33, 3, | 1,250,000 I I| 515,000 Ir| 305,000 I I I 317,000 I I| 905,000 I Ii 3t0,000 I t-_ I I 131,5t6,000 I t--_ 000 000 0r2 5t{ 9{7 023 ?18 307 907 359, 001 , I ,739, I , C92, 3,3l 8,217 I0t703 1 I0 , 903 ,803 25 ,000 77,000 597 ,000 n 5 382 I ,l7l 30 2 t08 203 2,181,{33 98 009 00007I2226 ,107 , 53 P1{ASE IY Proposed I 993 8 , 210, 500 I,811,000 t ,015 , 500 3,33{,000 5 , 950 ,000 2 , 2C0 ,000 3 , 090 ,000 5C0 ,000 323 ,000 103,000 000,85i ,2g 0 82I 000 000 50 00 I 3 0025,0 75' c20, 52 000 000 000 000 000 39 I --t I I 13t,590 I , 185 _--- I ------t__l 2 -t t-- ocP/92.1 Pase 16 FTGURE 2 BUDGET BY CATEGORY OF EXPENDITURE . 1993 ta 1t I t2 3 It 15 2 3 4 (us $) (%") 7 a I 9t 1 7 0 5 I Pononnel rorvlcor2 Goncuhantr 3 Oporetlonaltravcl4 Contracts (rcrarch & othoru) 5 Aerlal operatlonr 6 Operatlng costc 7 Larvlcldes 8 Suppller9 Meetlnga 10 Fcllowshlpe and tralnlng 11 Natlonal tcamc 12 Admlnlstratlvc Support coctg. Geneva 13 Offlce furnlturc 14 Data procotrlng oqulpment 15 Vehlcles 18 Technlcalequlpment 17 Bulldlngc Total 8,240,500 1,841,00O 1,045,500 3,3i14,000 5,950,000 2,260,ooo 3,690,000 560,000 323,000 403,000 85O,000 360,000 25,000 75,000 620,000 152,000 10,000 27.71 6.19 3.52 11.21 20.01 7.60 12.41 1.88 1.09 1.36 2.86 1.21 0.08 0.25 2.08 0.51 0.03 29,739,(x)0 100.00 ucP192.1 Page 17 ItStt 3 IIJDGIT FOR IOE3 . SUTIIRY 8Y PROCf,TTIE TCIIYTIY A]IO CITIOOflY OF IIPETCTIUf,E (ljs t) a Crtrgory oi arprndltura Rtcllf,Rttl c0sn Prrsonncl srrvlcas Consu ltrnts Ogerrtionrl trrval Contrrctl (rcsearch I othcrs) lrrirl opcrrtlons Oprrting costs Inrcct I cldcs Suppl ics Fcl lorships rnd trrlnlng trtionrl lcus ldrlnlstrrtivc Supgort costs-0cnavr Strtutory rcrtings Sub-totll GmnAt cosls 0ffio furniturc 0rtr processlng cquigrant Uchicles Irchnical equipmnt Su!-totrl 8ui ldings IOIAI I I lctivity lProgrum | 0i roctor I I I E0,000 I5,000 00009 t0,000 15,000 0005l 000 000 t0 -t Vrctor Cont ro I 1 , E00, 000 3, 090,000 300, 000 tE, ll3,000 6E5,000 tplduio- log I crl Evalurt. 9t,000 6lE,000 20 I ,000 t50,000 50,000 000 000 000 000 000 {, {31, 631 650 212 950 30, 000 000 000 000 110,000 I 10,000 350, 000 000 '61 I0,000 000 I3,000 500,000 I I it I -t_t_ 000 000 2 r2 0 22 10,000 5 0 000 I I 000 | tE,85E I -l- -t_ I I I I I I 5t6,000 i 260,000 I I 399,ooo | 3E{,000 I I 30,000 | 2E,000 I I 25,000 12,982,000 I I I I I I 5,ooo i I I I I I I| 25,000 I I t03,000 | 'l I I I I I I I I I I I I I iostrt i s- tlcs t Inf Systus l , {3E,000 11,000' l{,500 290,000 lt,{52,500 13,610,000 t6l,500 10, 0oo 12,500 20,000 0003,019, 000 00010 000 000 000I9 -l_t_t_t_ 000 500 I l0 -t_t_t_ -l-l-l-t-t-t t- ttttttlli iChno- ltdrinis- lstrtutory lDavoluttonlthcrupy ltrution Ii jProjcct I ltmtings llllt-t-t-r- , Ig2 ,000 10,000 t00,000 {5,000 -r_t_t_t 300,000 100,000 360,000 000IOI I0,500 500II ,000 500 000 20,000 -r-l-l-r_t t_t 323,000 | -l-l 00023 0 -t 323,000 Iotrl rcgS 5,950,000 500,000 {03,000 29, I39,000 2t0,500 33{ t50,000 t60,000 I Et2,000 -t E 000 500 000 ,8{l ,0{5 260,000 3,ooo,ooo ,000 323 tc2t I I I I I I il I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 2 t5 -t I ll il il lt il il il lt il il il il ll il il il ll ll il ll ll il ttlr ll ll ll ll ll ll lt ll ll ll lr il il lt lt 11 ll ll tl ll il il il ll il il il il 1t -l il il lt il il il il ll il lt lt il ll il il ll ll il il lt il ll ll ll il il lt il ll il l-l I rll rll , ,,I tr Iil I tli 25,ooo I iI ltI tti 15,000 I i r lrI tti 620,000 i i Iil Illi t52,ooo I iI tt rili to,00o I i I tl It l1illrll ocP/92.1 Page l8 4. ESTII{ATED OOST BY PROGRAIiIE ACTIVITY 4.1. Vector Control Unlt Introductlon us$ 18,173,000 4.1.1. The plan of action of the Vector Contro'l Unit for 1993 has been prepared accord'ing to the P'lan of Operations for the fourth Financlal Phase(1992-1997) adopted by the Joint Programme Committee at its twelfth sesslon(Riyadh, 1-4 December 1991). Zones to be treated (See map ln Annex VII) Eastern Zone including the southern extenslon 4.1.2. The river basins to be treated by aerial larvlciding will mainly be the same as in 1992, 'including the Iower Comoe below Betie, 8t the beginning of the rainy season in order to prevent savanna specles from settl ing there. Likew'ise, six to eight larviciding cycles w'i'll be carried out north of the Red and White Voltas in Ghana at the end of the rainy season. The objectlve of these seasonal treatments is to control the reverse reinvasion that affects the Kulpawn/Slss'ifi during thls period. In the southern extension zones, vector control actlvities wil1, as ln every year, be directed aga'lnst the savanna species in their usual blotope (Oueme, Okpara, Zou, Mono basins) as we]'l as 'in the phytogeographical zones they wou'ld occupy, considerlng their seasonal movements. In particular, in the hi11y areas to the east of the Volta Lake, the treatment of certain reachgs will be determ'lned by their presence which wi'll be closely monltored through regular morphometric identif'lcations of anthropophi I ic females and cytotaxonomic ident'lfications of larvae col'lected in the breedlng sites of the rivers under monitoring. Partlcu]ar attention will be paid to the Chal, the Wulubong, the Kpasa/Kou6 as well as the Bonakye at the beginnlng of the rainy season. In the mountainous areas where pure S. squamousum and S. yahense populatlons deve'lop generally (upper basins of rivers Asukawkaw, Wawa/Ghana-Hou, Dayl, Anie and Amou), vector control will in principle be conducted seasonally, as in previous years, mainly during the dry season, a period during which thgse vectors of 'lesser importance breed. The Sio, a sma'|1 At]antic river, wi'11 be treated as long as necessary (tO week'ly cyc'les) in order to prevent, if need be, the development of savanna spec'les there. [estern Zone including the extenslon 4.1.3. In the initia'l area, the larvlcidlng plan will practically be simi'lar to that of 1992. Residual treatments are planned in the Wh'lte Bandama bas'in 1f necessary. Larvlcid'lng has been suspended on the Banlflng IV in 1992. The rest of the zone will be treated as in 1992. ) : aocP192.1 Page 19 In Guinea, the treatment plan will be slmllar to that of 1992. For the moment, the emergence of S. soubrense Menankava populations ln the l,lakona basln remains a sporadic phenomenon which does not justlfy the budgetlng of seasona] treatments in thls basin. The reinforced coverage of the upper l.llIo will be maintalned. In Sierra Leone, because of the situation prevailing in the south-east and Ithe detay caused by two consecutive years of larvictding suspension, it is realistic not to inc]ude the treatment of rlvers l.{oa, WaanJe, Sewa, Tabe, Jong and Gbangbaia in the plan of action. The treatment zone will be delimlted to the south by the'lower Rokel, the Pampana/Teye and the Bagbe; the Bafi wlll be treated only very seasonally. The coverage of the northern half of the country wil'l be maintained, notably in the upper Rokel where the Tonkol i I1 wi 1'l be brought under 'larvlciding with effect f rom the ralny season. Larvicidins 4.1.4. The larviclde rotatlon principle is running smoothly notr. The B.t. H-14 de'livered in 1991 has had to be used at an lncreased dose (1.5 to 2 times the dose) and, in 1993, 58,000 lltres more than what was planned wlll have to be ordered to re-establlsh a minlmum security stock. However, the 'lnsectlcide company has agreed to compensate the Progranme for the defectlve product. Pyraclofos and phoxim will be used particularly durlng the transltion periods(rlse in water level and flood-subsldence) while Abate will be used main'ly during the high-water period 1n rotation wlth permethrln or carbosulfan. As regards the chemical 'larvicldes, the safety margln expected at the end of 1993 is less than that envlsaged at the end of 1992. For B.t. H-14, it is 'imperative that a safety margin of about 60I of the planned consumption be mai ntai ned. The requlrements for 1993 are as fo1lows: Abate B.t. H-14 Phoxim Permethri n Carbosul fan Pyraclofos 750 I 800 'l ood r 000 I 000 I 000 I 58, 253, 16' 42, 35' 14, itres ltres itres itres i tres itres Entomlosical evaluation netrork 4.1.5. With respect to the western zone, there is an essential changeto be noted, compared to the 1gg2 activltles. rn sierra Leone, the entomological surve'lllance network will comprise one sector and three basesin which 12 teams vi I I work. The same app'l'les to Guinea where the entomological survel'llance will comprise two sectors and nlne bases in which 23 teams will work. In the whole zone, this concerns catching and dissection teams each composed of an entomology technician, ttro vector collectors and a driver. ocPl9z.l Page 20 4.1.6. Forthe eastern zone, the Niamey sub-sector rlas closed at the end of 1991 and used ln 1992 by the national team. A plan of action has been prepared between the government of N'iger and OCP as part of devo'lution. Furthermore, the Natit'ingou sub-sector was c'losed at the end of June 1992. It should be noted a'lso that the Bobo-Dioulasso sector that had some 30 workers has been turned'lnto a sub-sector in view of the decrease'in activ'ities in the in'itia'l area. It now has 17 workers. Fina'11y, the Ouagadougou sub-sector now has on1y one catching team. These sub-sector c'losures and the staff reduction (two profess'ionals and 18general service staff members'less in 1993) follow the budgetary stringency measures. It shou'ld be pointed out that entomologica'l evaluation results are an indispensable tool for operational decision-making part'icu'larly with regard to the resumpt'ion or temporary suspension of larvicid'ing. Besides, wh'i1e 'it has been possible to remove the relnvasion monitoring network because of the excellent resu'lts obtained in 1989, 1990 and 1991, post- contro'l or post-treatment studies, which are necessary for two years after the final cessation of larvic'iding, have, on the other hand, had to be increased. These studies are aimed at checking that blackf'lies which recolonize the onchocerciasis-freed zones are real ly free from any infestation or that at 'least their rate of infestation 'ls negf ig'ible and doeg not perm'lt recrudescence of the disease. Aerial operations 4.1.7. The year 1992 'is the thi rd of the current aeria'l spraying contract. 0n the who1e, the company's performance has been satisfactory, particular'ly as regards the new he'licopter spraying systems. Furthermore, arl automatic spraying record'ing system (number of points, time, insecticidOquantity used) on both the helicopters and aircraft allows a bettel monltor'lng of the work of the pilots. For 1993, the number of flight hour$ is estimated at 3,205 for the eastern zone and 4,200 for the western zone.J This gives a tota'l of 7,405 hours. It shou'ld be reca'lled that the liaison aircraft w'ill no longer be used for the Programme's needs, but could be hired upon request for occasiona'l missions. Applied reseach 4.1.8. As mentioned in 1992, the necessary research act'ivities in the extension areas have nolJ been completed. New research activities on 'insecticides, vector cytotaxonomy, identlf ication of adult blackf 'lies or onchocerca strains,etc., are now carried out by VCU staff who have received adequate training in these different topics to which should be added their experience and field knowledge. Research contracts have therefore been reduced to a strict m'inimum and are ma'inly aimed at helping VCU staff in fie'lds in which the work'load'is excessive (insectlcide research, dissections or sorting of hydrobiological samples during certain periods of the year). I aocPl9z.t Page 2l To be noted 1n particular 1s the opening ln 1992 in Bouake of a DNA-probe laboratory, permitting the identification of anlmal (0. Ochengt) or human (0. volvulus) Onchocerca and the dlfferentiat'lon of savanna or forest 0. volvulus strai ns. The budget proposed for research contracts in 1993 amounts to US$ 45,OOO. llonltorins of aouatlc envlronrent 4.1.9. The monltoring of the aquatic envi ronment w'll'l contlnue to be carried out accordlng to the recomrendations of the Eco1oglcal Group thethirteenth session of whlch was held in January 1992 in Bobo-Dioulasso(Burklna Faso)". It has, notably, been decided to evaluate bioresmethrln and OMS 3002 1n river. In the initla'l area and southern extension zone, the mon'itoring of the fish fauna 'ls undertaken by the national teams and that of the entomofauna by VCU teams. In 1993, the latter will partlclpate also ln the screening of newproducts or nebr insecticide formu'lations. The monltorlng 1s centred mainly on the baslns treated with "hard" lnsecticldes (permethrln, carbosu'lfan). Inthe western extension zone, technical servlces agroements_have been signed wlth the national teams and the study statlons selected ln Guinea and Sierra Leone are under monitoring. Furthermore, lt has been recommended that a monitoring station be set up in the south-eastern extension zone (southern Togo) Servlce contracts 4.1.10. As 'in every year, these service contracts mainly concern hydroblology and hydrology. In thls regard, 1t should be noted that there is a cost increase of more than 50I in the Argos te'letransmlsslon contract dueto a saturation of the satel'lltes current'ly belng used. With the launching of new more powerfu'l satel'lites, the costs are expected to become stable. The verif icat'ion of the hydrological mode'ls has been completed by the FrenchInstitute of Scient'if ic Research for Deve'lopment through Cooperatlon (ORSTSM)in 1992 and therefore no longer appears in this category of expenditure. Personnel 4.1.11. The WHO/OCP personnel requlrements for VCU, including the staffof app'lied research and of the environmental monitoring groups, -wil'l be asfol'lows (comparison with 1992): 1 992 1 993 - WHO/OCP Professional staff members General Serv'ice staff members - Nationa'l staff Tota'l 18 361 379 14 110 223 a 347 The number of profess'ional posts has been reduced by 57I, between 19g7 and1993 (from 37 to 14). Th'is drastic reduct'ion has been made possible by theprogress of the Programme, the red'istribution of duties withln the Unit andthe change of some professiona'l posts to short-term profess.lonal posts (srp), whlch a'l'lows more f lexibi 11ty ln the use of abi l.ltles ocPl92.1 Page 22 Consultancv servlces 4.1.12. The serv'ices of seven short-term profess'ionals w'|1'l be required ln 1993. This concerns two insecticide speclalists, one based in Bouake, who is responsible for the Insecticide Research Unit and is Research coordinator in VCU, the other based ln Bamako, who ls responsible for lnsecticide trlals in the western extension, two entomologists based ln Bamako, taking care of vectolldentifications (morphometry, electrophoresls) and xenodiagnostic studies, the officer responsible for the DNA-probe laboratory in Bouake, the officelin charge of hydro'logy in the whole Programme, based at 0dienne, and, f ina11y, an aerial operations specia]'lst based ln Kara. In addition, consu'ltancy services are related to research activlties'in the fo'llowlng f ields: Number of Months - DNA Probe - Hydrobiology - Hydrology - Aerial operations - Cytotaxonomy 14 l{ational personnel 4.1.13. The national personne'l requirements for 1993 w'i11 be as follows: Post Guinea Sierra Leone Total ) 2 3 2 5 2 National Coord Dep. Nat'lona'l Coord Entomologist/Med. Off . Ento. tech./Nurse Hydrologi st Asst. hydrolog'ist Adm. asst. Secretary Radio operator Mechanic/Asst. mechanic Dri ver Storekeeper/Asst. Storekeeper Vector col'lector Boatman/asst. mechan'ic Watchman Messenger Budset 4.1.14 1 1 1 16 2 4 2 1 3 2 18 1 24 3 ,_ 86 1 1 4 26 2 4 3 2 10 5 33 3 48 1 14 1 2 2 5 42 4 8 5 3 13 7 51 4 12 4 21 1 158 244TOTAL The budget proposed for VCU in 1993 amounts to US$ 18,173,000. l a0cPl92.r Page 23 IABTE { vEcr0n collln(,t uxn '(us I ) Grtr$r, of ugrnditurc RECURNETI COSI8 PERSOTXEL SERYICES (lCP SIAFT Giirf IC{ (l} Scimtirtr (l) Ircinicrl 0fflcrrr tdrinirtrrtivr Arirtrntr clrrk, rtrnogrrphcrs rnd otirr 0rntnl Srrvim pcmonnrl Irtionrl Strff Irrporrry rtrff $ub-totrl Gonsu I trnts Opcrrtionrl travcl tcrirl opcratione Contrrcts(reocrrch I othcrs) llrtionrl tcrrs 0pcrrting costs Insccticidcs Suppl i cs Sub-totrl TOTAT 99 0 390 I 2 POSIS (l) chief VCU rnd one Scicntist undcr contrrct rith'lnstitut frunqris dc rechcrchc ecicntifiqur pour lc d6veloppcmnt cn cooperation' {0R$I0lt) 992 I t 3il 3r9 937 Erpcndi turc r 99008r/I 993 I I I I I I I ll I I I I I I I I I I I I I I I I I I I I I I I ,t- I l l 2t, t 79,3Co It-- I l| 2,000,577 I I I 3,003,ilt I I | 26,0t7, lzt I I| 2,C5C,il1 I I| 2,339,t27 I I I I,t5t,c52 I I 1 2C,7C3,7t3 I I I t ,558 ,292 I t---- I I | 72, t00,7c7 I t-- I t 198,280,t27 It-- 0 5 0 232 3{7 31 PllASE III lpgrovcd I 992 Erpmditurr r99t 000t0 999,000 c08, oo0 t- I I I I,322,0007,310,165 5,ll5,000 t00,000 ,0001, 250 300,000 5,0{3,000 172,000 I00,000 0 , 500 ,000 200 ,000 c15,000 2 ,000 ,000 fi9,855 678,739 c,299,{51 _ 150,il1 t6c, {75 l , 73C, l0c 880t8I I ,023 , C33 22 , 3C5 ,000 20t,0 t c l-_-- I I | 2t, 303 , 798 I l-- PII ASE IV poscdPro r 99t 962,000 000 600 000 000 600 r0 I 200 cc9 25' t{ 2 c 2 500 000 c90 300 000t3t{ 03I ,000 5 , 950,000 000 ,000 00 000 000 000 000 2 3 t- 00039I 00010,173, 3 ttt-l ttltttlrttl-ttttt i {t2 ittl-_t --l t- I a tttt1ttt lOrudr!tltllltltt tttl tltl tttttttttttllllltltl iPc :tllt I P6/Pr ltltt I P3/Pt il1tttlttlttt rltl ie.siitttt1tlttlt ll lt lt ll llttttt-lltlt a -t_ ocPl92.r Page 24 4.2. Epidemiological Evaluatlon Unlt (EPI) US$ 1,679,000 Overview 4.2.1. The activities of the EPI unit for 1993 wi'l'l focus primarily on: the continuat'ion of the distribution of ivermectln ln hlgh-risk areas of onchocerca'l blindness as wel'l as other areas to be included as a resu'lt of widening the criter'la for treatment; the evaluation of villages in larviciding is p'lanned; areas where lnterruption of continuation of the select'lon of villages for surveillance for the detection of recrudescence; the pursuance of surveys, 'lnc'ludi ng socio-anthropological studies, to assess the 'importance of mlgration 1n the onchocerci as'is-f reed areas; contlnued training of the national coordinators 1n the management of epidemiological results; evaluation of vector control and treatment on morbidlty; the lmpact of ivermectln ophthalmological evaluatlons'ln follow-up villages ln the Programme area to assess the effect of lvermectin treatment ln control'ling onchocercal eye d'lsease. Distrlbutlon of Ivermectin 4.2.2. Large-scale d'lstribution of ivermect'ln wi1.l contlnue ln all thc previously mapped areas with hlgh rlsk of onchocercal bllndness as well as in additional new areas being included on the basls of uslng a wlder crlterla of se'lection. It 'ls envlsaged that well over 500,000 people will be covered through active treatment with ivermectin. As in the past, several NGOs wlll take part in the treatment, and ot,her voluntary organlzations are expected to jo'in in the distr'lbution. These NGOs w11l carry out thelr actlvlties ln spec'ific areas wlthin the OCP but 1n areas whlch are not already belng treated through the national teams. In al'l the other rlver basins the treatment w'i1l be carried out by nat'lonal teams with the support and mlnlmum supervls'lon of OCP personnel. Adverse reactlons to ivermectin have been very mlnlmal over the yoars. However, monitoring and documentat'ion of severe adverse reactions to ivermectin treatment will be contlnued. The careful documentation of the effect of lvermectln treatm€nt on the eye and the skinload of microfilarla as well as the impact cri the other onchocercal morbldity wil'l be continued, to underllne the beneftclal effect of the drug after repeated treatment. I awPl92.1 Page 25 4.2.3. In the northern part of the western extenslon area where no larvicldlng ls being carrled out, there wtll be a contlnuatlon of the extens'lon of the coverage of lvermectln treatment. }{lth the wlder crlterla for selection of areas for ivermectln dlstrlbution, it ls expected that rell over 100,000 people will'receive treatment durlng the year. The rlver baslns north of the Tlnkisso river ylll constitute the zones to be lnvolved. The teams to perform the dlstrlbutlon wlll be made wholly of natlonals from the varlous countrles, 1n collaboration with OCPIEPI personnel who wlll play a minlmum supervlsory role. It 1s antlclpated that more NGOs will become lnvolved in lvermect'ln distrlbutlon ln the year. Other ways of distrlbutlng 'lvermectln, for example tagged onto other natlonal health dellvery systems or through other routes to simpllfy and facllltate the dlstributlon, will be further addressed. Biannual lvermectln treatment will contlnue ln the ilako area. In the Rio Corubal basin 1n Gulnea-Bissau, lvermectln treatment being glven three ttrnes in the year wlll also contlnue. These are studles which will attempt to determine the effect of more frequent treatment wlth lvermectln on transmi sslon. 4.2.4. Illth lncreasing use of lvermectln through passive dlstrlbutlon, a slmple and more up-to-date documentation and control on the use of lvermectln vlll be lnstltuted. Selected staff at the health centres and other health lnstltutlons responslble for passive dlstributlon will be encouraged through the natlonal coordinators to produce up-to-date records of the treatments glven. Thls mode of dlstrlbutlon is hoped to benefit thoselndividuals who for one reason or another may have been excluded in thelarge-scale dlstrlbutlon. Increaslng use of outreach mobile distrlbutlon systems wlll be encouraged and tested. Staff at the fixed health lnst'ltut'lons wl I I be encouraged to provlde health educatlon on the need for annual and long-term treatment wlth lvermectln and to motivate the lndlvlduals to contlnue thei r treatment. 4.2.5. The experlence wlth the community ln being fully lnvolved intheirown treatment, l.€., cormrunlty self-treatment with ivermectln, has been very encouraging. In thts regard, more areas wlll be treated through conmunity self-treatment 1n line with the devolutlon process. I{ith the large-scale, mobile and passlve ivermectln dlstrlbutlon as well as comnunity self-treatment at play, tt 1s envlsaged that over 1.8 mllllonpeople wlll be treated ln the comlng year. Interruptlon of Iarvlcldlns 4.2.6. Epidemlological evaluation wl1l be carried out ln selected villages wlthin stretches of river baslns ln the origlnal ocp area whereinterruption of larvlciding ls planned. The surveys wttt be conducted inlnd'lcator (fol lorup_) vl I lages, as wel I as in other surrounding vl I lages.Selection of the villages for evaluation will be done ln conJunctitn with theVector Contro'l Unlt (VCU) and the Blostat.lstics and Informaiion Systems Unlt(Afs). The results from these selccted areas will be dlscussed with vCUbefore a flnal declslon as regards stopp'lng of larvicldlng is taken. Thestaff to undertake thls epidemio'logica] evaluation will be nattonals, under OCP supervision. ocP/92.r Page 26 EpldEnloloslcal survei I lance 4.2,7. It is anticipated that larviclding w'i'1,1 be lnterrupted in severa'l more river basins and new villages wiI'l need to be selected for post-control epidemiological survel'llance. The selection of these v1'llages wi'l'l fol low baslcally what was p'lanned for the previous year. At 'least three flrst-'l'lne vlllages from each focus will be selected, each vi'llage being examlned once every three years and at 'least a vil1age 1n the focus belng examlned each year. The actual survei l'lance act'lvity wi 1'l be carried out enti rely by natlonals. However, the EPI unit wil'l undertake selected monitorlng of this act'iv i ty. tllgratlon studles 4.2.8. Hitherto, lnformatlon on migratlon of the population in the oncho-freed zones has been obtalned through the standard EPI surveys. With the increasing importance of the phenomenon of migratlon with'ln the various countrles, there wlll be a continuation of the mlgration studies to further determ'lne the lmportance of mlgrants ln the reintroduction of infect'lon into the onchocerciasis-freed areas. A soclo-anthropologlca] component wi'11 be 'lnc]uded'ln these studies wh'lch will focus on new settlements and nomad'lc popu'latlons, for example, flshermen who move between the new settlements and other places at high-r1sk'locations. Epldemioloclcal Eval uatlon 4.2.g. The eva'luation of vector control activlties in areas u.nder 'larv'ic'iding wi l'l contlnue. These areas wi'll be certa'in portions of thg southern pCrts (Phase IV) of the origina1 OCP area, the reinvaded areas, th9 problem spots and the extension areas. In an attempt to eva'luate thq effect'iveness of vector control in interrupting transmission in the extension areas - where both larviclding and ivermect'in treatment are going on - the currently introduced evaluat'lon, based on the incidence of infection as revea'led by sk'in snips, w'i'l'l be continued. Oohthalmologl cal eval uatlon 4.2.10. The ophthalmo'log'ical actlvit'les wi l'l invo'lve the eva'luation of the effect of large-sca'le 'lvermectin treatment in the popu'lation. Fol1ow-up vil'lages in Guinea and Sierra Leone wil'l be examined to mon'ltor the effect of 'lvermect'in 'ln control l ing eye d'isease and in preventing bl lndness. Inparticular, the fo11ow-up study to document the 'long-term lmpact of large- scale treatment with ivermectin on ocu'lar onchocerciasiS, bY photographlc and angiographic documentat'lon of certain 'indiv'ldua'ls in the Asubende area, wi'l I continue. Stud'ies wil'l a]so be conducted to determlne the evo'lutlon of the eye lesions of the few ind'lviduals who for some reason or other continue to take ivermect'in i rregularlY. Research 4.2.1i. The DNA studies already in progress to clarify the onchocerciasis parasite stra'ins together wlth sequencing of the strain spec'iflc clones w'll'l be continued. In addition, a search for a DNA probe to detect early infection 'in the popu'lation to be app'licable in devolution w'lll be addressed. Thls test 'is envisaged to serve as an a'lternative, or as a comp'lement d'iagnost'ic tool, to the immunodiagnostic test now being developed. The role of HLA II allele I 0cP/92.1 Page 27 (H.lstocompatlbtllty antibody) as a risk factor for developing severe eye lesions and b]'lndness from onchocerciasis wi 1'l be studied using the DNA probe. The'lmpact of 'lvermectin on onchocerc'iasis morb'idity'including sk'in symptomato'logy and les'ions w'l1l be studied. Other less objective impacts of ]vermectin on morbidity w1l'l also be addressed with the help of a social scientlst. The migration studies as combined with the epidemiological evaluat'lon surveys wi'll contlnue. However, stud'ies on migration involv'lng complete transhumance and new sett'lements wi'll be undertaken as separate issues. Personnel 4.2.'12. The fo'llow'ing personne'l wi I I be requi red to carry out the activit'ies out'lined above (as compared w'ith 1992): 1992 1993 - Profess'ional Med'ical Staff Members 2 2 - General Service Staff members 23 18 Tota'l 25 20 Provis'ion is made for short-term professionals, temporary advlsers and consu'ltants, to help in carrying out the extension of the lvermectin distribut'ion and to assist'ln the ophthalm'lc work. 4.2.13. To assist with the management and coordination of ivermectin distribution, and 1n line w'ith the task force requirements, an epidemlologlst w'i'l'l be requ'ired as short-term profession*1 to coordlnpte, visit thepotential fixed centres earmarked for passive lvermect'ln dlstr'lbut'lon, and adv'ise on the best posslble means of distribution as welI as proper documentation of the use of ivermectin. The epidemiologist will carry out operatlonal research in an effort to determine a'lternat'lve means of d'lstributing ivermectin and lmproving coverage. Consultancy 4,2.14. The fo11ow'ing consu'ltancy serv'ices are proposed: - Medical epidemiologists 29 months(Short-Term Profess'ional and Temporary Adv'isers) - Ophtha'l mo 1 og 'i st 4 months National Teams in vestern extension 4.2.15. The nat1onal teams that are expected to be prov'lded on part-time or fu'l'l-time basis by thei r governments for epidemiological evaluatlon and ivermectln distribution wi'll be as fo]'lows: ocPl92.l Page 28 Part-time personne'l Full-time personnel Each of the governments of six countries in the original area (Benin, Burklna Faso, Cote d'Ivoire, Ghana, Niger, and Togo) w'ill provide a meciical officer and six technlc'lans/nurses to the Programme for epidemiologlcal activities. OCP wlll pay them travel allowances and salary subsidles during missions. llatlonal rpdical personnel and health centres 4.2.16 For the extenslon of ivermect'in distribution, local doctors and nurses wj'll be ca'l'led upon to help in both active and passive treatment. Some fixed centres that wi'll be ma'inly'involved in pass'lve d'istribution may be required to extend their servlces through mobile outreaches to the popu'lat'ion at large 1n the areas concerned. Travel and subsistence allowances and other1ogist'ics for th'is personnel may have to be covered by OCP. Budget 4.2.17 For 1993, the budget required amounts to US$ 1,679,000, i.e., a decrease of US$ 124,000, compared to 1992, due mainly to the decrease in consu'ltant costs. Gu'inea Gui nea Bi ssau Ha'li Senegal S'ierra Leone Total Med 1ca'l Off i cers 3 1 3 2 1 10 Technicians,/ Nurses 14 6 12 6 14 52 Dri vers 8 3 6 6 3 26 Total 25 10 21 14 18 88 Gui hea Bi ssau Ma'lt Senegal Total National Coordinator 1 1 1 3 Dep. National Coordinator 1 1 1 3 Adm. Asslstant 1 1 1 3 Radio Operator 1 1 1 3 Others (drivers, guards) 3 4 4 11 TOTAL 7 8 I 23 ocP/92.1 Page 29 TABLE 5 EPIOEIIIOLOGICAT EYALUATIOII (us t) I a Category of expenditure RECURREilI COSTS PERSOII}IEL SERVICES Chief EPI lledical 0f f icer-0phthrlmlogist lledical Officer trboratory assi strnts/l{urses ldri ni strali ve assistant Clerk and typist Ieaporary staff Sub- lotr I Consu I trnts United tlations volunteer (l) 0perational travel Aerirl operations Operating costs Supp I i es Contracts (others) llational teans Sub-tota I iOIAL Grrde P.5 P.5 G.S P5 G.S 0.s I 991 I t 2 3 21 2 (l) Guinea-Eissau (epidemiology) 5,29 I ,236 I ,329, ll7 POSTS r 992 19 I 3 25 25 I 993 5 20 20 E xpend i ture r 98C/ r 9s0 3, 126, 180 617,{28 515,0{9 I 2,669 310,68t 389,913 35 ,000 277,686 2, I 65,056 P H A S E III Expend i ture r99r 611 ,182 It,66i 98,809 t 28, i09 107,321 2{t,659 650,905 Approved I 992 I I I ,000 I I I,000 285,000 15 ,000 25,000 005 0 IO 30 592 ,000 200 ,000 t{0,000 1 00 ,000 15,000 350 ,000 000 000 0002 PHASE IV Proposed r 993 0009 il9,000 300 ,000 20 ,000 {0 ,000 20 ,000 00030 6t8,000 231,000 I 50, 000 I 10 ,000 il0,000 50 ,000 350,000 l,0cl,000 c0007 I a lPt 2 ___ I ___ ___t___-__--t---___ I I ,803,000 | I _-__ I -----_--- I ______ I --l -_-_- I I ocP/92.r Page 30 4.3. Blostatlstlcs and Information Svstems Unlt (BIS) us$ 279,000 Data processlng 4.3.1. Data processing will be continued in the unit. As in the past, the data entry w1'11 be made by the staff of the units concerned, main'ly EPI and VCU, and the unlt w'l1l support this work durlng the peak periods by recruiting a temporary data entry c'lerk. As regards devo'lution, '1fl co]laborai'ion with the nationa'l devolution comm'lttee of each country, the unlt wl'll set up a computer ce1'l for data exchange and analysls with OCP. In this context, the entry and validation progranunes existlng 1n OCP will be revlewed to make the processing clrcuit more flexible. In col'laborat'ion with the OCp documentation centre, the unit will continue to develop the b'lbl tographlc data bank on the compl'lation of reports produced by the progranme and that of art'icles published on onchocerciasls. It wi1l also supervise and coordinate the development of data banks on aerial operatlons and the admlnistration (Transport, Supply, Personnel, Budget and Finance)' Analvsls of evaluatlon data 4,9.2. The unjt wi'll devote itse'lf ma'in'ly to the analysjs of entomo'logical and ep'idem'lologlca'l data. Emphas'is wl l'l be partlcu'larly lald on the medlum- and long-term impact of the combination of ivermectln with 'larvic'ld'lng on transmission. In th'ls respect, the 'lncldence studles started in the western and southern extenslons wlll be continued with the EPI unit for the sampllng of the v'lllages and the mon'ltorlng of the protocol to be adopted ln the field. The preparation and analysis of the data of the first resu'lts from the epldem'iologica1 surve'il'lance 'ln the initial Programme area wil'l constltute a priority. These analyses will be made ln col'laboration with nationa'ls. The interpretation of post-larviciding entomologlcal evaluatlon data will be another priority. The techn'lcal support glven to the other unipsin routine analysis w1'l'l be mainta'lned and'innovatlons made if necessary. Eoldemloloslcal model I lng 4.3.3. Epidemlo'loglcal model'ling wl I I continue to play an important role in the lnterpretation of results from the epidem'lological surveillance of the initia'l Programme area. This mode1, current'ly called ONCHOSIM, will be used malnly to study trends in the vlllages 'ln case fina1 dec'lsions on cessation of larvicid'lng operatlons wou'ld be taken. In the initial Programme area' where the paraslte reservolr 1s a'lmost ni'l and where larviclde spray'lngs havc ceased, the ep'ldem'lo'logical surveillance results wi'll be tested and valldated 'ln comparlson with the predicted trends obta'lned so far with 0NCHOSIM. Thus, emphasis will continue to be 'la'ld on simulations of recrudescence detect'lon and its contro] with ivermect'in. Furthermore, the impact of migration on recrudescence of onchocercal infectlon will be addressed again, taking lnto account observations made in the fie'ld. The analyses of the ophthalmological data wil'l be continued with a view to al]owing a good quantif'lcat'lon of the parameters of the ocular submode'l which 1s st'l'11 being deve'loped. ,ocPl92.t Page 3l OCP computer netrork 4.3.4. The un'lt plays the role of permanent secretarlat of the computer coordination group established in OCP. Accordingly, all techniCal studles ln the computer flelO will be made by the BIS unit which, besides, tri'l'l contlnueto centralize requests, propose adequate equipment and superv'ise the maintenance of the exlsting computer equipment. In 1993, stress will beparticu'larly laid on tra'ining to make the staff more effic'lent'in the executlon of routine dutles. This will alsoenable the use of the computers to be optimlzed. Equipment and softvare 4.3.5. For 1993, 'it will be 'indispensab'le to purchase,a number of equ'ipment'in order, on the one hand, to lmprove the use of the computer tool and, on the other hand, unblock some computers that are over-used. All documents for the Jolnt Programne Committee and other OCP technical documents and reports wil'l now be prepared and finallzed in Ouagadougou, while a good part had so far been produced in Geneva. It is therefore important for the un'it that takes care of meetings to have a microcomputer, and a 'laser printer that could be shared with other users. As regards the Admin'lstration, a support m'icrocomputer for the Finance and Personnel unlts w'ill increase their output conslderably. In view of the settlng up of a local periphera'l computer equipment sharing network in Ouagadougou, the purchase of computer accessories ls to be envisaged for the BIS Un*t, partlcular1y ln order to deve'lop a cartographlc data representatlon system. A portable is necessary for the Devolution unit for the monitoring and analyses of ep'idemlological surveillance data of the national teams and of ivermectln treatment data, on the one hand, and, on the other hand, for the processlng of the many correspondence and other technica'l reports. To strengthen the Kara operationa'l base, it appears necessary to plan for a mlcrocomputer and a portable. Apart from the purchase proposals for 1993, a general scrapping po'llcy for the computer equipment obtained frqn 1983 to 1985 should be envlsaged. The performance of these computers has reduced in relation to the new softyares current'ly on the market. Because of thelr obsolescence some of the user unlts cou'ld be seriously handicapped. The scrapplng proposal wtll concern some twelve PC, XT and PC-compatible computers and four portables. Most of these computers to be scrapped are related to the reinforcement of the entry and ana'lysis of research data on cytotaxonomy, morphometry, lnsecticldes and transmission studies. The rest concerns, 'ln partlcular, word processlng and data entry in Ouagadougou. t of,Pl92.t Page 32 Personnel 4. 3.6. The personnel requlrements for 1993 are as follows: - Profrsslonal - General servlce - Short-term professlonal(programmer-anal yst) 4.3.7. The budget proposed for the Blostatlstics and Information Systems Unit amounts to US$ 279,000, i.€., US$ 9,000 Iess than 1n 1992. a 1 2 1 a ocPl92.t Page 33 TTBTE O BIOSTAIISIICS A}IO I}IFORIIAIIOII SYSIEI|$ (us t)t IYE III i PI{ASEPltAS POSTS Proposed r 993 Erpenditurel tpproved I I r99r i 1992 I - I ---- ExpenditurcCrtegory of expcnditure Grrde _l"u" "o r 993r 992I 991 000 000 I 500 20 2 I I I I I I I I I I| il1,000 I I I I I Ii 15,000 I II 1 5,000 I I| 5, ooo I _-__ I ------ I I 92,920 | 116,000 I -_t-_ I I 39,597 | 80,000 I I il,{15 | t2,000 I I 30,000 | 30,000 I I 5,tot | 5,000 I I 10,225 i 15,000 I --_- I -I I 90,308 i. 112,000 I --t-- I I 189,288 i 288,000 I P.t RECURREIII COSTS PER$O}II{Et SERVICES Strtisticirn rnrlyst Statisticirn rnalyst Programcr rssistrnt Adri nistrrtive rssistrnt Ierporary asristance I I 3 P,3 G,S G.S 20,000 t61,500Sub-totrl 70 ,000 I 2,500 20,000 5 ,000 10,000 uur,:1_ 5 ,002 56,092 g0 , g0g 189,001 _Ii: 988 33,553 3, Consu I trnts 0perrtional trrvel Contrrcts (others) 0perutional costs Suppl i es I -__ -t__l_ 1 1 7,500 279 ,000J Sub-total 3tIOTAL 31 -t -_t --t -_-- | t-__- t- -l-t -t-t ocP19?.1 Page 34 4.4. Devolution Unit us$ 1,438,000 4.4.1. Reminder of the Unit's role The role of the Devolution Unit, which was set up in 1991, is: - to train the nationals at a]'l levels (centra'I, intermedlate, periphera'l) to take over devo'lution act'iv'it'ies; - to promote effective participation of the nationa'l teams in theplanning, execut'lon, supervis'ion and evaluation of the activities; - to sens'it'ize the governments to the importance of tak'ing the necessary steps for the reintegration or absorption into the nationa'l structures of thei r nationals prev'iously working in OCP; - to promote information, publ'ic awareness and commun'ity mobi'l i zation activjties; - to provlde technical assistance to the Partjcipating Countriesfor the organization, strengthening and management of maior endemic diseases' control departments; - to support operationa'l research on devolut'ion-related subjects. The Unit's ooerational structure 4.4.2. OCP techniques and technologies can be transferred to the Participating Countries only by experienced Programme staff who have been imp'lementing them for a suffic'iently long t'lme. It is therefore the duty of each Unit chief and his staff to feel directly concerned w'ith all devolution- related activities of the Programme. To put this approach 'into concrete form' the Devo'lution Unit will now function according to the following structure: (a) at the central level in Quagadougou, the Un'it will comprise: - one professional from the 0ffice of the Director, Unit Ch'ief: heis in qharge of the coord'ination of the activ'lties of al'l the parties concerned; - one profess'ional in the Vector Control Unit, responsible for the monitoring of entomologica'l act'ivities as part of devolution; - one publ ic health special isi in the Ep'idemiologica'l Eva'luation Unit, in charge of the tra'in'ing of the nationa'l eva'luat'lon and treatment teams; - one short-term profess'iona'1, socia'l scient'ist, responsible forthe preparatlon of soc'iolog'ica'l study protocols and the coordination of act'ivities embarked upon by socio'logists recrulted as temporary advisers in each Participat'ing Country; 1 , IocPl92.l Page 35 - one short-term professional f rom the Off ice of the D'irector, 'in charge of Information (b) in the f 'le1d, the Programme wi'll be divided into three zones ca1led animation zones for devolut'lon activlties: - a western zone comprising Guinea, Gu1nea-Bissau, Ma-li , Senega'l and Slerra Leone; - a centra1 zone covering Burkina Faso, COte d'Ivoire and Niger; - an eastern zone covering Benin, Ghana and Togo At the head of each zone wl'll be put a st'imu'lator given the respons'ibility of stimu'lating and anlmating devolut'ion activ'it'les in the countries making up his zone. These three zonal stimulators wi'l'l be Evaluat'ion and Vector Control Unlts. professionals of the Epidemiolog'ical In each country, there will be a local st'imulator who will be either the VCU sector or sub-sector chief (Ben'ln, COte d'Ivoi re, Ghana, N'iger) or the national coord'inator (Guinea, Guinea-Bissau, senegal, sierra Leone) or the zonal stimu1ator h'lmse1f, in the country in wt,1ch he resides (Burk'ina Faso, Ma1 i , Togo). Devolution 4.4.3. As al ready ment'ioned above, the long-term success of OCP is 'llnked to the success of the devolution process, viz., the safeguarding and strengthening of OCP's ach'ievements through'information, education and commun'icat'ion, 'long'itud'inal epidemio'logica'l survei l lance and ivermectin t reatment . In addit'ion to the seven Part'icipating Countries'in the initia'l programme area (Benin, Burkina Faso, cote d'Ivoire, Ghana, Ma1i, N.lger and rogo), whosedevolution p'lans have a'lready been adopted by the Joint Programme Committee, the Programme's western extension countries (Gu'inea, Guinea-Bissau, Senegal and Sjerra Leonq) have embarked upon the preparation of the.ir devo'lution p1 ans. Burkina Faso has obtained the financing of its plan for five years (1992- 1996) and has started carry'ing out the activ'ities provided in 'it. The searchfor financing is being actively cont'inued by the other countries with the support of OCP. However, without waiting for the flnancing, some of these countries have already begun their devolution act'ivit'ies mainly in the fieldsof training, information, educatlon, communication and ivermect.lndistribution. 4.4.4. The WHO Reg'iona1 Off.ice for Afrjca (AFRO) continues to show itsinterest and determ1nat'ion with respect to devolution activit'ies. Thus, in addition to the post of intercountry devo'lut'lon coodlnator, created andfinanced by AFRO, t{Ho Representatives in the OCP Participating iountries have received instruct'ions from the Regional Director to reserve part of their "country budgets" for devolution act'ivities. These 'lnstructions have al readybeen implemented 'in some of the countrles. ocPl92.1 Page 36 Training 4.4.5. As al ready ment'ioned above, to better estabf ish devolution, OCP wi'll continue with 'its train'ing pol jcy, favouring the fol'lowing discip'lines: epidemiology, health services management, statist'ics and data processing, health education and pub'lic health. Training in al I these discipl ines wi'11 be received in universities and training institut'ions in Africa. Furthermore,particular emphasis will be laid on in-service and field training (for example, refresher courses, seminars, workshops). An amount of US$ 403'000 wjll be required to continue to finance fellowships already awarded, whose beneficiarjes are stil'l ccntinuing with their studies, and to finance new fel lowships and in-service training. Information 4.4.6. The Information D'ivision will continue with and strengthen its act'ivities, laying particular emphasjs on devolution. l.,ithin this focus, information campaigns wil'l be carried out through all availab]e means (print media, radio, f i1ms, exhibit'ions and 'lectures), aimed at the general pubf ic, the Participating Countries and the Donors. In collaboration with the health educat'ion departments of the Participating Countries, a specjal effort will be made to raise the target populations' awareness of the devolution process i n genera'l and i vermecti n treatment 'in part'icu I ar, Personnel 4.4.7. The Unit's new structure presented above shows 16 workers di rect'ly involved 'in the coordination and implementation of OCP's devolution- related act'ivities. From the budgetary viewpoint, seven of these workers w'ill continue to be under the EPI and VCU budgets. The nine others w'i11 be 'included in the budget of the Devolution Unit and are broken down according to their respective status as follows: - 5 full-time professional staff members - 3 short-term professionals - 1 short-term consultant Included also in the Devolution Unit's budget are two general service staff members responsib'le for administrat'ive support and part'icularly secretarial duties. The tota'l cost of the personnel prov'ided for under the Devolution Un'it'is us$ 576,500. Consultants t 4.4.8. th'is item. The short-term profess'ional Informat'ion Officer js included under The services of social scientists (one per Particip'ri'ing Count,ry'in the 'initia] Programme area) wil'l be used for specific studies to be conducted as part of the Un'it's support to operational research: m'igratorv movements and risk of recrudescence in the onchocercias'is-f reed zones, impact of d'ifferent aids on rural community awareness-rais'ing, acceptability of skin snip in the communities se'lected for epidemjological surve'il lance, etc. 0cP/92.1 Page 37 As al ready mentioned above, a short-term consultant socia'l sc'ient'ist w'|11 be given the responslbi'lity of preparing sociologlcal study protocols and coord'lnating the work of the other temporary adviser soc'iologlsts. Eighteen months of consu'ltancy 'ln the social sc'ience fie]d (two months per country concerned and four months for the short-term consu'ltant) are planned. In addition, the services of other consu'ltants wi'l'l be used for 'limlted periods as and when necessary. For this latter category, six (6) months of consultancy are envisaged. Provis'ion has therefore been made for a total of 35 m<inths of consu'ltancy serv'ices ('including the time of the professional information officer) for the unit in 1993. Operation research support 4.4,9. To better 'lend 'its support in the field to operational research on devo'lution-related subjects, in add'ition to the above-mentloned servlces of social scientists, the unit needs a specific budget llne to enab1einitiate some activlties on'its own or support act'lvities embarked upon national teams in th'is djrection. An amount of US$ 15,000 is requ'lred such a support. This amount has been inc1uded'ln the serv'ice contracts. Budset 4.4.10. Considering the above, the Unit's budgetary requirements wi'll amount to US$ 1,438,000, i.e., an amount greater than that of 1992 by US$ 474,000. This increase'is due to the increased number of fe]lowships and consu'ltants and to the putting in place :f the new structure proposed for the Un'it. tt by for a ocPl92.l Page 38 TIBLE 7 0Ev0LuII0ll (us t) t PHASE IV POSIS 93 App roved r 992 P roposed Category of expenditure adeG 992 39 PERSOII}IEL SERVICE Chief 0evolution tlcdicrl 0fficer Scientist Agro-econori st Sci cnt i sts Clcrk stenographer 5 5 1 { 3 S il1,000 11t,000 il1,000 t11,000 00 00 00 119,0 119,0 1t9,0 2 2 t 5 ,000 1 79,000 t0,000 Sub totll I 159,000 576,000 Consultrnts ( | ) Operational trrvel 0perrting costs Contracts (others) Fellorships and training 1 36,000 35,000 7 ,000 I 0 ,000 317,000 399 ,000 30 , 000 5,000 25,000 103 , 000 Sub-totr I 505,0oo 862, ooo TOTAL 5 1 96{ ,000 I ,438,000 (l) Including the short-tern profEssionnel in charge of Infornation, rho ras previously in the Office of the Director. a IRECURRET{T CoSTS 5 ---t- --_- I 0cP/92.1 Page 39 4. 5. Onchocerciasls Chemotherapv Project (oCT/1.{acrofil ) - US$ 3,679,000 4.5.1. The efforts of the Onchocerciasis Chemotherapy Project (OCT) to discover and deve'lop safe and effective macrof i laric'ides for onchocerc'iasis have now been fu] 'ly i ntegrated wi th the ef f orts of TDR to deve I op nove l adu'lt'lcidal drugs for lymphat'ic f 1'lariasis. The combined programme has been designated the Macrofil Chemotherapy Project. TDR has a]located US$450 000 per annum to Macrofil during the bienn'ium 1992-93. The budget out1'ined here represents only the OCP contributions to the work. The major objectives of Macrof i I during 1993 wi'll be a) Support Ciba Geigy efforts to reg'ister CGP 6140 (Amocarztne) for use 'in onchocerciasis. Fol'lowing registration, OCT w1l'l encourage 'its further testing in Africa, to evaluate its potentia'l va1ue, particu'lar'ly in contro'l of recrudescence. b) Collaborate with Ciba Geigy on deve'lopment of CGI 18041. If PhaseI tri al s 'in uni nfected vol unteers have been successf u I 'ly comp'leted, mu'lticentre Phase II tria'ls using onchocerc'iasis patients wl'll be carried out. Cl inical trials against 'lymphatic f i lariasis wi I I be carried out 'in col laboration w'lth the TDR Fi lariasis Programme. c) Preclin'ical development of UMF 078 or its salt UMF.289 will continue, with the a'im of in'itiating Phase I clinical trials as soon as poss'ib1e. These act'iv'ities wi I1 be carried out in collaboration w'ith the Product Development Unit (PDU) of TDR. d) In vitro and in vivo screen jng of potential macrof i'laric'ides obtained f rom industry and elsewhere wi'l'l continue, testing as many compounds as possible. New high throughput screens, predictive of antif i'larial act'ivity, wi'l'l be introduced if their va1idity is conf i rmed. These act'ivit'ies wi'll be managed by the Prec'lin'lcal Drug Development Team (PDDT) and the Project Manager. e) Resynthesis of compounds found act'ive in primary screening assays wj I I be initiated to a'llow ear'ly screen'ing 'ln secondary and tertiary animal models (dogs, primates, catt'le, etc. ). f) Precl inical studies to al'low act'ive compounds f rom anlma'l testlng to proceed to Phase I clinjcal trials wi'l'l be carrled out mainly using contract laboratortes specializing in thls work. s) Some research topics wi 1 I be supported di rected towardidentification of nove'l chemotherapeutic targets, alternative methods of assay'ing adult worm viabl1i'lty in man and anima'ls, and techniques to detect resistance to ivermect'ln. a ocP/92.r Page 40 The spec.lfic activites and resources required to carry out this programme of work are summarlzed be1ow. Clinical centres 4.5.2. The Onchocerciasls Chemotherapy Research Centre (OCRC) at Hohoe Hosp'lta1, Ghana, wi'l'l cont'lnue to carry out c'linical trlals of neh, macrofi'larlcides. It is envisaged that the Hamburg Group (Professor D. Buttner) carrylng out in vitro drug assays uti'liz'lng adult 0. volvu'lus, wi'11 util'lze 0CRC laboratories for th'is work until they can return to Liberia. A second cllnical centre has been ldentlfied at the College of Mediclne, Enugu (University of Nigeria), and being sited in the Department of Pharmacology and Therapeutics, drug assays and pharmacok'lnetic stud'les onpotential macrofllarlcides can be carried out by the same group. The comblned costs of these two c]ln'lcal centres 1n endem'lc areas will be approx'lmately US$ 337,000 per annum. Addltiona'lly, US$ 200,000 has provisiona'l1y been lnc1uded to cover any thlrd clinical centre which can be used to undertake tria]s of CGI 18041. Precllnlcal DruE Develompnt 4.5.3. l{ith UMF 078/289'ln development there will be an ongoing need for studies of metabof ism, toxicology, pharmacokinetlcs, formulation, etc., on this compound. Additlonally, resynthesis of active compounds for further animal testlng and radlo'labe'lled compounds for metabo'lic stud'ies w'll'l be requlred. It is hoped that some collaborative work on this compound will be done with a partner from the pharmaceutical lndustry. A sum of USg 925,000 has been allocated to cover all such activlties; mainly to fund contract I aboratori es. Drug screenlnq centres 4.5.4. Prlmary screening in rodents will be continued in two centres 'ln the UK and the USA, with a third centre being sought elsewhere if numbers of compounds available 'increase beyond the capaclty of existing laboratories. Secondary screening'in the Brusia pahangl/dog model has proved to be a re'llable test system, and will contlnue to be used extensively. Onchocerca infectlons 'ln cattle are the on'ly val1d model of onchocerciasls chemotherapy, and use will be made of 0. qibsoni 'in Austra'lia, and 0. ochensi 'ln Cameroon. As models of human lymphatic filarlasis, B. malavi and Wuchereria kallmantan'i 'ln leaf monkeys wi'll be used 1n Malaysla and Indonesla as approprlate. In vitro testing of active drugs using adult0. vo'lvulus and 0. sutterosa wi'l'l continue us'ing 'laboratorles 'ln Ghana, Guatemala and the UK. The use of two other nematode models, Caenorhabditis e'leqans and Trlchine'l'la spl ral is, as predictors of macrof i laricide activlty w'i'l'l be studled, and if useful, wi'l'l be used as hlgh throughput primary screening systems. , a ocPl92.l Page 4I 4.5.5. As in the past, research studles will be d'lrected into three major areas: Advances i n the general area of helm'lnth chemotherapy, wi 'l 1 be mon'ltored for their possible applicatlon to macrofilaricide development. l.{o'lecular biology and biochemlstry.of nematodes, particu'lar]y that reported on C. elesans, wi'll be supported if of relevance to antif i'larial chemotherapy. Dlrect assays of the sens'itivity of Onchocera microfilariae to ivermect'in wll'l be developed, together with a search for mo1ecu'lar "probes" which are indicators of ivermectin res'lstance in other nematodes, and may be app'l icable to onchocerciasls. Irnmunologica'l assays, or other techn'iques, wh'ich are predictjve of drug induced death of adult worms 1n man or experimental animals, wi'11 be promoted. The Macrofil Project requests'lncreased spending in this area at aleve'l of USg 600,000. 9uDDlY of test compounds to screenlng centres and malntenance of computerdata-base. Short-term consultancles. 4.5.6. A contract 'laboratory w111 continue to store and ship compoundsto screenlng 'laboratories. }{'ith increased numbers of compounds being'tested,the adm'lnlstration and handl ing of chemica'l and b jo'logical data generatedwill require a 6-month short-term consultancy to create and ma.intain a computeri zed data base for screening activ'ities. A two-month consu'ltancy toassist with the 1ega1 agreements required for compounds obtained irompharmaceutica] compan'les is requ'ired. The Cha'irman of the pDDT wi'll cont.lnueto be paid an annual sum re'lated to expenses incurred and time al'located tothe Macrofil ProJect, and the Director OCRC, w'il'l cont'inue to be util.lsed asa WHO consultant. The tota'l costs of consultanc.ies are therefore US$ 2g2,000 per annum. Personnel !.?:7: One professional sclentist, the proJect l,tanager, assisted by onefu'll-t'lme general serv'lce secretary, w11l admiirtster thL Macrof i I project.Current personnel costs jn Geneva are fixed at USg 260,000 per annum. Ooeratlonal Travel 4.5.8. Travel_ by the Project Manager to statutory meetings of oCp in ouagadougou and elsewhere, and to phaimaceutical compantes, iontract and research laboratorles, scientific meetings, etc., is estimated at us$ 2g,oooper annum. a ocPl92.1 Page 42 t4acrofll and PDDT neetlnss 4.S.9. Two Macrofi'l Steering Comm'ittee meet'ings wi1'l be held'in 1992' at a cost of USg 50,OO0 per meeting, together with an additional PDDT meeting at a cost of US$ 8,000. Supplles and operational costs t 4. 5 , 1 0 . Ope rat'l ona 1 costs at Geneva , purchase of supplies, are estimated at US$ WHO Headquarters, and direct 25 , 000. TABLE 8 OilCHOCERCIASIS CHEI,IOTilERAPY PROJECT (us $) P H A S E IYP H A S E III sedPropod0veppAi turexpended 6/1 (l) Costs of neetings rre included under 'Consultrnts, telporary advisers' tur 990 xpe !98 EPOSTSdeoGr Crtegory of expenditure I 993r 992I 991I 993r 992l99l P.5 G.S RECURREIIT COSTS PERSO}IIIEL SERllICE Scientist Secreta ry 00 000 1 05,0 95 I I 55 ,000| 88,500 I _--------- I - I I 191,988 | 2{3,500 I --------- I - I I t3{,810 | 157,000 7 ,672 I 25,0oo 792,095 | I ,715,500 - I 10,000 _t I 27,0C1 | 15,000 I I I 733,80{2Sub-tota I 38{ ,000 28,000 , 982 , o0o 108,371 81,327 I,989,968 109,92{ 6,905 t9, 160 ::_o'"' 9,839,072 Consultants, telporarY advisers Operrtional travel Reserrch (others) 0ther contractual Services 0perating costs Suppl ies lleetings ( I ) Sub-tota I TOIAL 2 --_- I -------- I _- I I 96t,578 11,952,500 I ---------- I - I I 1,153,506 12,196,000 I _--------- I - 22 3,o7g,ooo a ---- __ --- I ----- I ----- I 2 I I 2o0,ooo I I ----- | 25 ,000 I I I I ------ I I I 3,119,000 | I --- I ---- I _-------- I _____ I --- I _--_- I I 110,5I2,8I0 I -l-- ucPl92.l Page 43 ATIil]IISTRATIVE OOSTS Prel lrlnarv note Sectlons 4.6. , 4.7 . adninlstrative costs and 4.8. concern all the costs considered to be . Each section is followed by the usual table (Tables 9, 10 and 11). The three tables are sumnarized in Table 12 ("Overvler of admlnistrative costs"). Figure 3, rhtch presents the budget by Progrre activity, highlights the adminlstrative costs represented by the Office of the Dlrector, administrative and management services and adrrinistratlve support in Geneva. 4.6. Offlce of the Dlrector us9 579,(xx, 4.6.1. The Offlce of the 0irector will be responslble for the following functlons in 1993: general policy and Prograrme management; liaison wlth the statutory bodies, Donors,, Participating Countries and the sclentific cormun'lty; coordinatlon of all Prograrme activities, including research contracts; statutory meetings. Devolutlon actlvlties, although grouped under a separatq unit, will, as in the past, be closely linked to the Office of the Director. The Documentation Centre vill continue to make documents available to internal and external vis'ltors. All documents prepared by OCP will contlnue to be translated by theOfflce of the Director. Followlng a streamlining of functions, one Professional post has been abollshed in the Llalson Office; Geneva. Personnel 4.6.2. To carry out these duties, the Office of the Director will requl re: two professlonal staff members; one short-term professlonal (translatlon) ;flve general servlce staff members; a part-tlme consultant; a worker ln the natlonal status category. . The proposed budget for the Office of the Director ts USg 579,000 a decrease of US$ 148,000, compared to 1992, mainly due to the tion of the post of Chief of Liaison Offlce in Geneva. a Budget 4.6.3 i.o., abol i ocPl92.1 Page 44 IAELE 9 OFFICE OF T}lE OIRECTOR (us t) CatEgory of exPenditure PERSO}I}IEL SER\,ICES OCP Strff Prograne Director Coordi nrtor Scientist (Geneva) Adrinistrative Off icer Adri nistrrtive Assi stants Secretary (Geneva) Clerk stenographers 0r i ver llationrl Staff Sub-tota I Consu I tants Operational travel Contracts (services) 0perating costs Supp I i es Fellorships and trrining Sub-tota I T()IAL errd 0.2 P.5 P.5 P,3 G,S G.S G.S G.S G 93I POSTS 99 i ree2 I __-l-- 5 0.5 0.5 8 I I 2 I 2 I I 8I IIIPHASE Expend tur, 990 Expene d tu e I 986/ I 3,307 , I 93 r99r {17,860 178, I07 66,999 50,30I 75, {7 I I ,290,3{0 t1,{58 1 2,963 102,567 081I3 68{,098 5,1{0,817 PHASE Il, s Approved r 992 1 22,000 Proposed I 993 t3t,500 t 55,000 83 ,500 30 ,000 ,500 ,000 ,000 88 30 t5 89,500 t0,000 95 ,000 t0,000 0003 521,000 98,000 70 , oo0 10,000 25 ,000 203,000 a I I IRECURREIIT C0SIS r ----- I I r llI lli 399,ooo I II ll r--_-l II ll r lli so,ooo I ii 75,ooo i i r ll I tli 10,000 i ii 15,000 li r ll I ll I ll t----l I I ll r lli rso,ooo I i r ll r_---_l II llI tli 579,000 i I r ll r ------ I I | ---------I I I I I I I I I I I I I I I I I I I I I l I 2 I 2 | -------------- t6{,538 90, 1 72 ------ | I __---- | ---- I tll tll I l,35l,5lc | 727,000 i ltl t_-_-l-------l ocPl92.1 Page 45 4.7. Administration and Supoort Servtces Unit usl 2,347,000 4.7 .1. The Administration wi I I continue to work in c'lose co]laboration w'lth the other oCP sectors to which tt lntends to play a supporting role. l{ith this in mind, the rigorous contro'ls over expend'itures and commitments in the whole Programme area should take lnto account the need to establ'lsh a correct ba]ance between administrative exigencies and the flexibiltty indispensab'le for the smooth running of the operations. To continue to dissem'inate basic management principles, four management seminars have been organized in the western extension countrles. Th'ls approach, wh'lch has been h'igh'ly apprec'iated by the nationa'l teams, wi l'l be continued. The computerization of vehic'le spare parts' management, which is the last stage of a process that has been going on s'ince 1988, 'is now operatlonal. Personnel 4.7.2. The staff requ'irements for the administrative and managerlal dut'ies are as fo]'lows: 1 992 1 993 - wHo/ocP Professional s General serv'lce staff 6 85 6 52 - Nationa'l staff 33 Total 91 91 The national staff comes from the conversion of a number of OCP general service staff members (drivers, messengers, labourers) to national status. Budget 4.7.3. An amount of US$ 2,347,000 is proposed for 1993, which represents a decrease of USg 211,000 compared to 1992, due malnly to the introduction of a national status for part of the general service staff. a ocP19?.1 Page 46 IAELE IO IO|lIIIISIRATIOII AI{D SUPPORI SERVICES {us t) Crtegory of cxpenditure RECUIREIIT COSIS PERSOI{IIEL SERVICES OCP Strff Chicf Adrinistrution t llrnagemnt Adriniotrutivc Officer Sudget rnd Finrncc ()fficer Irunsportrtion I Cou. Off icer Sugply rnd Scrvicco Officcr Supply rnd Srrvices Officcr Finrncc Officcr ldrinistrrti ve 0f f i ccr/8uako Prrronnrl Officer Pcrsonncl Officer Adrinistrrtivc and lrchnical rrr i strnts Clerks/typist6 I storrkorprrs llrtionrl Strff 0rivcrs, rosstng!r8, rnd lrbourcrr Tcrporary strff Sub-totr I Consul trnts Operational travel Service contracts Operating costs Supp I i cs Sub-tota I Grrde P.0 P.5 P.{ P.t P.{ P.3 P.3 P,3 P.3 P,2 G.S G,S G s POSIS 99r I r992 I --__ I ____ I I t I I I I I I I I Itilrl-til riltil _ I ., Ilitli- -ir ti- I I rr I r{ 16i15 I I I I lt tt I I 28i26 I I lt l__t___ lt I le6ier 0 1 993 9t t1 38 33 _l__ I Expend i turc 1 986/ r 990 223,39 t 583,392 86,200 1 ,099,909 0I3,807 3,200,705 TOTAT 9l ll,{70,3{7 {05 t-_-- 000 , P II A S E III Expcnd i tu re r99r 1 2,030 82,305 38 , 378 336, {{2 0l,286 533 ,1{ t 002 A rovedpp r 992 83,500 I t I,000 I 1 I,000 il 1 ,000 I ,000 005582 0 PI{ASE IY Proposed I 993 t3l,500 119,000 il9,000 89,500 89,500 500I 280 ,000 700 ,000 99 ,000 1 5 ,000 I ,792,000 t 0 ,000 t 00 ,000 t5 ,000 300 ,000 I 00 ,000 555 ,000 312 1 I t I ___ I ____ __t-- ___t__t___ I ___-_ i 83,500t_ I I I I 2t0,000| 075,000' I I I I I I I I| 390,000i Io,oo0 I I __-____ I I I I ,890,000 I I ___-_ I I| 55,000I I 20,000| 32,000| 350, ooo i 1 05 ,000 I I -------_- I Ii 062 ,000 I _--_-- I __ I I 8,203,582 | 1,872,101 I ______ I - I __-- I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I aocP/92.1 Page 47 4.8. Adninistratlve suoport ln Geneva tE0 $0,m0 4.8.1. WHO Headquarters w'il'l contlnue to provide administrative support to the Programme ln a series of fie'lds which cannot be covered separate'ly in Ouagadougou: salaries, ol'lowances, pension and 'insurance, personnel admin'istration, med'ica1 services, centra'l procurement of suppl ies and equ i pment . 4.8.2. For these services, I{HO is authorized to charge OCP 13% of the Programme budget (s'ince it is a programme supported from extra-budgetary sources). Th'is wou'ld have meant, for OCP, an amount of US$ 3,862,000. However, l{HOHeadquarters has agreed to waive this requirement in OCP's case, and charges OCP only on a cost recoverable basis, i.o., an amount of approximate'ly US$ 360,000. TABLE I I ADIII}IISTRATIVE SUPPORI GE}IEVA (US I) P H A S E III P H A S E I1l r99r r 992 I 993 Clerical rssistance tinance, iersonnel Supp I y 990986/ | 25l0g,l 58 I 0perating costs Suppl ies 700 281 305,026 35,182 000290 0005 35 ,000 00003 0005 35 ,000 0I 00 ALTOT ,3{3,709 359,308 3{0 ,000 360 ,000 .1 it I I __________ ----- I ocPl92.1 Page tt8 TABTE 12 ADI|IIIISIRAIIVE CO$TS - CO}ISOLIDATEO TAELE (us t) Crtcgory of expcnditurc RECURREIIT COSIS PERSOIIIIEL SERVICES OCP Strff Progrrmc 0ircctor Ciief Adrinistrrtion t llntgoront Scicntist (Gcnevr) Budgrt t Finrnce I Trlnsport Officers Finrncc t Supply I Tech. Officers Pcrronncl Officer Adrinistrrtive rnd Technical rss i stants Secretrry (Geneva) Glcrk stcnogrrphers Cl crks/typi sts/storekeepers Drivers, lcsssngers rnd lrbourcrs Adrinistrutivc Support costs - Gencvr tlrtionrl Strff Icrporrry strff Sub-totrl Conru I trnts Oprrutionrl trrvel $rvicc contructs 0pcrrting costs Suppl ics tcllorships rnd trrining (l) Gradc 2 0 5 { 3 3 G c G G G POSIS 992 l0 I 2 {5 2t 00 993 2 3 I t6 I 2 38 31 99 ture 990 Expcnd I 980/ I 2,963,232 61t,251 I ,062 , 099 1 53,205 I,783,210 767,100 I ,290 , 310 P I{ A S E III turendExpe t99t 2,539,979 1 76,568 ll2,fil 38,378 350,900 l1 ,2lg 102,507 aSub-totrl IOIAL 00.5 (l) Cltcgory of cxpenditure trunsferred to Devolution Unit in 1992 5C0 1{900 99 25 I09 I 392 I 3,757,118 t- l---l-l-tlll t l- t- i reer ililiri2i3 t_ I I Ii l0iri 2,5 i{6i 2e I I I I I I I I I I I I I I I I ---I I ir00.5 I t--_ I I I I I I I I I I I I I I I 1 I I 2 3 I s s s s S ____ I _ t--l- _____ I - PllrSE IY i Iffii ll lltt tl reez ll ree3 iill ll --t l-_---t I rt ttll ll rt ttil llll ll rt lttt tlll lllt tttt lttt tltt 11ll llrt tt l22,ooo ii r3r,500 ll Iil,ooo il r3r,500 !l ts5,oooll - li 222,000 ii 238,ooo ii 278,ooo il 268,500 il 83,500 ii 89,500 lltt lltt tl 2{o,oo0 ii 320,000 ii 88,500 ll 95,000 ii 30,0oo li 10,ooo il c75,0oo il lco,oo0 il r05,ooo ll illl llil ll 3ro,ooo il Sooroo(} l!tt tltt llii 102i000 iitt tllr ll lo,ooo li rt;ooo i!lr lllr lltt ll --tt#ll tt ' llrr tl 2,760,000 I i2,55t,000 i ! ll ll -l t-l I ll ll tt ll t53,ooo li 90,000 li 190,000 il r75,000 ll 32,000 ll {5,000 ii 360,ooo ii 3ro,0oo ll 130,ooo ii il5,000 ll - tt tlll lltt ll -tl-l I tt lltt ll 865,000 il 735,000 lltt ll --r t---l Itt ll tl ll 3,625,000 | i3,28o,ooo li ll ll -l l-l I I -t- I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I _-__-- I - -t-- FIGURE 3 ocP/92.1 Page 49 BUDGET BY PROGRAMME ACTIVITY. 1993 ADMINISTRATIVE GOSTS 8 910 a 5 4 1 Vector control 2 Epldemlologlcalevatuailon 3 Blostatlstlcs & lnformatton Systems4 Devolutlon 5 Chemotherapy profect 9 Statuiory meettngs 1O Capltat costs Totel (us $) 18,1 73,OOO 1,67g,OOO 27g,OOO 1,43g,OOO 3,67g,OOO 323,OOO 882,OOO 61.10 5.65 o.94 4.84 12.37 1.O9 2.97 (%) a 29,739,OOO 100.oo 7 rl 3 2 1 ocPl92.t Page 50 4. 9. StatutorY meetlnss usf 323,000 4.9. 1 The meetings planned for 1993 are: the Eco'logical Group, the Expert Advlsory Commlttee, three sesslons of the Comnittee of Sponsorlng Agencies and the Joint Programme Committee. The budgetary provislon covers the costs of travel and per diem, temporary assistance, translation of documents, interpretation services and various supplies. One full-time admlnistrative officer and a secretary, budgeted for in the Office of the Director, are employed for the organization of meetings. 4.9.2. The costs of the participation of non-OCP experts in OCP meetings other than the above (research, ivermectin distribution, hydrology, hydrobiology, etc.) have been included in the "Operatlonal travel" category of the budgets of the host units. 5.9.4. The budget proposed for thls Programme activity is estimated US$ 323,000, l.e. , US$ 18,000 more than that approved for 1992 anticlpatlon of an increase ln air-fares and re'lat,ed costs). IT0LE I3 STAIUTOf,Y IIEEIIIISS (us t) P II A S E III PHASE IV Expend i ture at('ln Expend i ture I99t 11,122 Approved r 992 Proposed Category of expcnditurc 990I e80/ I I 993 RECURREIII COSIS PERSO}I}IEI SERYICES Terporary assistrnce 000{5 00015, Sub-totr I Consu I tants/Isrporrry advi sers 0pcrrtional trrvel Operrting costs Contrrcts/Trans I rt i on 0thers I I6 00{5 ,0 15 ,000 ---t_ 080 c3{ r29 393 812 {95 {97 25 t9 206 1 53,107 t3t,503 0 ,8{5 3?7 I 35 ,000 il0,000 1 0,000 5 ,000 r15, ll5, l3' 5, 000 000 000 000 -l 10821t I 292,192 000200 000782 t_{ 9t333 I a 085 305 000 323,000 -l --t t- I II Sub-total It----_---I T0rAr I 0cP/92.1 Page 5l '1.10. CAPITAL COSTS us$ 882,000 Office eouipment 4.10.1. The amount for the replacement of furn'iture and other office equlpment will be the same as in 1992, 'i.€., US$ 25,000. Data processins eauiqnent 4.10.2. To replace a good part of the data processing equipment bought between 1983 and 1985, and now worn by use, and because of the need to provide a number of OCP centres with high-performance equipment in order to facilitate the establishment of increas'ing1y complete data bases, more 'ln-depth analysis and a quick exchange of data between the centres, it is planned to purchase dew equipment at a cost of USg 75,000, i.e., a decrease of USg 2,000 compared to 1992. The details of the requirements are given under the Programme activity "Biostat'istics and Informat'ion Systems Unit". Technical equimpnt 4.10.3. This mainly concerns the purchase of important scientlfic equ'ipment required for the smooth function'lng of the VCU and EPI research laboratories(hydrobio]ogy, DNA, Insecticide Research Unit, App'lied Research and Envl ronmentalMonitoring). It is planned to spend US$ 152,000, 'i.e., a decrease of Us$ 46,000 conpared to 1992. Vehicles 4-1O.4. The OCP fleet comprises at present 320 vehicles distributed 'in the whole Programme area, i.e., 190 for the initia] area and southern extension, and 130 for the western extens'ion. For 1993, lt 'is planned to reduce thls number to308. Because of the very o]d age of part of the present fleet (a'lmost 121 of the vehicles have a k'i'lometre reading above 25o,OOo), 34 rep'lacement vehicles. w i1l have to be bought. An amount of US$ 620,000 is requlred, .i.e., an .lncreasb of US$ 23'000 compared to 1992. The evolut'ion of the number of vehic'les in use from 1983 to 1993 is given in Annex X. Bui ldings 4.10.5. As in 1992, th'is concerns expenditures for the improvement of the ex'lst'lng infrastructure. The estimated cost of this operation witt be the same,i.e., US$ 10,OOO, as in ,l992. t ocPl92.l Page 52 ITBLE II CAPIIAL COSTS (us t) P H A S E III PHASE IV Expend i ture r 986/ r 990 Expend i tu re r99 I App roved I 992 Proposed r 993 Office furniture (t) Data processing equipnent ( I ) Equ i pnent Vehicles Building 27I,185 8r5 2 92 0005 25 ,000 t I I ,050 2tlll,5ll 2,152,691 596,336 57,359 t00,859 668, 1 29 91,838 I7,000 1 98 ,000 597,000 10,000 75 ,000 I 52 ,000 620 ,000 1 0 ,000 ALTOI I5 5 3752I 0007 0 000288 (l) 0uring 1986 to 1988, the acquisitions of data processing equipment rere charged to 0ffice Furniture TTELE I5 BREAI(DOT}I OF CAPITAL COSTS IO ACTIVITIES (tJs t) EQU I P}IEIII 0ff urn ice iture Data process i ng ctIechn Yehicle IOIAT 70,500 ngdBu 0 F Vector Control Epi deni ol og i ca I Evaluation Biostatistics and Infornation systens Oevolution Progranne 0irector Adrinistration and support Services 0 000 0 000 30 ,000 122,0 0 00020 52 00 00 5 00 00 0 0 3 0 000 085 9{ 000 000 000 500 000 2 ,00 000 500 2,000 1,000 I ,000 1 5 ,000 t0,500 1 t 6 I 3I,000 TOTI L 05 00 00200 0 00 00000 882 000 , 10,2 t --------___ I Ii 25,000 It--_ _--t__t____ -t -__t-- t - aocPl92.1 Page 53 5. RESEARCH PROGR/Uil4ES 5.1. In several sections, the Plan of Action and Budget refers to research undertaken by the Prograrune in different fie'lds. The main research subJects selected, which are in the document of the OCP "Annual InternalTechnical Review l,leet'ing" held from 23 to 27 Harch 1992 in ouagadougou, the report of which tras presented to the Expert Advisory Committee at itsthirteenth session (Ouagadougou, 8-12 June 1992 - document ocplEAc.1g.4), arethe following: The study of ivermectin distribution: community distributlon, management, acceptabi I ity, acceptance 'in re'lation to the endemicity, increase'in the coverage rate, evaluation of the cost-effectiveness of the different distribution systems, etc. The impact of blackf'ly nuisance on the resettlement and socioeconomic development of the onchocerciasis-freed zones. Migratory movements and the risks of recrudescence in the onchocerciasis-f reed zones. 4. The impact of the different aids on commun'ity awareness-naising. 5. The acceptabil'lty of skin sn'lp'ln communit'ies selected for epidemiological survei I lance. 6. The deve'lopment of a survei'llance system for the detection of the appearance of res'istance to the averrectines. Research inlaboratory and on populations treated. 7. The identification of parasites and parasite strains using DNAprobes. 8. The development of alternative methods for the epidemiological eva'luation of zones where there is combination of larvicidin! andivermecti n distri but.ion. 9. The sear':h for an alternative diagnostic too'l: irmunodiagnosis, DNA-probe techniques. 10. Applied epidemiological modelling. 11. Insect'icide research. 12. Aquatic monitoring. 13. Vector taxonomy (cytotaxonomy, morphology, morphometry). '14. Improvement of management: management seminars. !.?: The synthes'is of the amounts required under the 1993 budget is asfol'lows (the amounts shown are a'lready'lnc'luded ln the budget oi each unlt and are therefore not an addition to the budget presented): 1 2 3 a ocPl92.1 Page 54 Tablc lC RESETRCH Pf,OGRAIIIIES {ust) Vector Control Devolution Epi dcriol og i crl cval urti on Bi ostrti sti cs and infomations systers Adni ni strati on and support services TOTAL t 2{ , 600 I ,000 60 03 2 21,000 I ,000 3 l ,600 3 2{,600 7 ,00 0 31,600 { 2t,000 24 ,600 5 2{ ,600 5,000 29,000 6 5 ,000 5,000 116,000 5,000 t2l ,0cl0 I l0,000 1 0 ,000 9 000t 1,000 t0 20 ,000 20 , 000 ll 0005{ 0I 0 t2 13t,000 l3t,000 r3 2{ ,000 2{ ,000 t{ 30 ,000 30,000 IOIA {25 ,000 20 ,000 30,000 Io thc totrl of USf C{8'000 should bc rddcd thc rnount for the 0nchoccrcirsis Chemtherrpy projcct co4lrtcly dcvotcd to rescarch (USf 3,0I9,000). Ll I 00023 00050 6t8 ,000 a I ----- | -----__I I olI > = 0cP/92.1 Page 55 AI{NEX I otc oF Elrlg z o3 e9.;i -= r= EE z I I Fo r,r HFIIOEo6 o zo -U,3ta z 2lrl o .E Y az 9 nt! o.o J! c, IT (, lrlo9g>JEauL'2a a otuts-tIa9- 3Ea ltl = =EOr E{II? -JOOrF< -2 -Z'*oLJ :.OE es ?eOri fr5 o - Iozo (, ozq9 Eso)JF<2>IrlII lrlzzoa3ltL zI 3 a 2 = o tl -olrt 3E! , lltz 5 G' Folrl! alrl Eo C! (, o o3o I o -o - lrlJ=- ;EEtra-o<oo J II,zlta JO < lrl .' <fU<2a3!(ra =I a lrl o(, -9ozI xI zcII olrl] !aa -Clrl aIlI Ilc =sco zoo 12 <urlrlFEX <urJZ<EziC,+ Efoo0 ulE zc trlFo lrl tE c G,lrto F aoGA =, oz zo C I 2 = o 29 Fz IT - ,(, oo 6 .!t2 talrl - zI , o lrlo 3 I ITI SBOG' - l?9 6tii6a -<L<, aE ao EoFo3 uJOE,A6P H3 E5E o. o -IIFI , z9 -Eolr = oY E a ur(,E<lL>oE eE _a A alrtlu ts i-t xsrro -Eoc dI(, -o l)q croo=1<!f3 =4 => =rIl! to G'too o to oGt-zo(, -o (,ft acPl92.l Page 55 ATIi{EX II Personnel Professionne'ls D2-P6 P5 - P4 Prograrme area Geneva P3.Pl General Serv'lce Prograrme area Geneva National Personnel Consu I tant/month Temporary (General Servlce/month) Guaranteed hel icopter hours Excess he1 icopter hours Guaranteed flxed-wlng aircraft hours Excess fixed-wlng aircraft hours Guaranteed L'ialson aircraft hours Excess lialson alrcraft hours Insect i c'ldes Cost per 'litre B.T. H-14 Temephos Permethrin Carbosu I fan Pyraclofos Phoxlm Value of US dol]ar CFA Franc French Franc Swlss Franc Pound Sterl ing Deutschmark Canadian Dol'lar Yen AYERAGE OOSTS t'TiED FOR BI'DGETARY CALCULATIOilS 1991 us$ 1 992 us$ 1 993 us$ r13 103 144 t7 13 82 000 000 000 500 500 500 122 111 155 83 15 88 000 000 000 500 000 500 131 119 165 89 *20 95 3 500 000 000 500 000 000 000 7 000 800 7 700 900 000 900 * The average cost of US$ 20,000 used for the General Servlce staff refers to higher-grade staff members who wll'l maintaln the OCp status.i Aerial Ooerations Cost per flving hour (inc'|. fuel) 1 991US$ E53 742 869 758 248 124 1 991 us$ 4.81 11 .96 9. 05 21.75 27.14 285 5. 68 1.47 0.60 1 .68 1.18 149 4.64 14.13 10.64 20. 59 26.45 lt.14 .68 .47 .60 .68 .18 4.64 12.80 10. 20 20. 59 26.15 15.03 1 992 US$ 853 742 869 758 248 124 Co0t (CIF)1992 1993USO USO 3 E23 ,:, 199 US$ 20r( Ec 202 Ec 25r EC 50r Ec Budget 91 Budset 92 Budset 93 D 285 5 1 0 1 1 149 2E5 5. 68 1.47 0. 60 1 .68 1.18 149 I I ocP/92.1 Page 57 AI{I{EX I I I Nr-ps LoEFtrooo,EFo o o) o) F L(E o .c o(E o rF o o 3 -? o(r, t, G o tr, 5J oo U,f ru IIF lL o IJJF E IJJ(, z II ox ltJ a a L(Utr .YE Etq.7oI o E€E{-(tr (E =tr CLoo aEoo? g, E E HE -.=(l)EnzgEe llqrr r+oorOC'@c)Noooo)oo F o F F o ot F o(9 F o$ F olo F o @o F oo o, F N @o F @ @o F rO @ o) F $ @ o) F (r, @ o, F onlel eg6 ! 1o e6eluacrod ocPl92.l Page 58 A]{I{EX IV NUMBER AND PERCENTAGE OF OCP STAFF^TTIEMBERS BY SEX AND NATIONATITY As at 31 May 1992 ( a PROFESSIONALS GENERAL SERVICES NATIONALITY ALGERIA BELGIUM BENIN BURKINA FASO CONGO COTE D ' IVOTR,E FRANCE FED. REP. OF GER. GAMBIA GHANA MADAGASCAR MALT NIGER SENEGAL TOGO UNITED KINGDOM USA MaIe 1eFema taITo % ItaTo MaIe emaFe I TotaI x taLTo 0 1 1 5 1 3 2 I 1 5 1 4 0 1 3 2 2 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1 1 5 1 3 2 I 1 5 0 4 0 I 3 2 1 0.00 3.03 3.03 15.15 3.03 9.09 6.06 3.03 3.03 15.15 3.03 12.13 0.00 3.03 9.09 6.06 6.O6 0 0 53 L20 0 89 0 0 0 63 0 54 1 0 56 0 0 1 0 54 141 0 90 1 0 0 64 0 57 1 0 56 2 0 o.2L 0.00 11.56 30.20 0.00 L9.27 0.2L 0.00 0.00 13.70 0.00 L2,2L o.2L 0.00 12.00 0.43 0.00 I 0 1 2t 0 1 1 0 0 1 0 3 0 0 0 2 0 rorAL i 31i 2i 33i100.00i 4361 31i 467 100.00 .t ocP/92.1 Page 59 AilI{EX V L. o o L ottrg Go (Y' oo F (\t o) o) F F o,o F o o) o) F o,og) F @ @ o, No o, (o @o r. lOoo $o o) F (D o o) F lo Gl s ro N lo o(o ct6 o o h(o o N Gl o N o,(o C)(ot\ .!)(o T\ o rd o, o o, ll o ol o c, +, o o(, o =oL- o of o o CL rF o L o .ct E z (r) o)o F oF G) @o F =oEIL a IJJ o I E IJJa J IJJzz o U'E UJ o. lJ. o F U, o o F$ o ot Na ctt ht Gllo E o Gl o t I l' o oE6g e t PteAo. ll , Es; E E Eoo= F.E E ;;Ho- g E55FzzF mHloo(\toto@o@oooolo$o@o@ a onlel eg6 [ ;o e6eluecrod (D BH L or€ocooF(E o F o) o) F oo o) F Ao, t,o.E9i E oCo.x0ot-o)E F= o oN.L3 fl,F 8E .o EE3 ZiFr-1, =tFoioro .co3 EEYtts -t-rFE th-\t oc3 E;F ooF() E IN o to ocPl92.l Page 60 AI{NEX VI to o f lo C,tF u)d +to oo o =oL o oL =oE u, lL cr) o) o) F oF cr) @ o) F =o E,IL az o Il- t UJ o. o J sE IJJ at @ir I GIo c,(o s o lo o66F (oC6t\ qIt o lo NN N F(, It !) G, o6oN ooF q .t, oo6toto@ooooooto$o@oo F oo C\ GIoI anle^ 886 t lo aEeluacred iI zL t,o le at e c , t o a a t. -l , ,i ", ocP/92.1 Page 5l AT{ilEX VIIg iIUJl, 2 t , i ) I I .)(. \. , I I EFo -F EEE E5 .a oact argED Ed6o E, o bE 3E Brg TE E.: E;gE E: ;,7 L.=(LJ =< EEir)r:lBi7)0z \ \ er rOo o Gf o(L lrJ @ o 0-o(r(L f, C) LJo anz o F (r H lrJHg H'olrl Z 2J XroY!oz' otz oL an zo tr (ts lrJ(L o tLo z J o- :)o o UJ(/, og oE o- I a a t :l l. t a n ocPl9z.r Page 62 ANI{EX VI I I IilITIAL AREA Countrv C6te d'Ivoi re Ma'li WESTERN EXTENSION Countrv Gu i nea Mal i S'ierra Leone Countrv Burki na-Faso r VCU ENTOI{OLOGICAL EVALUATION NETTTORK - 1993 Western ooerational area WOA - Bamako. Mal'i Sector Bouake (x) (Superv'is'ion, HQ t{OA) Sector Kankan Faranah (Supervision HQ l{OA) Maken i Eastern operational area EOA, Kara. Toqq INITIAL AREA + SOUTHERN EXTENSION Sub-Sector Korhogo 0d i enne S6gu6'la Bamako @ratima] Base, 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. Kankan Si gul ri Beyla Kerouana louroussa Faranah Dabol a Klss'idelwp Mamou Sl kasso Makeni Kaba'la Bo Sector (Supervision HQ Ouaga) Sub-Sector Bobo-Di oul asso Ouagadougou I n I ocPl92.1 Page 63 ANNEX VIII (cont'd) I 1 a I COte d'Ivoire (Supervis'ion Bouake) Bouake Bondoukou Togo Kara Kara Atakpame Ben'i n Parakou Parakou Bohi con Kandi Ghana Tamal6 Tamale Ki ntampo Hohoe Bol gatanga (x) As a result of the new del imitat'ion of area, the sector of Bouake remains in the l{estern Area but its sub-sectors have been shared between the West and the East. o oo ucP/92-l Page 64 ANLEI IX otr (,(u E o .= c o E o o ot ah o E5rN Ju -. EU, ,oEE '.9 o!r96rie \qLO(U t-t- o.= ,ll (i ooc .Yoaz o c .9 atr o xo t1 oE' o .E f ot, c,J ol} c o th cg x lrj a a a a a a a a o E E c, E'I o (L f!, o E ': .= o a o o o o E Eg E'I0 0- E E (u E Eg(, o o. tE e ._EJ oE cJ oo 0-() o IqJItQr{J \(o t 5 o 5FotrJ- l ( I I t I I I I Y + $ + e?I N z -J s\ E I o o!t 8 frl 8 N o e + + t oq ?-oI o I I ta, L,t la q (D! l{Jh I{<ri s$SI N ft I \ , I trlf o tr IL I EL UJ TI \\\\ I \ s (- I I EI I t -l( ) \J r-1..,s v o ct a I -c_ll t--l c (, s If I I J tsaI I \ I I I UJ ,(,o a z ll't Bgo= -F z?t :=EG<w H.?tsJ Hq FI 7U H8 = lrlqCt utz -E 1g(D Co(Jl-o> tr, lrJoE 3E bE gl uJIo Rr z o N E f -F H u.lx lrJzz x tr, z z \ +)t ocPl92.l Page 65 ANilEX X I (D oPE SEoEFg oFO o, o) F o o, o) F o) @or. @ @o F ]\ @ o) l. (o @o F lo @o F tf @ o, F (D @o F f-lo(\t o) r\ ot t\o ot oo(D o F c, o ot(Y' tN(t, @(?,(D o sf(') @t(t, @lo(Y' a) o) o) F oF a) @ o) F =o E,IL z o IF E, IJJ o- o z U' lUJ C) I - I EI t a oooooooocroooooott(D$IFOol00F(olO$(oNrF FFFFF ente^ e86 L lo aEeluacrad