ocPf73.L ANNEX VI-S

I ONCHOCERCIASIS CONTROL

IN THE

VOLTA RIVER BASIN AREA

Report prepared for the Covernments of Dahomey, Ghana, Ivory Coast, MaIi, Niger Togo and Upper Volta

ANNEX VI-s - THE METHODOLOCY OF THE ECONOMIC ATIALYSIS

It I

I Geneva 1e7 3 a

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a

Unrted Natlons Development Programme Food and Agrlculture Organrzation of the Unlted Nations International Bank for Reconstruction and Development World llealth Organrzation Annex l'I -5 page i

THE METTIODOLOCY OF TIIE ECONOMIC ANALYSIS

Contents ! Page

I. INTRODUCTION

2. SOURCES OF INFORMATION

3. THE DISEQUILIBRIA AI{D THEIR CONNEXlON WITH ONCHOCERCIASIS I

3 I Disequilibria rn the natural environment 2 3 2 Disequilibria in population distrr.butlon 3 I 3 3 Disequilibria in production . . 3 4 Disequilibria in infrastructure . . 4 3 5 Disequilibria in income . 5 3 6 The role of onchocerciasi.s b

4 EPIDEMIOLOCICAI ASPECTS OF ONCHOCERCIASIS THAT ACCOUNT FOR ITS ECONOTIIIC I MPORTA}ICE 6

4.L The transmission and course of the disease 6 4.2 The very high prevalence 6 4.3 The high level of transmission and severlty of the dlsease, leading to a reduction in the productive capacity of affected indi viduals 7 4,4 The distrrbution of the disease, resulting in depopulation 7 4.5 Methods of onchocerciasis control . 8

5. PRESENT SOCIOECONOMIC EFFECTS OF ONCHOCERCIASIS 8

5.1 The decrease in the productive capacity . . !l 5.2 The loss of revenue . . 10 5.3 The loss of potential production L2 5.4 The cost of onchocerciasis in national budgets 13

6. THE EcoNoMIC EFFECTS oF oNCHoCERCIASIS CONTRoI, t4

6.1 The improvement in the profltabilitl, of ongoing proJects I4 6.2 The possibility of implementing new economic development projects r6 6.3 Induced effects of economic development proJects 20

7. OVERALL ECONOMIC EVALUATION 2l a 7.L The profitability of development proJects 2l 7.2 Comparison of the three possible options 22

CONCLUSIONS 26 Annex VI-5 page I

A COST-BEN'EFIT STUDY OF TI{E ONCHOCERCIASIS CONTROL PROGRAMME IN THE VOLTA RIVER BASIN AREA AND OF THE ASSOCIATED ECONOIIIIC DEVELOPT!{ENT PROJECTS

I. INTRODUCTION a l. This document describes:

(a) the information that has been collected and the use that has been made of it; (b) the bases and methods of calculation that were employed to evaluate the socloeconomic effects of onchocerciasis and the benefits to be expected from its control; (c) how a methodological analysis of the available alternatives and the chorces on which economic action will be based can maximize the benefits derived

from onchocerciasis control .

2. SOURCES OF INFORNTATION 2. The sources of information are national administrative services, internatlonal agencies, development societies, scientifrc research bodies, etc., and the data are not uniformly collected or presented. Consequently the comparison and inteBration of the data has received special attention. 3. The data were not always complete and extrapolations have been attempted when it seemed feasible. In other cases, no evaluations could be made. 4. In certain sectors the surveys were started too late to allow the processed results to be included in this document. However, the general trends of these studies (sociology, human geography, etc.) are well enough known from provisional notes and conversations to ;ustify their being taken into account. 5. Specialrsts in the various disciplines associated with the programme were intervietved during missions in the capitals of the countries covered and dur.ing field surveys. The list of those interviewed and the nature of the information obr:ained is given in Appendix A.

6. A considerable amount of information was extracted from the documentation made available in the various countries to the consultants and supervisors of the programme. a A list of the more important documents consulted and the type of information extracted are given in Appendix B.

3. THE DISEQUILIBRIA AND II{EIR CONNEXION WITH ONCHOCERCIASIS

7. The reglon covered by the programme lies almost entirely between the 600 mm and 14OO mm rsohyets and forms a homogeneous area with a savanna-type climate. 8. About 83% of the population in the seven countries as a whole is rural (7O% rn Chana,72% in the Ivory Coast, 95% in Upper Volta and MaIi, and 94lo in Annex VI-5 page 2

Niger, including 19% nomads). The population growth rate is high, exceedtng 2% everywhere. 9. Consequently, the economy of the programme area is basrcally agricultural; overall, 80% of the population work in the primary sector rvhich, except in thr-' Ivory Coast and Ghana, accounts for about 5O% of the gross d()mestic product ((;DP). a Production is mainly rn the form of subsistence farming, and the gr<;wth rate t.s low. Clrmatic factors exclude the cultivatlon of most of the "rich" crops, zrnd the potentially profitable production consists almost entirely of cotton, groundnuts, and sesame under dry cultrvat:.on, and rice and sugar cane under lrrrgat!on. Exceltt rn the Ivory Coast and Chana, the average per capita lncome ts very lorv. IO. These national averages nevertheless provide only a very imperfect plctuls o1' the situation in each of the countries, which suffer from sertous drsorlurlibrr.at to varying ext5nts. 3.1 Disequilibria in the natural environment tl. This disequilibrium results less from rnsufficient rainfall than from rts poor distribution. However, the oisequilrbria are worse towards the north, whcre the two factors operate in conJunction. There are also yearly fl-uctuations in the rainfall and variatlons in the start of the rainy season; at Caoua in l,ppcl Volta, for example, the annual rainfall ranges from 823 to 1564 mm and the ralny season, which lasts an average of 15O days, starts between late May and early Jul-y. At Dori, also in Upper Volta, the rainy season begins at about the same time, but lasts only 90 days and the total rainfall ranges from 4O2 to 783 mm. These climatic characteristics cause severe problems of water supply particularly on the plateaux, and the agricultural timetable is sub;ect to unforeseeable restrictr.ons. ]-2. The soils have varying potentials for production. tsroadly speaking, the I valleys contain a higher proportion of good soils than the plateaux, rvhere the soil structure is more varied and over-use has led to degradation. lt rs unfortunate that the highest population densities are found in the reglons where the natural conditions are least favourable.

I a According to the report of the Upper Volta Ministry of Agriculture and Animal Production entitled "Programme of Preliminary Studies for the Exploitation of the Volta Valleys", the abandoned valleys contain 3OOO km2 of brown soiIs, vertisols and hydromorphic soils and 5OOO km2 of average soils, that are similar to those of the Mossi plateau but not degraded because they have not been cultivated. After development, 10 OOO hectares of irrigated rice fields could become available. Annex VI-5 page 3

3.2 Disequilibria in population distribution 13. The areas with a high population density ale found outside the valLeys, which in general are depopulated. Some examples are given rn Table VI-5.I. This disequilibrium causes substantial migrations, mainly of young men, from the densely a populated areas leading in turn to a disequilibrium rn the demographic structure, the proportion of the working population dropping progressively. 14. In the Ivory Coast, more than 2OOO men leave the densely populated Korhogo area each year, about 1OOO of them permanently. HaIf the mlgrants are between 15 and 34 years of age, and in 1965 it was estimated that a quarter of the age group 20-24 years had left. 15. In the Upper Regron and the northern part of the Northern Region of Chana, there are southward mlgrations from all districts, affectlng up to 3% of the population in the Kassena-Nankani district and as much as 7% Ln certaln cantons of the plateau between the Red and White Voltas. In these dr.stricts there is a very marked disproportion between the numbers of men and women agecl 15-44 years: there are 65 men to every lOO women in Kassena-Nankani, 66 men to IOO women in Kusasi, and 51 men to IOO women in Lawra. 16. In Upper Volta in I97t the number of permanent emigrants rvas estimated at 365 OOO, and the number of temporary emigrants at t86 OOO, mostly in the age group 18-25 years. According to the demographic forecasts for the Second PIan the working population, which amounted to 5o7o in 1g72, wrll drop to 48.3% by 1985. In Mali there are only about 73 men to every IOO women in the age group 2S-3O years. In Togo there are migrations of young people from Dapango and the Kabr6 country, mainly towards the plateau region but also to Chana (the annual rate of seasonal migration is estimated to be 10 OOO-2O OOO). 3.3 Disequilibrla in production 17. The concentration of the population in areas where the natural conditions are poor has direct consequences on production. The size of the farming units is smaller in the very densely populated areas and the land is overrvorked: at Korhogo, 56% of the farminB units I cover less than 3 hectares; in the Upper Region of Ghana, the average size of a farm for 6.8 people is 1.92 hectares, dropping to l.2g hectares in the Bolgatanga district; in the rvestern part of the llossi plateau, Upper !,olta, in most farming units (supporting 8-9 people) less than 3.5 hectares are curtivated; in the eastern part of the ttlossi plateau, the average size of farm in the densely populated area is 3.38 hectares for about 7 people; in the Nabinkrssa area (Zorgho dlstrict) the area is 2.8 hectares for 5.7 people, and at Lama-Kara in Togo the size is l.O5 hectares for S or 6 people. Annex I I -5 page 4

18. The orrer-use of land results in a loler yield. In the Regional Development Offices (RDO) of Ouagadougou and Koudougou the drop is thought to be around 2OO OOO OOO CFA francs (US$ 8OO OOO) annually. This over-use results not only from the excessi-vely high population density but also from the fact that the farmers, a Iacklng adequate resources and technical kno\.ledge, cultivate mainly the lightest soils; tn the Ouagadougou RDO 38..1% of grade 3 soils are exploited, whereas only 7.410 of the hydromorphic grade I soils are in use; the average population density on the grade 3 soils i-s 5? and 22.8 on the grade I soils. However, the irregular rainfall is also a cause of productivity fluctuations. Table VI-5.2 provides an example from the Ouagadougou RDO. 19. The consequences are famine and a concentration on subsistence farming. 20. (a) Famrne: rn Upper lolta the shortase of food procluction is ectimated at 50 oOO tonnes annually (rn an a\rerage year). The averaBe per capita consumption of cereals rs 188 kg per annum (but only L32 kg in the Ouagadougou RDO, 141 kg in yatenS,a and 154 kg in Koudougou). rvhereas 2OO kg (equivalent to about 2OOO kilo- calories per clay) are needed, since the meat consumption of 8.7 kg per head does not suppl5. the necessary supplement. In the east of the fUossi plateau , 12% of family heads produce enough foocl for their orvn needs. 2L. Accordrng to an li\o stucly, rn the upper Region of chana, in an average year' the total amoutlt of food consumecl is about IO% less than the amount needed' In the Ivory Coast, the intake of animal products and vitamins remains inadequate according to the f971-1975 Development Pl-an, and in Dahomey the situation is similar with only 7.2 kg of meat Per Person Per annum. 22. A report by the Office for Development and Agricultural Production indicates that in the Dapango region of Togo the daily foocl intake is about 1600 kilocalories per person , or 23% Iess than the normal requirement - 23. In Nlger there is also a serious problem of feeding lrvestock. The transfer of some of the livestock herds west of the river rs under consideration but the vaIIeVs in that area will first have to be made healthier for the men arrd animals- (b) The concentration on subsistence farming and the abandonment of certain 24. a crops regarded as rnsufficiently remunerative: only 67 tonnes of cotton were 1969; in marketed In the ouagadougou RDO in lg72 compared with 3OOO tonnes in 1969 to 23 OOO Upper Volta as a whole cotton production fell from 36 OOO tonnes in tonnes in 197O. 3.4 Dl.sequilrbria i n infrastructure qualrty and is unequally 25. The infrastructure i-s inadequate both in quantrty and distributed. 26, (a) The road network the primary network has been improved but the are 44OO km of second- and third-cIass roads remain very poor. In Upper Volta there Annex VI-5 page 5

national roads, 4600 km of secondary roads and SOOO km of rural tracks ; 3O7o of these routes are practicable in the rainv season. The srtuatlon in the north of Ghana o is simrlar. In the lvory Coast, accordinB to the 19?1-1975 Plan, class C tracks (of local importance) are passable under normal driving conditions in fewer than 50% of journeys, and the roads of regional importance are often btocked as a result of damage or inadequate bridges and culverts. Dahomey has a network of 6000 km of roads, 1408 km of which consist of rural tracks inadequately maintalned and needing major repairs. 27. (b) The commercial infrastructure: inadequacy of distribution and credit facilities both in organization and financial reserves forms an obstacle to the settlement and development of certain areas. The situation in Upper Volta is described in Annex VI-4. 28. (c) Education: the proportion of the population attending school ls l@o in Upper Volta, in Dahomey, L2.97o Ln the Kandi district, and 13.47o Ln the Natitingou district (687o at Cotonou); in Togo it is 6.L% at Dapango and the national average is 45.L7" (63.6% at Lom6). 29. (d) Pttblic health: In Upper Volta, there is I physician per ?9OO inhabitants in urban areas but only I per 188 OOO in rural areas; in the Ivory Coast, I physician per 48OO inhabltants and I per 64 OOO in Abidjan in the northern region; in MaIi, there is I physician per 3365 inhabitants in the capital, but only I per 173 OOO in the rest of the country; in Niger, I per 1765 in urban areas and I per 123 8OO in rural areas; in Togo, I per 2755 and I per lOO OOO in urban and rural areas, respectively; and in Dahomey, I per 5769 and I per 36 7O4. 30. At Bolgatanga in the Upper Region of Ghana, there ate 22 health workers including 6 medical officers for 167 3OO inhabitants; at Bawku there are 5 heatth workers (no medical officer) for 219 lOO inhabitants; at Lawra there are 3 health workers (no medical officer) for 123 4OO inhabitants, etc. 3.5 Disequilibria in income 31. The operation of these disequilibria explains the very low income levels throughout the region, which are themselves factors ln the disequilibrium. However, the national per caplta income is comparatively high in the Ivory Coast, Ghana, and to a lesser extent Togo, because these three countries have been able to develop much higher-yielding and more diversified economic activities in their humid tropical zones. In these countries, therefore, there ls a regional disequilibrium but in each of the seven countries there is also a very marked sectorial disequilibrium; some examples are given in Table VI-5.3. Annex VI-5 page 6

3.6 The role of onchocerciasis 32. The main effect of onchocerciasis is the abandonment of the valleys. This process has been crearry demonstrated by the following methocls: a 33. (a) Clinical surveysi the greatest prevalence of blinclness and the largest proportions of individuals affected are encountered in the villages nearest to thc. Simulium breeding sites. 34. (b) National statistics: those for Upper Volta in particular show t5:rt rhe cantons and villages most affected are those close to the rivers and streams where breeding sites are found. 35. (c) Studies on the graduat retreat of populatrons: in former times there may also have been other reasons for population retreat such as certain social factors or other endemi.c diseases; nowadays those reasons have disappearecl but the retreat continues, onchccerciasis being the main factor. In Ghana 600 km2 (60%) of the area between the Red and White Voltas were abandonecl between 1940 and L96o. Similar movements have been observed in Upper VoIta (Brsa country). It is clear that onchocerciasis and depopulation are invariably linked. 36. (d) Experiments with spontaneous repopulation in the infested areas (at St.Pierre, Tansila, in Upper Volta) have resulted in a rapid increase in the prevalence of onctrocel'ciasis, the development of eye disorders and cases of blindness and renewed depopulation. This has also occuri'ed in areas where water regulati.on proJects have resulted in the creation of breeding praces (Loumana in upp.er volta, Boukoura in tllali, for example). 37. on the other hand, Farako in Mali was abandoned Io years ago but onchocerciasis control has permitted the settlement of 25 villages, the establishment of six plantations totalling almost 60O hectares of tea, m61ina, teak, cashew and sugar cane, and other proJects are being initiated. 38. Chart VI-5.4 lllustrates the process whereby onchocerciasis leads to disequillbria in population distribution and to lower productivity.

4. EPIDEMIOLOGICAI ASPECTS OF ONCHOCERCIASIS THAT ACCOUNT FOR ITS ECONOMIC IMPORTAI.ICE 4.1 The transmission and course of the disease 39. Five kinds of transmission can be distinguished, corresponding to the different types of watercourse; these are illustrated in Table VI-S.5. 4.2 The very high prevalence 40. The number of affected individuals in the programme area is around one million. However, there are other diseases with a high prevalence; although there are 4oO ooo cases of onchocerciasis in Upper Volta, there are also 2 million cases of schistosomiasis, ?OO OOO cases of trachoma and 134 OOO cases of leprosy, etc. In Annex VI-5 page 7

the lvory Coast, IO OOO cases of onchocerciasis were detected during I97O, but

there were also 118 OOO cases of yaws, 24 OOO cases of dracunculiasis, and 13 OOO cases of schistosomlasis. This characteristic is therefore not a decisive factor ln the economic role of onchocerciasis. 4.3 The hish level of transmission and severity of the disease, leading to a reduction in the productive capacity of affected individuals 41. The reduction in capacity may be partial (pruritis, cysts, severe skln leslons, "hanging groin" with associated hernia, sllght eye disorders) or total (severe eye disorders, i..e., economic blindness and complete blindness). 42. For a partial reducti.on in capacity it is at present difficult to assess the disability rate, particularly si.nce it is the rural population that is mainly affected. However, one fact is certain; onchocerciasis mainly strikes the working population and 65-707o of onchocerciasis patients are men over 20 years of age, most of whom work in the fields. 43. This characteristic distinguishes onchocerciasis from the other diseases that cause bllndness: trachoma malnly affects women and young children, the complicatlons of measles (against which vaccination campaigns have been conducted) or smallpox (which ls in the final stages of eradication) af.fect children; glaucoma and cataracts affect old people. It should be added that the number of people affected by these various types of blindness is considerably less than the number with eye disorders caused by onchocerclasis (about 60 OOO in the programme area). 44. Leprosy' characteristically a disabling disease, could be compared with onchocerciasls (2S OOO of 134 oOO lepers in Upper Volta are clisabled) but the disabilities it causes are much less concentrated on the working population and in any case this disease has been regressing for more than 15 years as a result of a mass campaign. Almost 997o of the blind victims of onchocerciasis are over 15 years of age and 65% of them are males; this represents a loss of more than lo million working days each year in the progra.." ."...1 45. No doubt the economic effects of blindness due to onchocerciasis are reduced by the fairly general underemployment in rural areas I nevertheless, there is a loss of productive capacity, even if its effects are only partially felt, and in addition onchocerciasis patients are entirery dependent on the community. 4.4 The distribution of the disease , resulting i.n lation 46. The distributlon of onchocerciasis along the rivers has the following characteristics. The hyperendemic villages, where almost the entire adult

I on the basis of I7O working days annually, a woman being considered to devote half her working time to agricuttural work. Annex \.I-5 page 8

population rs affected and where about IO% of the inhabitants are blind, are sltuated between a hundred metres and 10-15 km from breeding places, depending on the extent to lvhich depopulation has progressed. The same process is repeated in each case: once a certain threshold proportion of blind people in relation to the total population 1s reached, the vr.Ilage is deserted and its inhabitants move further a\.ay from the rive:'. lf the new site is relatively well protected, the health situation improves and attempts are then made to re-occupy the former sites. Therr, horvever, the situation worsens and the process of depopulation starts again. 47. The area of the abandoned valleys programme , in the area is estimated to be: - 2? OOO km- in Upper Volta 2 - 22 OOO km in the Ivory Coast 2 - 10 OOO km in f\lalr - at least 5ooo kn2 in Ghana 2 - 8OO km in Dahomey. These figures do not include forest reserves. 48. It ls this cumulative effect, produced by no other disease, that gives the onchocerciasis problem its large economic impact and justlfies the choice of this disease for control action. 4.5 IUethods of onchocerciasis control

49. Various methods of control can be considered, at least in theory. Some methods must be discarded because scientific research has not advanced sufficiently (biological control, for example), or because they involve unacceptable risks (mass chemotherapy) or would be of limited effectiveness compared with the very high cost (control of the adult S. damnosum). The advantages and disadvantages of each of the possible methods are summarized in Table VI-5.6. 50. The cost of applying insecticide treatment from the land has been assessed partly on the basis of the expenditure on the European Development F\rnd (FED) project in the Banfora, Sikasso and Korhogo regions, and partly on the basis of an estimate made in 1968, the costs having been adjusted to present values. The extensive logistic requirements, the slow rate of advance of the treatment and recording teams, and maintenance problems make this approach unrealistic in a programme as extensive as the one envisaged. 5I. Of the technically feasible methods, insecticide application by aircraft seems to offer the best cost^fficiency ratio. 5. THE PRESENT SOCIOECONOMIC EFFECTS OF ONCI{OCERCIASIS 52. Onchocerciasis decreases the working capacity of those affected, burdens the community with the care of large numbers of blind people, leads to the desertion of Annex VI-S page 9 good agricultural land and requires expensive public health action. These effects are summarized in Table VI-5.7. 5.1 The decrease ln productive capacity 53. This effect is difficult to measure in onchocerciasis patients who are not suffering from serious eye lesions or bllndness, because the level of absenteeism from work is unknown in the rural populations. Measurements cannot be based on the demand for medical services and drugs; this is certainly far below the true requirements on account of the inadequate health i.nfrastructure and the lack of suitable chemotherapeutic remedies. Moreover, there is more or less hidden underemployment r.n many areas, and under present conditions the whole of the additional productive capacity could not be effectively utilized. Fina1ly, there are probably other diseases including malaria, schistosomiasis, and dracunculiasls, that help to decrease the productive capacity and it is difficult to lsolate the part played by onchocerciasis. 54. It has, however, been observed in Nigeria that as soon as onchocerciasis patients suffer from eye trouble, they abandon the fields distant from their dwelling and cash crops. An estimate of the number of persons suffering from serious eye lesions ("economic blindness") and blindness, is given in Table VI-5.8. 55. The observation that this disease attacks essentially the active part of the population is based on clinical surveys that show (Table VI-5.9) that more than 98% ot the blind are at least 15 years of age and that men are affected more often than women. The average is 65 men to 35 women in every lOO cases of blindness. The following proportions were obtained in local surveys: - 63 men and 3? women in every lOO blind persons in the Bisa country in Upper Volta (Rolland & Balay survey); - 657o men and 35% women in 218 persons examined in Togo (Schlitter survey); - 55% men and 45% women in Dahomey (94 74I- persons examined) according to a Directorate of Health report; - 66% men and 34% women in northern Ghana (Scheffel report); - 7O7o men and 30% women in northern Chana (Waddy survey). 56. These data are confirmed by some surveys in which the results are given both by sex and by age group. On combining these results and applying them to the total number of blind persons in the Programme area, the distribution shown in Table VI-5.10 is obtained. Accordingly, there are probably about 33 8OO men and 18 2OO women suffering from onchocercal blindness in the Programme ..a..1

On the basls of the most recent lnvestigations the total number of persons suffering from economrc blrndness would be around 70 OOO. Annex VI-5 page 10

57. The total number of potential working days lost can be estimated from these data, taking an annual average of I7O working days as a basis for the estimation.l For the whole of the Programme area (not including Togo) the loss is about 8 84O OOO days per year. However, this frgure is only theoretical, mainly because of the underemployment in the rural regions. 5.2 The loss of revenue

(a) The cost of maintaining the blind I 58. Because of the underemployment those suffering from onchocercal blinclness must be regarded as being a burden on the corununity, in which it increases the numher of economically inactive persons, rather than decreasing the productive capaclty.

59. The annual average income per inhabitant in the Ivory Coast r.s about US$ 8Ct2 in the project area and the cost of maintainrng the blind may be estimated at US$ 80 OOO per year. In Dahomey, since the annual average income in the rulal zone in the northern region is between US$ 21 and US$ 23, the overall burden is of the order of US$ 38 OOO to US$ 40 OOO per year. On the basis of the annual incomes in Ghana found in the family farms at Bawku (US$ 168 for seven persons) and Navrongo (US$ 8? for six persons) the cost of maintaining the blind is about US$ 160 OOO per year. The total cost of maintaining 40 OOO blind persons rn Upper Vo1ta is about US$ 640 OOO per year since the average annual income per head in the hyperendemic zone is US$ 16.3 In tllali the annual average income per person in the rural zone is US$ 24; the burden of supporting at least 2OO blind persons Is therefore of the order of US$ 48 OOO. The annual average income per person in the rural zone of Niger is US$ 40 and the maintenance cost for 2OO btind persons US$ 8OOO. For Togo the basic data are unknown.

I Figures from the Ministry of Agriculture of Upper Volta, confirmed by an examination of agricultural timetables. 2 Based on the July 1972 value of the US dollar, $1 being equivalent to 250 CFAF. 3 Another method of calculation can also be used. In6tead of calculating the proportion of the total income of a region required for the maintenance of a given number of blind persons. the cost of feeding each blind person can be esti.mated, having regard to the local dietary customs. The results are practically the same since, except on the very rare occasions when there are practically no blind, the income of the whole of the zone does little more than satisfy the most immediate needs. For example, in Upper Volta the annual mi.nimum requirement could be 160 kg of various cereals at an average price of 25 CFAF (USg O.1) or USg t6 per year per blind person. Annex VI-S page 1l

(b) Underemployment

60. The economic importance of the underemployment of agricultural labour caused by the lack of suitable land for cultivation within a reasonable distance of inhabited localitles has been evaluated for those regions where the problem is most acute and widespread. 6I. The total number of farms in the Regional Development Office (RDO) of ouagadougou, upper vorta, is lo4 ooo, representlng 46g ooo active persons. The cultivated surface per active person, which averages I hectare over the whole of the programne area' is only O.84 hectare in the Ouagadougou RDO. The total area farmed is therefore 75 ooO hectares less than the average. In thrs RDO the average value of production per hectare is US$ 15.8, which makes an annual average loss because of underemployment of us$ t 188 ooo. In the Koudougou RDO the total area of land cultivated by 35O OOO active persons is 29O OOO hectares or O.84 hectare per active person. Taking the norm as I hectare per active person and a mean production of US$ 15.8 per hectare, the loss due to underemployment is about US$ 9oo Ooo per year. 62. In the Navrongo district of Ghana, there are 52 OOo farms with an average of 2.5 active persons on each and a cultlvated area of I.3 hectares. The average varue of production per hectare is us$ 18.95. on the basis of I hectare per active person, 62 4oo hectares are not farmed on account of underemployment, and the loss amounts to US$ f 182 OOO annuatly. 63. The Bawku district of Ghana comprises 29 ooo farms with an average of 3.2 active persons and 2-8 hectares cultlvated land per farm. The average value of production per hectare is US$ 9.59 and the loss of production due to underemployment is us$ 115 OOO.

64. There are about 40 ooo farms in the Lama-Kara Region of Togo with an average of 2.5 active persons per farm, each working O.4 hectare. The average annual loss due to underemployment of the land ls of the order of US$ 5 million, the average value of production per hectare being US$ 90. (c) Decrease in the active lation 65' The fall in the ratio of the working population to the population as a whole is caused by the high emigration rate of young people while the birth rate remains at a high levet. 66. In Upper volta the demographic prospects for the second plan indicate an annual decrease of o.16% in the number of economicalty active inhabitants. lvith a Gross Domestic Product (GDP) of us$ 164.8 milrions in the primary sector, the decrease in value is about US$ 260 OOO every year. 67. Similar evaluations cannot be made for the other countries. Annex VI-5 page 12

68. Allowance should also be made for the drop in the productivity of the active population since to compensate for the departure of a large proportion of the young men, those remaining are obliged to work longer, some of them when over 60 years of age. On the Mossi plateau the average age of the active men is 40 years. The avarlable data do not permit this drop in productivity to be calculated. 5.3 The loss of potentlal production (a) Non-explortation of the valleys 69. An endeavour should be made to measure the potential production of the valleys as a rvhole on the basis of the traditional family farms. 70. Upper llolta: TVo approaches to the problem are possible, one based on the average agricultural production per hectare and the area of land suitable for cultivatlon which the Onchocerciasis Control Programme would open up for farming; the other based on the average production per family farm and the number of these farms that could be establisherl on land at present unoccupi.ed. 71. The GDP is US$ t64.8 millions, givrng US$ 15.84 as the average value of production per hectare. The total area remainrng available for agriculture is estimated at 8OO OOO hectares.l The potential value of lost agricultural production due to the desertion of this land is therefore US$ 12.67 million per year. 72. 'fhe averaBe annual value of production per farm is US$ 160-180. As many as ?O OOO-8O OOO traditionat famrly farms could be established on the 8OO OOO hectares available, and the probable annual production would be of the order of US$ 1-I.2-14.4 miIlion. 73. Both methods of calculation therefore produce very similar results and one or other method has been employed in the other countries covered by the onchocerciasis programme, depending on the nature of the best statistical basic data available. 74. On the basis of an annual production of US$ 84 per farm the total annual loss ln the Ivory Coast is US$ 4.8 millron. In Dahomey, 50 OOO people could be settled on go ooo hectares at the rate of 1.5 hectares per person. Assuming an annual production per head of US$ 32, the annual loss in potential production is US$ t.6 million. 75. One-third of an area of 10 OOO k*2 i., Chana can be regarded as usable; 30 OOO farms (I5 hectares each) could be established, each with an estimated About a production of us$ 156. This represents a total of US$ 4.68 million. a third of tO OOo xm2 in MaIi also can be regarded as usable. On the basis of IO people and 12 hectares per farm, 25O OOO persons could be settled with a production rate of US$ 18 per head and a total annual production of US$ 4.5 million. No evaluations could be made for Niger and Togo because of inadequate data. I E.tirnut"s made in the devetopment proJects. Annex VI-5 page 13

(b) Falls in yield rn densely populated areas 76. [tlost of the studies and reports concerning the Mossl plateau indicate falling yields. The direct cause is the over-concentration of the population in certain zones resultinB in over-explortation. Details of this effect have been given for the RDO of Ouagadougou in a SMUHI study dating from 1966 ; 827o of class 3 land 2 (SOGETHA classification) is settled and 38.4% is farmed. Ttre population density is 5? inhabitants per km2; that is wetl beyond the capacity of the land under the existlng conditions of traditional farming. Such an occupation rate makes it impossible to Leave an adequate area of land fallow, although this practice is essential for soils of very moderate quality. The extent to which yields are falling cannot be evaluated because the statistics do not cover the critical period. Yield comparisons for the Ouagadougou ORD were made between 1969 and l9?1

(Table VI-5.2) but they merely reflect the insufficient rainfall in 1971 and not a continuous trend caused by soil degradatlon. Nevertheless, according to an estimate by the Minlstry of Agriculture of Upper Volta the financlal loss due to the fall in yield is equivalent to US$ 8OO OOO every year in the Koudougou and Ouagadougou ORDs.

77. On this basis the average loss per hectare cultivated would be 285 CFAF (US$ 1.14), whrch would give the foltowing results in other zones with simllar population densities and levels of over-cropping, assuming that degradation is the same for similar soils and population densities: Yatenga (Upper Volta), annual loss of US$ 228 OOO; Ghana (Bawku and Navrongo districts), annual loss of US$ I7O OOO; Lama-Kara region in Togo, annual loss of US$ 52 OOO. The basic data are shown rn Tab1e VI-5.11. 5,4 The cost of onchocerciasis in national budgets 78. The usual method of budget accounting does not reveal the annual expenditure on onchocerciasis. In several countries, however, estimates can be made. 79. In the Ivory Coast accordi.ng to a study of the social medi.cine services which attempted to reclassify expenditure by disease, the total expenditure on the detection and treatment of onchocerciasis in 19?03 was US$ 160 OOO. 80. In Upper Volta expenditure on drugs and minor equipment for onchocerci.asis treatment was about US$ f2 OOO in 1971. Expenditure of this kind represents 20% of the total health bill so that, on this basis, the total expenditure on

I Secretariat des missions pour l'urbanisme et I'habitat (Department for Town Planning and Housing Missions). 2 C6n6rate des Techniques Hydro-Agricoles (Corporation for Hydro- .Soci6ti, Agricultural Techniques ) . 3 National budget plus external aid. VI-5 Annexpagm onchocerciasis treatment in 19?1 would be US$ 60 OOO. To this should be added case-finCing costs but these expenses cannot be isolated in the present budgetarv structure. g1. It should also be noted that as part of an intercountry operation assisted by the European Development Fund (FED) of the European Economic Community and by OCCCE, the Ivory Coast, Upper Volta, and Mali expend Jointly US$ 160 OOO per year, to which must be added about the same amount from FED as well as technical assistance from

OCCCE not costed, on an onchocerciasis control campaign aimed at protectin8 2- 60 OOO km- close to the borders of these three countries. g2. In both the Ivory Coast and Upper Volta the cost of onchocerciasis control represents some O.O2% of the national revenue. Extrapolating' the overall expenditure on onehocerciasis in the seven countries rs probably ar<.rund US$ 38O OOO. 6. THE ECONOMIC EFFECTS OF ONCHOCERCIASIS CONTROL 6.1 Improvement in the profitabilitY of onBoing proJects g3. The profltability of ongoing proJects, or proJects already decided on, has becn evaluated by comparing the data on the transmlssion of onchocerciasis in the proJect area and the financial and technical characteristics of the proJect under two condi tions: (i) an absence of onchocerciasis control; (ii) with onchocerciasis control. 84. The general conditions for onchocerciasis transmission in a given zone were determined from the entomological data available for the Volta River basin ateat a surnmary of which appears in Table VI-5.5. The special characteristics of transmission in the pro;ect zones were extracted from the reports of entomological and clinical surveys to determine the extent to which the situation described corresponds to one of the patterns indicated in the table. 85. The technical and economic characteristics peculiar to each proJect consist of the site, the types of agricultural or other production, the timetables of expected costs and profits, and the size and localization of the labour force. This is a first approach and still far from accurate; it remains to be seen whether in a subsequent stage the larBe body of collected data can be used to set up a mathematical model. (a) The sugar cane proiec t in Ferkess6dougou, IvorY Coast 86. In the Ferkess6dougou sugar cane proiect' under the hypothesis of no onchocerciasis control, the data suggest the probable desertion of the land srnce the project is located in a hyperendemic zone where the proportion of eye lesions would rapidly increase, reaching the critical threshold for desertion within 5 to 10 years. Annex VI-S page 15

87. On the other bank of the Bandama River at the same level as the sugar cane proiect zone 5-8% of the populations of the small villages with 60-250 inhabitants situated 3-5 km from the river, and 3% of the populations of the larger vitlages with 4OO-15OO inhabitants situated 5-7 km from the river are blind. 88. A11 the settlements planned for the sugarcane project zone are less than 5 km from the line of Simulium breeding places and there can be no doubt that the same situation as that on the right bank would develop in the zone particularly as new population groups would be involved. 89. Another assumption was made at this point - namely, that 50% of the workers would desert - to allow for the fact that some of them will have arrived more recently and some will behave uncharacterlstically, being possibly more lnfluenced by the good wages than the health risk. The assumption is certainly an optimistic one in view of the usual pattern of desertion which rapidly becomes complete; even so, the profitability rate of the project would farl almost to zero. 90. For the second condition, i.e., onchocerciasis control, the cost of control is included in the expenses of the project for the purpose of the comparison. The basis for allocating the cost was the relative length of the watercourses in the area, bearing in mlnd ln a total of about 14 ooo km, there are gooo km of permanent watercourses (assigned the coefficient I) while the other 6000 km are seasonal watercourses (coefficient tfl. 91. The protectlon of the sugarcaneproject calls for treatment for a distance of 30 km along the Bandama River. The fraction of the health campaign costs to be included in the annual project expenses ls therefore the annual overall cost of control multiplled by: 30 (8OOO + 6000/2) The incorporation of this cost in the proiect expenses reduces the profitability rate from 7.37o to between 6.5% and l% (Tab1e VI_S.12). 92. It should be noted, however, that the health campaign would benefit other (handicrafts, activities trade, transport, etc.) whose rlevelopment would be stinulated by the imprementation of the sugar cane proJect, and also activities that might conrmence on the opposite (right) bank of the ri.ver. For the moment, however, 1t is not possible to measure these secondary effects. 93. It has to be understood that this hypothesis applies to a regional onchocerciasis contror programme; in the case of an isolated programme to protect the sugar cane proiect, a length of the Bandama three or four times as great would have to be treated to reduce the risk of onchocerciasis transmission. Annex YI-5 page 16

(b) other ongoing proJects 94. The same method of calculation could be employed for the other ongoing proJects mentioned in this document. It has not been possible to do so for all the projects on account of inadequate basic data (absence of entomological or clinical surveys, Lack of precision concerning the siting of the installations and activities envisaged) but a few details are given concerning a certain number of development projects in Table 9 of the Report. 6.2 The possibility of implementing new economic development projects (a) Conception of the programme and criterra of choice 95. The extent of the Onchocerciasis Control Programme, the size of the deserted valleys rt wiIl be possible to repopulate, the consequences for the national economies of the migrations that can be foreseen, and the expected increases in production are all important motives for framing a general economic policy. 96. Such a general policy seems essential, both at the level of the individual. beneficiary countries, in order to make the most of the chances that arise and to avoid the harmful economic and social consequences that might follow dlsorganized population movements, and at the regional level, in order to harmonize the different kinds of productionl and the management of the pro.1ects.2 97. The aim of this economlc policy should be to maximize the economic benefits expected from onchocerciasis control and to resolve at least some of the social problems acting as a brake on development, e.8., underemployment, low income, and malnutrition. 98. Next, it should be determined what activities are feasible, taking into account the type of soil, water resources, climate, manpower resources, and sociological factors. Apart from these possibilities and the Iimitations peculiar to each of the countries and to the project region as a whole, the external factors must also be assessed, export prospects for example. 99. On the basis of these data as a whole it should be possible to evaluate the results that can be expected, but this will also depend on the type of action envisaged. Table VI-5.13 shows the various types of action between which a choice can be made.

I ^ Clearly the savanna zone and the wet tropical zone are complementary, being either producer or consumer according to circumstances. -2 For example, in order to exchange the results of research or experience; to avoid the wastage of resources; to define requirements and harmonize the lines foltowed; and to prevent uncontrolled population movements which would empty some areas and saturate others. Annex VI-S page 17

1OO. Consideration of the different possibilitles makes it evident that priority should be given to the installation of family farms; this type of action is the one most like1y to achieve the aims laid down, and could be supplemented by a few activities of other types such as large agro-industrial farms or ranching. 1Ol. However, other choices have still to be made as regards the type of action to be undertaken with respect to family farms. On the basis of the traditional activities on such holdings, the vari.ous options described in Table VI-5.14 can be envisaged. The criteria for choice are discussed in Annexes VI-l, VI-2 and VI-4. LO2. Finally, a whole series of cholces must be made for the implementati.on of the solutions adopted: for action on a broad scale or restricted to a small number of areas; selection of migrants by departure area, age, etc.; and for action restricted to the essential measures of reception and investment, or provi.ding for lntervention on a larger sca1e, at a slow or rapid pace. The results obtained will obviously be different in each case. tO3. In Table VI-5.15 the case of Upper Volta has been examined because it is the country where the problem is most widespread and where the consequences of the choice made will be the most important. Combinations of the different parameters can provide a very large number of optlons with a wide range of advantages and dlsadvantages. 1O4. Some of the hypotheses envisaged are as follows: (i) The annual selection of 40 OOO persons in the group of administrative districts with a hlgh population density (2 million inhabitant"') *ho would settle over a period of 15 years ln all the deserted valleys (capable of absorbing 600 OOO persons overall). The number of settlers chosen is equivalent to the annual population increase in the departure areas, L.e.,2?o. If the selection were evenly distributed between economically active and non-active persons, a demographic stabilization would be achieved that would render improvenent in the conditions of production possible. (ii) If the settlers were selected under the same conditions but comprised active persons only, the proportion of the latter would represent only 4@o of the population 1n the departure areas, with unfavourable consequences for production. (iri) If the only settlement area chosen were that of the Red and White Volta, which has an absorption capacity of I5O OOO persons, and if settlement were carried

I Ouagadougou (124 OoO lnhabitants), Bouss6 (94 oo0), Komblssiri (89 Ooo), Manga (1O9 OOO), Koup6la (91 OOO), Zabr6 (?4 OOO), Garango (6? OOO), Ti6bdld (52 OOO), Tenkodogo (Io9 OOO), Koudougou (293 oOO), R6o (84 OOO), Courcy (I18 oOO), Yako (165 OOO) Ouahigouya (215 OOO), pi6bougou (168 OOO), Gaoua (178 OOO). Annex VI-5 page 18

out over 2O years it would represent every year only Ig% of populati.on growth in the densely populated areas. If it were carried out over Io years it would represent 3070. (iv) If there were selection of the departure areas (the eight nearest districts, with 7OO OOO rural inhabitants) settlement over 20 years r.n the Recl and White Volta area would represent only 50% of population growth in the eight distrlcts. A balance could be ensured only by settlement over a perrod of 10 years. (v) If two settlement areas were adopted, namely the Recl and White Volta plus Bougouriba with a total absorption capacity of 2to ooO persons, then the districts of Di6bougou and Guot,.l would have to be added to the departure areas chosen. In this case, settlement over 10 years would be necessary to neutralize the population growth 1n the departure areas. tos. Finarly, six of the possibte sorutions (lg, 2C^, 7o, 22, go and 92) given in Table VI-5.15 present certain advantages, both in the cleparture and the arrrval areas, but solutions 18 and ?O presuppose a considerable volume oI investments and financial resources. On the one hand, this is not very realisttc ancl, on the other, it might upset the national economy. Solution 90 might be preferred for technical reasons, but would solve the problem only in certain densely populated areas and would only partially ensure the exploitation of the economic posslbilities of the valleys freed from the disease. Like solution 92, it would also be difficult to implement because of the strong desire among the population of the densely populated areas to migrate. 106. At the present staBe of these studies there can be no questlon of proposing a final solution but merely of defining the criteria for choice and indicating certain types of solution with the most favourable characteristics. (b) The bases for evaluating the supplement ary proJects 1O7. The supplementary reclamation proJects were evaluated on the following bases Direct inputs on traditional farms: - fertilizer: lOO kg per hectare; - insecticides for cotton protection: 30 x 25O cm3 boxes, i.e., 7-8 kg per hectare; - thioral: I bag (f kgl to every 15 kg of seed; - gamagrain: 1 bag (35 kg) to every 5OO kg of cereals.

I The selection of departure areas should in no case ignore the neighbourlng densely populated areas, part of whose population might formerly have lived in the valleys; to overlook this point would create grave difficulties of a sociological nature. Annex VI-5 page 19

1O8. Direct inputs on the traditional type of farm described in the report is the mean of the amounts used by the farms as a whole because the proportion of farmers using fertilizer or insecticides is relatively low in the traditronal system. For the Dedougou ORD the proportions are as follows: 8-97o of farmers use fertili.zer for cotton; 5% use fertilizer for groundnuts; L6-L7% use fertlllzer for rice; LL-L21o use insecticide for cotton protection. tog. Infrastructures The evaluation took into account the existing infrastructure, the area concerned, and the size and number of farms installed. 11O. The density planned for the network of second-class roads is 1 km of road to every 4.5 - 6 km2 (the present mean for Upper Volta whole km per , as a is only I 60 km-); this represents about I km of road to every l3-I4 farms. The proportion of new roads needed is lowest in the Btack Volta area where there are already some 3OO km of second-class roads. In the Boromo area the coverage will be slightly higher on account of the configuration of the territory, which is like the fingers of a hand. 1I1. The aim of the network of third-class tracks is to serve each farm. Since on average a farm covers 15-18 hectares, corresponding to the occupation of three times that area of ground, the density planned is I km of track to every 6-? farms. LI2. Villages with 1OOO inhabitants, i.e., 1OO-11O farms, have a mean area of 30- o 40 km- and the most distant points lie 4-5 km from the centre of the village. The installation of two wells with a high ftow rate in every village is therefore the essentlal minimum. 113. The provision of a market to serve five vitlaBes takes account in particular of the distances to be covered, which will not exceed l2-IS km. 114. The establishment of one school per village makes allowance, on the one hand, for the distance to be covered, whi.ch will not exceed 5 km and for the number of children of school age, on the other hand, which wilt be of the order of I5O-2OO per village. a f15. By creating a clinic for every 10 villages it will be possible to serve an average of 10 OOO persons, the greatest distance to be covered being about 10 km. Maternity homes will serve 30 ooo-4o ooo persons, the greatest distance involved being 20 km. 116. The proportion of supervisory staff provided for in the other proJects durrng the lnitial years is one to every 25 farms. rn the case of the Dedougou, Boromo, and sissili proiects it is considerabry lower since in these praces the action aimed Annex VI-5 page 20 drrectll' at the farmers rvill be less intensive. However, the ratio cannot fall belol one supervisor to every 40 farms because of the frequency of visiting. The ratlo has been doubled for the Pama and Como6-L6raba areas since they are more scattered and especially because of their considerable distance from the points of departure of the migrants. special receptlon measures shoutd probably be envisaged for these two cases. 6.3 Induced effects of economic development proJec ts 117. The implementation of various development projects would have a certain number of induced effects, €.8., an increase in industrial production based on cotton or other products; an increase in the national product due to the rise in the agricultural added value; an improvement in the trade balance on account of elther increased exports or decreased imports; new sources of revenue for public finance; the creation of;obs in the different sectors, etc. At the present stage it rs difficult to evaluate these induced effects as a whole but an estimate has been made for some of them. (a) The expansron of industrial activities l18. In Upper Volta the increased production of seed cotton resulting from the proJects as a rvhole, would be 37 I5O tonnes, i.e., 14 860 tonnes of cotton fibre. The Department of Industry in Upper Volta estimates the number of jobs arising from the treatment of IOOO tonnes of cotton frbre to be about 3OO, i.e., nearly 45OO Sobs for the whole supplementary production of cotton envisaged. These Jobs are broken down in Table VI-5.16. 119. The treatment of 5OOO tonnes of groundnutsl wiII create 2OO jobs and 2 20 OOO tonnes of paddy rice 3OO ;obs. I2O. In the Ivory Coast, on the basis of these ratios, the following numbers of 3obs could be created: - 8OO in the cotton industry (6000 tonnes of seed cotton to be processed); - 25O in the oil industry (8OOO tonnes produced and TOOO tonnes treated); - 45O in the rice industry (27 OOO tonnes produced and 25 OOO tonnes processed). ]-2l-. In Ghana, the number of jobs expected would be: - 5OO in the cotton rndustry (4OOO tonnes of seed cotton produced); - l5O in the oil industry (4OOO tonnes of unshelled groundnuts produced); - 3OO-35O in the rice industry (2O OOO tonnes of paddy rice produced). t The remainder of the supplementary production, i e 3OOO tonnes is home consumed. 2 The remainder of the production, 13 OOO tonnes is ground by hand and consumed within the country. Annex VI-S page 2I

122. Altogether, 19 OOO-2O OOO 3obs could be created, counting those created in other sectors such as trade, handicrafts, transport and administration. Taking into account the difference in the income levels from these jobs and those in the primary sector, it is probable that 1O-I5 persons (see Annex I-1) could be supported by each of these 3obs, i.e., a total of 2OO OOO-3OO OOO people. I23. The added value of the expansion of the cotton industry in Upper Volta would be about US$ 8 million since the added value in the textile industry of Upper Volta rn 1971 was US$ 3.2 million, involving the treatment of 14 OOO tonnes of cotton fibre. I24. The value of imports into Upper Volta was US$ 51 852 million in 19?I. Assuming that the supplementary production will be completely utiLized localIy there should be a corresponding decrease in imports. Table VI-5.17 shows that a by no means negligible part of these imports could be replaced by local products. 125. The implementation of the projects would lead to an increase in tax revenue from direct taxation arising from the work itself, an increase in a

1-29. Since the implementation of the Di6bougou-Gaoua and Bandama-Bou pro.lects is planned to cover 35 years calculatr.on of the profitability rate has been based on that period, i.e., on the mrnimum duration. 13O. Social facilities have been included in the investment costs because, on the one hand, they represent an essential part of the project ensuring the stabi-lity of the installed population, and, on the other hand, they do not replace other facilities that could already have been provided for rn the departure areas and are supplementary to the national lnvestment programmes. 131. The evaluation of maximum costs and the evaluatron of minrmum benefrts suBgests that the internal rate of return of the five pro;e.a.,'after lncorporation of the cost of the control rneasures. will be between 6% and 6.5%. The cletarls of this evaluation are given in Table VI-5.24. The same method of calculartion is employed in Table VI-5.25 for calculating the rate of return of the frvc ma;or proJects and the five supplementary projects together; this is about l0%. 7.2 Comparison of the three possible options I32. In order to try and give a more complete picture of the various advantages, the general trends that production could follow in coming years are outlined here and compared with the possible course of events based on alternative actions. The three alternatives envisaged are: (1) the situation that would arise in the absence of onchocerciasis control; (2) the situation that would develop if onchocerciasis control were not accompani.ed by an economic development programme; (3) the situation to be expected from onchocerciasis control accompanred by an economic development programme. 133. The comparison of these alternatives is very approximate because a considerable number of basic data are still lacking. For example, the following details are not known: (1) the prevalence and the seriousness of onchocerciasis in the three aI ternative programmes ; (2) the effects of the disease apart from blindness on the productive capacity of the population; (3) the influence the different hypotheses might have on population movements; (4) the future immigration requirements of Ghana and the Ivory Coast, and

I Calculation over 35 years, although the 35th year will be the first one rvhen certain projects are runni.ng smoothly; moreover, these five projects represent only part of the possible benefits, as is indicated in Chapter VI of the Report. Annex VI-5 page 23 the levels of immigration the Governments of those countries will consider acceptable. In the absence of these data, the trend over a period of lO years has been predicted, maklng the following assumptlons: (1) in the absence of onchocerciasis control, the prevalence and severity of the disease will remain at the same levels; <2) there will be no sociological changes, whatever alternative is chosen; (3) in the third alternative (onchocerciasis control ivith economic development) all the development proJects could be implemented; (4) other factors, such as population growth, public investments, improvement in agricultural techniques, will not vary appreciably. I34. The present value of agricultural production in the programme area was estimated using the bases of calculation given in Table VI-5.26, while Table VI-5.27 shows the expected contribution of the projects at the present production level. 135. According to the first option, attempts to repopulate certain zones (e.9., the RDO D6dougou in Upper Volta) will continue simultaneously with the depopulation affecting, for example, the valleys of the Red and White Voltas in Upper Volta and Ghana. Attempts at repopulation will have litt1e positive effect because some at least will be short-lived and also because the farmers will not succeed in improving their techniques. There is even a risk, following long-lasting and large-scaIe repopulation movements, that after a few years the same overcropping and soil degradatlon cycle found in the plateau regions would reappear. This ri.sk cannot be neglected. 136. Again, under the first alternative, if an attempt is made to maintain production at the present rate, output will decrease by O.5% annually on account of sol1 degradation and lower yields in zones with a high population density. This assumes a constant rate of soil degradation but it could become faster over a period of years. At the same time, the relative aging of the population due to the emigration of young people will cause a corresponding drop in productivity (estimated at O.L6% per year). 137. The joint effect of these two phenomena would result rn a fall in total agricultural production from US$ 27O million to US$ 25O million in the course of 10 years. However, during the same lO years the population will rise from IO to 12 million (assuming a 27o growth rate) so that the annual average lncome per head will fall from US$ 27 to US$ 2O.8, i.e., an annual decrease l.n income of about 2.5%. The effects of the decrease will be: Annex VI-5 page 24

(f) to reduce the working capacity of the population by aggravating the malnutritlon problem; <2) to discourage the development of new agricultural techniques, by seriously 11mi.t].ng the possibilitres for intermediate consumption (i.e., the selection and protection of seeds and use of manures, insecticides, small tools, and equipment ). I38. Assumrng US$ f6 per person to be the minimum annual cost of the food required to maintaln more or less normal productive capacity, then the US$ 6.2 annual decrease in income over IO years represents almost the whoLe average amount spent on a tradltionaL farm to cover farmrng costs (see Tab1es VI-5.12 and VI-5.19, and also Table vI-2.B.II rn Annex ttl-2.8 and Appendix 4 in Annex VI-2,C). It appears almost certain that this expenditure on farm inputs would suffer from the faIl in income, and that the loss of yield per hectare would increase in at least the same proportion

( i . e. , more than 2qo Per Year ) . 139. l{owever, a correction should be made to allow for the growth in production and incomes resultrng from the implementation of proSects in certain regions such as the northern Ivory Coast with an annual average growth rate of 4% fot about 1 mtllion inhabltants, and to a lesser extent the western reBion of Upper Volta and northern Togo. The annual increase in rncome in these regions as a whole would represent some 1.5% of the present total annual income in the programme area. I4O. It must also be borne in mind that lO years from now some of the rather poor and overcropped soil now under cultrvation will have become largely infertile and wiII have been abandoned. It is not possible at present to estimate the extent of this abandonment rn terms of hectares and production value, but such an assessment shoulcl be possrble later on, once the charts for population-supporting capacity of the soil and populatlon denslties have been completed (see Annex I-1). 141. Consequently, production will inevitably fall for three reasons: a weakening of the labour force, a decrease in the cuttivated area, and a faII in yields. Falling lncomes will probably accelerate the migratory pressures also but the degree of acceleration cannot yet be predicted' and it will be necessary to discover the threshold (drffering from country to country) at which the population no longer accepts the prevailing conditions but prefers to leave. These data geographical studies. shoutd be forthcoming from future sociological and human a Annex VI.5 page 25

For the time being we can only say that, taklng into account the various factors the overall value of production in the programme area would decrease by not less than 2% per year, assuming constant prices.l L42, In the second alternative (i.e., onchocerciasis control without an economic development prograrnme) the situation would evolve in a different way, except as concerns the possibilities for repopulating the valleys, which would be more favourable thanks to the disappearance of onchocerciasis. However, the lack of an infrastructure in most of the valleys would restrict settlement to the valley of the Black Volta ln Upper Volta. Nloreover, due to lack of resources and supervlsion, only farming of a traditional nature, providing an average annual income of less than US$ 25 per person could be undertaken on the 2OO OOO-3OO OOO hectares suitable for settlement. The annual increase in production would be only about US$ 3 million and the risk of capital destruction would again accompany spontaneous settlement. 143. The deterioration in production would therefore be only slightly less than under the first alternative, although the socioeconomic burden would be somewhat less for two reasons: (1) river blindness should gradually disappear as the older victims die and the interruption of transmission prevents the occurrence of new cases. Table VI-5.28 gives an estimate of this trend and shows that after 10 years the number of blind persons will have fallen bv 4O%, the assumption being made that the life expectancy of those suffering from onchocerciasis blindness is the same as that of the rest of the population since there are no definite data to disprove this; (2) each country now allocates certain funds to onchocerci.asis control but the effectiveness of these efforts is small and under the control programme this money would be better employed. Nevertheless, the advantages of the second alternative will not counter- balance the drop in production and incomes. 144. In the third alternative (i.e., the Onchocerci.asis Control programme plus an economic development progranune) the recovery of new land in the valleys freed from the disease should from the start provide a substantial increase in production and reverse the tendency for incomes to fall. The increase in agricultural income achieved by the different projects for the area as a whole would be 3.5% in the tenth year and would be in excess of l27o after 20 years.

I It must also be borne in mind that the population increase on the plateaux will become more and more expensive for the conmunity. New drilled wells will be necessary and they will become increasingly expensive, whereas the settlement of surplus population in the valleys, where ground water is readily available, would involve a quite modest expenditure; see Annex I-1. Annex V[-5 page 26

I45. The total gains made in implementing proJects undertaken independently of the onchocerciasis Control Programme should also be added; examples have heen grven rn Chapter VI of the Report (cf., Tat-rLe 9) but an overall assessment rs not possrble owlng to a shortage of accurate data about the disease on ttre one hand and the' localization of operations on the other. The fact that hyperenclemic zones where the programme's chances of success would be poor in the absence of appropriate health measures, coincides with those parts of the valleys where the soil is ferti.le, justifies the view that the rmplementation of the Onchocerciasrs Control Programme would be accompanied by very substantial benefits in these areas also. L46. A third type of benefj.t can be obtained in regrons of hi.gh populatron clensity thanks to the drop in demographic pressure. There will be some reliel because ot departures to the new proJect zones, the resurts varying accordinlr to the alternative chosen (see Table VI-5.f 5). In addition stuclies <.rf human ge()graphy (Cllapter I of the Report and Annex I-1) show that the population densrty and intenslty of farming in zones with a high poputation concentratron (e.g., the l\lossr plateau) are far from being homogeneous and that certain good sorls are scarcely exploited, if at all. It should therefore be possible to extend and amplif.y the operations started in the Ouagadougou RDO aimed at relocating farms at the loot of the slopes where the soil is better. This action should of course be accompan:-ed by measures to ensure an improvement in farmrng techntques, an essential condrtion i.f such soils are to be properly exploited. For example, the utllizatlon of hydromorphic soil at the foot of the slopes would necessi.tate the use of draught animals. Such an operation is sociallv and economically necessary to avoid the complete desertion of these zones by the actlve population so that they become an increasing burden on the community. L47. It appears therefore that the extent of the benefits to be expectecl from the adoption of the third alternative will be directly proportional to the development polrcy. The main polic.y outlines that have been proposed are given in Chapter VI of the Report.

CONCLUS IONS 148. It has not been possible to make an exhaustive evaluation of the benefits to be expected from an onchocerciasis control campaiBn whose trends are outlined in Figs. 65 and 66 of the Report (Chapter VI) because of the lack of many essential data. The quality of other data varies according to the source (e.g., population growth trends) while others are incomplete or very approximate (e.g., .yields of the various crops, areas farmed, production rates, etc.). The use of these data has therefore involved a number of cross-checks and extrapoLations. When disagreements were found in the data from different sources the lowest values were always chosen; Annex VI .5 page 27

for example, a rate of 2% was adopted for population growth, and the decrease i.n yield caused by over-cropping was regarded as being linear in nature whereas it is probably exponential. 149. The migratory movement may also become exponential if incomes continue to fall, population pressure becomes more severe, and the present climatic conditions persist. It has been assumed here that the cLimatic conditions will be normal but, in fact, the present drought is likely to have repercussions for a number of years to come on the crops and consequently on the nutrition of man and animals, i.e., on the overall productive capacity, and may well lead to an acceleration of the migratory movements which would accentuate further the disequilibrra discussed at the beginning of this Annex. 15O. Consequently, it is like1y that the trends outlined in connexion wlth the first two alternatives present a rather optimistic view of the situation and that on account of the worseninB disequilibria the outcome would be less favourable than has been suggested and the gap between the first two and the third alternatives would be wider. However, this will only be true for activities carried out in both the settlement zones and the departure zones. Depending on the number of pro.lects, the number of people settled wiII vary from 3oo ooo to I million. Assuming the number to be a million and the settlement period 15 years (minimum) the annual average nunber of people leaving the densely populated zones would be 65 OOO, i'e., one-third of the total annual population increase at a rate of.2%. Therefore, even if there were rapid settlement in all the proJect zones, demographic growth would continue on the plateaux, aggravating the present disequilibria and reading to a fall in the proportion of active persons, the overcropping of land and a fall in yields, and an acttte water supply problem. The whole plateau population might finally become a burden on the community and partly cancel out the advantages obtained in the settlement zones. 151' At same the time as settlement, therefore, complementary action should be undertaken on the plateaux where all the land has not been uniformly overcropped and where some soirs can still be used, provided that improved farming methods are introduced. L52. In conclusion, it is worth mentioning that alt the social and economic factors involved must be taken into consideration to ensure the stabilit.!.of the new settlements and to give the projects the best chance of success. It forlorvs, therefore, that a wide ranBe of studies (sociology, human geognaphy, regional improvement and pranning, agricurture, stock breeding, hydrotogy, etc. ) must be undertaken and this wilr be posslbre onty if the studies are coordinated for the whole programme area and carried out in a spirit of cooperation. .\rrner II-l'> pago 28

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TABLE VI-5.I. EXAMPLES OF DISEQUILIBRIA IN POPULATION DISTRIBUTION

Densely populated zones Desertecl or almost de5erte(l zones

Count ry Densi ty Dens i ty Name 2 Name 2 per km per km

Ivory Coast Korhogo zone over 50 Bandama vaIley Como6 va1ley Less than I Nzi valley Bank of the Black Volta

Dahomey Boukomb6 district I 40 M6krou valley Nata district 80 Alibori valley Dompago district 52 Sota valley [,ess than I Pendjari valley Valley of the Oudmd' and its higher tributaries

Ghana Fra Fra II6 Valley of the White Vol ta Kassena-Nankani 75 Valley of the Red voLta Kusasi bt Morago vallev Less than I Lawra 44 Asibelika valley Sissili valley

Upper Volta Gourcy over 75 VaIley of the White Vol ta Less than I Yako over 75 Valley of the Red Volta Less than I Ouahigouya over 50 Valley of the Black Vol ta o-5 Koudougou over 50 Bougouriba valley Less than I Manga over 50 Sissili valley Less than 1 Zab16 over 5O Valley of the Como6 and Less than I Ti6b6r6 over 50 L6raba rivers

Niger Canton of Say 32 Tapoa valley Less than I Sirba valley 1-5

Ma 1i Kadiolo administra- 14 for the whole Baould valley down- Less than 5 tive district of the "cercle" stream from Bougouni but 381 per km2 Ouassoulou valley over 1 I actually a width of ?-8 km; occupied parts of the Bago6 2 va I ley

Togo Dapango 4L Oti val1ey Less than I Lama-Ka ra r04 Koumongou valley 1-5 80 Kara valley 5 - 10, then Pagouda r-5 downstream Annex VI-5 page 39

TABLE VI-5.2. VARIATIONS IN YTELD PER HECTARE OF THREE FOOD CROPS AND ONE INDUSTRIAL CROP IN THE OUAGADOUGOU REGION BETWEEN 1969 AND 197I

Yield in t

Year Crop

t 969 r 971

Sorghum ?oo 400 Groundnuts 400 250 Paddy (traditional farming ) 700 600 Cot ton 400 150 - 200 .Annex \:I-5 page 40

o o c-o LI o c- (0 ..t cq o60 o> oo E(g lr t{ t{ kk ..1 E b0= o oo C) qq) E bO>r .dv q ..{ O @ o ooo P trl > lrd d @d d k Od & lrQ .d O ..{ .d O O'rl o >,E E> E.d> o.oo ..{ O.d ...{ O k.a t4 p c) ac) c) a() O O+r = = EO oo>co =(, .dCli o o.d o o Lb0 IE ^o6O ooo C) !+) q boP C)^ o (E(l o(!(s q otr ^.d+rlr >q Y> E .d po (, li C) o) 'do OP bo tr no b0 .d .d .do 6C/] >h c o60 l{b0 ! ..1 pO FI z (g.O ko oo) +rE ,o fr +{l{ o ofa oq) r< .d (s .do E(! (t ET t4 o do oc obt -oo @ p (!b0 tl)t{ c =(J a o .r(O (g o) 9o t oo O p o (!.q kE j4Ir F3d .d'd z 3 .O tr OP 3> br b0 o (!0 >li (! (! F(Il H J Q:< (s0 AZ .dd'd && vtr vao tq QO OC.) o .O rO raOO (oc) rr)@ N O.l d ; AE c.,t (7)

J H O) op oco 14 od(! an dt,tro ! o (d$ o @ o sr o 0r C) d (n (f) v $I (o i ot\ h0! @ J14 A xE t4 C) o & t< tr(! oo oo io, & h c.j o oo ol ooI o lo rr) t4 (.J F- $ @ c- tO N I (!k ot ON o d H c0) +J oa" +)qr P(H o 14 .a +{ +{ J (! (n o o ca z F

c- c- O) O) d .1 c- (o {J (,) @ (d (o ! th d (o P (o tr (! O) d o) (o c- Fl o F{ o O) o C) Fl F{ O C) E (n tr f{ tr o o o .d o (d A bo d bo (! p. ..{ d o H a o z Er = I o o z E 2 2o I : a o2 6 a I 6 2 6 6 t l 5 E o & b f Z 6 *E 6 - 2 G =I 5 ;l i3 I I o 6 o o - G 2 EA e- o E 6 tt oJ. G t o= t3 6 2)

I2 o a5 o E 2 6 o :o

GE o- I : - I 4 a 6* p 2 o 2 5? I o g< 6 2 6 6 =i2: E aooz a

=s o2 I 3 co l o2 E z 6 e 9 = o2 G I o) I E 2 o o el o o o o o 1 2 q d z 2 I ; z= I a 2= 9 I o 9 ol 5l 6 2 o d !l E 2 2 o 6 o (9 o o E o a o2 o Annex VI-5 page 42

TRANSMISSTON ON THE MOVEMENT OF HUMAN POPULATIONS IN DIFFERENT TABLE VI-5.5. EFFECT OF THE INTET'ISITY oF oNCHoCERCIASIS ROLLAND ANO PflILIPPOI'I ,.EPIDEMIOTOCICAL TANOSCAPES'' IN THE VOLTA RIVER BASIN AREA' ACCORDING TO LE BERRE'

slgns Effect on the Types $/ater courses Transmr s s ion Cl1nlcal levels observed observed populat ron

? km from the L6raba (l) Large and P€rmanent Malr : Sankaranl, - 15 OOO rnfectiv€ 73% rnfect€d water courses wlth Ouassoulou, Baou16, tarvae/man/year at brrdge: persons, Valleys deserted two maln lnfestatlon Bago6, Ban1f1nB, the L6raba brrdge 1O7o serrous eYe seasons: JulY-October I vory Coast : -l600at7km 5.5% blrnd. and Decenber-March. Bandama, Como6, Nzl from the bridge' leslons, t pper Volta Btack !'olta, como6, L6raba Ghana: rtvers south of the Cambaga Scarp

Vall.eys deserted (a few (2) West Upper Volta: 4 2OO rnfectlve At GuSna: Juventle, Permanent persons people are stopplng at flowrng upper valleys of the larvae/man/year at ?8% lnfected water courses Cudna, because of the brldge Volta, Como6, ou6na (Upper Volta) 52% eye teslons; rn rugged country Black at the L6raba, Northwest 5 4OO rnfectlve 7% blrnd. and at la FaYa, wlth tvo lnfestatron and Forestry statron) Dahomey upper val- Larvaefnanfyear at Rrvers seasons: (Mali). - July-September leys of the PendJarl, la Faya - January-March. M6krou, Aliborl Deserted valleYs wrth (3) of Red volta and tl,hlte On the KourouBba At 3.2 km: t{later courses persons; atteopts at reoccupatlon not Volta as well as (trrbutary of the 5?% lnfected average slze, followed bY new retreats permanent (flowrng thelr trlbutarles Red volta) 27% eye leslons, 3.5% blrnd; from June to Novem- as far as the Ganbaga 2 IOO lnfective ber) llnes of breed- Scarp. Larvaefnatf!ear at 4.5 ko: kn : 72O 39% rnfected persons; rng Places ln JulY- - at l.? kn : 45O ll% eye leslons; Augu st . - at 3.2 - at 4.5 kn : 25O 1.6% bIrnd. - at 6.0 kD : 160

bY about the l% rnfected persons I Doserted (4) Banks of vater courses Examples: I 4OO rnfectlvo Sarnt-Plerre, tarvaefnanflear on tnstallatlon; I t6nth Year. where there has been gqo settle- Tanslla (Upper Volta) alter ? Years spontaneous by the gth ment wrthout Protec- Year: 63% eye leslons, t ron. includrng 3@ serrotts ones ln all age groups.

At Loumana: 2% of Abandonnent of lnstallatrons (5) Creatlon of artlflcral Examples: ? year3 and desertlon Lounana (Upper Volta); rnfected persons the after breedlng Places bY year of constructlon. of tho terrltory of dams Boukoura (Malr ) . constructton Aft€r 8 yaars, 27% ol or lrrlgatlon canal3. the lO to 14 Years age group wlth eye leslons. 53% serlous eye leslons abovo 30 years of ag€. 5& blrnd persons above 40 years of aBe. Annex Vl -5 page 43

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U E a o C, (, o t o € o o o o o o o o ok E o d o o E! o o Od 6 o (, o o o d a o 8 o> c 6 A UK o 6 h6 q k o o o - o 6 o> A o @ c o o qE o CA Cd OP od c oo E do €o du E cd o cc 90 4C cc o od oc 6' qE od E ox oo do OA (o POo I od 6 o oEo o du dE OE oo o Odc A oo oo h oo kli c AP E\L >E AO €< Eq f.loo <6

q A 6 oc o 6 x t 6 cd o oq! @ o o ooE oo € A tc UO ct o o f H k o od k 6 o ok o ah roI o k o.o o z A E E o o oc Po> c oo ckoo c E Annex VI -5 page 44

TABLE VI-5.7. EVALUATIoN OF EFFECTS OF ONCHOCERCIASIS ON NATIONAL ECoNOMYI

Evaluation of the cost of Extension or number Nature onchocerciasi s us$

I Effects on population (a) Diminution in the productive I million individuals Not measurable capacity of onchocerciasis in all zones affected people (malady + malnutri tion)

(b) Under utilization of PeoPIe RDO. Ouagadougou, 2 too ooo in dense zones Upper VoIta Upper Region, (Ghana) I 300 000

(c) Charge of blind PeoPle on the Upper Volta: 40 OOO 640 000 fami Iy Ghana: 8 OOO 160 000 Ivory Coast: I OOO 80 000 Mali: 2 OOO 48 000 Dahomey: I 600 40 000 Ni. ger: 2OO 8 000 Togo: not known

decrease (d) Relative aging of PoPulation Upper Volta: 260 000 due to emigration of Young of O.16% per year adu I ts Other countries not known

(e) Costs of field treatment Ivory Coast (f97o) 160 000 teams Upper Volta 60 000 Other countries 380 000

2 Effects on production (a) Inability to farm valleys Upper Volta 12 800 000 Ivory Coast 4 800 000 Ghana 4 800 000 MaI i 5 200 000 Dahomey r 400 000 Togo and Niger not known

(b) Soil degradation and RDO of Ouagadougoq and subsequent Yie1d reduction Koudougou (Upper 800 000 VoIta) (Upper RDO of Yatenga 228 000 Vol ta ) Navrongo Bawku and 170 000 districts (Chana) Lama-Kara area (Togo) 50 000 t o., rn" basis of the most recent investigations' the total number of persons suffering from economic blindness would be about 70 OOO. Annex VI-5 page 45

TABLE VI-5.8. EVALUATION OF THE NUMBER OF PERSONS LTVING rN THE VOLTA RIVER I BASIN AREA AND SUFFERINC FROM ECONOMIC OR TOTAL BLINDNESS OF ONCHOCERCAL ORIGIN

a Count ry Number of blind Sources persons

Dahomey I 600 Directorate of Public Health surveys.

Ghana 8 000 Report by J. Blanc.

Ivory Coast I OOO Evaluation by the Directorate- General of Pub1ic Health (in report by J. Blanc).

lllaI i I 200 Report by J. Blanc.

Niger 200 Surveys by Drs Bru and Chamorin

Togo Unknown

Upper Volta 40 000 Estinates of the Directorate- General of Rural Health (in Le Berre: La lutte contre 1'onchocercose dans le cadre de I'6volution 6conomique des Etats de l'Afrique de I 'ouest ) .

Total 52 000

I According to the results of the most recent studies the total number of personsr suffering from economic blindness in the Programme area amounts to 70 000. Annex VI-5 page 46

TABLE VI-s.9. DISTRIBUTION OF ECONO{IIIC AND TOTAL BLINDNESS OF ONCHOCERCAL ORIGIN, BY AGE GROUP, IN TIIE VOLTA RIVER BASIN AREA

Number of blind persons by age group Number of persons Sources 30 and 14 r5-29 Total examined o-4 5-9 10- over a r 264 ll 51 62 Rollancl & Balay Brsa count ry

189 I6 T7 33 Rol land - Banforlr

t97 2 3 5 Rolland - Banfora

r2A 4 8 r2 Rolland - Carango

114 4 15 1!) Roltand - Retl Volta

95 3 3 Rolland - Red Volttr

t62 5 5 Rolland - Recl Volta

509 3 47 50 Rolland - Red Volta

433 2 15 I7 Rotland - Red Volta

110 2 I 11 I4 Schlitter - Northern Togo

108 I 9 16 26 Schlitter - Northern Togo

3 309 o 2 I 52 19r 246 TOTALS

o% o.8% o.4% 2T.L% 77.7% lOQT, PERCH{TAGES

i Annex VI-5 page 47

TABLE VI.5.10. PROBABLE DISTRIBUTION OF ECONOMIC AND TOTAL BLINDNESS OF ONCHOCERCAL ORIGIN BY AOE GROUP AND BY SEX tN THE VOLTA RIV-ER BASIN AREAI

Age Males Females TotaIs group

O - 4 years o o o 5 - I years 400 o 400 10 - 14 years 200 o 2o,0 15 - 29 years 7 500 2 500 10 000 30 and over 25 7o,0 15 700 41 400

Totals 33 800 18 200 52 000 I On the basis of the most recent investigations, the total number of persons suffering from economic blindness would be about 70 OOO. Annex I I -5 page -18

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ANNEX VI.5.14 ORIENTATION OF THE ACTIONS TO BE TAKEN WITH RESPECT TO FAJIIILY FARIUS

Ac t lons Cont6nt and charact6rlstlcs ol the actlvltleS Resu I ts

Shal I LarSe Food Cas h llvestock I i ves tock caops cfops fa rm1 nB lamrng

Tradr trona-t Instabrlrty of Product of Poor economlc aBrrculture, productlon owlng r odr fferen t output of the degradatlon of to need to grve quallty, outlets herd, health and No actton sol l, drop 1n prlorlty to food rrregular and feedlng problems Stagnatlon output, crop9, very lr[rted 1 nadequate Poor outputs p roduc tron

Brg elforts gree Ret€nt1on ol No solutron lor ExtreDely slow only poor resulta, prrorlty for food outlet probleo. progress that can V€ry llmrted so that is crops and rEprov€nent there the , Lrttle progres s. a return to the rnstabllrty of ln th€ quallty of Sepaaa Ee foLlryed by t radr t lona I productlon con- the product only after many sec tor a return to 0ethods stltute a brake on yea.s, so that there ac t rons earller 1t3 expansron rs a lack of condrtl0ns motlvatron for the breeders

lnteractron of operatlons: actton on cash IEproveoent ln Commencement Srou I taneou s crops leads to a gmall locrea3e ln tncome nutrltlon thank9 to of development actlon on lood whlch makes actlon on food crops acceptable an lncrease ln of lamlng crops, cash (use prod- of fertlllzer3 for example). Itrprovement agrrcultural techntques. and small rn the condltlons of productron of food crops ucttoo and lnprove- S I lght llve9tock releases posslbllltles crops ment quallty ln farcur of cash rn the l0proveoen t farns (physrcal and 1nv€stment capaclty). of the product ln lncome

Better technlques leadlng to regeneratlon of the so11 (or at least a halt Awareness of the I mprovement rn rts degradatlon). IDprovement 1n farErng condltrons and rncome oakes economlc value of cattle rn techniques posslble the use of d.aught animals (one ol the natn leasons whlch so far and lncome, has stopped the adoptron of thls technlque has been the lnabrlrty to make Work fum- Incooe Commencement the necessary tnvestment). Thls rmproveoent also enables sDall lrve- rshed by derlved ol a change stock farnlng to be developed, the draught from resale rn mental anrma I s at t1 tude

{c ctotr on other sectors: handlcrafts, Entrmce of trader credl t I Need for oalntenance of agrtcultural equlpnent and eoergence of desrre to lmprove housrng (recourse to fam1ly farhlnB t ransport craftsoen for seRrc€s). Ne6d to dispoge of product at gtable and suffrclently profrtable prrces, lnto the Need to utllrze the monetary rncon6, etther for gnall rnvestments or for consumer goods. mone tary ct rcul t

Settlnt rn Actron tn the Deslre to loprove one's own llfe and that of one's chlldren, whlch emerges when rt ls found that 3uch Dottm of the soclal fleId an lmprovement has become posarble, rural world ( hea I th, Awarenes3 of the servrce rendered by the rural eorld to the natronal co@unlty and of the duty of the and comence- teac hr ng I Iatter to r[prove worklng condltlong and "qualrty of llfe". ment of lts communr ty Local collectlve needs whlch become rncrgagrngly extonsrve and drversllled. partlclpatlon lrfe) ln the 11fe of the nat comul ty -\nrot \ l-:i

lAnlF rl-1.rs Tlnfs ot omioN [l{r eN nE coNstoEREo {\D THEIR (ONSEqt'EXaES

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IA8LF vl_i.15. TYPFS OF OmION TflAT CN nF TNSIDnRFO NO THf,IR (ONsteLlN(ts (.or'trnq.,d)

rlPl\ ots \ot,l'Tlm T(AT (,AN trE afrstoLRE0 elst 1,1 s ft) rnt t,\t{ ( I I I)

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62 63 Raprd 0l 65 66 504

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P.oductlm I Dr I f(5, AB I

50^. All sectors ! r : cl q2 Dr fIus. 9l I

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i'l I Annex VI-5 page 54

TABLE VI-S.}6. INDUSTRIAL JOBS CREATED IN UPPER VOLTA BY AN INCREASE OF 37 15O METRIC TONS IN SEED COTTON PRODUCTION

job Associated Type of Spinning Weaving activities Total

Engineers L2 I2 24 Foremen 145 r93 I2 350 Workmen I 535 2 370 r08 4 013 Clerical staff t2 r2 72 96

TOTAL 4 483

TABLE VI-S.17. LIST OF CERTAIN PRODUCTS IMPORTED INTO UPPER VOL'TA IN 197I WHICH COULD BE REPLACED BY LOCAL ONES (values in thousands of US$ )

Cattle . . I O92

Sheep, goats . . r52

Milk products and eBgs . 855. 20

Meat and meat preparations . . 81.20 Cereals and products based on cereals other than wheat 687.20

Vegetables (onions, garlic, potatoes) . 42 Sugar and its preparations 2 056

Textile fibres and waste . . 342

Paper, cardboard . . 972 Threads, fabrics, finished textiles 4 030

OiIs, fats, wax preparations . . 480

TOTAL ro 889.60 Annex VI-5 page 55

TABLE VI.5.T8. ESTIMATE OF BUDGET REVENUE CREATED IN THE IVORY COAST BY ECONOIUIC DEVELOPIVIENT PROJECTS CONNECTED WITH THE ONCHOCERCIASIS CONTROL PROGRAIIIME DURING THEIR IMPLEIvIEI\ITATION PERIOD (thousands of US$)

15% service tax

(3 774.8 x o. 15 ) s66.22 ?.5% VATI on commercial production (27 52O x o.o75) 2 064

funount derived from licences .O.O54 x 3 3OO- (o.zeo x 3oo ) 25o-.20 Proportional duties, national contributlon and additional taxes on licences 62.52 Taxes on fuels and vehicles 480 Miscellaneous (contractual taxes, royalti.es, taxes

on wages and salaries, etc. ) 320

Total over the 35 years of implementation of the projects 3 742.94 I Value added tax

TABLE VI.5.19. ESTIMATE OF BUMET REVE.IUE CREATED IN THE IYORY COAST BY ECONOMIC DEVELOPIVIE{T PROJECTS CONNECTED WITH THE ONCHOCERCIASIS COT{TROL PROGRAMME IN A NORMAI YEAR (thousands of USg)

VAT1. 240 Licences t20 Taxes on fuels and vehicles . 80 Misce I laneous 60

Total 500 I Value added tax Annex \rl -5 page 56

TAIJLE VI-5.20. RECURRINC COSTS ARISING FROM THE IIIIPLEMENTATION oF THE BANDAI\IA ECONOT\IIC DEVELOPMENT PROJECT, IN A NORMAL YEAR (in thousands of US$)

Ilzrintenance of tracks (O.O8O x 60O km) 48

funortrzatron of rnvestments . 32

Cost of supervisory staff (salaries etc. ) 52.40 Publi,c services (73 teachers, 20 nurses or

midwives, 20 clerks or supervisors) . r68

TOTAL 300. 40

TAI]LE VI-S.21. ESTII\TATE OF BUDCET REVENUE CREATED IN UPPER VOLTA I.}Y ECONOI\,IIC DEVEIOPI\IENT PROJECTS CONNECTED WITH THE ONCHOCERCIASIS CONTIi()L PITOGRAJ\III]r DURING THE II\'IPLEI\'IENTATION PERIOD (thousands of US$)

Turnover tax (I3'. of the works) . 6 007.56

I axes on r.orks (2": ) 924.24

'I'axes on suppl ies ( 1 . 5f; ) 8r. 30 30 OOO fourth class lrcences r 536 2OOO frrst class licences . . 480

30 OOO seventh class lrcences . . 320

lO OOO sl.xth class licences (craftsmen) . 2o8 Transport: licences, taxes on vehicles, taxes on fuels. 5 600 Taxes on industrial and commerci'al proflts 12 000 Taxes on salaries and wages, contractual taxes on income I 400 Hotels and lrcensed premises: taxes and li.cences 640

l\lrscellaneous (taxes on bicycles, cattle, servl.ce taxes , etc. ). 800

Total over period of 35 Years 29 997.r Annex VI-5 page 57

TABLE VI-s.22. ESTIIUATE OF BUDCET REVENUE CREATED IN UPPER VOLTA BY DEVELOPMENT PROJECTS CONNECTED WITH THE ONCHOCERCIASIS CONTROL PROCRAMME, IN A NORIvIAL YEAR (thousands of US$)

Turnover taxes, works taxes . 140 Lrcenses for craftsmen and merchants 260 Transport (licences, taxes on vehicles and fuels) 500 Tax on industrral and commerci-al profits I OOO

HoteLs and licenced premises . . t20

Incomes, salaries and wages . . r20 Mrscellaneous. 360

TOTAL 2 500

TABLE VI-5.23. RECURRING COSTS ARISING FROM THE IMPLEMENTATION IN UPPER VOLTA OF ECONOMIC DEVELOPMENT PROJECTS CONNECTED WITH THE ONCHOCERCIASIS CONTROL PROGRAMME, IN A NORMAL YEAR (thousands of US$)

l\talntenance of tracks (O.O8O x 43OO km) 344 Cost of supervisory staff (salaries, etc.) 792 Public services (600 teachers, 80 nurses ancl mrdrvives, 2OO clerks and supervisors) 760 Arnortization of investments . L20

TOTAL 2 o-l-6 Annex VI-S page 58

TABLE VT-5.24. II,ITERML RATE OF RETURN FOR IIIE FIVE MAJOR DEVEIOPMEI{T PROJECTS

Costs (thousands of US$) Benefits from Discounted at 6% the project Year Control ( thousands Project Total Cos ts Benefi ts measures of US$)

I 2 442 5 061 7 503 12.4 57 623 95 2 2 226.4 4 999 7 225.4 30 52 38r 2r7 3 3 556.8 6 935 10 491.8 159.2 71 758 1 08e 4 4 508 6 3ro ro 818 r79.2 69 776 I r55 5 s 218.4 5 352 10 570.4 4r4.4 64 265 2 5r9 6 6 489.6 5 L42 11 631.6 786 66 761 4 511 7 6 814.8 4 838 1r 652.8 I 37e.6 63 037 7 463 8 6 452 4 838 11 290 3 20e.2 57 6e1 16 398 9 6 942.4 4 838 Lr 780.4 4 0r4.4 56 77e 19 347 10 6 806 4 838 lt 644 4 r40.8 s2 863 18 795 I1 6 844.8 4 669 11 513.8 6 23e.6 49 390 26 765 L2 6 570.8 4 669 1r 239.8 7 506.4 45 405 30 324 l3 6 643.2 4 66e IL 312.2 I 7et.2 43 098 33 493 L4 6 647.6 4 669 11 316.6 ro 219.2 40 737 36 788 15 6 439.2 4 669 rt 108.2 Lr 642.4 37 656 3e 466 16 5 854.8 4 669 10 523.8 13 099.2 33 673 41 916 L7 5 s?8 4 669 ro 247 14 658.4 30 e45 44 267 18 2 82U^ 4 669 7 48e 15 864.4 2L 343 45 2r2 19 2 872 4 669 7 54r 17 0r4 20 2a5 45 767 20 2 474.4 4 66e 7 143.4 r7 94L.2 18 143 45 570 2L t 994 L 944 18 653.2 4 646 44 580 22 r 828.4 r 828.4 19 452.8 4 131 43 961 23 r 774.8 L 774.8 20 Lgo..4 3 778 43 004 24 t 660.8 1 660.8 20 8r4.4 3 336 41 836 25 r 600.4 I 600.4 21 423.6 3 o24 40 489 26 598 .8 598 .8 21 893.2 r o70 39 188 27 596 5s6 2L 33t.2 I OO1 35 536 28 590.8 590. 8 22 729.2 938 36 139 29 583 .2 583 .2 23 127.2 874 34 690 30 573 .6 573 .6 23 438.8 807 33 047 31 588 .4 588 .4 23 656 782 31 462 32 57L.2 57r.2 23 853.2 719 30 054 33 571 .6 571.6 24 o50.4 67e 28 619 34 570.8 570. 8 24 227.6 638 27 L34 35 566.4 566 .4 24 359.2 599 25 82U-

Totals 118 820.4 100 216 2r9 036.4 470 501.6 980 631 997 016

I Annex VI-S page 59

TABLE VI-5.25. RATE OF RETURN FOR THE PROJECTS AS A WHOLE II.rcLUDING THE SUPPLENIEIIIARY PROJECTS

Costs (thousands of US$) Benefits from Discounted at l@o the projects Year Control ( thousands Projects Total Costs Benefi ts measures of Us$)

I 4 946 5 061 10 007 12.4 281 r96 348 2 5 474.8 4 999 10 473.8 r52 267 480 3 882 3 6 902.8 6 935 13 837.8 387 .2 32r 295 8 990 4 ? 334.8 6 310 13 644.8 627.2 287 888 L3 240 5 8 146.4 5 352 13 498.4 L 2L4.4 259 0.26 23 304 t) I 224.8 5 r42 14 366.8 2 L66 250 543 37 775 7 s 43L.2 4 838 L4 265.2 3 447.6 226 242 54 679 8 8 829.6 4 838 13 667.6 6 161 .2 r97 078 88 844 I I 414.8 4 838 L4 252.8 7 894.4 186 701 103 416 10 I 870.4 4 838 13 708.4 9 396.8 163 262 lrt eo6 II 8 317.6 4 669 13 056.6 12 111 .6 141 396 131 162 L2 I 025.2 4 669 L2 6e4.2 14 518.4 124 908 L42 857 13 I 039.6 4 669 L2 7o8.6 16 983.2 113 736 151 997 L4 7 805.6 4 669 12 474.6 19 599.2 10r 538 159 535 15 7 348.8 4 669 12 01?.8 22 25U..4 88 925 164 650 I6 6 r8s.2 4 669 10 854.2 24 927 .2 72 93A 167 509 L7 6 002 4 669 ro 671 27 546.4 65 199 168 306 18 3 244 4 669 7 913 29 592.4 43 917 164 23s 19 3 296 4 669 7 965 31 342 40 223 L58 277 20 2 898.4 4 669 7 567 .4 32 749.2 34 762 150 317 2I 2 368 2 368 33 461.2 e 874 13e 532 22 2 252.4 2 252.4 34 260.8 8 550 129 845 23 2 198.8 2 198.8 34 998.4 7 583 L20 743 24 2 084.8 2 084.8 35 622.4 6 633 ltr 496 25 2 0.24.4 2 o24.4 36 231.6 5 768 103 258 26 L 022.8 r 022.8 36 7U.r.2 2 646 95 055 27 t o20 r o20 37 L39.2 2 397 87 276 2A I O14 .8 I 014.8 37 537 .2 2 169 80 329 29 L @7.2 r oo7.2 37 935.2 I 953 73 593 30 99? .6 997.6 38 246,8 r 764 67 695 31 r oL2.4 r or2.4 38 464 L 629 61 927 32 995.2 995.2 38 661.2 L 452 56 445 33 995 .6 995.6 38 858.4 t 323 51 68r 34 994.8 994 .8 39 035.6 r 2o2 47 232 35 990.4 990.4 39 t67.2 I O89 43 083

TotaIs 160 7a7.2 100 216 261 @3.2 819 339.6 3 324 285 3 231 146

e Annex VI-S page 60

ABLE VI-5.26. VALUE OF AGRICULTURAL PRODUCTION (TRADITIONAL SECTOR) IN TIIE VOLTA RI,VER BASIN AREA (IN MILLIONS OF US$)

Coun t r!' Present ( programme annua I Bases of calculation zone ) value

a miIllon Dahomey II The total agricultural GDP is estimated at I3.7 thousand CFAF (LlS$ 54.8 mrllion) or 12 thousand million CFAI'(US$ 48 million) of traditional crops, while the value of other products (coffee, palm tree products) is estimated at I.7 thousand million CFAF (US$ 6.8 milli.on). The agriculcural GDP per head (traditional sector), which is 5t9O CFAF (US$ 20'76), is obtained b.v drvidrng the total by 2 3I2 OOO rural inhabitants' The GDP per head is multiplrecl by 533 OOO, the number of rural rnhabitants in the zone.

US$ or, for the Ghana 32 Navrongo distrr.ct: production per farm 86'4, whole distr'ict (52 OOO farms): US$ 4.5 million' Bawku drstrlct: productron by farm US$ 167'7, or, for the whole district (39 OOO farms): US$ 6.5 millron' This gives as an average (29I ooo persons in Navrongo and 26I ooo in Bawku): + U 6.5 million US 4.5 mrllion - US$ 20 per head and for the 291 OOO + 261 OOO whole zone (1 60() OOO persons): US$ 32 millron

and the GDP per head in the I vory' 66. 9 There are 8OO OOO persons in the zone 9OO CFAF, or US$ 83.6 (1971-75 Coas t rural area is estimated tc.r be 20 Plan). (US$ 24)' or Mali 2A.8 Agricultural GDP per rural inhabitant: 12 OOO FM for the f 2OO OOO rural inhabitants in the zone: US$ 28'8 million. or US$ 3'6 million Niger 3.6 Agrlcultural CDP per rural inhabitant US$ 40, for the 90 OOO Persons in the zone.

Togo 27 AgriculturalGDPUS$106million'less12millionforcashcrops in the central and southern part (palm tree products' coffee' cacao, copra), or an average of US$ 54 per person' and for the whole of the zone (5OO OOO rural inhabitants): US$ 27 million' in the lg72f76 plan. Upper roo value of the agricuttural GDp is indicated Volta

Total 269.3 Annex VI-S page 6I

OL 6-.r.oo't o EES (?) (o gu> (o s @ v d ,< (\t F{ r. i-' rn oEo Y(')

oo o"1 .d tr c( P(g ! HO E9 =E oFtr iE qF>z = frl 14r= (E-.s5, li EFl r/) z>frl EUSqdh rO t- c- o rr) O trl d o o d t\ (o zoc) A:o:F{ 86 c oq)ao=z oo E14 .dk & +) (g trl oo @ @ (7) J- ,)\ (o o() rc c) q) J< @ o +) C, F ttt P l-' o (E d EC-E o o C) 59 o>1 o;o E (g }1 tr ,-{ o o tr .d o o o (, t ([ o 60 00 o +) g o 6 'd o g o (, H F A = z t< Annex VI-S page 62

TABLE VI-s.28. ESTIMATE OF THE PROGRESSIVE DECREASE IN THE NUMBER OF BLIND SUFFERERS FROM ONCHOCERCIASIS ON THE ITYPOTHESIS OF ONCHOCERCIASIS CONTROL

(a) Men

No. of blind by age group Years Total a under 15 years I5-60 years over 6O years

o 600 29 20,U. 4 000 33 rloo

5 350 23 100 3 350 26 800 10 o 17 500 2 50() 2() 000

(b) Women

No. of blind by age group Years TotaL under 15 years 15-60 years over 60 years

o o t6 000 2 200 18 20c)

5 o 12 7o,0 I 800 14 500 10 o 9 500 I 400 10 900

I - According to the most recent investigations the total number of persons suffering from economic bllndness would be around 70 OOO. Annex VI-S page 63

APPEI,IDIX A

LIST, BY COUNTRY, OF PERSONS INTERVIE\TED AND NATURE OF INFORMATION OBTAINED

q o tr o o .d +J +rC P c,o (,o) o .d .'{ F{E 0) FtO ,G) .o(u q> -) q .d o oo C) tr +) +{O 9.E (! & Otr +) a o O) (! p p +i Oq) trtr qrO o(! o !) o .d o .d t{ E oo p> ..{ +) +) a E dC 6+r O q o t.) (!0 o d ao ! 0, o! o.c o o +i oo) t o &6 q! frl A H a

DAHOMEY Chlef, Statistics Service, Cotonou x x Directorate General of Health, Cotonou x x Deputy Director, Dahomey Institute of Applied Research (IRAD), Porto-Novo x Messrs Faure and Viennot, ORSTOM, Cotonou x x Dr Gangbo, Director of Statistics, Documentation and Health P1anning, Cotonou x x High Commissioner for the Plan, Cotonou x x x Minister of Rural Development, Porto-Novo x x Mr Plug, Controller, European Development Fund (FED), Cotonou X FAO Representative, Cotonou x Dr Yekp6, Director, Major Endemic Diseases Service, Porto-Novo x

IVORY COAST Mr Boutillie, Chief, Regional Action Service, Ministry of the PIan x x Mr Bousquet, Bureau for Development and Agricultural Production (BDPA) x Mr Demoulin, Regional Action Service, Ministry of the Plan x x x Departmental Director for Animal Production, Korhogo x x Dr Kone, Director of Social Medicine, Ministry of Publlc Health, Abidjan x Mlss Lecoin, Ivory Coast Society for Economic Studies, Management, Taxation and Accounting (SIGES) x Mr Lemaitre, Veterinarian, Ministry of the Plan x x Dr l.ozachtMeur, Chief, Social Medicine Sector, Korhogo x Arrtrex tII-5 lrage ti-l

.\ppendix A

LIST, By COUNTRY, OF PERSONS INTERVIE'IVED AND NATURE OF INFORMATION OBTAINED (continued)

o o q) o .dptr +) qo (no +J .Fl ..{ -.{ E o .o(!.{O q>2(D .F) .d o tt oo C) L 1.c) p.E (g tr a o Ot{ P q) S) -t (B P P +{ oo H oo o(U o a o o trE .d .d li E oo +r> .A +J P a dc 6+, E o tlt o 0) 60 .Fl o -lao ti -lo o€, o o q titr oo tr c C) A(B &E tl A H o IVORY COAST (continued) f\,lr ttlinard, National Bureau of Technical Stucli.es for Development (BNETD) x Mr [!lontenez, Directorate of Devc,iopmental Studies, IUinistry of the Plan x

Mr Mouni.er, Director, Institute of Tropical Geography V lVlr Ndri, Departmental Dlrector of Agriculture, Korhogo x x [I1r Rombaut, Adviser to the Mlnlstry of Animal Productron x x I\lr Rossain, Technrcal Dlrector of the Society for the Development of Rrce Crowing (SODERIZ) x x Dr 56rie, Director-Ceneral of Health x Mr Trouchaud, Director, Centre of the Office for Overseas Scientific and Technical Research (ORSTOM), Human Scrences, Abidjan Mrs Verny, responsible for public health questions, Mrnistry of the PIan x x MALI Drrector, French Company for Textile Development (CFDT), Bamako x llr Caramd, Ministry of Production x i\lr Sery Coulibaly, Director of the Operation, Upper Val ley x Dr Sow, Director, MaSo r Endemrc Diseases Service x t\lr Touri, Ministry of Production x

TOGO Mr Adclrah, Assistant Director of the Plan x x Mr Bekri, FAO x Dr dtAlmeida, Director-General of HeaIth x Annex VI-S page 65 Appendix A

LIST, BY COIjNTRY, OF PERSONS INTERVIEII{ED AND NAtlrRE OF INFORMATION OBTAINED (continued)

q q c o) o c .Fl +) E +rC +J t,o (! q) o HE o F{O 5o) .F) !d p.> o a oo o k P qo o.E (r, li a o Of{ +) 5 o o (t +) +J +{ oo trtr o o qi oo o(d o a o o CE 'd o Fr E oo +r> .'{ a o .{C (l+) E o o o q) (l0 F{ .'{ o a (! i-{ o a6 t{ q) o1, o.c o o q kc oo) o h o tr Ad AE H A o H

TOGO (continued) Deputy Director, National Institute for Scientific Research (INRS) x Mr Omer Koffl, Director of Rural Development x x Minister of the Plan x x x Dr Prince AgbodJan, Director, Major Endemic Diseases x Mr Bloch, Resident IINDP Representatlve x

UPPER VOLTA Mr Bodin, Department of Missions for Town Planning and Housing (StruH) , Paris x Mr Bouchardy, Adviser to the Ministry of the Plan x x Messrs Cartier and Schneider, International Rural Development Company (CIDR), Di6bougou x x Dr Compaor6, Director, Rural Health x Commanders ("Commandants") of the admlnistrative distrlcts ("cercles") of Banfora, Bobo and Boromo x x Chief, Statistics Service x x x x Director and Technical Adviser, Oragadougou Regional Development Offlce x x x Director, International Bank of West Africa (BIAO), Ouagadougou x x Director, National Bank of Paris (BI\[P), Ouagadougou x x Mr Leperchey, Technical Adviser to the Ministry of Flnance x Mr Marchal, ORSTOM, Ouagadougou x x Chief Medical Officer of the Rural Health Sector, Ouagadougou x

Mr R6my, ORSTOM Geographer x Annex VI-S page 66

Appendix A

LIST, BY COUNTRY, OF PERSONS INTERVIEWED AND NATURE OF INFORMATION OBTAINED (continued)

o o o o ..{ +) P +) (! o co E .d ..{ F{ o ) o .r-) .o(!-lO q o o .d o o o t< +J Hc) g (l lr a c) Ot{ +J o) o o (! +) P +r OC) tr q) H oo o cl o o o .d ..1 & E oo +J .'{ P P p. n F{tr d +) E c) o o C) ..1 (u 60 Fl o F{ o o f{ O) og o c o o H E o o) o fr C) tr A(t A C4 tr H n H

UPPER VOLTA (continued) Mr Sanon Salia, Assistant to the Director of Rural Development Society for Aid and Messrs Chabrol, Gatain and Mesnil ' Cooperation (SATEC), Paris x x Dr Sawadogo, Director-General of HeaIth x Dr Sentilhes' Adviser to the Directorate of Rural Heal th x Mr S6ri, Director of Rural Development x x Mr Th6venin' Director of the Dedougou RDO and Chief of the Solenzo Sector x x Ar,nl^oLTtCAl LrsT oF t[E CHIEF DocUME{Ts Coilsut,ttsD ND TATUtE ot flrt (Nt'olrmrto\ EIT(A.rFo

Prpu l{t 1oo. Paavalanca ot poPulatlon I nf.a- bl dot a Produc t ron lndn.at and danrlty and

C. rncey, Erplorr.tlona .jrlcotc. an pry! I Dlaill. 0J1trlnl, Oi8Tm. I | 1969 (Ca!o d'(volre) I i I Annurl.c ltrttlt1qu€ du X.11, 1969 I I BOee. Cgs.1.rr.mnt de l. culturo du r1z drna l. rd3lon d. Slk...o, I tr?t (rrlr) I uor^. pour l. usc 6n v.l€ur d6 Ir vrtla. d. l,Ort, l9?l (Toao) I "..o" I BOPA. La dalprrt.mn! dc Krtlol., r9?2 (cato d'Ivo(re) I I I Atrnc, Ettet. dconoDlquet do l. lqtte contre [email protected], O*1, I tqeq

I I Bmm, ProJet de olle en valoqr dcr a1re. de dd3raeEnt d€ Xorhogo, I AordJ.n, 1969 aCat€ d'Ivol.€) I I I 8mTO, Proposrtron d'l.pl.nrrtlon d6a vllllScr pour le proJ6t !rcr16r I d€ Ferkca6ddouaou, 13,9,I9?2 (Cat6 d,lvolr€) 80PA, Lr rcdernt..r1on .uill. d.nr I. Hrut€-Vrlldc du Nra.., 1960 Ph. funnefond, 81lan do 1'op6rrtlon aetour! pllotaa €n Ioyannc Cale d'Ivolre, ORSrOI, 1968 A. l( Bildlcy, A cra6.tudy oi orch@€.cl..l.1n rha Hartl vrllcy, Ntgorl., 1972 Oo(t€ur! Bru 6t Ch.rcrrn, L onch@orcore au tr1ger. 1966-1968 EulIetlns et.t13tlqu€a Ensu6Ii d€ Hrcto-Voltr, l9?l ct l9?2 Dr Chrrcrln, R.ppo.t ltnal I I. l{aD Cont6rerco .tnt!t6r1ette ln!.r- Et.t3 d€ li(ECOB, 25.tI .u 3.12.106? CFm, Strtl.clque! l9?O-19?l Fur pr5t6cture d. ht1ol. (Car. d'lvo116)

C(op(€3 dcononlqu€. de f,.ut€-Voltr pour 1968 Compres 6conoolque3 du hlt, 1960 Conpte. nrtlonrux du to3o, 1968 Convontlon N' SiOfllV/ClfAL entrc 1r CEE! .t lc! Rapubllqucr d. H.ut6- Volt., C6t6 drlvolrc .t kll, dc 10.I.1966 er annexoa Dtr€ctlon d6 la dd6clna .oc1rlo, AbldJan. Statl.tlquea, l9?O (CAte dr lvolr. ) Olr6ctton d6 lt lanta, Cotonou, L,orch@arcole au OrhoDy, 196{ olaecttoh d6 lr {nta .ural6, Ourgrdougou, Statlatlqua! par crnlon! do. porte'rra de kyst€3, .nqutte! 1966-I.,?O (Hrut.-Voltr) Orrectlon des 3€rv1ce6 da l'6l€vagc ct dea loduatrtoa anloalas, prosr.@ 6l6v.ac, 2{.lO.l9?O (H.uGo-volt.) Econoolc Survc/, (,h6n., I969 Fm, Proter d.to6na6eGnt et de olso on vrleur dos valla€a dor Voltas, fd!rler l9?2 (h.qt€-Volt.) FAO, SvelJppeGnt deB o.ux louteril1n6s, Drhocy, lo?2 FED, Sltu.tron de! proJet! lln.nc6i p.r le FED en Rdpubllque de Hrut.. VoIta or 1.9.19?2 X. F1€Iour, Etuds do! vlIIaS6! prlote3 da la 2one Kolodro-Blneda, mM. m.3 l9?I (C6t6 ditvolrc)

feddou Coudolan. Enqq8tca dana 32 vlllag€s de la r1v6 orlontrlo d6 Ir 8.8e, f!lr, soptotrbE 19?l Oeteur! Ou€rs6d, Sln3ar6 et Scrla, Etud6 3ur le3 a.pects 3oc10- lo81qu6s do le c6c1td d.ns 16 ftp.rtomnr d6 Boq.k6, Mrs l9?l (CAte d'Ivorr€) B S. Hatrldu, An outllno of an orplorrtory 6eMI lurv€y lor th6 Dlssron PAo/ffio, l9?2 (Chrne)

J. flend€atckx, Not63 sua 1€ nord Cham, 16 Boqourlba, la r63ton d€ (o.hogo et le IaI1, 1972 (Ch.n., Cate d.lvol.e, H.utg-Volt., hlt) D. hunt6r, ceoSraphlcal rsFacts ol orch@€rc1.!r3 conrrol 1n North€rn Oh.na, .oot l9?2 O. Hunter, R1v6. Blrndncas 1n trangodl, Northem Ohao., th6 Seoarrphrcal Revl*, N' 3, 1966 IoET-CECG, Enqugto sur lo3 s6rvlco! de ddecloe 3@ra16 en Cate d'Ivo1re, evrtl l9?2 I0ET-CEC6, ProSrrG d,.ct1on co@rctrle €n Cat€ d,Ivo1!€, novenbre l9?2

IFAN. earte [email protected]€ d€ l,Afr1qu6 occldantelo, lOS3 INEE, C@!a.atton, &Dko, Eaquat6 ddrcgrrphique 1960-196I (ltalr) IISEE, Coo#.rtlon, Enqug!6 ddmgr.phlquo prr .ond.g€! €n RdpuDItqu. de H.ute-volc., 1960-1961 (2 to@.) a INSEE, Coop6rrtlon, Enquot€ .g.rcot€ ru hl1, 1960

- CoDuniut6 dconoorqu6 euaopdeme 4s!_.'1!}_]i AlfilABLll{Ar I tsT (rF 1r[ (]lIfr rx(trMFNTS (('\sl,tTEo {ND \ATURF 0t lilE tNl(,nuTkrN t\lxA(TEt] (,(trr(rr'ued)

I nI..r - EconomrL datr I'rdu!!rnt

lUI, vert16(,16 et sols bruns eutrophes, 25.lI.I9?o or Jehl, L'(,nctrocercose huMlne dans le loyer de lc Boq&qrlbr, enquires lq6{ } l96li (Haute-volte) ,,onathan Jelnes, Re3er!otr Re3ettl€mnt lh Afrrca, septenbre IS6q ,, M Xohler, Actl!rtd3 a8r1col6s et transformtlons soclo{cononlqu€3 dans une r€Br(,n dc l'oueBt du iloss1, ORSTfl, l96a (flrute_volta) D,,v1 Kui.vr. Etude opdratlonrelle explorrtolre dens le Nord-To8o, I mS , Lod , lS?2 r. kellcrnenn, Etudes d6B poss1bl11t63 de dlverslflcatton de la productron rurale en llaute_VolCa, 196? J. P. Lahuec, Tal,ongo, Etude t6ographlque d'un vl1la8€ de lrest iloasl, Omrc{, re?I (Haute-volta) a Docteurs koerque et Rolland, Btlan d'un€ enquate cllntque et parasr_ tol('g1que sur ltonchocercose dans Ie foyer de la volta No1r6, 1967 (Haute-v,)1 ta ) Doctcurs tarlvlaro et S. Dlallo, L'onchocercose en Afrlque de l'Ouest, Ed€crne d'Afrlque Nolre, N' lO, octobr€ 196? R k Berre, La Iutte contre l'onchocercose dan6 I€ cadre de lrdvo- Iutron 6cono6lque des Etats de I'Afr1qu6 de lrtu€st, 19.1.19?o Dr R Lrndner, L'onch@ercose au To8o, .lutn 1968 M Lflmoqroux, Notlce e\pllcatlve de Ia carte p6dolo81quo du roSo au r'r m om Y. ilath1€q, 14s cultures tndustrlelles au centro a8rlcole polyvalaht de farourkou, Haqte_volta/FAo, 196? Mdecln-chel des Crandes End6nles de Slka93o, R6sultstB Cconoolque3 et 3@raux acqul3 dans Ie zone traltde du Farrko, 1968 (k11) J. ksnll, b cas de 1'op6ratton centre Xos31 (9 volucs), Julllet l!'70 (Haute-volta) Mrnrstere de I'Agrtculture et d€ l'ElevaS€ de Haute_volta, Progra[m d'6tudes pr6lrnlnerreB devant pel@ttre la [rse 6n valeur des (aIl6es des Volta3, l97O frnlstare de 1'Agrlculture 6t d€ 1'Elevag€ de Haute_voIte, RaPport d'.ctlvrtds, 1969, clDR trnlstere de lrEconotre et des Flnances de Htut€_volta, k rdglm llrcal en flaute_voltr, 19?2 xlnlstdre de l'Econohl€ et des Flnance3 de cate drlvolre, k frscrlrtd rvotrlenn€, 19?2 f1n16t+re de l'Econoole 6t de! Flnarces d€ C6te d'lvo1r6, R€fo.E de la co6Brclrll3atlon des prodults vlvrlers, evrrl l9?l {rnlstare du Davelopp€mnt du kll (hcrouts, Sr.nl8uet et Tyc), Exptoltqtlon du choptel bvln ru kl1, lS65 flnlstBr€ des Frnancesr d6 I'Econo[le 6t du Plan ru fo8o, Plrn propos6 pour un€ rs3lstance du ruD l9?2_19?6, -lu1llet 19?l Irntstare du Plan d€ Cate dilvo1re, Notes sur le proJet 3ucrler de Fe.kessCdoqSou, l9?2 tlnrstire du Pl.n de Haute_volta, ProJet cotonnter (3 !olum3), r969 Ilnrste.e du Plan do Heqte-volce, ilote sur Ie urrage Bur la volta Nolre I Koulbl (sans d.to) hnrstare de l! Prductron du &11, Eo.nd€ de f lnanc€ent au FED pour un proJet de d6velopFcnt de la productlon du drh .u fl411, 1972 Mrnlgter€ de la Prduccron du kll, hoande de frnancomnt eu FED pour un proJet de d6veloppeEnt de la rlzlcultur€ dans la r6gton de S€8ou, avrll lq71 Nlnrstere de la Productlon du k11, De@nde de frnancemnt rq FED pour un proJet de d6v€loppe6nt de lr productlon cotonnlere, Jurn l97o filnrstere de la Santd dq klr, lnfr.3tructure sanltalre au kll' I9?O Mrnlsttsre do lrEcononle rurale du Togo, R.pport annu€I, 1969 P. C. hrel, bs plans de d6v€lopp€rent de I'6leve8e et des productlons anlMles dens la zono du prolet PAC/ilS, septeDb'e 1c72 Ore, Reprdsentant OueSadougou, Etude coopentle€ du bud8et de la sant6 et du bqdgeG natlonal, 1960 a I9?2, 8.2.19?2 (ttaute_Volta) ilS. Repr6sentant ouagedouSou, RenselSnenents Banl talrea, novembra 19?2 (Haute_volta)

ORD de MdouAou, RaPport d'€i6cutroo technlque, l9?O (Haut€_Volta) ORo de D6dou8ou, Prolet de pro8ra@ pour le plan qutnquennal l9?l_19?5 (Hauto_volta ) t ORD de OuagedouSou. ilercurlale3 l9?2 (Heut6-volte) (H'ute_Volta) ORD de ouaSadou8ou, Repport d'actlvltd 1969, l9?O, 19?l A,{! r'(lr-" I ALPUBETICAL LtST oF THE frtEF mCUXEmS ONSULTED sD NATURE OF IIE INFOmTION ExTRAcrEo (conrrnued)

Populat 1on, Paovalonce ol populelron t nl.a - bl ldn6a. .nd konoarc data dcnsr ty md ofloc L s

I oRSIlx, Atrei dc Cat. d'Ivolre, lg?t I lORSm. Atrrs de H.ute-Volt., 1968 I I OEmI, Carto droccuprtlon des lols en H.ut6-VoItr oslol, Etud6 cdoloSlque H.utG-volr., 1968-1969 Dr Ovazza, ProJ6t do lutte contre I.orchoccrcore drna h zod r6cound66, 23.1O.1966 Jrcov P.ppo, Anrlr3o dconoalquc de t5 prototyF.a do l.m. lrDll(a16, st lO f6r@3 tr.dltlonn.lloa pour lirma€ l9OS, .vrtl 1966 (Haut6- Vo1 ta ) I racov PapF, NorE! d6 trAvall €t calculr dei rovonua d€t cultur€s srvrl6r€3, tLtourkou (.rna d.tc) (fl.qta-volt.) H, Patokldoos, L! clvlltlttlons patrlarcrlea d6! l(rbro lacc aux proar.@! @dc.nee de d6volopp.Dat 6cono.lq@ ct !e1.1. 1969 ( Toao ) PorsFctlves d6h3raph1qu66 pour 16 dcurlaF plan .n H.ctc-Vottr D. J. P€tlc, Rrpport Bur l,[email protected] iogo, ml 1969 B. Phrlrppon, Etude cnroelotlquo du loyer d,onch@orcoe de la val160 du tu.33oulou, 22.1.19?l (t{.tr) Oocteur3 Plcq 6t Altou &, L,endailc onch@orqqlenno dtnr I€ corc16 d6 Yrnlolll., rrs l9?O (LIt) Plan d6 d6v€1opp6cnt acorcolqu€ et !@1rl l9?l-19?S .u IoSo Pl.n nrtronrl 1nt6r1rr.o d€ davolopp.Ent dconorlq@ ct selal l9?l-t9?2, orho@y Plrn qulnquonnal de davclopparnt 6coooa1qu6, i@trl et cqltur6l 19?l-1975, C6te d. tvot16 Plrn quhquomrl do d4vgloppcDnt acononlqu€ ct 3@1al 19?2-10?6, H.uc€-vo1t. PXUD, Donn6€s 86.16r.!€B €t .nalyre dconoolque rur le Toao, ul lo?l Pr6slderc€ dc Oouvcrnomnt ac Xrl1, progaa@ trloonal dc rodr€!- scEnt acono!1quc et itnrrc1.r, l9?O-19?2 T [email protected] et O. do Rouv1ll.. Asrtcult6ur.ctal.vaur! do la r{t1on dq Oondo-Sourou, CVRlt, Jutn 1060 (Hrut6-Volcr) D. qu€lonnoc, Enqutt.. Draltllm1rc. .ur Slu!.lo d.no.o.t l'onche..co3. .u D.hocy. r6a.orm r.ooriFEiii.t-root 1962 Dr Quelcmoc, ProJg! d'ortrntr.tlon d. l. zona d. contrAle da BrDttut d Tbob.Id d.n! le nord-oue.c o.tloGy. cnqclro. lo€l I G;i=; sroE Ra!y, La d1v€r! rap6ct! du (rvoloppaDnt dana h pttla voltalquc qu b.!!1n do k Volt. Roq6 .t da la staatll (H.uto-Voltr)

Or Rrv€!, ProblaEB arnttrtro! d.B la r63(on dq lrc dc l(oaaou, lO?O (Cat€ d'Ieo116) Det6ur. R1v€. cc 8611€, L,[email protected] on C6re d.Ivolrc, !tE!,]!E d'Alrloue l{0116, X' lO. @tobre 106? Dr A. Rolland. La latrlona eulalFa caua6oa par l,onch@grcola drna 1€ ,oycr d6 l. Volta Roua6, 196? (Hrqt.-Volta) Dr Rolland, l., loyor dronchearcoaa & lr r{31on de ganlora (Hruto-Volt. ) 0r Rol.lrnd, Eptdtt[1ologle d€! copllc.tlon3 ocul.lres cruaaer prr I'onchocercole en thut€-volta, 19€g x Dr Rollrnd, Evolutlon du r4B6rvo1r d6 paraalba h@1nB alcro- lllarron! dr&rchocarca volvulua dana la loyer dG glkaaso apraa trelt.mnt l.rvlcldc rntl.lEl1dl0o et una c.4,rgrc ttutrepautlquo 1 prr bl r de 1966 I r9?r (hl1) | Dr Rollrd, L loyer d,orch@6rcoae d. l. Dlalm rtzlcole do I (hlf) Boukour., 19?l I 0. Rolland, lar cacltlt3 onchocorqulonnea drna laa aaaa coqvarte! p.r lc proJet r68lonal do lutte contre l.orchocarcorc .n Alrlq@ dc I rtu€lt, l9?2 Dr tullrnd, R..ultrt. d,6e 6qutt. ophtrlElo3lquo.ur l. r6partltlon 6t h cauG d€a cacltaa dan! la t{llon de troanoao, (Car t I9?2 dilvolF) Or Rollad, h ioy.r dronch@ercorc d6 l. r{31d dc brko, 1y2 (Lr1)

Doct€u.! RoIIrnd 6t Balay, L,onch@arcor€ dan! le loyaa Btaa, 1969 (Hrut€-voltr) I a (bctour! Rolland. Sanraarlcq at Cublan, L'orcheorcole en lllcta- voltr. Irnpo.t.@e, r6prrtttlon €t 3r.v1td d. I'cda.16, Ldffi troplcale. septeobr6-etobre 1969 fuctaur3 Rolland et Vln€t, Enqulto sur I€a catcltaa orchear- qu1em6! d.ni 1. r{G1on do Bouaounl, Jurllet lg?2 (&11) 4!rqlrj!-l-.! AI,HIANEI'I('AI, LTST OT TIIN (IItEF MCfrENTS (ONSULTED ANO NATURE OF THE INIIUATION EiTMCTTD ((ONtIN(d)

P..ret€h.e 6I Pooul at rdn - I nf ra- blrhd^6qe e.d 'oooulat ron d6n3r lv md onchoceacraars

Oocteu.s Rollrnd et Vrnet, L'onch@orcose en R6publtque du X411, lulller Ilr?2 R C Saqadogo, Etudes exploratolr€3 sur le facteur hum1n, CVRS Our8rdouSoo, @tobre 19?2 (Haute_Vo1ta) Dr SchelfeI. hch@6rc1a31s cont.ol p1lot proJect rn Ghane, Upp€r volta and Toao, 30,6,1960 [6dec1n Ch6f Schlltter, Comnceent d'une rech€.che stat13tlqu6 e! systdMtrque de l'onchoc6rco36 eu ToBo (9ans date) Sect6ur de Dddecrne so.1a16 de KorhoSo, Onchoc€aco36. tableeu per i !rllage des porteu.s de kyBt€s (C6te d'lvorre) SEDES, Crd.tlon d'un berceau de lr ra.e tl'Dam, r681on de Yenlolll. I (kll), novembre 19?I (talt) I SEDES, Etude pour le cont.6le de I'onchoaercoso dans l€ brsslo de3 voltas (3 volqGs), 1972 Servrc€ des statrstlques d€ Hrute_volta, Stat13tlqueB d6D8aaphrqu66 Servtce de3 statl3tlques du DahoEy, rBrdgets et statittlquos 6conotrrques, statlstlques d6rc8raph1ques SXUH, Protmc et .ctron de daveloPPornt 6t diadneseGnt de l. r681on d6 Ou.8.doutou, aoot 1966 (Heut6-Voltr) Smfr, ProSra@rtlon pour le proJet sucrler de Banlor!, @tobre I9?2 ( Hau re-vol t. ) \o Quan8 Tr1. Esqulsse du proJet de o13e en valeur de le (all6e d€ la Bou8ourrba, aoot 19?2 (Haute_volaa) vo Qu.n8 Tr1, E3qq13se du proJ€t &ndrm bu, aoat 19?2 (Cate d' tvorre )

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