Onchocerciasis Control Programme in West Africa Programme de Luttv. contre l'Onchocercose en Afrique de l'Ouest.

JOINT PROGRAIUME COMMITTEE, COMITE CONJOINT DU PROGRAMME Office of the Chairman JPC-CCP Bureau du Pr€sident I

JOINT PROGRAMME COMMITTEE JPC9.4 L !a Ninth session ( ocP/BB. 1) Dakar- 29 November - 2 December 1988 0ctober t9B8

Provisional item 13

ONCHOCERCIASIS CONTROL PROGRAMME IN WEST AFRICA

PLAN 0F ACTIoN AND BUDGET FoR lg8g

I

!-

; ONCHOCERCIASIS CONTROL PROGRAMME ocP/88.1 ]N WEST AFRICA

TABLE OF CONTENTS

Page

1. INTRODUCTION 3 L e 2. OVERVIEW OF THE PLAN OF ACTION.. 4

3. GENERAL CoNSTDERATToNS 0N THE pRopoSED BUDGET FoR lg8g 6

pstTuatEs BY PRoGRAMME AcTIVITY. t 4. 14

4.r. office of the Director. 14 4.2. Statutory meetings 77 4. g. Vector control t9 4.4. Epidemiological Evaluation 24 4 .5. Biostatistics and Information Systems 28 4.6. Socioeconomic Development 37 4.t . Onchocerciasis Chemotherapy Project. . 33 4.8. Administrative and Support Services. . 36

ANNEXES

1. AVERAGE COSTS USED FOR BUDGETARY CALCULATIONS 4o

2. COST OF PERSONNEL SERVICES 1981 TO 1989 4r

3. AERTAL oPERATToNS FRoM 1gB1 r0 lg8g 4z

4. QURIITTTY PURCHASED VERSUS COST OF LARVICIDES FROM 1981 TO 1989 4l

5. VEHICLES IN OPERATION FROM 1981 TO 1989 44

6. RATES oF ExcHANGE oF THE US DoLLAR 4s

7. CHART AER]AL OPERAT]ONS 46

8. vcu ENToMoLoGICAL EVALUATIoN NETIIoRK 1989 4t

9. PROPOSALS FOR RESEARCH AND SERVICE CoI\TTRACTS 1989 4g

PRoposED 10. REVTSED VCU PLAN 0F OPERATTONS FoR lggg 57

11. SUMMARY CONSOLIDATING LARGE-SCALE IVERMECTIN TREATMENT ACT]VITIES 7987-7990 52

MAp TVERMECTIN 12. - TREATMENT - lg8g 55

NUMBER 13. AND PERCENTAGE OF OCP STAFF BY COUNTBY OF OR]GIN (1 JULY 19BB) 56

t ocP/88.L Page 2

LIST OF TABLES

Page

TABLE 1 BUDGET BY PROCRAMME ACTIVITIES ... 9 J J TABLE 2 BUDGET BY CATEGORY OF EXPENDITT]RE.. 10

TABLE 3 PROGRAMME BUDGET FOR 1989 - SIJI.IMARY BY ACTIVITY AND BY CATEGORY OP EXPENDITURE. . 1L t

TABLE 4 OFFICE OF THE DIRECTOR. 15

TABLE 5 OFFICE OF THE DIRECTOR - SUMMARY BY CATEGORY OF EXPENDITURE AND BY SECTION 16

TABLE 5 STATUTORY MEETINGS 18

TABLE 7 VECTOR CONTROL. 23

TABLE 8 EPIDEMIOLOGICAL EVALUATION 27

TABLE 9 BIOSTATISTICS AND INFORMATION SYSTEMS 30

TABLE 10 SOCIOECONOMIC DEVELOPMENT 32

TABLE 11 ONCHOCERCIASIS CHEMOTHERAPY PROJECT. 35

TABLE L2 ADMINISTRATION AND SUPPORT SERVICES 38

TABLE 13 ADMINISTRATION AND SUPPORT SERVICES - SI]MMARY BY CATEGORY OF EXPENDITURE AND BY SECTION 39

TABLE L4 PROPOSED IVERMECTIN BUDGET 1989 AND 1990 . 54

i t

I ocPl88.1 Page 3

1. INIRODUCTION

1.1 The Plan of Operations for Phase III foresaw that by 1988 vector control would no longer be a constant conponent of OCP operations in all of the Original area and that a corresponding reduction of the entomological surveillance network would take place. However, due to the spread of resistance within the Original area in 1986/L987 and the incomplete control I of reinvasion, following the non- implementation of the planned attack operations in the Extension it was found necessary to continue larviciding during L986/L988 at a higher"r".", level than expected but with some reduction in the nileage of treated riveri, periods of larviciding and entomological surveillance.

L-2. According to the Plan of Operations, the two Extension areas were expected to be in the attack phase (ful1 vector control) by 1988: larviciding commencing throughout the Southern Extension area as from 1985 and, beginning in L986/87, in the eastern third of the l,Iestern Extension area with conplEte coverage of the entire area by L988/89. As a result of the resistance to temephos, the decline ln value of the US dollar and increased cost of goods, services and salaries, a deray in the implementation of the planned operations rras unavoidable. Vector control activities in the Extenslon areas were thus confined in L986/87 to a Partial control of sources of reinvasion and, as approved by JpC, vrere expected to continue at that level in 1988. However, in 19gg it proved possible to expand larviciding to cover all of the Southern Extension and part of the northern zone of the Western Extension area,

l-. 3. During 1988, epidemiological evaluation activities were carried out accordlng to plan with the addition of ivermectin field trials.

1.4. Other Programme activities such as support to socioeconomic studies and training have developed on the whole in conformity rrrlth the plan of Operations for the three years in question.

1.5. As a result of the intensive efforts made to deal with the spread of resistance, the Progranme has greatly enhanced its capability to rith lowered susceptibility to larvicides through the rotational use of the five"op. compounds now available to OCP. It has thus been possible to work out tactical treatment schedules for each river basin on a weekly basis throughout the year. It should be stressed, however, that tenephos has remained effective in rotation with other Iarvicides and is used routinely in extensive parts of the entire OCp area, including where resistance was previousry registered to the compound. Furthermore, the computerization of hydrological data and of loiistical support to larviciding operations has led to greatly improved cost-efficieicy of the vector control operations.

1.5. The conduct of ivermectin field trials and the analysis of the resulting data, which took uP an appreciable part of the Programme,s effort and t1me during the last two years, will help deterrnine the future role of this drug in onchocerciasis control.

I.7. Final1y, special efforts have gone into tightening the management of operations with a view to obtaining maximum cost-effectiveness in the use of resources. The Director of the Programme, after reviewing the increasingly strained financial sltuation of oCP early in 1987, issued strict guidelines for the approval of expendltures, linking such approvals to operational prioritles and the urgency of implementation. Regular consultations between the Director and his staff were reinforced so as to ensure a continuous review of programme operations and take immediate corrective action in case of need, a process iacilitated by an improved budget monitoring system. ocP/88.r Page 4

2. OVERVIEI{ OF TIIB PIAN OF ACTION

2.L. on the side of vector control, 1989 will be characterized by an imPortant expansion of larviciding operations in the l{estern Extension area. This, together with the start in 1988 of full larviciding in the southern Extension area and in the north-vrestern part of Mali (originally Ielayed to l9g9/90), will alrow a the Programne to recuPerate two out of the three years formerly expected to be I lost due to the spread of resistance and other adverse developments encountered in 1985 and early 1987. 2.2. Vector control in the original oCP area will continue unchanged from a 1988 leaving out the northern third of the area where larviciding has, i.n effect, ceased since 1985. Preparations will be made for the withdrawal 6f aerial larviciding from the original area in 1990 with the exceprion of cerrain circumscribed foci which will require continued vector control beyond 1990. The entomological surveillance network will remain at its 19gg revel.

2.3. Vector control operations will continue to cover the whole of the Southern Extension area i.n 1989 but with a great deal of emphasis on selectivity and seasonality in the application of larvi.id.s. In the western Extension area larviciding will be extended to the Gambia and Faleme river basins in senegal and to the Upper Niger basin in Upper Guinea which has been treated only seasonally since l-987- Here again, there will be room for operational flexibility aiming at the highest possible cost-efficiency. rt is also planned to treat pre-strned sources of reinvasion in sierra Leone during the April-Juiy period. The vector control infrastructure will be compreted in 1989 throughoui the western Extension area in time for larviciding to cover the totarity of th"t "r"" as from 1990. 2.4. In 1989, with five larvicides available to ocp and its ability use them ro according to rotational schedules, the Progranme should be capable of coping with any future instances of resistance. Trials of improved formulations and search for alternative compounds wilr, however, continue.

2.5. The efforts of the Epidemiological Evaluation Unit will, to a large extent, be directed to the organization, implementation and follow-up of laige- scale treatment with ivermectin. A great deal of the actual field work will be carried out by national teams in close collaboration with, and under supervision by, OCP staff.

2.6: The Programme staff concerned, together with national epidemiological evaluation teams, will continue the examination of strategically located indicator villages in connectlon with the planned cessation of larvfcidini within the originar ocP area. Also, efforts wirl go into rhe finalization of rt. epidemiological map of Llestern Extension area and the preparation of a sinilar nap of the Southern Extenslon area.

2.7. One of the principal activities of the unit of Biostatistics and Inforrnation System will be the continuing analysis of the results of ivernectin field studies whtch will be of crucial ilnportance to the determination of the use of the drug in conjunction with larviciding and of the balance betteen the two means of control in future oCP operations. The lntegrated operational rnodel is expected to be of particular importance in this connectlon. In addition, the unit will strengthen lts support to other operatlonal and administrative activities of the Programme. ocPl88 .1 Page 5

2.8. Support to soci.oeconomic development is now the responsibility of the Committee of Sponsoring Agencies (CSA). In this connection, there will continue to be collaboration in CSA-sponsored studies on settlement in onchocerciasis controlled zones, liaison between CSA and the Participating Countries, consideration of soci-oecononic factors in relation to OCP activities, e.g. drug distribution, and collectlon of ba.s-line data as and when required. I 2.9 . In the field of tralning the Prograrune will pursue its policy of concentratlng its efforts on preparing for devolution both as regards OCP- sponsored fellowships and its in-service training. An important element will continue to be the fleld training of nationals in the management of i.vermectin distribution. A11 awards will be directed to studies in institutions located on the African continent.

2.10. The OCP research prograpme will be geared to oPerational and other studies which are of absolute necessity for future Prograrnme activities as determined by the annual research priority setting of the ExPert Advisory Committee.

2.L1. On the management and adrninistrative side the objectlves throughout the Programme will rernain unchanged from 1988 i.e. the best possible results at the least expense of resources. A11 staff at all levels are now alerted to the need for cost-efficiency in all activitles and the OCP management will continue to encourage indlvidual staff contributions to meet that objeetive.

a ocPl88.1 Page 5

3. GENERAL CONSIDERATIONS ON TIIE PROFOSED BIIDGET FOR 1989

3.1. In March 1988, a Seminar attended by all professional staff members of the Programme laid out the blue print for the modifications to the OCP Plan of Operations for the last three years of Phase III. The Plan of Action for 1989 was also firmed up. The cost-savi.ng measures proposed during the 1987 Seminar on the -a Financial Management were reviewed to pursue further areas of improvement. The anticipated funding gap induced the Programme to seek the most efficient utilization of available resources by increasing cost-effectiveness and identifying opportunities for specific operational improvements and savings.

Budget

3.2. The proposed budget for 1989 requires funding approval for US $32 178 000 compared with US $29 466 000 in 1988. The increase of US $2 712 000 or 9.21 over 1-988 represents the cost of the additional activities required to implement the vector control in the Extension areas and the large-scale ivermectin treatment in the Programme area. The proposed budget reflects the needs expressed in the modified Plan of Action of each of the operational and technical units as well as the estimated expenditures for the Office of the Director, the Statutory Meetings and the Administration and Support Services. 3.3. Zero-based budgeting procedures were again followed in establishing cost estimates, and all activities and projects had to be justified as essential elements of the PIan of Action required to achleve the objectives of the Programme. As usual, no contingency reserves have been built into this budget. 3.4. The various Tables related to the budget were prepared on the basis of carefully calculated cost estimates that take into account the changes due to the fluctuation of the United States dollar and the increased cost of personnel, material and services.

3.5. The established average costs utilized to prepare the budget are shown in Annex 1.

The cost estimates of operations, personnel, supplies, equipment and services are based on the costs, prices and rates prevailing in JuIy 1988 to which has been added an assumed annual inflation rate which together with statutory requirements resulted in an increase of 5Z for professional staff and 122 for General Service personnel. In respect to procurement, an increase of 5Z for foreign and 102 for loca1 purchase of goods and services was provided for.

I ocPl88. 1 Page 7

Cost of personnel servi-ces

3.6. A11 personnel requirements have been scrutlnized and well justified. As a result there was a reduction of 68 personnel positions as shown below, by unit:

APPROVED PERSONNEL ESTABLISHMENT

Professional General Service

Units 198 5 t987 1988 1989 1985 t987 1988 198 9 Proposed Proposed

DIR 11 11 4 5 L2 13 10 8 vculAREM 35 37 30 28 487 507 463 4L9 EPI 5 5 5 4 38 35 32 23 BIS 3 2 1 2 ECO 2 2 1 1 1 1 2 ocT 1 1 1 1 1 1 1 1 ADM 11 11 8 6 1s8 16s 98 9L

TOTAL 66 67 52 47 597 722 507 544

The number and percentage of OCP staff by country of origin are summarized in Annex 13.

3.7. It is noted that while the basic salaries of the Professional staff remain stable, their post adjustments increased by only 52, the General Service staff costs, however, rose by 327, over the last 12 months.

3.8. Despite a proposed reduction of 9.51 of the professional positions and 8.52 of the the General Service posts throughout the Programme, the cost of personnel services is expected to increase by l-31 in 1989, and will require 28.87, of the total budget against 277, Ln 1987 and 30.52 in 1986. Annex 2 illustrates rhe cost of personnel services from 1981 to 1989.

3.9. The total national staff rnade available to the Programme in the Western Extension by Guinea, Mali, Senegal, Sierra Leone and Guinea-Bissau are as follows:

1985 225 L987 154 19 88 Ls4 L989 364

Paid by their government, these shall receive 201 salary supplement from the Programme, in addition to a per diem, for their travelling away from their place of residence.

The cost of the national staff will increase proportionately with the Sreater number of personnel provided by the Participating Countries from us $382,000 in 1988 co us $870,000 in 1989. ocP/88.L Page 8 Operational travel

3.10. In spite of the reduction of staff and a better control over travelling, the cost of operational travel will increase by 10.57. This increase is due to the enlarged vector control operations in the Extension areas and the large-scale ivermectin treatment which require more travelling over longer distanies and periods of time. f Aerial oDerations

3.11. In order to further extend treatment into the large territories of the Extension areas, the numter of flight hours for the helicopier and fixed-wing aircraft will increase fron 10,000 hours in 19gg xo L2,700 hours in 19g9, requiring an increased budget of 22.82. Self-explanatory cost statistics related to aerial operations fron 1981 to 1989 are shown in Annex 3. Larvicides

3.L2' Due to the control of the resistance, improved larviciding techniques, increased reserves of larvicides and better prices, the cost of larvicides for 1989 will decrease by 151 from 1988.

The cost of larvicides versus the quantities procured from 1981 to 1989 is displayed in Annex 4. Other operatlng costs

3.13. The increased cost for operations, supplles and service contracts are justified by the increased activities in the Extension areas, the large-scale ivermectin treatment, and the general cost increases due to inflation in the Programme area.

Vehicle acouisition oroErame

3.I4. In view of the financial constraints of the last three years, very few vehicles hawe been replaced during that period, and it is no longlr cost-efficient to maintain several of the older vehicles. A three-year vehicle ieplacement Programme will again be initiated in 1989. Furthermore, OCP is committed to provide the national teams with 60 vehicles. Consequently some US $1.5 million must be invested over the next three years, of which US $750,000 is provided in the 1989 budget towards Ehe procurement of 40 vehicles. Such pro..rr.r"nt will be carried out in line with the vehicle standardization policy of the programme. Budget details

3 ' 15. The proposed budget requirements are detailed in the following tables

Table I- Budget by Programme Activities Table 2 Budget by Category of Expenditure Table 3 Programme Budget for 1989 - Summary by Activity and by Category of Expenditure ocP/88. l Page 9

TABLE 1 - BUDGET BY PROGRAT.IIIE ACTIVITIES

(US $ )

Programme Activity E xpe nd ture xpend ture App rcv ed PT posed Tota I for Pe rce nt age total for

r 986 1987 I 988 1989 1986 to 1989 1 986 to 1 989

Offrce of the 0rrector 101 I Zb 888,000 500 4 /U 099

Vector Control 336 998 24 0i 1,t12,200 50! 34 0 -t--l

'! Eprdemroicarcal evaluatron 831,t00 90 1, , 163,2C0 1,379,000 281 c

Applted research and env. monrt, 1 284 8r7,378 3 934 nf,,

TT? Socro-economrc Development 28 86,638 159,000 8 500 ttt 691 0 45

Erostatrstlcs I Info. systems 356,600 000 bb / 600 0

Adtttrnrstratron I Support Servtces 2,276,598 2 436 60 2,050,000 2,416,500 9, i i9,705 1 59

nn 1;i Headquaters Suppcrt costs 269 770 300,000 .1J 0 t 34 n 94

n 0t Statutory l{eetr ngs 8 88 r 300, c00 JU 098 '53

,0 0r? flnn' ri10 0Er rr? Sub-total 492 6 26,329 000 lrrrl, rlVV r!JrJ!ltlle 90 '

? 117 nnn q Chemotherapy ProJect 3,050,91i ? ,623 ,i 42 2,261,00[ : i1,072,i59 tr

-t-

r2"C23,782 IOTA L 8 409 33,801,373 , 29,456,too 3?,'78.00! : ocP/88. r Page 10

TABLE 2 - BUDCET BY CATEGORY OF EXPENDIIURE

(US $)

I Category of expenditure I Expenditure Expenditurei Approved Proposed Total for Percentag€ total for 1986 1987 1938 r989 1986 to 1989 1986 to 1989

BECURNENT COSTS

Personnel services 7 , S26,805 9,060,71,t 8, r97 ,600 I , 337 ,000 3E,CzZ,LLg 28,44 Consultant s 7 19,325 959,97{ 615 ,000 5{8,000 2,8+z,299 z .35 Operatronal travel 1,032 ,897 935 ,984 I ,320,000 r ,359,000 4 ,647 ,881 3.8,1 AerraI operations 3 ,7 47 ,92? 5,3Ir,906 5 ,832 ,400 7 , s63,000 22,455 ,22A 18. 55 Contracts,research ( others ) {,006,652 2,736,523 3,250,000 2,35{,000 L2 ,317 , L7 5 10,20 Operating costs I ,813,935 2 ,086,699 2,L22,OOO 2,350,000 8,372,635 6.92 Insect icides ,l ,277,936 9,043,398 5,973,000 5 , 000 ,000 21 ,?9q,334 zo,o7 Local costs subsidi.es 366 ,063 352 ,000 870 ,000 1,6I6,063 l. 3il SuppI ies 516,770 i23,OZ3 470,000 526,000 2,210 ,793 1,85 Fellowshrps and trarning 311,678 ?q8,2tL 115 ,000 290,000 96{,919 0.80 Statutory Meetings 279,067 256,881 300,000 305 ,000 I ,170,948 0,97 Geneva Sup[rcrt costs 229,003 269,7?0 300,000 336 ,000 1,13{ ,773 0.94

sub-total. i2E,76L,990 i32,03{,131 28,8?7,000 i 30,838,000 116,511,1?1 96.27

CAPITAL COSTS

Bui Idrng 12t,290 7 3 ,925 75 ,000 75,000 645,215 0 53 Offrce furniture 53,911 68,319 42 ,000 30,000 19{ ,230 0 l6 Data processing equlpoent ll5,000 115,000 vehicles 484 ,631 750.000 1, Z3{ ,631 l,0z Iechnrcal equipoent 34 1,2 18 1,1.10 ,317 17Z,OOO 3?0 ,000 2 ,323,535 r.92

Sub-total 816 ,4 19 i 1,767 ,192 589,000 I ,340,000 {,512,611 3 73

TOTAL i 25 ,578,409 i 33,80r,373 : 29,466,000 32,178,000 L?L,O23,782 100.00 ocP/88.1 Page I I

TABLE 3 - PROGRAI,Il{E gUOGET FOR 1989 -SUIII,IARY BY ACTIVITY At{O CATEGORY OF EIPEIIDITURE

AL P r0graf,llne Vectcr Eprdenro- iSocro- B r ostat l Cheno- i Adrr nr s- lleet ngs Tota I Category D ccntrol logrcal ieconomrc trcs & I the rap y trat r on expendrture eval uat Develop s y stems P ro; ect

| lJst US E --_--ust us$ --r-t_l_l_t_UST USI USI ljst USI RECURREIIT COSIS

Personnel serYtces 638,500 6,266,500 582,000 91,500 173,000 1 86,000 1,396,500 45 ,0 00 9 , 382 ,000 ,E nnn Consultants 1 68 ,000 7i,000 28,000 14,000 I 30,000 25,000 135,0 00 603 ,000 Operattonal travel 1 24,000 I 1 5,000 180,000 35 ,000 25,000 1 30,000 1 30 ,000 110,0 00 I ,549 000

Aerral operatrons i , 508 ,000 55 ,000 7,563 000 Con!racts, research i others ) 25,000 429,000 45,00c ; 20,000 10,000 800,000 25,000 00 2,359 000 operatlng ccsts t5,000 1 ,800,000 1 15,000 I 1 ,000 31 ,000 I 0 ,00c 375,000 2,350 000 Insectrcrdes 5,000,000 5 ,000 000 ;n nnn Lccal cos'"s subsrdres 800,000 8i0 000 Suppl ies ?? nnn 210,000 80,000 i 3 ,000 25,00c 5,000 1 70,000 0000 536 00c

Fellcrshrps and tratntng 290,000 I 290 000 I 1)C 0ene'ia Stlpport costs 000

I

I lnq Sub-tota l ,151,500 2,996,500 , 204 ,000 i 181,500 281,000 12,26t,000 2,15 00 00 30 838 00 I -l--

CAPITAT CCSTS

Burldrng ; t5,000 -l_- 75 ,000 furnrture -r-l__l_ 0ff:ce I 20, ooo 5,000 5 .000 30,000 process,ng 't5 Data equrpment I 50,000 10,000 30 00 ,000 115,000 Vehrcles I 100,000 r 00.0c0 250,000 750 ,00c Techn:cal equrpilent 5,000 i 2E0,000 60,000 25,000 310 , 00c

---t-_ I I Sub-tcta I 5,000 i 835,000 1 75 ,000 30 ,000 295,000 40 000 I

I -t-t-t .IOIA I ---t- L 1,156,500 :23,831,500 379,000 8!,500 311,000 i2,261,000 2,152,500 305 000 32,178,000 I ----_--t--__ l-l-t-l--t-l ocP/88. I Page 12

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4. ESTIHATES BY PROGRA}II{E ACTIVIT]T 4-L- Office of the Director

4.L.L. The Office of the Director will remain responsible in 1989 for the following functions:

O General policy and Progranme management; Liaison with the statutory bodies, the Donors, the Participating goverrunents and the scientific community; The coordination of all Programme activities including research contracts; Information Services and Public relations; Administration of fellowships and training; Coordination of the socioeconomic projects; Statutory meetings.

4.L.2. The Information Services will continue to promote the Programme aimed particularly at the general public of Participating Countries and the Donors through all available means (press, filns, exhibitions). 4.L.3. The docrmentation centre will pursue the inventory and the cataloguing of the scientific documents to be made available to the staff and visitors. 4.L.4. As in l-988, the training of nationals will be limited to operational needs in order for them to assume their responsibility for maintaining certain activities within the devolution process. Funds available for fellowships will be exclusively granted to sponsor studies inside Africa. The budget for training proposes an increase of l52l over 1988 for a total of US $290,000. 4.L.5. The Office of the Director will take a more active role in the devolution process related to training, technical support, distribution of iwermectin, round tables and consultati-ons. Personnel 4.1.5. To carry out these responsibilities, the Office of the Director will require five Professionals and seven and a half General Service staff members. A Part-time consultant will be provided to complete the modified Plan of Operations for Phase III and initiate the preliminary work for the Plan of Operations for Phase IV.

Budset 4.L.7. The proposed budget of the Office of the Director is estimated at US $1,155,500, an increase of US $268,500 over the 1988 budget. Ihe increase of personnel servi.ces cost, training allocations and activities related to devolution account for the budget increase. ocP/88.1 Page I 5

IABLE 4 - OTFICE OE THE DIRECTOR

i i POSTa ,txpenditure Exp.nditure Approved Proposed CateSory of erpenditure iGrade i_ _i :1986 i1987 :1988 I 1989 1986 1987 1988 r989

US $ US$ US $ US$ BECUBBENT COSTS

PEBSONNEL SEBVICES

ProgralDe Director D.2 I I 85 ,000 100 ,000 Coordinator P.5 I I 85 ,000 90 ,000 Scientist (ceneva) (l) P,5 1 I 85 ,000 166,000 InforDation officer (21 P.3 I 65 ,000 AdDinistrative Of f icer P.3 I I 63 ,000 65 ,000 Ad[inistrat ive Assistant G.S 3 2 19,500 18,000 (Geneva) Secretary G.S z I L22,OOO 7,1 ,000 Clerk stenographer G.S 4 3,5 26 ,000 31,500 Driver G.S 1 I 6,500 9,000 (Geneva) Terporary staff 15 ,000 20 ,000

Sub-total 23 24 1{ L2,5 838 38 7 790,118 507 ,000 638,500:

Consultants i 63,L27 70 ,893 96 ,000 26 ,000 Op€rational travel : 96,304 r0{,533 100 ,000 12{ ,0oo Contracts (services) i 48,232 5,56{ 20 ,000 25 ,000 Operatrng costs I rr,233 6, ?{9 r5 ,000 15 ,0oo Supplies i 16,382 rz ,956 20 ,000 33 ,000 Fellowships and training i 311,678 248,24L 115,000 290, ooo

Sub-total s{6,956: 448,936 366,000 : 513,000 i r_l

ICAPTTAL COSTS :

: Bui ldi,ng i i Office furniture & Equi.Irent: 2,695 : - Vehic Ies Equipoent 13,0{7 i 22,060 15 000 5 000

sub- total L5,742 i 22, 060 15,000 I 5,000

TO?AL 23 24 1{ 12,5:1,40r,085 i 1,26r,r14 | 888,000:r,156,500

Note (l) : - 14 person/Donths were budgeted to cope with the change{ver of the Liaison officer in Geneva

Not€ (2) : - The inforlation officer post was created to forualize the erplo)aent of the public Relations end Infornation Officer previously retained as a consultant. ocP/88. I Page l6

t

TABLE 5 - OFFICE OF THE DIRECTOR -

SUMMARY BY CATEGORY OF EXPENDITURE AND BY SECTION r.ilq E \ Secti ons Programme Informat i on Geneva Devol ut'ion and and TOTAL Category of ef iture : Management documentat i on liaison trai n i ng I \i t_ I I t RECURRENT COSTS I I I Personne'l services 196,500 i 83,000 260,000 99,000 638,500 Consu I tants 6,000 I 20,000 26,000 Operati ona'l travel 50,000 i 7,000 62,000 5,000 1 24,000 I Contracts (s+-hers) I 25,000 25,000 Operating costs 5,000 i 5,000 5 ,000 1 5,000 Supp'lies 1,000 I 15,000 1 5,000 2 ,000 33,000 I Fellowships and trai ning I 290,000 290,000 I

Sub-total 258,500 1 1 0,000 387 ,000 396 ,000 1,151,500

CAPITAL COSTS -l

Bui lding Furn i ture 5 000 5,000 Vehi cl es Equi pment t_t

Sub-total 5,000 5 000 t_

-l TOTAL 258,500 1 1 5,000 387,000 396,000 1 , 1 56,500

-l ocPl88.1 Page L7 4.2. Statutory Heetings 4.2.L. The budgetary provislon for statutory meetings includes the estimated costs for the travel and per diem of participants and supporting staff, as well as for the translation of documents and interpretation services. One full-time adurlnistrative officer and one secretary working half time budgeted within the Office of the Dj.rector are employed for the organizati-on of meetings. The meetings planned for 1989 are:

The Ecological Group, The Expert Advisory Committee, Three sessions of the Committee of Sponsoring Agencies, The Joint Programme Committee.

4.2.2. The National Onchocerciasis Committees have decided to modify the format of their annual meeting, formerly attended by Ministers of Healch and to reduce ir to annual technical meetings of national experts under the coordination of the Programme Director, to be held in Ouagadougou, unless a formal invitation to hold them elsewhere was received fron a Participating Country. Only the costs of the secretariat and interpretation services have been budgeted for such a meeting. Although this meeting is not technically a statutory meeting, its costs are reflected in this budget proposal.

4.2.3. The cost of the participation of non-OCP experts to other OCP meetings of specialists/experts related to research projects, ivermectin distribution, hydrology or hydrobiology, modelling, etc., have been incruded in each of the budgets of the host units under "operational travel".

ra

t ocP/88.1 Page 18

TABLE 6 - STATUTORY MEETINGS

i i Posrs Expenditure i Expenditure Approved Proposed I CateSory of expenditure : crade: 1986 r98? 1988 1989 1986 1987 1938 19S9

IlQ US$ US$ $ US $ EECURBENT COSIS

PERSONNEL SERVICES

,15 Teoporary assistance .16 6 76 {5,000 , 000

Sub-t otal {6 ,676 ,15 E5 000

ConsuL tant s / TeDporary adv i sers 138,696 140,000 135,000 operatronal travel 92,464 r00,000 1r0,000 i Operatrng costs Contracts /TransIat r.on 6,875 5 ,000 s,000 i SuppI ies 2,t70 l0 ,000 r0,000:

Sub- total zEo,2o5 255 ,000 260,000 i

CAPITAL COSTS Duilding Furniture veh ic les lquipoent

Sub-total

TOTAL 206,872 286,881 300,000:305,000

a.

a ocPl88.1 Page 19 4.3- Vector Control

4.3.1. As in the past, Iarviciding will be the exclusive means of vector control and will be carried out almost entirely by air. The prirnary targets of the larviciding operations will remain the savanna species of the vector complex, whether they are associated with the savanna form of the disease or represent a recolonization risk for protected areas. As in 1988, improvement in cost-efficiency will still be the leitrnotlv of the activities related to vector control, particularly with regard to supervisory and operational personnel, aerial operations and insecticide use. Ooerational plan 4.3.2. Vector control operations will be characterized by the continuation of the programme for the geographical expansion of treatments towards the west. This was started in 1988 in Mali with the inclusion of the Senegal foci (the Gambia and Faleme basins, not yet treated) and the Upper Niger basin in Upper Guinea (treated seasonally in 1987-1988) during their period of productivity, as a prelude to the complete coverage of the Western Extension area planned for 1990. To limit the potentially unavoidable selection of resistance to the organophosphates, the available larvicides (temephos, L_!.. H-14, permethrin, carbosulfan) will right from the beginning, be used in rotation in the new zones to be treated as in the areas already covered. A seasonal rotation scenario has been established basin by basin and will be adjusted as appropriate according to the hydrological data transmitted continously by the Argos teletransmission beacons and to the computerization of both the operational and logistic data, and, the entomo-epidemiological results. Preparations for the total coverage of the ['Iestern Extension area will be made by establishing the infrastructures of 25 operational bases and by the collection of reference data by the national teams (55 in all as against 49 in 1988) in the five Extension countries described in Annex 8. The last major presumed sources of reinvasion in the zones not yet included (Sierra Leone) will be treated during their supposed period of production (April-July).

The protection of the results achieved in the Original area remains a priority. The regions of this area covered by larviciding will be unchanged in relation to 1988, but a particularly discriminatory use will be made of the insecticides in time and space. (See map showing the Proposed Plan of VCU Operations for 1989 in Annex 10). I^arvicides

4.3.3. Larvicide requirements have been estimated as follows

Temephos 2O7. EC 79 500 litres B.t. H-14 (HPD or 12 AS or 471 000 litres equivalent) Chlorphoxim equivalent 47 000 litres Permethrin 201 EC 55 000 litres Carbosulfan 251 EC 14 500 litres ocP/88. 1 Page 20

To make up for the withdrahral of chlorphoxim from the market, it is F planned to test another pyrethroid (cypermethrin) and another organophosphate (pyraclorfos) as early as possible. The scheduling of the orders will be such as to permit the introduction of the best performance formulations of B.t. H-14 I passing the operational screening stages. I Aerial operations

4.3.4. The estimated flight hours for 1989 emount to 12 /OO hours (as agalnst 10 000 hours in 19BB), for an air fleet ranging from six to eleven helicopters and one to two fixed-wing aircraft, depending on the season.

The organization chart of the aerial operations section shown in Annex J is being modified to meet both the requirements of this vital role of the Programme and the budgetary constraints. Strict management control of stocks and circuits which characterized the 1987-1988 operatlons will remain more than ever in force, and, it is envisaged to further optimize the output of the spraying circuits through modelling. Entomological Evaluation

4.3.5. The entomological evaluation nethrork of the Original OCP area wilf not be appreciably reduced in 1989 but the staff number will be reduced by the use of catching teams composed of two operators, instead of three. The surveillance network of the Western Extension area, staffed completely by the national teems of each country concerned and supervised by OCP, will be fu11y in place at the beginning of 1989, so as to be able to assess the effects of the treatnents in Ma1i, Senegal and Upper Guinea and to collect pre- larviciding data in the rest of the Extension area planned to be treated in 1990. The VCU entomological evaluation network is displayed in Annex 8. Applied researqlr 4.3.6. The budgets for research, technical service and consultant contracts, which cover applied and operational research activities not carried out directly by the Vector Control Unit, have been decreased; but priority research activit,ies remain guaranteed , vi-2.; - screening of new larvicide formulations; - identification of parasite species and strains in the vectors; - practical and precise identlfication of the vectors; - determination of the risk of recrudescence of protected areas after the cessation of larviciding and of the infection potential of residual parasite reservoirs; - evaluation of the impact of ivermectin treatments on onchocerciasis trans- mission and the possible association of such chemotherapy with larviciding. 4.1.1. The proposed research projects and service contracts listed in Annex ! will require a budget of US $429,000. It represents an increase of 2O"/" over the 19BB budget mostly to finance additional applied research projects. ocP/88.L Page 2L Surveillance of Aquatic environnent 4.3.8. The monitoring of the aquatic environment will continue to be carried out in the Original area according to the instructions of the Ecological Group. The monitoring of the fish fauna is carried out by the national tenms and that of the invertebrates by the OCP teams. The latter will participate also in the screening of new insecticide products. The D monltoring covers, in particular, the introduction or the repeated and cuurulative use of "hard" larvicides. A plan is being established for the extension of hydrobiological monitoring in the newly treated zones.

Personnel

4.3.9. The personnel requirenents for VCU, including the elements of the applied research group, will be:

Professional staff members 28 General Service staff: 4L9

Total 447

It must be noted that despite additional workload, the VCU permanent personnel establishment was reduced by 10I.

4.3.10. National teams are provided by Guinea, Mali, Senegal, Sierra Leone and Guinea-Bissau in the Western Extension area. The national personnel receives a 2Oy. salary supplement and per diem fron the Programme. The national personnel requirement for 1989 will be as follows:

POSTS GUINEA MALI SENEGAL SIERRA GUINEA TOTAL LEONE BISSAU

NATIONAL COORD 1 1 1 1 1 5 ENTOMOLOGIST 3 1 1 1 1 7 ENTO. TECH. 32 19 8 5 2 57 CAPTURER 54 38 L2 L2 4 130 DRIVER 40 20 8 8 78 ADM. ASST. 1 1 : 4 SECRETARY 1 i i 1 MECH. ASST. 3 2 5 MECHANIC 3 1 1 1 6 RADIO OP. l2 7 25 BOATMAN 1 1 : : i 2 STOREMAN t 1 GUARD 11 7 2 3 I 24 HYDROLOGIST 3 3 HYDRO. ASST. 6 6

TOTAL t82 98 36 36 L2 364

A provision of US $ 870,000 is made in 1989 for the increased operations of the national teams, compared with an approved budget of US $ 382,000 in 1988. ocPl88.1 Page 22

4.3.11. In regard to consultancy services, the VCU requirements have been reduced in rerms of costs fron us $ 300,000 in 19gg to us $ roa,000 in 19g9. Consultants witl be retained to conduct research activities in the following sectors:

- Insecti-cides evaluation 2 nonths - Hydrobiology 5 uronths i - Hydrology 12 uronths - Aerial Operations 4 months - Training 2 months Budset

4.3.L2. The suggested budget for VCU in 1989 of US $23,831,500 represenrs a ner increase of US $2,7L9,300 or L2.91 over the 1988 budget. This increase is due entirely to new activities in the Extension areas. Ihe vcU share of the budget is 74.L 7,. ocP/88. l Page 23

TABLET-VECTORCONTROL

POSTS iExpenditureilxpenditureiApproved :ProDosed cate8ory 'f ;xpenditure iGrade i- i i 1986 i rs87: 1988: 1s89 1986 1987 198E r 989

-: US$ US$ US$ US $ RECUBBENT COSTS

PEBSONNEL SEBVICES

Chief VCU (1) SRP I I I l,z5 rr2,500 Scrent ists iPs/P,l l5 16 1? 13. 25 I ,445 , 000 1,192,5oo fechnical Officers i Ps/Pr 20 20 I3 1{ 819,000 910 ,000 AdDinistrative Assistants G.S clerks, stenographers and Other General service persomel 447 504 { 63 419 3 ,009 ,500 3 ,916 , 300 Ierporary staff 75 20I 86 ,000 105 ,200

sub-total i s23 i s{1 493 447 4,599,513 I 5,E61,525 s,359,500 i 6,266,500

Consultants {59,648 581,298 300 ,000 168 ,000 operational travel 674,1{5 653,581 745 ,000 815,000 Aerial operations 3,747,922 5,31r,906 5,799,700 7 , 508 ,000 contracts, research (others) 1,162,'l14 472,843 350,000 {29 ,000 subsidies - National teaas 359,765 360,000 800 ,000 Operating costs 1,527 ,358 I ,683 , 864 1,600,000 I , 800 ,000 Insect rcides 4,277 ,936 9,043,398 5 ,973 ,000 5 ,000 , 000 suppl res 296,317 434,L72 200,000 210,000

Sub-total rz,tq5,740 18 , 5,10 ,827 L5,327 ,700 16 , 730 ,000

CAPITAL COSIS Bui Iding {21,290 73 I 25 75 ,000 75 ,000 Office Eurniture r8,805 20 { 98 25,000 20 ,000 Dat. processin8 equiprent 60 ,000 Vehicles 48{ ,631 400 ,000 Field Equiprent 268,93{ 9,17,043 I 325,000 280 ,000

Sub-toteI 709,029 1,s26,097 i 425,000 835 ,000

TOTAL is23 :5,r1 l{93 : 847 it7,454,282 25,928,449 izL,Lr?,2OO i 23,83r,500

Note (l): 15 person/uonths have been budSeted to cope wlth the change-over of the chief vcu ocP/88.L Page 24

4.4 Epidemiological Evalua.tion

4.4.L. During 1989 most of the activities of the Epidemiological Evaluation Unit (EPI) will focus on large-scale treatment with ivermectin for which the overall cost estimates are sumarized in Table 14 (Annex 11). However evaluation activities will also be conducted in the Original Programme area to document the continued decrease of the reservoir of the disease and to supply a timely feedback to VCU to guide their decision on interrupting larviciding. The epideniological mapplng of Sierra Leone and Guinea-Bissau will be completed by the end of the year. It is planned to start the epidemiological mapping of the Southern Extension area in 1989.

Epidenioloeical surve illance

4.4.2. In the next two years, larvicide treatment should be reduced or di-scon- tinued in large zones of the well-protected Original OCP area. The final decision to interrupt vector control will be based on the results of the epideuriological evaluati.on. Consequently, the quasi-totality of the 140 follow-up villagei will be surveyed during 1989. In addition, a number of non follow-up villages will be evaluated to determine the state of the human reservoir of the disease in selected areas.

In Sierra Leone, Guinea-Bissau and the Southern Extension area repre- sentative villages will be selected and surveyed by national teams. OCP personnel will strictly supervise this work. Quality control tests between national teams and OCP staff will be carried out to ensure the accuracy of the data collected. Large- scale ivermecti-n treatment

4.4.3. The consolidated large-scale ivermectin treatment activities from 1987 to L989 are sunmarized in Annex 11.

4.4.4. The Epidemiological Evaluation Unit lrill carry out the following large- scale ivermectin treatment during 1989. (See MAP Proposed Large-Scale lvermecti-n treatment activities in Annex 12) - Upper Niger (Guinea) This is a large hyperendemic area with an estimated populatlon of 117 000 people, about 50 000 will be targeted for treatment. The aim of this exercise will be mainly the prevention of onchocercal blindness. - Upper Ganbia (Senegal) Ihis hyperendemic area has been already treated as one of the 1988 ivermectin trials. Follow-up annual treatment will continue in 1989. - Upper Bakoye (l{ali) This is another hyperendemic area identified during the epidemiological mapping of the western Extension area and will be targeted for treatment. - Tienfala (Hali) This will be a follow-up yearly treatment of a 1988 trial area. The targer population of this area may be enlarged to allow substitution of larviciding with chemotherapy. ocPl88.1 Page 25

- l{aratrou6 (G6te d'Ivoire) Despite larvicide treatment, the epideniological indicators of the follow-up villages of this area have not registered any improvement and the risk of blind- i ness remains high in the hyperendenic villages. Ivermectin treatnent will start start in 1989 to prevent onchocercal blindness. - Upper Sassandra (C6te d'Ivoi-re) This river basin was heavily re-invaded for a ntunber of years The area will be surveyed and if the intensity of infection in the communities is sti1l high, ivermectin treatment will be scheduled.

- Lower Bandaua (C6te d'Ivoire) The treatment of the river stretch with larvicides is expensive. It is planned to substitute vector control with chemotherapy. - Pendi.e (Burkina Faso) This was an area selected for ivermectin trial in 1988. Because it is the only study airned at demonstrating the ability of the drug to control recrudescence of the dlsease it will retain its trial status during 1989. - Bui (Ghana) This is another trial area and annual treatment will continue

- Asubende (Ghana) Asubende has been an ideal study area and will retain its trial status in 1989. - Kulpawn Sissili (Ghana) Thls is an area where transnission of onchocerciasis has ceased and the reservoir of the disease will be controlled by ivermectin treatment.

- Asukawkas (Ghana) This area is the only well documented focus of blinding onchocerciasis of the Southern Extension area and the disease will be controlled by chemotherapy - Kara basin (Togo-Benin) This is a trial area and mass treatment will continue on an annual basi.s - Sota river basi.n (Benin) This is an area in which vector control has been unsuccessful and expensive It ls planned to substitute larviciding with chemotherapy. Personnel

4.4.5. The staff requirement for the above activities will be:

- Professional menbers 4 - General Service staff 24

The number of Professional staff members will be reduced by one member from 1988. It will be offset by 11 rnonths of consultancy services to be retained on an as required basis. ocPl88. 1 Page 26

National teams

4.4'5. National tearns of Guinea, Mali and Senegal will be involved in epide- miological evaluation activities and in evaluation and monitoring tasks related I to the large-scale distribution of ivernectin. Research Proiects

4.4.7. It is proposed to contract out research projects in the following fields Identification of parasites of human origin Identification of parasites of animal origin Immunology testing.

Budset

4.4.8. The EPr budger wirl be increased from us 91,153,200 in 19gg to US $1,379,000 in 1989 due mostly to the additional activities related to rhe large-scale ivermectin treatment.

{ ocP/88. r Page 27

TABLE 8 - EPIDEI'TIOLOGICAL EVALUATION

i POsTS iExFenditure Expenditure i Approved i Propoeed i Category of expendrture Gradel- : r986 I 1987 i r98E i 1989 i 1986 1987 1988 i 1989 i - - -i --TS-T-- ---us-T-- US -us-$--

RECURBENT COSTS

PEBSONNEL SENVICES

lredical Of f icer-EpideBioIoBist P.5 2 2 ? 1 127,500 90 ,000 Medical Of f i.cer-Parasitolo8ist P,5 2 z 2 2 r70 ,000 r80 ,000 Hedical of f icerophtha hho,l" o g i s P.5 I I I I 85 ,000 90 ,000 Laboratory, technicaL assistants G.S 18 l7 l5 1'1 97,500 126 ,000 clerk stenographer G,S 1 I I 6,500 9 ,000 Nurses G.S 2 u 2 6 13 ,000 5{ ,000 clerk and typist G.S 2 1 I 2 6,500 18 ,000 Drivers (1) G s L4 L4 13 8,1 ,500 Terporary staff 10 ,000 r5,000 i

Sub- total 43 {0 3 z8 590, {44 625,186 i 600,500 582,000

Consultants {8,9?9 7r. ,060 53 ,000 77,000 Operational travel 109,809 81 ,997 150,000 180 ,000 Aerial operations 32,700 55 ,000 Operating costs 16,163 9,151 95 ,000 r15,000 Suppl i es 40 ,646 75,256 45 ,000 t0 ,000 Contracts tothers) 75,000 ,15 , 000

Subsidies - National tea.rs 6,298 i 22,OOO 70 ,000

Sub-totaI 215 ,597 243,76?, t182,700 622,OOO

CAPITAL COSTS Bui Iding Office furnJ.ture 00 0 5 ,000 Data processin8 equrpoent r0,000 vehicles r00,000 Field equipoent 25 0 59 38 I 23 75 00 0 60 ,000 fj.a

Sub-total 25 0 59 38 823 80,000: r75,000

TOTAL zl3 {0 3 28 831,100 907,771 :r,163,200 :r,3?9,000

Note (l): AII drivers were la6psferred to the Administration and Support Services unit in l 988 ocPl88.1 Page 28

4.5. Biostatistics and Information Systems 4.5.1. The main activities of the Biostatistics and Information Systems unit are: I - the processing and analysis of routine evaluation data and of data from special studies; - the planning and provision of information systems support to Programme operations and management; - the provision of statistical and methodological support to applied research and evaluation activities; - the development and application of epidemiological modelling as a tool in analysis and long-term planning; and - reporting on the quantitative aspects of Programme evaluation and long-term planning. 4.5.2. Ihe workload of the unit has considerably increased ower the past year with the additional processing and analysis of the massive data from the ivermectin trials and the evaluation data from the Extension areas. The existing microcomputer configurations have proven inadequate for all this work and a progralnme of reinforcement of the hardware, which started in 1988, will be completed in 1989.

4.5.3. A najor new activity for 1989 will be the processing of the data on the large-scaIe ivermectin treatnent involving some 250,000 people. Priority will be given to the processing of data from those treatment areas where detailed informa- tion will be collected on the incidence and severity of adverse experiences fol- lowing treatment and on the effect of mass treatment on transmission. 4.5.4. Epidemiological modelling will be extensiwely used in the integrated analysis of evaluation and research data. A detailed transmissi-on model for oncho- cerciasi-s has been developed to enable the optimal utilization of the available information in the prediction of long-term epidemiological trends and in the pros- pective evaluation of alternative control strategies for the OCP. A major question to be addressed is at what stage it will be sufficiently safe to interrupt larvi- ciding in the Original OCP area and what the related risk will be of recrudescence of the disease. The second priority is the prediction of the long-term impact of ivermectin mass treatment in order to arrive at rational decisions on the optimal and cost-effective utilization of this new tool for onchocerciasis control. This aspect of modelling will be closely associated with the analysis of the ongoing ivermectin trials.

4.5.5. Support in compuEer programming and in the development of data proces- sing systems will continue to be a major activity of the unit, especially in view of the lncreasing use of microcomputers in the OCP. The introduction of a few more powerful computers will enable the optimization of existing computer progranmes and the improved use of evaluation data in operational decision-making. Computer training courses will be organized and regular informati-on systems support will continue to be provided to all operational centres where microcomputers have been ins ta11ed.

Personnel"

4.5.5. The staff requirements to carry out the above activities will be:

Professional staff 2 General Service staff 2

Two man/months of consultancy services will be required to supplement the professional staff in their activities. ocPl88. 1 Page 29

Budget

4.5.7. In terms of budget, BIS will require US $311,000 of which US $173,000 account for personnel services. This budget includes US $20,000 for the modification and improvement of the applied modelling and US $30,000 for the upgrading of the present hardware. ocP/88. r Page 3O

l

TABLE 9 - EIOSTATISTICS AND INTORMATION SYSTEMS

POSTS : lxp€nditure : Expenditure Approved Proposed Cate8ory of expenditure Grade : 1986 i 1987: 1988 1989: 1986 1987 1988 r989

US$ US$ US$ US$ NECURRENT COSTS

PERSONNEL SENVICES

Statistician (Chief ) P.5 1 I 85 ,000 90 ,000 Statrstician analyst P.3 1 I 63 ,000 65 ,000 Progra.DEe analyst P.2 I 53 ,000 PrograDoe ana}yst G.S I I 000 CLerk stenographer G.S I 1 6 500 000 OvertiEe 100

Sub-totaI i4 + zt1 , 600 173,000 |

Consultant s 6,000 1,1 ,000 Operational travel 25 ,000 25 ,000 (others) Contracts 45 ,000 10 ,000 Operational costs 32 ,000 34,000 SuppI ies 20,000 25 ,000

Sub- tota I 128 ,000 108,000

:CAPITAL COSTS Buildj.ng

Data processing equipoent 1l 00 0 30 000 Vehicles Equipnent

Sub- total 1l 0 00 30 000

TOTAL i4 :{ 356 ,600 311 ,000

Note : This unlt was organized froE elerents of the office of the Director in 198? ocPl88.1 Page 31

4. 5. Socioeconomic develoPnent 4.5.L. As in 1988, the main activities will consist of collaboration in the socioeconomi-c development studies sponsored by the CSA and financed by the World Bank and the study on resettlement into the onchocerciasis-controlled zone f inanced by 1INDP.

4.6.2. The Professional staff member will act as the advisor to the Programme Director and will provide liaison between the Participating Countries and the various organizations involved in the above studies. The other activities will focus on: - Gathering of socioeconomic baseline data in Senegal and Guinea- Bissau; - Analysis of macro-economic data in the Programme area; - Contribution and assistance to studies related to ivermectin dis tribut ion/treatment .

Research contract

4.6.3. A study aimed at assessing the effect of manpower constraints caused by onchocerciasis transmission on farming systems (manual cultivation, animal traction, etc.) and modes of cultivation (individually, collectively, etc.) is proposed.

Persormel

4.6.4. The above tasks will be performed by 1 professional agro-economist, 1 secretary working half-time

Budget

4.5.5. The 1989 provisions for socioeconomic activities will be US $181,500, which represents an increase of US $22,500 from the 1988 budget. ocP/88. r Page 32

!

TABLE 1O . SOCIOECONOMIC DEVELOPMENI

I i POSTS Expenditure ExpenditurelApproved iProposed Cate8ory of erpenditure :crade:_ I i1e86 1198? i1988 r989 1986 1987 1988 1989

US$ US$ US$ US $ IRECUBRINT COSTS

PIBSONNIL SERVICES

Econooist P.5 I I A!ro-Econorist P.4 I 90 000 A[ro-EconoEist P.3 I I I 63 ,000 CartoBraph€r G.S I 6,500 Clerl stenographer (l) G.S I I I 0.5 6,500 4 500 Terporrry staff 10,000

Sub-totaI 3 3 3 1.5 65 802 63 I 76 86, 000 9,1 5 00

,15 consultants , {01 LL,228 30 ,000 28 ,000 Operational travel 8,103 1r,56r 20 ,000 35 ,000 Operating co6ts 109 5 ,000 r ,000 Contract (others) 6,186 10,000 20 ,000 suppl ies 2 ,061 56{ 5 ,000 3 ,000

Sub-totaI 6l 7 I z3 462 70 000 37 000

CAPITAL COSTS Eui Iding l'urniture Vehicles Equiprent 3 00 0

Sub-totel 3 00 0

TOTAL 3 3 3 1.5 127 ,553 86,638 i 1s9,000 181,500 ocP'/8 8.1 Page 33

4.7. Onchocerciasls Gheuotherapy ProJect 4.7.L. Ihe najor objective for the Onchocerciasis Chemotherapy Project (OCT) in the triennitn L989/90/9L ls to identify and develop further potential macrofilaricides so that compounds suitable for clinical trials in rnan are clearly identified, and most of the preclinical work required to initiate such trials should be courpleted by the end of 1991. The clinlcal trials already in progress on Ciba-Geigy compound CGP 5140 will continue to identify the most therapeutically efficient and clinically tolerated dosing regimen for macrofilaricidal activity. The use of ivermectin, either alone or in combination with other drugs, will be further evaluated as a macrofilaricide at the Onchocerciasis Chemotherapy Research Centre (OCRC). The specific activities to be undertaken to achieve these objectives are listed below. Clinical trials centres

4.7.2. The maJor clinical trials centre for future drug testing by OCT will be the OCRC at Hohoe, Ghana. Ihis centre now has a staff of 40 persons, the majority of whom receive a basic salary from the Ghanaian Ministry of Health, but require additional pa1rments for overtime worked at the time of clinical trials. Four staff members are employed directly by the OCRC. Director OCRC is also paid as a WHO consultant for 11 months of the year, and this cost appears under the consultancy heading.

Hospital Point G in Bamako, Mali is currently used for clinical trials of CGP 5140 and this work will continue as long as suitable patients remain available. However, vector control and ivermectin treatments in the patient catchment area around Bamako will limit the useful life of Hospital Point G as a clinical centre for testing of macrofilaricides. Thus other hospital centres in West Africa and elsewhere will be visited in an effort to establish an alternative cllnical trials centre.

Funding for clinical triials centres is estimated at US $350,000 for 1989, but it is hoped that European Economic Community (EEC) funding will offset some of the costs of the OCRC. l{ultidisciplinary research groups in industry 4.7.3. Only one such group at the Wellcome Research Laboratories in the United Kingdom will be supported in 1989. Its najor objective will be to undertake research and develoPment studies on the phenylamidine series of compounds to enable a decision to be made in 1989 to take forward one or more members of the series as a candidate macrofilaricide for clinical trials in onchocerciasis patients. Funding will need to continue at a similar level to that in 1988. Drus. screeninE centres

4.7.4. The drug testing facilities supported by OCT, together with the clinical trials facilities, form the major asset which can be used to attract novel chemical entities from pharmaceutical companies, and other sources, for use as potential antifilarial drugs. These will continue to be supported and their efficiency improved. ocPl88. 1 Page 34 Prinary screening in small animal models will continue at the University of Giessen, Federal Republic of Gernany, and any primate testing will be done at the Institute for Medical Research in Kuala Lumpur, Malaysia, and at the Delta Primate Centre in Louisiana, USA, if an Q. volvulus model can be established in ? the latter centre. In past years tertiary screening of promising drugs has been carri-ed out against Q. gibsoni in cattle in Queensland, Australia. There are some problems with the present screening facility in Townsville and an alternative centre will be sought. Such a centre will require funding at a level of US $130,000 per annum, and approaches are being made to the Australlan Government to contribute to this centre.

In vitro drug screening using Onchocerca adult worms will be carried out at the CAB Institute of Parasitology in St Albans, United Kingdom and at the Bernhard-Nocht-Institute in Hamburg, Federal Republic of Germany. Computerized databases relating to chernical and biological information generated from antifilarial screening will be managed by Dr C. Canfield of Washington D.C., USA.

Supporting Research

4.7.5. In 1989, only two laboratories will be carrying out biocheroical rrork on drug identification. Inhibitors of chicin metabolism will be developed in the University of Aberdeen, UK, and of glutathione metabolism in the University of Vermont, USA. Nodule supply

4.7.6. Free worms and nodules obtained from nodulectomy campaigns in Mexico and Guatemala will continue to be shipped to laboratories in non-endemic areas. A similar supply of worms and nodules from O. gibsoni in cattle will be continued if a cattle screening centre is maintained in Australia.

Preclinical Drug Development Team (DDT) 4.7 .7. In order to optimize drug development in the screening centres funded jointly by OCT and TDR/Filariasis a small drug dewelopment team (one medicinal cheurist and one parasitologist) will meet three times a year (two linked with the Steering Committee meetings), and throughout the year will monitor the synthesis and flow of drugs through the screening systems. Operating costs./Supplies

4.7.8. Operating costs of US $10 000 and supplies of US $5 000 will be required during 1989.

Meetings 4.7.9. It is anticipated that the pattern of two Steering Committee meetings per year will continue in 1989. A Scientific Working Group meeting on a technical aspect of drug dewelopment is also planned in 1989. The cost of US $ 80 000 for these meetings has been budgeted under operational travel. ocP/88.1 Page 35

IABLE I1 - ONCHOCERCIASIS CHEI.'OTHIRAPY PBOJECT a

POSTS I Expenditure 3 lxpenditure Approvcd ProDosed Category of expenditure crrde :1986 1987 I 1988 r989 1986 1987 1988 l9E9

US$ US$ US$ US $ BECUBBENT COSTS

PEBSONNEL SIBVICE -t

scient ist P,5 I I I I 85 ,000 112 ,000 Secretary G.S 1 I 1 I 61 ,000 7{ ,000

a Sub-totaI 2 2 2 2 tL7 ,287 1t0,193: 1,16,000 186,000

-t_ Consultants {7,998 60,000 i 66,000 130 ,000 Operational travel 13,195 16,564 i 60,000 130 ,000 nesearch (others) 2,789,32O 2,t88,262 :2,750,000 I ,800 ,000 Other contractual Service6 52,000 Operatrng co6ts 5,s20 9{1 I r0,000 0 000 Supplies 4,902 1,062 i s,000 5 000 Heetings (l) 72 ,195 L48,222 : 90,000

Sub-total 2 ,933 ,630 2,467,05L i2,981,000 2,075,000

CAPITAL COSTS Equipoent t6 ,4 98 t0 000

Sub-total r6 ,498 : r-0 ,000 i

TOIAL 2 2 2 i2 3,050,917 2,623,7{2 :3, r3?,000 i2,26r,000 ocPl88. 1 Page 35 4.8. Administratlon and SuPPort Services 4.8.1. In 1989, this unit will pursue its support in providing services to the technical and operational units of the Programme. It will seek further a i-mprovements in the cost-effectiveness of its support by: - reviewing the requirernent and justification of each personnel position involved in administration and logistics within the Programme; - contracting out certain services related to vehicle repairs and transPortation; - continuing the decentralizatiotr of administrative suPport including local procurement and financial services; and - replacing permanent staff by temporary Personnel when possible. 4.8.2. The unit r.rill continue the strengthening of its management and increase its productivity in recruiting better qualified general service supervisors and reducing the number of professional positions accordingly. Budget and Finance operati;ns will be further computerized. It is also intended to comPuterize the personnel adminlstration by mid-l-989. 4.8.3 The Administration unit will play a greater role in the administration of the Aerial Contract and Ehe Technical Services Agreements previously administered by VCU and the Office of the Director. The administrative procedures will be reviewed to allow greater decentralized responsibility and authority to the units and sectors.

Personnel 4.8.4 Despite the reduction of two Professional positions and seven General Service posts, the cost of the personnel services will increase by 9Z because of i.ncreases in the local salaries and statutory requirements.

The personnel needs to implement the administrative requirements are: Professional sraff: 5.5 (compared with 9 in 1988 and 10 in 1987) General Service Staff: 91 (compared with 99 in 1988 and 155 in 1987) A professional position will be abolished in mid-1989. A consultant will be retained in 1989 to assist in improving the computerization of budget and finance and to initiate the implementation of a computerized personnel administration. Ooeratins costs

4.8.5. The operating costs are those related to the maintenance of the administrative infrastructure of the Programme, the cost of services such as water, electriclty and telephone, the spare Parts for the vehicle fleet, etc The srnall increase is due to expected inflation in the Procurement of goods and services in the countries of the Programme area. ocPl88. 1 Page 37

I Geneva Adninistrative support

4.8.6. WHO Headquarters ln Geneva provides administrati.ve support to the Programme in the areas of pay and remuneration, medical, insurance and pension services, personnel administration and central procurement of supplies, equipment and services. These services are essential to the Programme and cannot be conducted in Ouagadougou.

Budget

4.8.7. The cost of the administration and support services will total US $2,752,500 in 1989, an increase of US $402,500 over 1988. This increase is partly explained by a major investment of US $250,000 to replace a number of vehicles and an increase of US $115,000 in personnel costs to cover statutory cost and expected Iocal increases. ocP/88.1 Page 38

t

TABLE 12 - ADI.TINISTBATION AND SUPPORT SERVICES

a i i P O S T S lExpenditure Expenditure Approved Proposed Category of expendrture iGradei- : i 1986 i 1987: 1988 I 1989 i 1986 1987 r-988 1989 - - -i

rrs $ US$ US$ ils $ AECURBENT COSTS

PENSONNEL SEBVICES

Chief Adninistratron & I'lana8eEent P.6 I I I 85 ,000 90 ,000 Personnel officer P,,1 ? z 1 85 ,000 Budget and Fi.nance officer P.4 I I 1 I 85 ,000 90,000 Adrinistrative Off icer P.{ I I 2 1 170 ,000 90,000 Transportation Of f icer P.4 1 I 1 90 ,000 Supply and Services Officer P.{ 1 90 ,000 supply Officer P,3 I I I 63 ,000 linance Officer P.3 z 0.5 63 ,000 32,500 Personnel officer P,2 I I I I 63,000 65,000 Adrinistrative and Technlcal ass istant s G.S zz z3 zo 19 130,000 l7 I ,000 Clerks and typists G.S 48 49 45 E2 292,500 378 ,000 Drivers, oessengers and Labourers C.S 88 93 33 30 2r{,500 270 ,000 Tenporary staff 30,000 30 ,000

Sub-totaI 16 I I 76 06 97 I ,615 ,372 1,580,115 1,281,000 1,396,500

Consul tants 53, t72 16 ,94 I 54 ,000 25 ,000 Operational travel l3l , 3,1I 67,748 130 ,000 130,000 Service contracts l? , E54 25 ,000 Operational costs 253,661 385,885 365 ,000 3?5,000 SuppI ies 156 ,,163 Z0,l ,350 175,000 170,000

Sub-totaI 594 ,637 69?,778 72,1 ,000 725 ,000

Geneva adorntstratrve support 229,OO3 269,770 300 ,000 336 ,000

Sub-total 229,003 2 69 70 300,000 336 ,000

CAPITAL COSTS BuiIdrnS Office furniture 32,41 1 31,323 l0 ,000 5 ,000 Data processing equrprent 1s ,000 Veh ic Ies 250 ,000 Equipoent 34 ,178 132,391 35 ,000 25,000

Sub-total 66,589 I 163,714 45 ,000 295 ,000

TOTAL 169 :1?6 : 106 97 2 , 505 ,601 2,706,37? :2,3s0,000 i2,7s2,50O ocP/88. r Page 39

t

TABLE I 3 - AD}IiITISIRATIOII Al,lD SUPPORT SERVICES SUI{IIARY 8Y CATEOORY OF E)(PEIiDITURE AItO BY SECTIOII (tls 91

Sect r ons Adtllrnrstratrve Adlllrnrstratl\/e Eudget I I T ransp0 r Genev a

Personne I i Su TOTA L I Category of i ture |la nageme nt serv I ces F r nance I llana genent s uppo rt

--l RECURREIIT COSTS

-t- Personnel serYlces 99,000 000 212,500 28 000 7 l ,000 {95 000 296 000 1 ,692 , 500 Consultants 25 ,000 25 ,000 T 't0 Operational travel 1 5 ,000 000 ,000 I 3 ,000 1 7 ,000 000 t 30 ,000 Service contracts 000 25 ,000 0peratlng ccsts 110, 00c 5.000 S,lrtJu 10,000 000 25,000 100 ,000 r ?n Suppl es 1,000 : 000 2 ,000 2,000 1 0 ,000 000 15, 1100 t85,000

Sub-tota I 000 000 500 1 {8 ,000 208 000 935, C00 330,000 2 45 00 l-

CAPITAL COSTS -r-l-l-t 8u: ldrng Furnrture 5,000 5 ,000 0ata processtng equrprnent 4,50C 00c 4 00 1 5 ,000 Vehrcles 250,000 250,000 Equ t pment r0,000 15,000 25 ,000

l, --r-l-t-l I Sub-tctal 15,000 1,5C0 : 6,000 {,500 : 265,00c I 295,000 il

TOTAL nnn 4 nnr ,t0 000 r51,000 ;2r2,500 :r,200,000 JJ! 000 152 500

Nct e Ihe admtnrstrattve suppcrt rn lHO Geneva provides clerical assistance tn personne! frnance, rnsurance, and rn supplres servrces as xell the rentai of Offtce space for OCP staff rn Geneva, ocP/ 88 . 1 Page 40

ANNEX 1

, AVERAGE COSTS USED FOR BUDGETARY CALCUIATIONS

Staff 1988 1989 us$ US$

Profess ional D2 85 000 100 000 P6 - P4 Ouagadougou 85 000 90 000 Geneva tL2 000 P3-P1 63 000 65 000 General Service/OCP 6 5 00 9 000 General Service/OCP Geneva 51 000 74 000 Consultant/month 6 000 7 000 Annual Incentive pa)rment to national staff 1 000 1 500 Temporary General Service/month 5 00 600

Aerial Orrerations Cost Der flvins hour Without fuel With fuel

Guaranteed helicopter hours US $ 555 531 Excess helicopter hours US $ 444 s10 Guaranteed fixed-wing aircraft US $ 555 547 Liaison aircraft US $ 189 189

Insecticides Cost (FOB) Cost (CIF)

B. r. H- 14 per litre US $ 3.49 3.90 Temephos per litre US $ t4.78 15.35 Chlorphoxirn per litre US $ 10. 20 11.00 Fernethrin per litre US $ 10.20 11. 20 Carbosulfan per 1 itre US $ 18.75 19 .40

Value of US dollar June 1987 June 1988

CFA franc 298 287 French Franc 5 95 5.74 Swiss Franc 1 51 1 .43 Pound Sterling 0 613 0.538 Deutschmark 1 80 1. 70 Canadian dollar 1 .33 L.23 Japanese Yen 140 t25 ocP/88.1 Page 4l

ANNEX 2 i

l- o o o o) ^q) olL F. Fo t T' OJ c € Q' OJ u, q]8 F{ o o C') o {J F{o co r\(l o_--__ oA o) NT\ !-{ oz A+) HO !0 (o= =J o 6'o sE (n it +{a ro--@ at :).f, op m ox E lo ,s .F; rt 3e ha !o_- ? iJ GI o dg ro - .r{ +c 38F 6flAA ctl Io o.g -*,Oa 'O 5e{ o a rO 3 E t{ olooE 8 o) r,-o (L.9g F{ oxo (, q{ E F 6 t'r l N.=!, o H tr! "":oo l,t o, ti h-9 +) 1,l-.- a SdH o (o L) d ttE t\-ttt (o E b b; ul_.ll, o!6 rr-l -t---I -l -T-T- E Eb zz5:r^ ooooo()ooooooooaoaoo@ F @ lo + ro N ; o ot () l'- @ |r) + ro N F F F F F F F Nml anlon !86 L lo a6oluacla4 ocP/88.1 Page 42

ANNEX 3

I

?

t- |o N ts5crr r o N o N ! c (, @Ec) o) rO @o @ o o) OJ o F{ n f- o .o G' E{ o) l')o N F{ o @ OJ +t N @ F{ o r, @ o O) C) r,ao o o o :f pi t-o o tO 9t1 r) G) o Ol e a J o z E |-{o +t + E{ -c 'o (, .9 F\ CD h e pi F. e F] l-o tu t r/, 'o rl G' o CI) crl (o c FI t, '= tZ t-{ oq, o fr rt ()N t-X -r Erl (D 5* $ -J @ :trE>\-/ ro AoaC .t crro) ?, Ei3 @ n Ol i*c o _o _--l- -T Ir n'5 .l' r- T' *l- ---T- Jq, q o 85E oooooooooaqo+c{6@@+No@to+N NNNFF NI enlo^ l,96L lo aooluaclaS ocP/88. r Page 43

ANNEX 4 o @o F{ t- o (l 6s)o +) o o)- @ (o o F{ E co c o o @Eo, F{ rl @o r) g oN I o l+{t{ o N G) o) o F.o o @ € tJ ,a C) .i @ rfl @ t\ ol h o c, hl Fr N lr) q{ @ F. o + O! o rl 0) +, L o E o (, E Gl + c L) @ o No CD o rt f o o ) +t-c o ao h |.n o q) @ q) + o) o;o + 6oEZ € .J o oJ o GI G, @ ,Z al CD (, ! ct+ () =a+tcU) of f{ :l n rt c.s N () fr Crl N Efr GI oo fr _- - -r -.- FC) ..{{., -F T I +, o o o o o o o o o (f c rI., o rO o rO o lO o rO d + + rn rO N N ZI )i CT anlo^ [96l to a6oluacla6 ocP/88. 1 Page 44

ANNEX 5

I

t

l- (o org lO m -q, rO o)- o ! C 0, OJ coE @ o+ @o o) ro o) F{ o +J r\ + (l N ot F{ ro € O) F{ @ A o @ l{ CD H ro o ct{t{ rn A o, @ H f- N Ol .Ao +) Cd F{ + f- @ q) @ a N O) o A F{ rf) .F{ f- (l lr) a N ot o o .H N A N @ }{ f- o, 0) N

r.) @ r.o ol rn

o o o o o o o o o o lO o r) o lo o ln + FO hn N N

salslqan +o raqurnN ocP/88.1 Page 45

ANNEX 6

a

@ 38@ t- o ! r-oc pt o)()coo Fl oFl a ()(O a ol >) El E, r{ lrJ E{ lO @ o) I ofE{ o UJ tEl lr. o o + z @ Ll o) z }*{ :) O - o X M) fEl n lJ. h @ o o o, a v, EEI E-{ N pt @ 1 o) olL i,LL e ..E=O16 ;EC-|oi: KL] 3f;E E#== ; -_E tr-]._9 ooooooooo(fo E (Otr)+rrrNOOr@f-(O !3hf.22Fc e f l---F- Yo='tro Eo a coc) elor a6uor.lcxa [86[ ]o a6o1uac.ra; ocP/88.1 Page 46

ANNEX 7

/^

o I o trO (0l o(6 -t-----'1 a A oa I I o; oo I I &A I I I I I I I I I I }{ I I o I I o I I r{ I I r+{ I I .0 |! I I lr o I I -t(! (0 I I a t v o o I I o U o (6 ttt a I I +{ tr tr (! o I I u o u 6 la +{ I I r0 E r! V o !, ! I l. o) l. tt, orj ! I (0 (! r, @ o) I trO - - t - - -- I o (u a A O t{ t I +{ Q o G tl A@ I I F 6 o Fi o, oo I I tr lr (0 F{ I I E t r{ F{o ! I € o, LT t,|{ (0E I I (n !, o o) +{O I I z o r{ ku I I o (0 E otr I I H tr: ()

t{ o o o r{ d +{ a t+{ o o t 6 +t o o t E (a c o o (! o r{O rj rJ (0r0)l (!u l.E 0) 6 l{o o.u o r{ Ol +{ A€ r! l. a@ o a o oo I F.l c F{ JO tr(6 (0 rg 6E o0) o ,{o !J lr lr r{ l. t, (a< o E otr o ()

ANNEX 8

VCU ENTOMOLOGICAL EVALUATION NETWORK - 1989 Eastern Operational Area EOA: Kara. Togo Countrv Sector Sub-sector

Togo Kara* Kara I Atakpame Benin Parakou Parakou Bohicon Kandi Natitingou Burkina Faso Ouagadougou** Bobo -Dioulasso Bobo - Dioulasso $ llass6**** Bandiagara**** ( Tenporary ) Ghana Tamale Tamale Bolgatanga Kintampo Hohoe

Western Operational area I'IOA - Bamako. Mali

Cote d'Ivoire Bouake Bouake Bondoukou Korhogo Odienne* Seguela Mali Bamako*** Bougouni**)t

Niger NiameY**

IJestern Extension 1989 (Sectors and operational bases operated by national teams under the supervision of VCU)

Countrv Sector Operational Base

Guinea Kankan 1 Kankan 2 Siguiri 3 Beyla 4 Kerouane 5 Kiss idougou Dabola 5 DaboIa 7 Kouroussa 8 Faranah Labe 9 Labe 10 lrlarnou 11 Gaoual Mali Bamako L2. Bamako 13. Kita L4. Toukoto Kayes 15. Kayes 15. Manantali L7. Bafoulabe 18. Kenieba 19. Faraba Senegal Tambacounda 20. Tambacounda 2t. Kedougou ocP/88. 1 Page 48 ANNEX 8 (Cont I d) Sierra Leone Makeni 22 Makeni 23 Kabala 24 Port loko t Guinea Bissau 25 Gabu b

a * Airbase ** Managed by OCP HQ in Ouagadougou *** ![anagsd by tlestern area HQ in Banako **** ![a]i ocP/88. 1 Page 49

ANNEX 9

PROPOSALS FOR RESEARCH CONTRACTS 1989

{. OBJECTIVE us$ a TAXONOI.fY

1. Morphonetric analysis of adult S. damnosum in WOA including training of staff

2. Morphoroetric analysis of adult S. damnosum in EOA including training staff

3. Identification of adult S.damnosum by DNA probes

4. Identification of Onchocerca spec. in the vectors by DNA probes and cytotaxonomy

sub - total 50 000

ENTO. PARASITOLOGY

1. Dissections of adult S.damnosum (Ivermectin) 2. Identification of O.volvulus larval stages in the vectors 3. Detection of O.volvulus in biting populations by monoclonal antibodies

4. Entomo-epideuriological studies in Sierra Leone to determine the southern boundary of OCp/IIOA

5. Study on sources of reinvasion in Sierra Leone

5. Collection of pre-control entomological data in WOA

7. Production and collection of O.volvulus L3

sub - total 118 000

HYDROBIOLOGY

1. Aquatic monitoring data analysis 2. Aquatic surveillance studies t sub - total 21 000

INSECTICIDES

1. Screenlng of B.t. H-14 formulatlons and of IGRs 2. Carry and rnode of action of B.t. H-l_4 in running water; application to aerial larviciding planning

sub - total 45 000

RESEARCH CONTRACTS total 244 000 ocP/88. 1 Page 50

ANNEX 9 (Cont I d)

PROPOSALS FOR SERVICE CONTRACTS 1989 I I

OBJECTIVE us$ a

I{YDROBIOLOGY a

1. Surveillance of the fish fauna in Ghana 2. Surveillance of the fish fauna in Cote d'Ivoire

3. Surveillance of fish & invertebrate fauna in Guinea 4. Surveillance of fish & invertebrate fauna in Mali

sub - total 73000

HYDROLOGY

1. Improvement of the hydrology network in Ghana

2. Maintaining (reparation and recalibration) of water gauges in the OCP core area

3. Installation of hydrology network in Sierra Leone

4. "Calage des modEles de pr6visions" in EOA & I.IOA

5. Contract for utilization of ARGOS System

sub - total 87000

RADIO NETI.IORK

Maintenance of OCP radio network 2s000

SERVICE CONTRACTS total 185000

SIJMMARY:

a RESEARCH CONTRACTS 244000 SERVICE CONTRACTS 18s000

TSAs total 429000 u^l ocP/88. I o Page 5l 3 ANNEX IO 8 1 O) @ x I I E g oE. .Lt*- -__ + TL o {

\ az \ o, a k '1 E. IU oo_ + olr z J o-

(Jf

o + lrl (n IJ= E. o=Co.9cn h.=E E.U o qd) E, ts o IJ L .E>tsOL a U bE o Eb dE5.E€ E o_ .trE= oiilg t e= EE o l. r 'gE + 'Er :!b5>E t >o LC 0_ l' bt df,o ti o ..) C,+ ( ' {-, Eet t," oE 6E+ E Z,Nr ocP/88. I Page 52

ANNEX 11

1. Srmary Consolidating I-arge-Scale Ivermectin Treatuent Activities 1987-1990 ts rwermectin trials in 1987 and 1988 a 1.1. 50,000 people from endemic onchocerciasis foci in the OCP were treated in 1987 and 1988 with ivermectin and this number is large enough to allow I prelirninary conclusions to be nade concerning the safety of the drug. Adverse effects following ivermectin treatnent were more frequent than expected but only few cases required symptomatic treatment under uredical suPervison, and all recovered fully, usually within a few hours following the episode. Based on the available evidence it is presently concluded that ivermectin is sufficiently safe for use in large-scale distribution provided that an adequate system of monitoring of adverse reactions by paramedical personnel is maintained during the first 72 hours following treatment. The community trials confirmed the important microfilaricidal effect of ivermectin, and treatment resulted in very dramatlc reductions in the intensity of infection in the trial communities,

Larger-Scale treatnent of ivernectin in 1989 and 1990 L.2. Since the drug appears sufficiently safe to allow its controlled operational use, it would not be ethical to hrait for the remaining trial results on the effect of mass treatment on transmission before planning further large scale utilization of ivermectin. In the Extension areas and reinvaded zones there are many communities where the intensity of infection and the risk of blindness are still very high and priority will be given to ivermectin treatment in these high risk communities. The most endemic zones in the OCP area have been identified and designated for annual large-scale ivermectin treatment. A description of each zone is given in paragraph 4.4.4. Declsions concerning reductions in vectsor control oPerations following the introduction of large-scale ivermectin treatment cannot be taken before the final trial results on transmission become available early 1989. Nevertheless, several of the selected ivermectin treatnent zones are areas of najor operational importance. It was therefore agreed to extend in such areas the ivermectin treatment in 1990 to a larger population than those living in high risk communities alone, in order to rninimize the risk of transmission in these zones. The need for great flexibility in the implementation of the ivermectin programme for 1989 and 1990 must be stressed to enable the incorporation of the latest findings from the ongoing trials. Some of the key trials will also be prolonged to study the incidence of adverse effects and Ehe after several rounds of ivermectin treatment. reduction ln transmisslon a In spite of the general need for further trial results, control will be undertaken using chemotherapy alone for some specific OCP areas. In two isolated zones vector control has always been extraordinarily difficult and expenslve while the results have generally been unsatisfactory. Since it is belleved that these a zones do not constitute a source of reinvasion for other areas in the OCP, it has been decided to stop vector control in these two focl and to Protect the population at risk by chemotherapy. Furthermore, vector control is scheduled to cease in 1990 in large parts of the Original OCP area, and ivermectin will then be the only practical tool for the maintenance of control in the few isolated foci where there has been residual transmission during the control period. These foci will be kept under annual ivernectin treatment from 1988 onrrards. ocP/88.1 Page 53

ANNEX 11 Cont I d Involvenent of natlonal teans "l I

J 1.3. Natlonal personnel has been involved in the community trials fron the beginning. In the first four trials national partieipation constituted 50I of the a t personnel who carried out the distributlon of the drug and the monitoring of adverse effects. In the remaining four trials, nationals accounted for 75I of the I personnel inwolved in i.vermectin dlstribution and monitoring, and they did the epidenlological mapping of the trial areas. This formula will be expanded during the large scale ivermectin treatments in the subsequent years. At present only three national teams in the l^Iestern Extenslon are operational: the teams of Guinea, Mali and Senegal. T'hese teams are presently completing the epidemiological map of the Western Extension area. More national teams will be trained in each of the OCP Participating Countries from 1989 onwards. These teams will undertake the detailed epidemiological mapping of the selected treatment zones in preparation for drug delivery under the supervision of OCP staff. The final distribution of the drug and monitoring of adverse effects following treatment will also be done by the national teams in close collaboration with OCP.

Cost estimates for 1989 and 1990 L.4. The cost estlmates of the proposed large-scaIe distribution of ivermectln, for whlch the details are shown in Table 14, cover a period of two years for a total cost of US $2,227,70O broken down as follows:

1989: US $1 ,097 , 800 1990: US $1 ,129,90O Most of the activities will be carried out by the national teams under the supervision and monitoring of the OCP Professional Staff. OCP General Service personnel will also provide support to this operation.

To meet the objective of this project certain equipment, mopeds, laboratory equipment and supplies, drugs and medical supplies etc., will be acquired and provided to the national teams. Operating costs are those related to the operation and maintenance of vehicles and equiprnent. Mapping of the localities to be treated will be partly carried out by helicopters and fixed-wing aircraft.

1.5. The cost estimates for 1989 have already been integrated in the budgets of VCU, EPI and BIS.

t ocP/88.1 Page 54

ANNEX 11 Cont'd ) , t I I

I t

TABTI i{ -P00P0Slir I IEPItcTI t B{jD0[I 1989 iln i990 I

1989 1990 ( trs 91 I ll T(]IAT TOIAI, lt r00t vcu EPi B T0?rt TCU EPI iBiS 101t1 1989 r I 990 t 1988 I i _t _ t_ !l PEESO[XEI SEYICES tt 1q ,ti Pro fes s iorais 22, 500 21i,000 't0,000 258 500 I 25 000 226 000 000 00 5il,500 90 000 lIr 0|]fl General Service ?3,500 133,000 J ,000 209 500 ii 8r 000 1t8 900 Jr 500 236 !l 99 000

terpo rary I E9 500 rl r-l l-l I ,( SUB IOTTI, 96,000 3{9,000 I 23,000 t6 8 ,000 109,000 i 3?t,9oo 50 50 {00 Tt r00 58 00 I I II tl __t _ _t_ _t t- Corsul iarts 60,000 60, 000 60,000 60, 000 120, 000 2! ,000 -l- --t Duty Trrvel 38,900 120,000 ,000 165,900 {{ 200 125 ,000 I, 000 i??,200 3t3, 100 3l?,00c 10 0perating Costs 3 8 ,200 1?6,000 10 17t X00 E00 1t0,000 I, 000 i80, 300 35[ ,000 i[ 6 ,000 , - ,000 $ubs id ies R( nnn taticlrl Tears 1i ?00 66, ?00 500 60 000 ?3,500 it0,20c 138,000 r q niln lerial operations 55 ,000 25 000 ?5 ,000 80,00U {?,'l00 1r Coutracts 25 ,000 25 ,000 000 25,00c 5 0,000 10,000 Supplies 000 {0,000 000 r! flnn 000 l{ 00c 1 000 5{,000 l0?,000 59,000

I I I --r SUB lOTII, 93,800 {?0,000 595,500 1,190,300 78?,70c {8i,000 i 20,000: 59t,800 I i03,500 i i 2t,000 I ll ll ii r I r lr ll ll t-t-t--r-t t-r l-l I -t-l II l! --t --t -i --l lt -t clPIlrl c0sls -- qt Equiprelt 000 000 000 5000 20 000 00c 50,000 1t 000

!ehicies

l-'- _l___ soB ToIt[ I I,OOO I iO,OOO 35,000 5 ,000 i 20, o0o ?5 ,000 60 ,000 000 Ir lr l---r _-! -- _t-t- ,0 , rr? tfili I TOTII, 19t,8001 860,000 i {:,c00i 1,09?,80c ?1?,500 : 36{,900 : {?.500 90 ?6 200 tt -t I -l I ,-l--l -r -t -l flote : Ihe abcve,;osts fcr i989 Lare been rerged ic the budgels of l,C,U , [.P,] rnd B.l,S ---l -t

: , a \ s ocP/88.1 a E I a I lrJ Page 55 I d- 9 I lrJ I (9 I ANNEX 12 a I \ I z E t I U I E I d) t I 7 J I T a a I o I o j 9 a (9 F I ' c I U t \ :l o Ao i L- ]F a- ,' ZO + U vah F , I o I gn tr ! E o' t \ J I f t 8s I o, z t '1 I , (9 E t t t Or co o\ I : 9 a Ei 0F l, a z u t4 3 o + a F J o f ''l \r-l o 8 E] U & I -rl o I a tr t l- I z U I H J E+ J I U I E] z I z o ,- d IJ z -t fll E r< 2 E r= -U ( H I I I o I t or U I t 2 I o t E N I a I zrl '-t I :U t tt lrJ I I z + J I I a ) z (9 o tr ! ! a G o C U c a E a 2 g o o I .; a. t 2 o; E U ! F aca o UJ E B:;. ' i: ;3 2 ,.:. , I !o J '-! (9 c z6 i, o G trJ 5 G2 (, a B! z o \:.:d: lrJ -:cr-: + o U !;i-;; o ;:,: - ! i + oU g::!i: U J 3 e 3 i gn 'i o E:'- o z CO43.:;: (,U I ! I U ;E€e i IrJ l f J 3 r::3. r!< LrJ co

BUBKINA FASO ? 14.00 LlL 29.90 1?8 28,62 cArrEBooN o o.oo 1 0.17 1 0.16 cAIitADA 1 2. O0 0 0.00 1 0. 16 coNco 1 2. 00 0 0. 00 1 0. 16 corE D'IVoIRE 2 4.00 102 17.83 104 L6,72 FRANCE 3 6. O0 2 0.35 5 0.80 FBG24.0000.0020.32 cAtilBIA 1 2.00 0 0.00 1 0'16 GHANA 5 10.00 73 12.76 78 L2.54 rTAIY24.0000.0020.32 JAPAN 1 2.00 0 0.00 1 0.16 TEBANON 1 2.00 0 0.00 1 0.16 IiIADAGASCAB 1 2. OO 0 0.00 1 0. 16 lrAlr 4 8.00 91 15.91 95 t5,2? NETHERLANDS12.O000.0010.16 NIGER 0 o.oo I 1.57 9 1.45 SBNEGAL24.0000.0020,32 I 0.32 swITzERtAND I 2.00 1 0.17 2 : TOGO 4 8.00 60 10.49 64 10.29 I a uK 5 10.00 2 0.35 7 1.13 usA36.0000.0030.48 ======GRAND TOTAL 50 1o0.oo 572 100.00 622 100.00

NOTE : On 1 JuIy 1988, 95.5I of the staff cane fron African Countries south of the Sahara of which 85.42 frou West African Countries and 502 of the professional staff were of Countries participating in the Programne.