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Trust Fund for Phase II and Phasr,G out Period Be Mai,Tained B;;;;Fii;';;R;;;,;. Such Cdtr

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Trust Fund for Phase II and Phasr,G out Period Be Mai,Tained B;;;;Fii;';;R;;;,;. Such Cdtr I Ali'rcan Proglanmre for Ouchocercrasis Control (APOC) Progranltre afrrcarn de lutte colttre I'onchocercose JOINT ACTION FORUM JAT'-FAC FORUM D'ACTION COMNIUNE Office of the Charru-an Bureau dLr Prdsident Tenth session of the Joint Actiort Forunt African Programme for Onchocerciasis Control Kinshasa, Democratic Republic of Congo, 7_9 Decernber 2001 FINAL CONTNIUNIQUE 1' At the invitation of tlle GoYenment of the Denrocratic Republrc of congo (DRC), the teuth session of the Joirlt Action Forurr.r (JAF) rvas held at the Grand llotel of Kinshasa Dece,rber Iiour 7 to 9 2004.The rist of participarts is attacrred as Ar,ex l. 2' The meetingrvas opencctbyHis Excellency, MrArthurZAHIDI NGOMA, Vrce presrdent of tl-re Democratic Republic of congo in charge of the commission on Socral and cultural Alfarrs, rvhose opening remarks r,l'ere preceded b/statements of the Director-General of the world organization (wHo), Health read aloud by Dr claude Heuri Vrgnes, representrng the Legal office of wHo; of the chair of JA-F9, repreiented by Mr Stephen"RANDALL, chirg6 d,Affarres of t5e Embassy of canada to DRC; and of Dr Azocloga setetetr, Director ol Apod. All lbur speal<crs essettttally outlined the achteveurents the ol Pr;granlne to date, Sarled t5e ure,ts oi'CDTI ancl the oppot'tunrties it provided fbr integration, anditressed the need for cou,trres to allocate ,rore resources to ensure sustarnabilrty of CDTI actrvrtres. 3 ' Dr s6k6tdli rvamed not all projects th3! would have benefited fiom the requrred 1ri,ir.,u,r of fir,e years funding from APOC Trust Fund by the year 20lO as sonre projects have strll uot yet started. It u,ould be necessary therefore to make arraugeutents rvith tfue donorc to authorize that the APOC Trust Fund for Phase II and Phasr,g out period be mai,tained b;;;;fii;';;r;;;,;. projects *,ithin such cDTr the budget of US$79,riliion forecasted fbr the period. 4' D| Seketeh also autrouttccd that he u'ill be retrring ll-om his position as Drr.ector. ot-Apo(. ilr September 2005. 5' Partictpants expressed their sincere gratitude to the gol'enlreut of the Democratrc Republrc of congo for hosting this tenth session and for the ri'anir hosfrtalrty afforded to thelr 6u,.q r.5err stay ln Krnshasa. 6' Tlte Forunl elected the Denrocratrc Repubhc o1'cougo as the charr.ol JAF10 hcld b1. IIer Excellency, Dr Atrastasie N{oLEKo I\'IOLIWA. N{iniste"r of Ilcalth of DRC, and lrrarrce as \,-rcc- chatr' lteld b1' D| CII'rstlan Br\lLL\', Coorcirnator o1'the CellLrle luter-Regronale cl'Eprtlclr.lrologrc (CIRE), Rennes. Fr.ancc.. 2 I The prol'istonal ' agertda attaclted as Annex 2 rvas adopted u,ithout anl.nrodrfications. 8 In his presentatton ol the reflections ' of thc committee of Sponsonng Agencies (csA), I\{r Bruce Bentoll, chatnnatr of the cotrlmtttee focused on the achieveurents of AFoc over the past t*,el'e t.nonths attd outhned tlte main acttvtties plarured for the next conring year. He rnfomed the Foruur of changes iI tlie leadership of the onchocercrasrs coordination unit at the world Bank r, relatton rvtth his recent retirement as Mauager of the unit. Mr Benton reassured JAF that hrs successor' Dr ousmane Battgoura as rvell as Dr Alexandre Abrantes, Sector N{auager, Huma, Development Depafimeut at the World Bank, wrll continue to provrde hrgh level suppoll to onchocerciasis control activities. 9' The discussions that lbllotred are summarized under the follou.,rr-rg agenda items. A full report of thrs meeting u,rll be made available at a later date. PROGRESS REPORT' OF THE TI.ORLD HEALTH ORGANTZATION, REPORT TECHNICAL OI-- THE CONSULTATIT/E COMMITTEE AND OF THE NON-GOVERNI,IEIVTAL DEVELOPMENT GROUP FOR ONCHOCERCIASIS CONTROL INCLUDING SUPPORT OF THE GROUP TO APOC ACTIVITIES 10' The F-orunl congratulated the APOC Management, the Technical Colsultative Commrttee a,d the NGDo Group on their collecttve elTorts to suppoft the parlicipating countries that lecl to the iulpressive achievetneuts the of Programnre o,r". the puit y.ur. over 33 milliol people *,ere treated rn 2003 and 77 projects out of 1 06 approved projects ur" ,ror., berng implenrented. REN4o exercise had been conrpleted ttt ntost or tne apoc countries and the pof,rtriio, at rrsk rs uow estinlated at 87'7 millton people compared to the figure of 50 million'people me1tio1e6 rp the Progranune document. I l' Th.e Forulll expressed its appreciation to Merck & co. Inc for therr pledge of an amoult of US $l million, to be paid over a period of fir'e years, to the NGDos rvorking on onchoccr-ciasrs rn Africa' coltrol N{erck & Co. Ittc' also pledged a simrlar amount to onchocerciasrs co,trol Alltencas. i, the COUNTRY REPORTS l2' Presentations lr"ere llade by Uganda, Tanzania, Cameroon, Ethiopra, Congo, DRC, Bur,rdi, Liberia, Sudan and CAR on their CDTI project actrvitres. l3' fhe Forut-t.t congratulated the countnes otl their achiet.eltlents ancl noted the drfflcultres and challenges etrcouuterc-d in the inrplenrentatron of CDTI. Nlost of the countnes reporled that CDTI \\'as successfully rDtegrated irlto other ltealtlt activrtres aud their govemr.neuts u,ere coptrrbuti,g financrally to CDTI actiYrties. u'as It hou'ever stressed that parricrpatu.lg couutles peedecl to allocate l.llore resources to healtlt, and particularly, to onchocerciasis control actrvrtres. 14. Tlie Foruur agreed that: l coulltrles should specrfy tn ftttltre tlte uature of governnrent contrrbutrous (cash or kincl. salarres, capital equipr.re,t, irrrastructure and recurrent cost); 3 ll' countrles should also indicate tn firture, over a tnrnir.num ol- 3 years, the trerd o1' govemnlellt cotrtrtbutions (rvhether they are rncreasiug or decreasilg); APOC ,l.ean.r lll' N{attagetlletrt should collate and ntake avarlable to the Exterual Evaluatron ttlforurattot.t oll go\/emllteut contributrons to enable Ihe Tear-n to easrly nrahe a comparatil'e assesstuettt of the contributions dunug the evaluatror.r, ir" couutries be encouraged to adopt an integrated buclgeting systenr such as those reported by Uganda and Tauzania. 15. JAF rvas also infonned that: l a sttrdy otr tlie ttllpact of the cost-shartng expenence in Congo Ilrazzaville is ougorlg aucl the resulrs *,rll be reporled at JAF1 I in becimber 2005; ii' some studies ltave been doue on "uodding drsease" but appear to be inconclusrye as to its cause' Coutrtrtes rvhere the disease is present were requested to foru,ard details of therr studies to TCC for revierv and consideiation of the need for fufther research by TDR or other research iustitutions; rii' Severe Adyerse Events (SAEs) occured lu areas u,here onchocerciasrs a,d lorasrs co- exist in Bas-Cotrgo and Tshopo CDTI pro;ects rn DRC. The cases \\,ere car.efirlll, matraged although deaths lvere repofted. Steps are berng taken by the hcalth althoritres and paftuers to ntinrrnise such events rn the future. CONSIDERATION O1,- N,4TTONAL PLANS AND PROJECT PROPOSAL,\ 16' The Forut-n endorsed the prror approval by APoC Management of the contrnuation of 63 olgoing projccts as rvell as the itnplernentattou of I1 neu, cdtt prolect proposals r.ecouurercled tbr approval by TCC. OPERATIONAL RESE.4RCH AND A|ACROFIL l7' RAPLOA valrdatiotl studies had been undertakeu in DRC and congo.'l-he validrty of the,rc.thod had been confimred and RAPLOA u'as uorv berng Lrsed by Apoc tbr mapping Lru loo. ta study Jtle^multt-country ot-t couu-uur.uty-directed inten'entror.rs (cDI) had beeu laulcheci APoc countries' coverltlg r,5 a total of 45 health districts. The }rorum expressed cousrdcrable ttlterest in the study and- noted tts sigrificance fbr the luture of rntegrated disease co,l.rol r, Afi'rca' The Forunl looked lbnvarcl to the first results of the study u,hich rvould becor1e ayarlable by mid 2005. l9' JAF u'as ltrfbnned,. an! noted u'tth gratitude, that the Brli ct Nlelincla Gates Fou,tjatr., h.d agteed to futrd, at a leYel ol$2 rtttlhon, the proposed studies on the fl'asrbrlrty of local elrr.r.rrpatrorr of transr.nrssion rvrth Ivenlcctut treatr.nent aIone. aI 20' Ihe Forut.u acknorvledged that the development of a macrofilaricide rernarned a high priorrty. The del'eloptnetlt of the use of moxtdectin for onchocercrasis has been suspended iue to a saf'ety collcenl $'ith otle of the veterittariau products containing moxidectrn. Furrher developmepl u rll be pursued tf the cottcems arc cleared (at the US FDA heanng on 3l January 2005). 2l Studies have ' det.ttottstrated the saf-ety and efficacy of the co-adprrlistratro, of alberclazole, t"'ertlectit.t artd praziquantel, attd tltis u'as operationally sigrrficant for the lntegratlou o1't5e treattrlent of ottchocerciasis, lyrphatrc lilariasis and other hellrinths. 22' other MACROFTI drug developntent and research actrvities rvere acklou,ledged and endor.sed by JAF. One key issue underscored rvas the need to create and sustain basic and clinrcal research capacity in developing countries. S U STA TNA B 1 LITI' O F CDTI 23. Sustainability evaltrations ltave shou'n that CDTI rs very strong at the conllulrty le'el a,cl that the conlluuity is a key factor lor sustarnability of ivemrectut treatmeut. Tle sustarnlbrlrty itldicators shorv a less favourable prcture for the fomral health system, especrally the Frrst Lrue Health Facihty (FLHF) rvhich rvas considered u,eak. 24.In conclusion, the Forum notecl that: r. GDTI $'as sustarnable at the conlnuuity but rveak at the FLHF leyel; ll. there u'as a need to contiuue ntourtoring the inrplementation of sustainabilitl,plals especially during the post-ApOC era; to euhauce iir' the sustainability of CDTI projects, it rvas ir-nportaut to streugtSen the lealtlr systents and enrpou'er the FLHF; ir'.
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