Onchocerciasis Control Programme ln West Africa Programme de Lutte contre l'Onchoc€rcose en Afrique de l'Ouest' CONJOINT DU PROGRAMIVITi JOINT PROGRAMME CO]ilMMTEE COMITE .CCP Bureau du Pr€sident Offico of the Chairman JPC JOIN'T PROGRAMME COMMITTEE JPC7.3 Seventh sesslon (ocP /86.7) Accra, 9-12 December 1986 ORIGINAL : FRENCH ocrober 1986 a Provisional a item 1 ( t REPOBT ON THE EVALUATION OF THE SOCIOECONOMIC ]MPACT OF THE ONCHOCERCIASIS CONTROL PROGRAMME INTRODUCTION 1. The control of a public health disease is rightly considered by medical authorities as a health priority, especially when it j.s severely disabling for a considerable part of the population. The health priority becomes a national imperative when such a disease prevents the socioeconomic development of many areas 1n the country. When it extends beyond the borders of one country and the solution to the problem of public health lies in activities involving several countries, it ls necessary to arrive at a regional control. The inter-country cooperatlon can then appeal for in*.ernational aid proportional to the scope of the activity to be carried out. 2. Qnchocerciasis control corresponds to the above outline. This concerns bringing under control a severely disabling disease, river blindness, that is widespread in some of the African regions. This control will prompt the populations to reclaim lands that had been abandoned in the past and this will make it possible to improve the socj-oeconomic development of several countries. 3. It was with this end in vj.ew that four international agencies of the United Nations systems (UNDP, FAO, the Wor1d Bank, WHO), supported by a group of donors, decided in 7974 to assist seven West African countries (Benin, Burkj-na Faso, C6te d'Ivoire, Ghana, Ma1i, Niger and Togo) affected by onchocerclaisis. 4. After ten years of lntense activities for tl-re control of the disease, the entomological and parasitological results are highly satisfactory. It may, however, be wondered how, wi.th the support of the Donors, these results are Laken advantage of by the states, communities and individuals living in the protected areas. ) t 5, This report on the evaluatlon of the socioeconomic impact of the Onchocerciasis t- Control Programme (0CP) is being submit,ted i.n response to a request made by the Programme's statutory bodies. J 6. The report, which has been prepared in close collaboration with the Participating Countries and with the assistance of the Sponsoring Agencies, is intended to be a reflection document primarily for the members of the seventh session of the Joint Programme Commlttee (JPC). As such, and considering the complexlty of the subject and the fimlted time available, it is confined to highlighting the main aspects of the socioeconomic changes which have taken place in the Programme area. 7. First, the economic importance of the OCP area in the l,{est African region (see para. 1-! for definition of this Region) is highlighted through 1ts natural resources, suitability for production and settlement capacity. JPCT .3 ( ocP/86.7 ) page 2 (r o tr F F- ,f, tri LrJ + LA ! o : (,o 2 z ) \ z r a o o :l cr I c a I o- I :l I u- o t I --] i o \ A .{ ' (Y E LI € z :c ;= 5o I g \ d* (9 3 5 E o lrj O \ o z .{ 2z .I o e I @ (r E 96 I v * o I () uo I tu aa E I o- I q Lnz. I u6 I c'OE. Jc) 41 ) a/ 3 _ll- 5.t r 1( ( G o' 6F I trJ uJu) ( \ CD !r EUJ ( ) 9 + -^r I Y lJ.l E; ! <= I Ju, I cr = o ./ a\ (r - . 0- $ I o (,: o 91 - e / ! rd o I 3 CL \o i z.* .rJ J z LT, rd )_l o uoz' //' J |-- 5 lr_ ,) -o t I 1 (, :" i o-ur () I 4 LrJ : ) \ ] - (r ; oz. t! o 1) ) ii c .oo ,t IJ U (, cNJ I z UJ o [= J \z l) ; UJ t] (JEf o- (1:E ; 2 (n ) E ( oo (J /(9 JI J No i \\ O) ? ( G: Y i qf JPC1.3 ( ocP/86.7 ) page 3 B. Second, the trends observed in the area are analysed and lessons drawn: migratory movements (organized or spontaneous) are characteristic of the OCP area at the regional leve1 of each country and, especially, at the village 1eve1' The analysis shows to what extent the indicators obtai-ned at the village level can help to understand the direction, significance, intensity and motivation of these population movements. g. The statistics show an appreciable and sometimes remarkable increase in agricultural production in the Programme area; what role have natural resources played in thj-s change? 10. Because of the migration towards the valleys formerly subjected to onchocerciasis a transmission, the populations concerned appear as pioneers; what are the driving forces behind their dynamism and the limiting factors? 11. Furthermore, a marked increase in the pace of land occupancy is noted in some of the former onchocercj.asis valleys, with disturbing ecological- consequences, and a regression of land pressure in other areas; how is balance restored in the utilization of the resources within the zone? llhat are the ways and means of access to the land? 12. Third, the report attempts to synthesize the new development strategies being implemented. Not all the needs have been satisfied, the level of exploitation of the natural resources is sti11 comparatively low and the development strategies have not yet been sufficiently adapted. Such lessons show the obstacles to be cleared for a better understanding of the development problems of the OCP area. Considering the lmportance of thls zone to a1t the Participating Countries, how can these inadequacies be overcome? 13. The present report is based on data collected from three sources: (a) documentation ava11ab1e from the agencies involved in the executj-on of OCP: UNDP, FAO, The World Bank, WHO; (b) OCP's archives and documents (kept in Ouagadougou and/or Geneva); (b) a survey carried out jointly, during the first half of 1985, nv ECo/oCP (with the assistance of consultants or contract reseach workers) and the seven national teans of the Participanting Countries (Benin, Burkina Faso, C6te d'Ivoire, Ghana, MaIi, Niger and Togo). This survey will henceforth be cal1ed "1985 Survey". It was carried out in the seven countries of the Programme, and covered 1200 famillies in 25O vi11ages. For the writing of this report, it was possible to analyse only the forms relative to 850 of these families, belonging to 180 vi11ages. Thus, the results obtained give only ir,dications; they are nevertheless significant in a number of fj.elds. I The methodology of the 1pB! survey is in Annex I. 14. The initial OCP area covered 654 000 km2, mainly in the different countries in <r the Volta basins involved in the common fight against onchocerciasis. 15. t^lith the extensions that have been effected or planned in C6te d'Ivoire, Ghana, Togo and Benin, this area now amounts to 875 000 kmz. Thus, the oCP area occupies 45 '/" of Lhe ecological region referred to in this report as the "West African Region" (t^lAR) which, in turn, forms part of the geographical block commonly known as West Africa. JPC7.3 (ocP /86.7 ) page 4 16. The West African region is defined here as the environment capable of influencing the entomological results (particularly reinvasion) and the future development of 0CP. It covers the whole of Burkina Faso, COte d'fvoire, Benin, Ghana, Togo' Senegal, Guinea Bissau, Gui-nea, Siema Leone as well as parL of Nigeria Mali and Niger. ,l 17. The West African Region is limited to the north by isoline zero-day1 plant growth (Niger possibility and Mauritania, to the eqst by tongitude 6o50rE basin) and to the t west and south by the Atlantic oceanz. 18. In general, the rainfall and lrater conditions in the OCP area are quite favourable. The soil potential is greater than the average for the region. This situation gives it a particularly great importance in the whole of the sudano- sahelian zone. Climate 19. The greater part of the OCP area is situated in the sudano-sahelian region, with a wet and dry season. Rainfall varies from the north to the south, from J00 mm to about 1400 mm. The dry season can last between six and nine months. 20. For about 1! years, this region has been subjected to a serious climatic crisis3 whose main characteristics and consequences it is essential to bear in mi.nd. 21. The region's rainfall attained its greatest deficit in 1983, with a considerable descent of the isohyets towards the south. For example, in Burkina Faso and MaIi, the rainfall deficit was estimated at 30% Ln 1t8l, as compared with the average for 7977-L9BO. Scarcity of daily rajns of more than 40 mm 22. The s!,udy of the moving weighted averages applied to the annual rainfal-l fractions4 shows a stability of or a slight decrease in daily rains lower than 40 mm, but a great decrease in daily rains above 40 mm; this alone explains 5O/" of L]ne annual rainfall variation. Persistence of the deficit period 21. Since 1950, the decennial isohyets have been descending regularly towards the south; this was most pronounced in 1983. uAI1 the previous observatlons reveaf a phenomenon of persistence of the deficit period"1. Nevertheless, the OCP area has remained within the limits of the 500 to 1000 mm isohyets, which, combined with the isolines of plant growth possibility, has maintained the area in a favourable agricultural production situation during the past decade in comparison with the Sahel.