AFRICA REGION Special lntervention Zones 01 B.P. 549, Ouagadougou 01, Burkina Faso Tel: (226) 503429 53; 50 34 29 59;50 34 29 60; 50 34 36 45/46 @)P,'3fJ':,TLT,,sant6 Fax: (226) 50 34 28 75,50 34 36 47 Report of the flfth actlvlty tevlew and plannln$ meetln$ of the Speclal lnterYentlon Zones (SlZ) Ouagadougou, 8 - 10 Noaember 2006 SUMMARY OPENING A. OF THE MEETING.......... 3 B. BACKGROUND TNFORMATTON ON SIZ .....................4 C. GENERAL INFORMATION ON THE 4th SESSION OF THE SPECIAL ADVISoRY 6' D. FOLTOW-UP OF RECOMMENDATIONS OF THE FOURTH REVIEW AND PTANNING MEETING 8'{ E.INFORMATION ON ACTIVITIES OF THE MULTI-DISEASE SURVEILLANCE CENTRE 1.0 F. REVIEW OF ONCHOCERCIASIS SURVEILLANCryEVALUATION AND CONTROL ACTIVITIES IN SIZ COUNTRIES (INCLUDING NON-SIZ AREAS) FROM 2003 TO 2006, RESOURCES EMPLOYED AND PLANNING OF ACTTVITIES FOR 2OO7 12 G. POST.OCP ACTTVITIES IN 2003, 2OO4 AND 2OO5 IN THE SIX COUNTRIES OF THE FORMER OCP THAT ARE NOT PART OF SIZ, AND ACTIVITIES PLANNED FOR 2OO7 ......... 28 H. FINANCING OF ONCHOCERCIASIS ACTTVITIES IN THE SI2........... 4't I. PROGRESS REPORT, RECOMMENDATIONS AND CONCLUSIONS OF 2006 MEETINGS OF THE NGDO COORDINATION GROUP 4't I. SUPPORT OF PARTNERS FOR ACTIVITIES FROM 2OO3 TO 2006 AND PROIECTTONS FOR 2007 43 K. IVERMECTIN TREATMENT (MULTI.ANNUAL TREATMENTS, RESISTANCE TO 44 L. WHEN CAN IVERMECTIN TREATMENT BE STOPPED, FEASIBILITY OF ELIMINATING ONCHOCERCIASIS WITH TVERMECTIN ONLY .,.,.........46 M. OVERVIEW OF NEW CDTI DATA MANAGEMENT PROGRAMME ........... ............,....46 N. RESOURCE MOBILISATION STRATEGIES FOR THE CONTINUATION OF ONCHOCERCIASIS CONTROL AND SURVEILLANCE IN FORMER OCP COUNTRIES............. .....47 O. OTHER MATTERS .....48 P. APPROVAL OF RECOMMENDATIONS 49 Q. CLOSURE OF MEETTNG ............. 52 ANNEXES: ANNEXE 1: List of pafiicipanfs......... ...............04 ANNEXE 2: ProvisionalAgenda ......fg. AArrlrP(E 3.' Coverage of eapfure poiafs in counfit'es eondsetrhg eatomologieal surver1lanee......,.6i AAIATEKE 4r Resulh af infectivity rafes trom 2@l fo 2005..... ..........63- .AIvlvExE 5.'Enfomologieat Surveillance Results for 2(N5 rn Gfiana. ...............64 ANTIIEXE 6.' Oncfioeererhsrb entomologfcal ne(worft for 2AO6 .........6d 1 uFeasibility ANNilE 7: Partial result trom surueillanee poiafs ol the stu$ an of eliminatian of Anehocerciasls by tvermectin dtstibtttion"......,.".... ..........."....."..65 ANNE)(E 8.'Resulf from yectors coll*ted in APAC surueillaneepoints. ........65 ANNEJI/E 9: Plan of action and budget SIZ 2(n7 in Benin ................65 ANNEXE 70: Summary of distribution af iverm*tin in the SIZ dlstn'cts in Ghana durtng year ANNFJ(E lt: Summary of epidemiological results of Eas{tern region tn Ghana e@q........."...........66 ANNFJ(E 12: Summary Results of Ashanti Region in Ghana OAO$ ................67 ANNEJ(E 73: Summery of Vatta region results in Ghana fi$q...... .................67 ANNEJ(EI*SienaLeoneOnchoeontrol aefi'viffes in2(N7.... ........68 ANNEXE 15: SIZ AREAS lN GUINEA ................68 ANNE)(E 16: Epidemialogical Evatuatian in nan-SlZ in 2Nl6: Guinea..... .........69 ANNFJ(E 17: Pailial resuffs of ceptures in Guinea e@q...... ..........69 ANNil,E'18: Timetabte af activities to &e conducted in 2(N7 and 2Nl8 in Guinea. ..........70 ANNH(E 79: Recap af the tahle af bulk captures and disseetions in Togo P(}{/,3-2U}6/...................70 ANNEXE 20: Flan af Action and Budget: 2007 SlZITogo.. ................7't ANNFJ(E 2l: Pragress af CDTI in 2003, 2W and 20Oi in Senegal ........".."......71 ANNE)(E 22: Trend af indicators of epidemiologicalsurueillance of onchocereiasis (Senega$......75 ANNEJ(E 23: Avervlew table of 2@3-2N)T PAB for the 5 SrZ counfrfes. ..........76 2 A. OPENING OF THE MEETING Three speeches were made during the opening ceremony The first speech was by Dr Laurent YAMEOGO, who deputised for the APOC Director. Dr YAMEOGO, first of all relayed to participants the warm greetings of the APOC director, who went on mission in Nigeria following the plane crash that occurred in the country on29 October 2006, and in which three APOC temporary advisors lost their lives. He continued by recalling that this was the last-but-one meeting, which should take stock of our achievements, appraise our strengths and shortcomings lor a final effort that should see us achieving our objectives and maintaining the gains of OCP. He then underscored the problem of resource mobilisation to support the onchocerciasis control effort. To this end, he appealed to all partners at the session for their assistance in search of new avenues for resource mobilisation. Regarding the technical sector, he stressed that to maintain the said gains, adequate and timely surveillance was critical. In this connectiorl the countries should have a national system (available tools and protocols used) enabling a good appraisal of the sifuation, informed decisions and appropriate responses made on the basis of complete and reliable data. Then, Dr Laurent YAMEOGO appealed to the countries about the need to draw up plans of action in the endemic districts, in conjunction with partners, so as to continue ivermectin distribution until 201.2 (in line with the ONCHOSIM simulation model), in view of the imminent closure of SIZ in December 2007. Finally, he called on participants not to be complacent in their deliberations so that they could find solutions to the various problems encountered. Dr Laurent TOE, representing the director of the Multi-Disease Surveillance Centre (MDSC), made the second speech. He announced greetings from the MDSC director to participants, after which he recalled that Review and Planning meetings were opportunities for exchange and planning among the various actors involved in onchocerciasis control, namely the coordinators from the 11 former OCP countries. This is why the MDSC is so much interested in participating in this sessiory which gives it the opportunity to once again throw some more light on onchocerciasis surveillance in the former OCP countries. Dr TOE reminded participants that surveillance and research activities undertaken by the MDSC were becoming increasingly evident in the countries, and needed to be strengthened in the years to come. In conclusion, he reassured participants of the support and effective contribution of his team to the success of the meeting. The third speech was by the representative of the WHO in Burkina Faso, Dr Amidou BABA MOUSSA. In his opening address, he, on behalf of the WHO Director General and Regional Director for Africa, welcomed all participants to this important meeting. Next, he reminded participants of the special nature of this meeting, which was holding at the beginning of the last year of the 2003-2007 period. This period was set by partners involved in onchocerciasis to bring entomological and epidemiological parameters in the areas in question to levels that are compatible with the elimination of river blindness as a public health problem, which countries could handle. He congratulated participants on the positive results obtained during the five years of control, and called on all actors to remain vigilant J until the final objective is achieved. Dr BABA MOUSSA stressed that, at a yeil from the end of SIZ activities, efforts needed to be geared particularly to strengthening control activities, and defining broad outlines of onchocerciasis control and surveillance activities to be conducted after 2007. He ended by exhorting participants to make objective and constructive criticisms and discussions that could address some lingering bottlenecks, so that onchocerciasis will no longer be a public health problem. After the speeches, Dr Laurent Yameogo, Team Leader of SIZ (TL) presided the election of a three-member presidium, made up as follows: Chair: Dr Lamine DIAWARA, NOCP Coordinator, Senegal; Main rapporteur: Dr KARABOU K. Potchoziou, Coordinator of NOCP, Togo; Second rapporteur: Mme Gracia ADJINACOU, representative of NOCP coordinator, Benin. The Chief of the Vector Control Team (CVCT) was requested to assist them. The new Chairperson thanked participants (llsf in Annexe 1), for the confidence placed in him, and called on all to help in steering the meeting to a successful end. He then requested participants to introduce themselves. The agenda (in Annexe 2), proposed by the organisers, was adopted without any amendment. B. BACKGROUND INFORMATION ON SIZ General information on SIZ and the stakes were presented by Dr Laurent YAMEOGO, Team Leader. The inJormation was on: a The workshop, which was held in Ouagadougou from 1 - 2 March 2006 on onchocerciasis control on the Upper Oueme basins and the tributaries of the Oti, at which a decision was made: 1) to suspend larviciding on the Upper Oueme, and to continue treatment on the tributaries of the Oti; 2) to maintain entomological surveillance on the Oueme, and to conduct investigations to detect the source of contamination of female flies; 3) to use the saved flight hours on the Upper Oueme for aerial identification of untreated endemic villages/hamlets and specific groups;4) to train many CDDs and adopt the treatment per hamlet strategy; 5) to enhance epidemiological evaluation for the longitudinal analysis of the impact of control, and to use the ONCHOSIM model for predicting the epidemiological situation beyond 2007;6) and finally to do advocacy for integrating CDTI activities into national health systems. 4 a The workshops on the CDTI revitalization strategy in Benin (from 20 to 24 February 2006) and in Ghana (from 22 to 25 August 2006). During these