Onchocerdasts Corurot Pto·gii'ammc •n West Afri:ca Prog.ra.mme de Luuc contrc rOnchocercose en Afrique de I'Oues't OCP/EAC/92.1 ORIGINAL: ENGLISH EXPERT ADVISORY COMMITTEE Report of the thirteenth session Ouagadougou. 8- 12 June 1992 Contents List of Participants. 2 Executive Summary and Recommendations . 4 A. Opening of the session .................................................. 7 B. Adoption of the agenda ·................................................. 8 C. Follow-up of EAC.12 recommendations ..................................... 8 D. Matters arising from the twelfth session of th'e JPC ............................ 8 E. Administrative and financial briefing . 9 F. Vector control operations ............................................... 10 G. Report of the thirteenth session of the Ecological Group ....................... 13 H. Epidemiological activities and treatment . 16 I. Onchocerciasis Chemotherapy Project (OCT/Macrofil) . 20 J. Devolution ......................................................... 21 K. Research . 24 L. Other matters . • . 26 M. Date and place of EAC.14 .............................................. 26 N. Adoption of the draft report ............................................. 27 0. Closure of the session ........................ : . ........................ 27 Annex 1: Report of the thirteenth session of the Ecological Group . 28 . JPCI3.3 (OCP/EAC/92.1) Page 2 LIST OF PARTICIPANTS Members Dr Y. Aboagye-Atta, Resident Medical Officer, Department of Health and Nuclear Medicine, Ghana Atomic Energy Commission, P.O. Box 80, .I..&&.Qn., Accra, Ghana Dr A.D.M. Bryceson, Hospital for Tropical Diseases, 4 St. Pancras Way, London, NWI OPE, United Kingdom ~ Professor D. Calamari, Istituto di Entomologia Agraria, Universiui degli Studi di Milano, Via Celoria 2, 1-20133 Milano, Italy Professor J. Diallo, 51 Corniche Fleurie-La-Roseraie, 06200 Nice, France Dr A .D. Franklin, 14 Impasse de Ia Cave, 77100 Meaux, France Professor T.A. Freyvogel, Swiss Tropical Institute, Socinstrasse 57, P.O. Box CH-4002, Basle, Switzerland Dr N. G. Gratz, 4 Chemin du Ruisseau, 1291 Commugny, Vaud, Switzerland Professor D.H. Molyneux, Director, Liverpool School of Tropical Medicine, Pembroke Place, Liveroool, L3 5QA, United Kingdom (Chairman) Professor A.S. Muller, Academic Medical Centre, Department of Social Medicine, University of Amsterdam, 15 Meibergdreef, 1105 AZ Amsterdam, The Netherlands World Health Or_ianization Dr E.M. Samba, Director, Onchocerciasis Control Programme, Ouagadougou, Dr H. Agoua, Devolution Unit, Onchocerciasis Control Programme, Ouagadougou .. Dr L.K.B. Akpoboua, Vector Control Unit, Onchocerciasis Control Programme, Bamako Dr C. Back, Vector Control Unit, Onchocerciasis Control Programme, Bouake Dr D.A.T. Baldry, Chief, OCP Liaison Office, Onchocerciasis Control Programme, WHO/HQ, Geneva Dr D. Barakamfitiye, Programme Manager, Communicable Diseases Control Programme, Brazzaville Dr Y. Bissan, Vector Control Unit, Onchocerciasis Control Programme, Bamako Dr B.A. Boatin. Chief, Epidemiological Evaluation Unit, Onchocerciasis Control Programme, Ouagadougou Dr O.W. Christensen, Consultant, Onchocerciasis Control Programme, WHO/HQ, Geneva Dr Y. Dadzie, Epidemiological Evaluation Unit, Onchocerciasis Control Programme, Ouagadougou Dr C.D. Ginger, Manager, Macrofil Chemotherapy Project, Onchocerciasis Control Programme, WHO/HQ, Geneva Dr P. Guillet, Vector Control Unit, Onchocerciasis Control Programme, Bamako JPCI3.3 (OCP/EAC/92.1) Page 3 Dr J.M. Hougard, Vector Control Unit, Onchocerciasis Control Programme, Bamako Mr P. Kabore, Vector Control Unit, Onchocerciasis Control Programme, Ouagadougou v Mr G. Koulischer, Chief, Administration and Management, Onchocerciasis Control Programme, Ouagadougou Dr A. Maiga, Team leader, Inter-agency (WHO/UNICEF) Dracunculosis eradication Programme in Africa, Ouagadougou Dr D. Quillevere, Chief, Vector Control Unit, Onchocerciasis Control Programme, Ouagadougou Miss M.L. Ravelonanosy, Programme Officer, Director's Office, Onchocerciasis Control Programme, Ouagadougou Dr J.H.F. Remme, Special Programme for Research and Training in Tropical Diseases, WHO/HQ, Geneva Dr D. Sangare, Consultant, Epidemiological Evaluation Unit, Onchocerciasis Control Programme, Bamako Dr A. Seketeli, Chief, Devolution Unit, Onchocerciasis Control Programme, Ouagadougou Dr E. Soumbey-Alley, Chief, Biostatistics and Information Systems Unit, Onchocerciasis ControL_ Programme, Ouagadougou Dr A.W. Tiemtore, Intercountry Devolution Coordinator, WHO/ AFRO, Ouagadougou Mr L. Yameogo, Vector Control Unit, Onchocerciasis Control Programme, Ouagadougou Mr D.G. Zerbo, Vector Control Unit, Onchocerciasis Con7;1 Programme, Kara Mr J.B. Zongo, Devolution Unit, Onchocerciasis Control Programme, Ouagadougou Other participants Dr I. Niambele, National Oncho Coordinator, Oncho National Team, Epidemiological Division, P.O. Box 228, Bamako Dr A.R. Wurie, National Oncho Coordinator, Government Hospital, Magburaka, Sierra Leone JPCI3.3 (OCP /EAC/92.1) Page 4 EXECUTIVE SUMMARY AND RECOMMENDATIONS I. The thirteenth session of the Expert Advisory Committee (EAC) was held in Ouagadougou at the headquarters of the·Onchocerciasis Control Programme in West Africa (OCP) from 8 to 12 June 1992. Informal briefing was provided to EAC members on Saturday 6 June. 2. At the opening of the session, the Programme Director told the Committee that he was well satisfied with the progress of the Programme over the past year. The Programme was in a healthy financial situation~ there had been no significant blackfly reinvasions; insecticide resistance had been contained; large-scale ivermectin (MectizanR) distribution seemed to be having a greater impact on the disease and its transmission than at first predicted; collaboration with industry had been further developed to assist in the searches for new insecticides and a macrofilaricidal drug; and aerial operations costs had been further reduced. 3. With regard to administrative and financial matters, the Committee was informed that the third Financial Phase ( 1986-1991) had ended with an unspent balance of US $2.7 million. The budget approved by the JPC for the fourth Financial Phase (1992-1997) amounted to US $175,465,000 and had been prepared on a decreasing scale from year to year. An important consideration in the preparation of the Phase IV budget had been the change in the status of staff from WHO/OCP to -- national employment conditions. Cost-saving measures were still in force and special efforts were continuing to keep down administrative costs. Management seminars continued to be held, but with greater emphasis on holding them outside Programme headquarters. Already in 1992, two seminars had been held (in Sierra Leone and Guinea) and two more were scheduled for later in the year (in Senegal and Mali). 4. Vector control operations had continued to rely upon the rotation of six operational larvicides. There had been significant reductions in the use of Bacillus tlzuringiensis serovar. H-14 (B.t. H-14) and temephos, which had resulted in overall reductions in insecticide consumption and aircraft flight hours, with corresponding cost savings. Throughout the Programme area excellent entomological results had been obtained and parasite transmission had either been completely interrupted or maintained at very low levels. Larviciding had been discontinued in about 80% of the Original Programme area and the results of post-control entomological studies in this area had generally been good. 5. In the extension zones, the entomological situation was equally satisfactory. Even in areas where there was no larviciding, infection rates in the fly populations were low and it seemed possible that this was due to a complementary effect of large-scale ivermectin distribution. The Committee discussed the situation in the area of southern Sierra Leone occupied by Simulium soubrense B and endorsed the decision not to consider further larviciding in that area. For other parts of the Extension areas, the Committee reconfirmed its earlier recommendation that vector control operations be conducted continuously for a period of 14 years, unless unambiguous data to the contrary became available, or. unless a macrofilaricide became available for large-scale distribution. 6. The Committee reviewed the report of the thirteenth session of the Ecological Group and expressed its appreciation for the valuable advice provided to the hydrobiologists of the Programme and of the Participating Countries. Once again, the Committee noted that the Ecological Group was satisfied that vector control operations were not having any significant impact on the aquatic enyironment. The Ecological Group's recommendations for aquatic monitoring and applied research were endorse~ by the Committee. 7. The Committee was informed that the Committee of Sponsoring Agencies (CSA) had sought the advice of the Ecological Group on the development of a work plan for studying broad environmental issues in the context of environmentally sustainable land settlement. The Ecological Group had responded to the CSA by preparing a proposal for monitoring physical changes in the environment and the most likely impacts of agro-chemicals. Although this matter was not strictly within the mandate of the EAC, the Committee endorsed the Ecological Group's proposal for pilot JPC13.3 (OCP/EAC/92.1) Page 5 studies, recommending that the CSA establish an Environmental Working Group to draft a plan of action, and, that external sources of funding be