' ' ' . . . . . , . r JAF'-F'AC

JOINT ACTION FORUM Office of the Chairman

JAF'-F'AC

FORUM D'ACTION COMMUNE

Bureau du Prdsident

i

?'

JOINT ACTION FORUM Fifth session

Hague.8- I 0 December 1999

JAF5.6

ORIGINAL: ENGLISH September 1999

Provisional agenda item 9

- kr Bidndo^FoPd

r

CONSIDERATION OF'

NATIONAL

ONCHOCERCIASIS CONTROL PLANS AND PROJECTS PRPOPOSALS (CDTI, VECTOR

ELIMINATION

AND HEADQUATERS SUPPORT) APPROVED

BY

THE CSA

IN

1999

Projects submitted by the NOTFs of:

.

_Carneroon

,

_{Central African Republic}

.

_Chad

.

Equatorial Gurnea

.

_l-iberia

.

_Malawi

.

_Nigeria

'

^Sudan

'

^Tanzania

'

^Uganda

ftd.

Table

of Contents

Introduction

Community Directed Treatment with Ivermectin projects proposals Cameroon

Pages

I ²

3

3

J 3

4 6 6 7 8

8

9

A

2.

?

J

2.1

2.2 2.3 Liberia

3.1

3.2 Nigeria 4.1

General Rapid Epidemiological Mapping of Cameroon Community Dirrected Treatment with Ivermectin Areas South West

II

CDTI Project

General Rapid Epidemiological Mapping of onchocerciasis (REMO) of Liberia Lofa, Bong, Nimba and Montserrado CDTI Projects

General Rapid Epidemiological Mapping of onchocerciasis of Nigeria Benue State CDTI Project

Kebbi State CDTI Project Kwara State CDTI Poject Bauchi State CDTI Project

Ekiti

State CDTI Project . . .

Gombe State CDTI Project Niger State CDTI Project Ondo State CDTI Project ^{. . . .}

4.

4.2 4.3 4.4 4.5 4.6 4.7

.

^1l

,

13

15

T7

19

2t

23

24 24 4.8

4.9

5.

^Tanzania

5.1

General Rapid Epidemiological Mapping of onchocerciasis of Tanzania

Tukuyu Focus CDTI Project

5.3 27

6.

Malawi ²⁸

28 29

31

6.1

General Rapid Epidemiological Mapping of onchocerciasis (REMO) of Malawi

6.2

Malawi CDTI Project (Extensions)

B REVIEW OF PROGRESS REPORTS (TECHMCAL AND FINANCIAL) AND BUDGETS FOR SUBSEQUENT YEARS FTINDING

t

Y

JAF 5.6 Page I

Table

1:

^SUMMARY

oF

APPROVED PROJECTS As

AT

SEPTEMBER 1999

Drtc of rpprovel

NGDO Partncr

Pcnons to bc trcaacd Approvcd Ycer I US S

Cort/Pcn

Country Project Ycrr I Ycer 5 USS

Malewi

Ugende Kascse Hornra Masindi Fmal vcct eli. rn ltwam focus Mpamba-Nkusr Focus

Kabale, Mbale, Kabarcle & Bushcny Rukungrn, Nebbi, Aru, Mbanm Adjumani, Moyo. Apac, Guhl Kibalc NOTF HQ

Kaduna Tamba Cross Rivcr

Kogi Adanrawa Bomo Fedeml Capital Plateau Nigcrir

Enugq Ananrbrr, & Ebony

Imo & Abia

& D€Itr

Kebbi Kwara Bauchi Ekrtl Gombe Niger Ondo NOTF HQ Southcn sector Sudan

sector HQ Malrenge Focu

focu, Vector clinrinatron

focu CDTI project HQ

Banyo & Tignerc Province Wcst I Lrttonl Il

Centrc 3 South West [l

Chad CDTI CAR CDTI

Equatorial Gurnca CDTI Broko Island, vcctor elrnriuation Ched

CAR Eq. Guinee

D.R. Congo HQ

Kasais Gebon

Liberia

Gabon CDTI Nrmba

Dec-96 Dec-96 Dec-96 Scp-97 Apr-98 Aug-98 Ap197 Apr-97 Apt-97 Apr-97 Apr-97 Scp-97 Sep-97 Sep-97

Apr-98 Apr-98 Aug-98 Aug-98 Aug-98 Mar-99 Mar-99 Mar-99 Jul-99

Apr-97

Sep-97 Apr-98 Jul-99 Jul-99 Sep-97 Sep-97 S€p-97 Sep-97 Sep-97 Scp-97 Jul-99 Scp-97 Sep-97 Apr-98 Apr-98 Aug-98 Aug-98 Aug-98

IEF GRBP

GRBP, GTZ RBP, CBM

GRBP

SSI CBM UNICEF SSI HKI HKI CBM GRBP UNICEF

RBP

SSI SSI UNICEF UNICEF LTNICEF UNICEF UNICEF

HNI

IEF GRBP SSI BASED HKI SSI OPC, Africare CBM

U Barcclona

CBM CBM

SSI

l0l ⁰⁶⁶

139 473

296 008 371 188 565 891

327 789 518 0o0 300 000 406 890 72t 202 735 545 20t 562 679 lll

226 160

I 718 283 230 000 946 22t 189 000

tlz 984 10@000 474 480 39 696

4lt 220 89 987 3& 057 583 978 359 6t4 3r9750 356 942 357 700

406 890 100 000

267 N4

326%41 75 000 10 s44

92 555 172 000 305 000 139 081 37 @3 150 224 731 272 75t 920 33 000

253 000

I 08 000

947 999

I 53 210

344 824 431 2t7 632 785

665 442 822 000 654 870 I 081 590 8l r 720 827 862 280704 770 300 623 326 I 921 207 400 000

I 063 067 315 000

I 28 000

I 134 777

I 124 554

I 35 480 I 7M O38 IOI 600 665 000

I5647(n

1

969 740)

1

727 sszl 638 460l

t ⁴²⁷ 7341I

560 000 540 000

295 873

373 716

I 50 000 32 390

27t 792 t720oo 408 379 334 330 274 238 336 227 889 250 I 000 000 85 000

3 043 667

I 68 500

198 163 28

555 I 106 291 120 @7

l5l 833 t29 774 t60 125 200 400 243 522 226 736

l6l 2t4 226 213

243

297 075 292 388 t'14 258 160 89 305 150 72 245 t08 t03 223 195 175 327 237 t57 376 262 195

t4t ll3

20t 192

6t

545 923 655 152 885 120 555 495 506 740 206 830 332

653

79 818 152 612 138 815 219 360 238 767 t05 4t0 258 129 347 t84 492 032 177 lw

72 289 190 414 82 130 t24 72t 108 182 185 830

I.l

0.41 0.4r 0.23

0.61 0.47 o.76 0.40 0.30 0.31

0.

0.85

0.31

t.2t 028 0.38 0.54 0.55 o.92 0.66

0.93 2.&

0.

2.61

t.28 0.7E 0.

2.3t o.67 o.24 2.t9

0.49

l 00

TOTAL I 2 countnes / 57 ProJecB l7 t23 314 32 046 120 to 967 521 0.64

I

Tenzenie

Cameroon

* iI

S.da ftrc{ia

Fig.

1:

Projects implementation ^areas

t

* CDT|Pojed

^ ^{V€dr Ermndon ftopd} I Fo S.pport

1.

INTRODUCTION

In

1996, 1997 and 1998, the Committee of Sponsoring Agencies (CSA) approved 45 projects proposals recommended

by

the Technical Consultative Committee (TCC). These ^Projects proposals were ratified by the Joint Action Forum (JAF) at its second session

in

December 1996

(4

projects),

third

session

in

December 1997

(25

projects) and

fourth

session in December 1998 (16 projects).

For

1999, the CSA, on the behalf

of

the JAF, has approved 12 new projects proposals recommended by ^the TCC at its various sessions.

Table 1 on the first ^page of ^the current document shows the total number of pro.lects proposals (57) approved by ^the CSA as of today.

The 12 Projects proposals approved by the CSA

in

1999 are herewith presented to ^the

joint

Action Forum (JAF) for ratification.

Furthermore, after a technical and financial review

of

the first and second year progress

of

twenty nine (29) APOC-funded Projects, the CSA upon recommendation of the TCC during its 7tr' and 8'r' sesstons, has approved in April and July ^1999, the second and third year funding of these projects. This approval is also submitted herewith to the JAF for ratification.

Table 29 on page 33 summarizes the total budget approved by the CSA in 1999 and submitted to the current ^session of JAF for ratification.

JAF 5.6 Page 3

A.

COMMUMTY-DIRECTED

_TREATMENT

WITII IVERMECTIN

_PROJECTS PROPOSALS

2.

CAMEROON

2.1. General Rapid Epidemiological Mapping

of

onchocerciasis

(REMO) of

Cameroon (see Fig.2. below)

Fig.2:

REMO results of Cameroon

REMO results,

Nodules (%)

o0 o l-9

o l0- 19

o 20-39

o 40-l0O

ffi ^{National parks}

I--tKM

0 100 200

)', community-Directed rreatment with rvermectin (CDTD areas

in Cameroon

Fig.3:

CDTI areas in Cameroon

CDTIareas & Districts covered by approved

Legend

Possiblc CDIT arce

J DcfmitccDTtarcr

I Nadonztparks

COn Prcjects areas m ^{Disricb @vcrcd}

r--'tKM

0 ^{100 200}

2.3.

South West

II

CDTI Project

In September ^1997, APOC approved support

for

^{large scale} ivermectin distribution in one part

of

the South west Province which is referred to as South West

I

CDTI

project.

The South West

II

Project Proposal is a consolidation of the on-going South West CDTI Project.

2.3.1.

Backeround information

T able 2: General information

The total population of the Province is estimated at 1,115,370 (1999) , 710,050 people live in the area

of

the South West

I

^approved project and 405,320

in

the South West

II

area. The Project Proposal intends to cover 5 health districts while South West I project covers 8 health districts. The South West

II

^{project proposals seeks} to cover 435 communities with 346,227 people to be trbated by the fifth year. Fig. 4 indicates the detailed REMO results for the South West Province.

Fig.4:

Detailed REMO results of South West Province, Cameroon

Administrative unit ^Total 17 Health districts

Target 5 Health districts

Population of the Province Total ⁽¹⁹⁹⁹⁾

I,l

15,370

Target SWII ⁽²⁰⁰⁴⁾ 346,227

Communities Total 2

ear 435

Health facilities (centers/clinics) in the province Dry season

Persons treated in the 5 past years

Partrer SSI

REMO results of South West

Legend

Possible CDIT

! ^{oerntte cort} f, Nationalnarts

Nodules (%)

o0 o ^l-9 o ^10-19 o ^20-39 -s 40-tO0

Cr:

hotmakak ? '.a;

v

Icl t:

tl

i.l fr

ti

t,'

bafia q'o:

akwava ':'. .

mDeeJwr tubaI

massaqgam

nllithga

:cl

bokito x?.:

s

r.i'l:

^l,;

,.3*

hatibo

ndom ngambe

a. ndiklnimeki

!l _t;

.,,.-

yingui

,.rr.!;

"

r9P'1P-a4 _r:::

' _mat#t'dten r: 3t ^!_.

?!

t:

/

t,'

muhdemba

r. !:

'j,7 ^.

JAF 5.6 Page 5

2.3.2.

Budget summary

Table 3 below summarizes the five year budget as submitted

by

the NOTF/Cameroon and Fig. 5 shows the trend of the cost per person to be treated between 2000 and 2004.

Table

3: Five year

summary budget

of

South West

II CDTI

^project as presented by the NOTF/Cameroon

Fig.5: Trend ofcost per person to be treated (2000-2004)

US$

4.00

3.50

3.00

2.50

2.00

'1.50

'1.00

0.50

0.00

2000 2001 2002 ₂₀₀₃ 2004

150 224 278 764 316 443 325 835 336 227

566 004 184 730

1 85 526 185 724 192 091

3.77 0.66 0.59 0.57 0.57

347 184 104 109 60 360 45 182 45 170

2.31 0.37 0.19 o.14 0.13

336 227 1 314 075 3.91 602 oo5l 1.79

i()ItS-fl()r rr

3. LIBERL\

3.1. General Rapid Epidemiological Mapping

of

Onchocerciasis (REMO)

of

Liberia ^(see Fig. 7 Belorv)

Fig.6:

detailed REMO results of Liberia

Resutts of Rapid Epideniological Mapping of Onchocerciasis, Liberia

Leged

f--l N"tirrl Bor,rdo.i"t t-_J

Effi Lakes

w - ^Rirers

lw6f4 O0 o ^l-9 O ^lGl9 o*9 O ^4G100

r---l

KM

0 50 100

o o oo

o

')io

Ftg.1:

CDTI areas in Liberia

CD'II areas & propGed project areas

t ^ge.d D NatirnlBdrdaries

W ^tkes I oerurccunuo lljiii ^cDnkety f ^ttoConrcc

I:---l 0 50 100

JAF 5.6 Page 7

3.2.

Lofa, Bong,

Nimba

and Montserrado CDTI Project

The National Plan and the first CDTI project proposal submitted to TCC for consideration

show the effort of the

parhrers

(MOH and Sight

Savers International)

to

control onchocerciasis known as a public health problem in the country since the early nineteenths (Strong,1 936).

The National Plan

of

Liberia

is

the result

of

a comprehensive contribution

of

the NOTF parfirers which are the Ministry of Health, Sight Savers lnternational, CHAL, UMCEF and the WHO/Liberia.

3.2.1.

Background information

Table

4:

^General information

The

project proposal

will be

implemented

in four

counties

with a total

population

of

2,083,435.362 communities out 416

will

be covered

by

the project.

Fig.7

indicates the detailed REMO results of Liberia and shows the areas to be covered by the proposed project.

3.2.2.

Summarybudget

Table 5 summarizes the five year budget as submitted by the NOTF/Liberia and Fig. 8 shows the trend of the contribution of the partners.

Table

5:

Five year summary budget of Lofa, Bong, Nimba and Montserrado CDTI project as presented by the NOTF/Liberia

Administrative unit Total 4 counties

Target 4 counties

Population of the four counties 2,083,435

Target

Communities Total 416

Target 362

Health facilities ⁽centers/clinics) in the province Dry season

Persons treated in the past 5 years

Partner _SSI

57 32 28 20 20

43 68 72 80 80

185 830 s8 410 52 856 40 047 40 277

83 750 68 480 74 948 94 763 100 089

54 470 57 334 60

25t

62 60r 65 186

t38 220

tzs 8t4

r35 199

ls7

364 165 275

324 050 184 224 188 Oss 197 41r 205 552 34 66 377 420 422 030 299 842 721 872

I

^{099 292}

Total (1999)

reee

2000 ll ll

2001 2002 llll

2oo3

ll

eo

60

70

m

.9 50

3lo

30

20

10

o

1W 2m 2m't 2002 2003

4.

NIGERIA

4.1.

General Rapid Epidemiological Mapping

of

Onchocerciasis (REMO)

of

Nigeria ^(see

Fig.9

and ¹⁰ below)

Fig.9:

REMO results of Nigeria

l{#s(7l

0 G9

lG19 2L39 ,{G100

KM

0 ^{100 200}

Fig.S:

^Trend ofcost ^per person to be treated (1999-2003)

I

JAF 5.6 Page 9

Fig.10: CDTI areas in Nigeria

4.2.

Benue State CDTI project

The current proposal is the third submission to APOC for funding.

4.2.1.

Backsroundinformation

Table 6: General information

Administrative unit Total 23 LGAs

Target 14 LGAs

Population of State Total (1998) 4,000,000 Target (2003 2,101,250

Communities Total 3942

Target ₃₀₀₀

Health facilities (centers/clinics) in the State

Total 361

Coverage (%o',₎ 0.01

Dry season From November

To February

Persons treated in the past 5 years 750,018

Partner LINICEF

The Project proposal is a consoltdation of on-going onchocerciasis control activities as well as the introduction of APOC sh-ategy on Community-directed treatment with ivermectin (CDTI)

in

14 of the 23 Local Government Areas (LGAs) of Benue State. Mass treatment assisted by LTNICEF has been taking place since 1991.

In

this Project proposal, mass treatments with ivermectin

will be

provided

to a

total population

of

2,101,250 (53%

of the

State total population) by the

fifth

^year of APOC funding.

Fig.l1

shows the detailed REMO results for the State concerned.

CDTI Projects areas, Nigeria

COTI ProJecG LGAs Covered

Layers

! ^{ocfinitc con} ae iiY ^PmiblcCDTI

:/::.: Additional dda n@dcd

I

^uocorr

r---]

0 100 200

rgr

Fig ^I

i:

detailed REMO results of Benue State

4.2.2.

Summary budget

Table 7 below summarizes the five ^year budget as submitted by the NOTFA{igeria and Fig.12 indicates the trend ofthe ^{cost per person to be treated} from i999 to ^2003.

Table 7: Five year ^summary budget of Benue CDTI project as presented by the NOTFA{igeria

Layers I ocfinirccolrarca

ii.i cnrr rircty - ro refinc

Z ^{CDTI utlik ly (@ tc(N)}

1.i..1:. No uuo ^ycr

tate

^\

o o

o

t%t

r---l o2040

Ben

o0 o l-9 G lGl9 o 2G39

. 4G100 KM

0.60 0.13 0.06 0.03 0.02 426, 590

330,079

311 ,246 258, 623 262,894

1.04]

0.28 0.16 0.13 0.13

245,120 152,420 114,120 53,220 44,710 411,220

1,162,500 2, 000, 000 2,050, 000 2, 101,250

0.76 609, 590 0.29

2,101,250 1,599,432

I

o

'ra

t:

riil l:

t;

ll

L:

l:i)t:

?:

tl

L:

l:' ' i)

i) il r:

!:

ll _lu ,:

s

JAF 5.6 Page I I

Fig.12:

Trend of cost per person to be treated from 1999 to 2003

1.20

1.00

0.80

0.60

0.40

0.20

0.00

1999 2000 2001 2002 2003

4.3.

Kebbi State CDTI Project

This proposal is the first submission to APOC for funding.

4.3.1.

Background information Table

8:

^General information

Administrative unit Total 2l

Target 6

Population of the State Total ?

Target (2003) _101,600

Communities Total

Target 139

Health facilities (centers/clinics) in the State

Total ?

Coverage (%) ?

Dry season From November

To _June

Persons treated in 4 220,812

Partner SSI

Kebbi State, created out of Sokoto State, is divided into

2l

Local Govemment areas (LGAs) out of which the Project proposai intends to cover 6 LGAs with target population

of

^101,600

persons by the

fifth

year: 45,920 persons from 66 hyper-endemic communities and 55,680 from meso-endemic communities.

The project is a reorientation to CDTI of ^an existing vertical programme operating since 1995 as a partnership between the Ministry of Health (MOH) ^and Sight Savers International ^(SSI).

During the past four ^years, a cumulative total of ^220,812 people were treated.

Fig.

13:

^{Detailed REMO results of Kebbi State}

4.3.2.

Summary budget

Table 9 below summarizes the five year budget as submitted by the NOTFA{igeria and Fig.14 shows the trend of the cost per persons to be treated between 1999 and 2003.

Table 9:

Five

year budget

of Kebbi CDTI

^project

^as

^presented

by

^the

NOTFAIigeria

n

u I'-lKM

CDTI unlikcly (to rcfinc)

0 2040

Source: IIOTF Noeria,

Legend

!

o.n"ir"cott."*

m ^{cDTt likcly (o refin )}

m* ^NoREMoy.t

ffi ^Nocorr

149,566 77, 427 63, 397 43,227 25,254

1.66 0.83 0.66 0,44 0.25

108, 5551

32,400 23, 015 8,675 2,400

1.21 0.35 0.24 0.09 o.o2 89, 987

93, 263 96, 370 98, 1 50 101,600

3.53 175,04511 1.72

101,600 358, 871

.lAIr 5.(r

Parc l 3

[]rg. l4: 'l'rcnd 01-cost per person to be lreated flonr 1999 to 2003

160

1 20

100

0 80

060

0.40

020

000 I

1999 2000 2001 2002 2003

4.4.

^Ku'ara State

CDTI

Project

-1..1.1. Ilackgror-rr-rd information

'l'ablc

l0:

Gencral infbrmation

I ..\drrrinrstrative Lrnit Total l6 i-(lAs

'l'alget

I 6 LGAs 1'otal('/) r,968,0i9 Target (2003) 66_5,000

(-onlrtunitics lotal ^')

Target 1 140

Health lacilities (centers/clinics) _in the State

Total 49

Coverage (%) ^/ _{\ I} ¹⁰/O

Dry seasor-r From December

l-o March

Pcrsons tleated rn the 5 past years s

tt

^)rR

l)a r.tncr-

Iroprr latior.r o1- the State

qqr

lhc

l)r.tt1cct pr.rtltosal is a t.corientation o1' an eristrnu prograllnte, assisted

by

Sight Savers Intcrnationril

(SSl).

_thal has trcaled a cumulatrve total of ,5 13,238 peoltlc

in I6

LCiAs from

I ()()l ttt I t)t) ^.

I ire l)l.o.1cct u

rll

stat't u rlh S l.CjAs t() covcr

l(r L(r.\s

by year

2

and rvrli _targct

lbr

ntass

irclltlttcltt oi-6(ri.(X)0 itcolrlc ^rn h1,'per cr.rder.urc (350.000 peoplc) and rreso-cltden-ric (115,000 ]lcrtlric) con'tntut.trtics b1, 1i,. f

ilih

_1,ear. Frg.

l5

sltous thc dctailed REMO results tbr Kwara

\l;rlt'

TOTAL

160 .

140 i

-o.o2

Fig.15:

^{detailed REMO results of Kwara State}

-1.4.2. Summarf br-rdget

Table

11

belos' summarizes the five ycar br-rdget as submitted

by

the NOTFA{igeria ^and Fig.16 shows the trend of the cost per persorl to be treated between 1999 and 2003.

Table ¹ 1:

Five

year budget

of

Kwara

CDTI

project as ^presented

by

^the

NOTF/Nigerra

wara State

Ilerno updatc Date, N'Iarch I999

{'

0 t-9 t0-19 20-39 40- I 00

Nodule ^(%) o

o o o

C

c

o ^{!..1, i}

Layers

! NczoNrz,a.r" ot

f!i NczoNsz,co:itir.t' //7 NczoNgTtorcnac

:::;t NczoNgT:No ;.EMo

:r:tli Z

o

"*.t/r; c

Person ,o,,0",,, S

Treated (A),,

otal cost US _$

:,(B)

^'

.tT CosUtreat

'(e)=$/tr- 364, 0s7

640, 196 665, 000 665, 000 66s, 000

148,926 130,484 93, 505 77 ,223 75, 065

0.41 0.20 0.14 0.12 0.11

103, 4esll 6e, e1 1ll

35, B2ell

1 B, 01 BII

13 e26ll

0.28 0.11 0.05 0.03 0.02

665, 000 525,202 0.79 241, 17811 0.36

YEAR..

GoiUper,A-POG : US$:(E)='D/A

2 3 4 5 TOTALS

.tAr-'5.6 Page I 5

I'rg.l6:

-l-rcnclo1'tlte

cost llcr ^pL.rsol-I to be treated from ¹⁹⁹⁹ to 2003

045

0.40

0.35

0.30

0.25

0.20

0.'t5

0.10

0.0 5

0.00

TOT,

f

19S9 2000 2001 2002 2003

4.5 Bauchi State CDTI Project

4.5.1.

Background rntbmration

'fable

l2:

^General informatron

'lhe

_{State. located}

in

the North-lrast

ol

^Ni-ueria, compnses

20

Local Government Areas

(l.GAs) u'ith a total esttmatcd population of 2.826,454. The Prolect seeks to establish CDTI rn 950 conrnrunities

ol I3 I-(iAs

ancl arnrs 1tl treat 1,564,700 people {55

% of

the State

popr-rlatiorl)b1'the 1ilih year.'l'hc I)ro-lcct proposal is a reorientation of an existtng programme initiatcd

rn l99l

u,ith thc su1'rport o1'

tlNICIrir.

Fror-r.r 1994

to

1998. a cumulative total

ol

49(r.

l5l

peoltie rvere trcated. Iirg.

l7

indicates the detailed Provisional results

lbr

the State.

-l'he

validatrotr o1'the addrtronal

t{EMo

clata provided _{and the} definition of CDTI areas are

going on.

Admir.ristrative unit Total ₂₀ LGAs

Target i3 LGAs

Population Total (199i) 2,826,454

Target (year 5) 1,564,100

Cor-m-nunities Total ^,I

Target (year 5) 950 Llealth facilities ^(c nrcs) in the roVlnce

Dr y season November-April

Persons treated in the -5 past _),ears 496,151

Paltner _LTNICEF

0.41

I

Fig.

17:

Preliminary REMO results of Bauchi State

I

4.5.2

Summary budget

Table 13 below summarizes the five ^year budget as submitted by the NOTFA{igeria and Fig.

18 shows the trend of the cost per ^person to be treated between 2000 and 2004.

Table

13:

Five year summary budget of Bauchi CDTI project as presented by the NOTFA{igeria

i & Gombe REMO data added to the

{%)

o0 o l-9

o ^10-19 6 20-39

e ^40-lO0

223,506 169,291 120,876

65, 750 29,250

0.381

019

0.'11 0.05 o.o2 583, 97Bl

868, 200 't, _{100, 358}

1, 424,253 1,564,700

386, 123 336, 384 324,796 229,918 199, 163

0.66 0.39 0.30 0.16 0.13

1, 564, 700 1,476,384 0.94 608, 673 0.39

:i:

Year

PersonSlrttiiti,$,

Treaffiil{d):!.

.iT.dti$usr.$

.':---il:i(B)

l'

q$$u;F,,,e

(Gl,!B7a;

2 3 4 5

rOTAL

JAF 5.6 Page 17

Fig.18:

Trend of ^the cost per person to be treated from 2000 to 2004

US$

0.70

0.60

0.50

0.40

0.30

0.20

0.10

0.00

2000 2001 2002 2003 200/.

4.6.

Ekiti

CDTI Project

4.6.1.

Background information

Table

14:

General information

Ekiti

State was created from Ondo State

in

1996. The Project proposal is a consolidation

of

on-going onchocerciasis control activities as

well

as the introduction

of

APOC strategy

of

Communify-directed treatment with ivermectin (CDTI)

in

16 Local Government

Areas.

In this Project proposal, mass treatment wrth ivermectin

will

be provided to a total population

of

969,7 40 by the fifth year of APOC funding. Fig. 19 above shows the detailed REMO results for Ekiti ^ar-rd Ondo States.

Administrative unit Total 16 LGAs

16 LGAs

Population Total (1999 I,538,895

Target (year 5) 969,740

Communities Total ₁₄₈₂

Target (year 5 889

Health districts ₁₉₅

Dry season November-March

Persons treated in the 5 past years

Partner TINICEF

I

Target

rg.

l9:

^detarled REMO results for Ekiti and Ondo States.

Ondo & Ekiti States,

REMO

results

I I

d

o.

%t o0

o ^l-9 o ^10-19 o ^20-19 c ^40-100

Layers

I Definire CDTI de6

Possible CDTI

....:.... Additionaldata

ffi

^Nocorr

b

40 Kill 20 0

:6.2.

Summary budget

Table ¹⁵ beiou...rrnmarizes the flve year budget as submrtted by the NOTF,/IJigeria and Fig 20 indicates the ,:end olthe cost per person to be treated from 1999 to 2003 in Ekrti State.

Table 1: Five year summary budget of Ekiti CDTI project as presented by the NOTF/Nigeria

Year

Persons to be treated (A)

Total Cost US $ (B)

CosUTreat.

(G)=B/R

cost

us

$ (D)

CosUPers. APOC US $ (E)=D/(A)

,|

2 3 4 5

359,6'14 566,013 923,012 946 086 969. 740

302, 530 248,421 219,228 166,794

21 1, 930

0.84 0.44 0.24 0.18 0.22

195,740 141, 460

1 12, 960 60, 200 44,100

0.54 0.25 0.12 0.06 0.05

TOTAL 969, 740 1,148,903 ¹ .18 554, 460 0.57

I

t

i]O5t;"6 O

!,*ritlr- ^,

'6. ^o

uil t;

t'

\

ti

lo: 'a

u

,.,,, rti

JAF 5.6 Page 19

Fig.20:

^Trend of the cost per person to be treated from 1999 to 2003

USS 0.90

0.80

0.70

0.60

0.50

0.40

0.30

o.20

0.10

0.00

1 999 2000 2001 2002 2003

4.7. Gombe State CDTI Project

4.7.1.

Background information

Table

16:

General information

Gombe State was carved out of Bauchi State in October 1996. It has 11 LGAs with a total estimated population of 1;252,826. The Project proposal is a reorrentation of an existing programme, assisted by UNICEF that has treated a cumulative total of 552,843 from 1994 to 1998.

ilie

^pioject will cover l0 LGAs and will target for mass treatment 127,552 people in hyper endemic (462,236 people) and meso endemic (265,316 persons) communities by the fifth year. Fig. 17 shows the Aeiaitea provisional REMO results for Gombe and Bauchi State.

Administrative unit Total 1l LGAs

Target 10 LGAs

Population Total _1,252,926

Target (year ₅₎ 727,552

Communities Total (10 LGAs) 295

Target (year 5) 295 Health facilities Icenters/clinics) in the provinCe

Dry season

Persons treated in the 5 past years 552,843

Partner T]NICEF

-1.7.2. Summary budget

Table 17 belou, summarizes the five year budget as submitted by the NOTF,Nigeria and Fig 21 shows the trend of the cost per person to be treated from 2000 to2004.

Table

17: Five ^year

surnmary budget

of

Gombe State

CDTI prqect

as presented by the NoTFAlligeria

Ftg.2l.:

^{Trend of the cost per person to be treated from 2000 to 2004}

US$

100

0.90

0.80

0.70

0.60

0.50

0.40

0.30

o.20

0.10

0.00

2000

YEAR

^I

2 3 4 5

319,750 443, 360 685, 787 706, 361

727,552

Total Cost US _$ (B)

294,376 233, 960 198,257 156, 191

149,395

0.92 0.53 0.29 o.22 0.21

175,2 0

0 0 0 0 129,

88, 46, 34,98

TOTALS 727, 552 1, Q32,179 1.42 473,80711 0.65

NGDO& MOH

200 1 2042 2003 2004

CosUTreat.

(c)=B/e

JAF 5.6 Page 21

4.8.

Niger State CDTI Project

The current proposal is the fourth submission to APOC for funding

4.8.1.

Background information

Table

18:

^General information

The Project proposal is a consolidation of on going control programme which began

in

1990

with the support of AFRICARE and treated a cumulative total

of

833,506 people from 1994

to

^1998" In this Project proposal, mass treatment with ivermectin

will

be provided to a total population

of

638,460 by the fifth year of APOC funding. Fig.22 shows the detailed REMO results for the'State concemed.

Fig.22:

detailed REMO provisional results of Niger State

o Bagudo o

@

Benin

Niger

K\i

o o

oo o o Krchia

o

Moro o

o o-fiu

CO,,

o. _o

oo o o

I I

l

Orire

o I rtyxlun Toto

OO

50 100

Administrative unit Total ₂₅ LGAs

Target 13 LGAs

Population Total ⁽1998) 3,169,477

Target (year _{5) 638460}

Communities Total

930 Health districts

Dry season N

Persons treated in the 5 past years 833,506

Partner _LTNICEF

Target (year ₅₎

!

^neeions

*

f. I tobercfircd

f ^nocdti

Orelope o

o

I fedapo

-{.8.2.

Summary Budget

Table 19 belor.r' summarizes the five year budget as submitted by the NOTFAtrigeria and Fig.

23 indicates tl-re rend of the cost per person to be treated from 1999 to 2003 in Niger State.

Table

19:

Five year summary budget of Niger ^State CDTI Project as presented by the NOTF/Nigeria

Iirg.23:

^{Trend of} the cost per person to be treated from 1999 to 2003

US$

160

140

120

100

080

060

040

020

Year

Persons to be

Total Cost US _$ (B)

APOC cost US $ llGosUpers APOC

(D) _ll ^u.

^{$ (E)=D/A}

il 1

2 3 4 5

356,942 490, 548 596, 3'16

617,026 638, 460

476,197 319,379 309, 152

206,246 155,227

1.33 0.65 0.52 0.33 0.24

327, 830 192,030 177,230

90, 330 53, 040

0.92 0.39 0.30 0.15 0.08

TOTAL 638,460 1, 466,201 ^2.30 84o,460ll 1.32

1 999 2000 2001 2002 2003

i; ia:::

APOC ::,r:::

C6stflreat.

{G)=B/e

iAF 5.6 Page 23

4.9.

Ondo State

CDTI

Project

The proposal is the second submission to APOC for funding.

4.9.1.

Background information

Table

20;

^General information

Ondo State is in the South West of the country and is divided

in

¹⁸ LGAs with an estimated population of 2,843,517. The Project seeks to treat 1,427,734 people in2126 communities by the

fifith

year. The Project proposal is a reorientation of an existing prograrnme assisted by UNICEF. From 1994

to

1998, a cumulative total

of

1,01,7,751 people were treated. Fig.19 shows the detailed REMO map of Ondo and Ekiti States.

4.9.2.

Summarv budset

Table 21 below summarizes the five year budget as submitted by the NOTFA{igeria and Fig.

24 indicates the trend of the cost per person to be treated from 1999 to 2003.

Table

21:

Five year summary budget of Ondo State CDTI Project as presented by the NOTFA{igeria

Administrative unit Total l8 LGAs

Target

Population Total ⁽¹⁹⁹⁹⁾ 2,843,517

Target (year ₅₎ 1,427,734

Communities Total 2630

Target (year 5) 2126

Health districts 194

Dry season November-March

Persons treated in the past 5 years l,ol7,"l5l

Partner TINICEF

2 3 4 5

357, 700 798, 700 1, 358, 938

'1, 392, 911

1 , 427 ,734

396, 557 234,834 248, 565 194,208 178,584

1 .11 0.29 0.'tB 0.14 0.13

237,332 134,050 137,568 78,204 49,614

0.66 0.'17 0.10 0.06 0.03

TOTALS 1, 427,734 1,252,746 0.88 636,76811 0.45

l:tg.24:

'frend of ^{the oost per person} to be treated from 1999 to 2003

US$

2000 2001 2(N2 2003

5.

TANZ.A,.\IA

5.1.1. General Rapid

Epidemiological

Mapping of

Onchocerciasis (REMO) of Tanzania (see Fig.25

&

²⁶ Below)

Fig.25: REMO results of Tanzania

TANZANIA

Rapid Epidemiologicrl Mapping of Onchocerciasis

Legend

T-l ., , -... o ^,"

L-J o tr.t,

'"*\'A'

-

120

100

080

060

040

0.20

000

1 999

JAF 5,6 Page 25

Fip.26: CDTI area in Tanzania

5.2.

The Project proposal is a reorientation

of

an existing programme initiated 1995 and which treated 6622 people from 1995 to March 1999. The project seeks to cover 149,999 people by

the fifth year of APOC

funding. Fig.25

& 26

show

the

provisional results

of

Rapid Eprdemiologrcal Assessment (REA) in country.

TANZANIA

Regions covered by CDTI Project

COTI Prohd

Sl Reuions covered

r$n,

Legend

r-*"*--

$k$ -*-"-

lirnis ofdistrics are no( available in our Svstm

I-

'.'gJ

Administrative unit Total 4 districts

Target 4 districts

Population Total (1998) _1,200,000

Target (year 5) 149,999

Total ₁₄₀

Target (year 5) 59 53 June-August

1n 5 6622

HKI Tanga CDTI Project

5.2.1.

Background information

Table22:

General information

Communities Health facilities Dry season Partner

5.2.2.

Summary budget

Table 23 belou summarizes the five year budget as submitted

by

the NOTF/Tanzania and Fig.27 shows the trend of the cost per person to be treated.

Ftg.27:

^{Trend of} the cost per person to be treated

US$

4.00

3.50

3.00

2.&

2.00

'1.50

1.00

0.50

0.00

Year'1 Yeat 2 Year 3 Year 4 Year 5

YEAR

Person to Total Cost US $ (B)

1

2 3 4 5

75, 000 109,321 150,000 150,000

1 50, 000

279,173 134,413 129,117 127,369 '141,633

3.72 1.23 0.86 0.85 0.94

192,036 70,972 61, 203 56, 341

53,304

2.56 0.65 o.41 0.38 0.36

TOTALS 150,000 811,705 5.41 433,85611 2.89

Table

23: Five ^year

summary budget

of

Tanga

CDTI

Project as presented by the NOTF/Tanzania

CosUTrdat:

(c)=B/A, US $ (E)=D/A

JAF 5.6 Page 27

5.3 Tukuyu Focus

CDTI

Projcct

5.3.1.

Background infomration

Table

24:

General information

The Project proposal seeks

to

establish mass treatment

with ivemectin in

an area where vector elimination through ground larviciding was approved in

April

1997.

l4

communities

will

be covered

with

a total population to be treated

of

32,390

by

the

fifth

year

of

ApOC funding. Fig.27

&

26 shows the provisional results

of

Rapid Epidemiological Assessment (REA) in country.

5.3.2.

Sumnrary budget

Table 25 below summarizes the five year budget as submitted

by

the NOTF/Tanzania and Fig' 28 indicates the trend of ^the cost per person to be treated for the five fofthcoming years.

Table

25:

Five year summary budget of Tukuyu CDTI Project as presented by the NOTF/Tanzania

Administrative unit _Total

Target 2

Total (1999) 480,500 Target (year 5) 32,390

Total ₂₂₄

Target (year _{5) 14}

season June-October

treated in the past l27,6tg

Paftner _SSI

VEAR-.

APOC cost US

,

(D)

1

2 3 4 5

30,544 30, 970 31, 400 31,850 32, 390

106, 581

39,181 29,587 24,257 14,310

3.49 1.27 0.94 0.76 0.44

2.61 0.78 0.44 0.20 0.10

TOTAL 32, 390 213, ^g'16 6.60 127

.floll

years

Treatid

(A) llcosunels

APo(

ll ^tei+ora

7e, BlBll 24.21511

'l _fflll

3, 386ll

3.gz

Fig.2B:

Trend of cost person to be treated

us$

4.00

3.50

3.00

2.50

2.00

1.50

1_m

o.50

0.00

Yeat 2 Year 3 Yesr 5

6. MALAWI

6.1 General Rapid Epidemiological Mapping

of

Onchocerciasis

(REMO)of

Malawi (see Fig. 29

&

³⁰ below)

Fig.29: REMO results of Malawi

Legend

illl ^Lot"

tfi _{Errptv n .u} lff PossibleCDTIZone

I Priority CDTI zone Rivers

Nodules (%) o

D

c ,t o

.00 to I .00 to 10.00 to 20.00 to 40.00 to

.00 9.00

19.00 39.00 I 00.00

Malawi

Rapid Epidemiological Mapping ol' onchocerc KM

----=-l

100 200