List of

Onchoccrciasis Control-programme ltr &est Africa

Programme de Luttc contre I'Onchocercose en Afrique de I'Ouest.

JOINT PROGRAIITME COMMITTEE Office of the Chairman

JOII.IT PROGRAMME COMMITTEE

Ninth session Dakar. 29

JPC . CCP

COMITE CONJOINT DU PROGRAMME Bureau du Pr€sident

JPc9.3

(ocP/EAc/88. _{1 )} ORIGINAL: ENGLISH

September lgBB

Page 2 5 o 9 10 10 10 11 11 75 76

November

-

² December 19BB

Provisional agenda item 7

List of

participants Executive Summary

ONCHOCERCIASIS CONTROL PROGRAMME IN WEST AFRICA EXPERT ADVISORY COMMITTEE

Report of the ninth _Eession 0uagadou@

CONTENTS

27 A

B

c

D E F

G H

I

J

K L

M N

0 P

o

R

Opening

of

the session Election

of

Chairman

Adoptlon

of

the agenda

Follow-up

of

EAC.B reconmendations ..

Matters

arlsing

from the eighth session

of

the JpC

Report

of

the ninth session

of

the Ecological Group Review

of

vector control_ operations

Review

of

epidemiological evaluation

activities ...

Ivermectin and results

of trials ....

Modifications

to

the plan

of

Operations

for

the

thi

Phase (1985-1991)

....

Review

of

the Onchocerciasis Chemotherapy project Progress report on epidemiological modelling .

...

..

Research Devolution 0ther matters

Date and place

of

EAC.10....

Adoption

of

the report Closure

ol

the session

rd

Financial

77 1B 79 ZU

22 23 23 23

Annex

I

Report

of

the ninth session

of

the Ecological Group ₂₄

JPcg.3

(ocP/EAC/BB. _{1 )} page 2

LIST OF PARTICIPANTS Mernbers

Dr Y. Aboagye-Atta, Resident Medical

Officer,

Department

of

Health and Nuclear Medicine, Ghana Atomic Energy Commission, P.0. Box 80, Legon, Accra, ^Ghana Professor T.A. Freyvogel, Swiss Tropical

Institute,

Socinstrasse 57, 4O5f Basle

Swi tzerland

Dr N.G. Gratz, Chemin de Ruisseau No.4, 7291 Commugny, Vaud, Switzerland

Dr C. L6v6que,

Institut

franqais de Recherche scientifique pour 1e D6veloppement en

Coop6rat,ion (ORSTOM)

,

^{213, rue La Fayerte,} 75480 Paris Cedex 10, France

Professor D.H. Molyneux, Department

of

Biological Sciences, University

of

Salford, Salford, M5 4WT, United Kingdom

Dr D. Qui116v6r6, Service d'Entomologie m6dica1e, Centre Pasteur, B.p Cameroon

1214, Yaound6

Professor A.S. MuI1er, Director, Hygiene,

6l

tvlauritskade, 1Ot2

Dr

J.L.

Stockard, America

Royal Tropical

Institute,

Department

of

Tropical Ad Amsterdam Netherlands

72807 Falmouth Drive, Colesville, Maryland 20904, United States of Professor A.M. T/njum, Department

of

Ophthalmology Rikshospitalet, Pilestredet _12,

002/ 0s1o

1,

^Norway

Dr P. Viens, Directeur, Centre

of

International Cooperation

in

Health & Development,

Faculty

of

Medicine, University

of

Lava1, _Qq6bec, Canada G1K _7P4 Wor1d Health Organization

Dr E.M. Samba, Director, Onchocerciasis Control Programme, Ouagadougou, Burkina Faso

Dr S. Accorsi, Epidemiological Evaluation

Unit,

Onchocerciasis Control Prograrnme, 0uagadougou

Dr

0.

Ba, Epidemiological Evaluation

Unit,

Onchocerciasis Control Programme, 0uagadougou

Dr R.H.A. Baker, Vector Control

Unit,

0nchocerciasis Control Prograrnme, Bamako, Mali Dr D.A.T. Baldry, Vector Control

Unit,

Onchocerciasis Control Programne, Ouagadougou

Dr D.A. Carvalho, Coordinator, Director's

Office,

Onchocerciasis Control ^Programme,

0uagadougou

Dr

0.

W. Christensen, Consultant, 0nchocerciasis Control Programme, Geneva,

Switzerland

Dr Y. Dadzie, Epidemiological Evaluation

Unit,

Onchocerciasis Control Programme, 0uagadougou

Dr A. Davis, Director, Parasitic Diseases Programme, Geneva

Dr G. De So1e, Epidemiological Evaluation

Unit,

Onchocerciasis Control ^Programme,

0uagadougou

JPC9.3

( 0cP/EAc/88. 1 )

page ₃

Dr C. D. Ginger, Project Manager, Onchocerciasis Chemotherapy Project, Onchocerciasis

Control Progremme, Geneva

Dr

T.

Godal., Director, Special Programme

for

Research and Training

in

Tropical Diseases, WHO, Geneva

Dr

J.

Grunewald, Vector Control

Unit,

0nchocerciasis Control Programme, Banako

Dr P.

Guillet,

Vector control

Unit,

onchocerciasis contror progrnmne, _Bamako Mr P. Kabor6, Vector Control

Unit,

Onchocerciasis Control Progrnmme, Ouagadougou

Dr M. Karam, Epidemiological Evaluation

Unit,

Onchocerciasis Control ^programme,

0uagadougou

Dr D. Kurtak, Vector control

unit,

Onchocerciasis control progrsmme, _Bouak6, Cote

d'Ivoire

Mr J.D.M. Mam, Chief

,

^{OCp Liaison}

Office,

^Geneva

Dr A. Moudi, PHC, AFRO, Brazzaville

,

^Congo

Mr C. Pharand, Chi.ef, Administration and Support Services, Onchocerciasis Control Programme, Ouagadougou

Dr B. Philippon, Chief, Vector Control Unit,

Bamako Onchocerciasis Control Programme,

Miss M.L. Ravelonanosy, Progrnmme

Officer,

Director's

Office,

Onchocerciasis Control Programme, Ouagadougou

Dr J.H.F. Remme, Chief,

Biostatistics

and Information Systems

Unit,

Onchocerciasj.s

Control Progrnmme, Ouagadougou

Dr A. S6k6t61i, Vector Control

Unit,

Onchocerci.asis Control programme, _Bamako Mr J.E. Senghor, Information

Officer,

Onchocerciasis Control programme, Ouagadougou

Mr A. Soumbey,

Statistician, Biostatistics

and Information Systems Unit, Onchocerciasis Control programme, 0uagadougou

Dr Y. Yanagata, vector control

unit,

Onchocerciasis control programme, Kara, Togo

Mr

L.

Yam6ogo' vector control

Unit,

0nchocerciasis control progremme, ouagadougou Mr D.G. Zerbo, Vector Controt

Unit,

0nchocercj.asis Control Programme, ouagadougou Mr

J.B.

Zongo, Socioeconomic Development

Unit,

Onchocerciasis Control ^programme,

0uagadougou

Onchocerciasis Chemotherapy project

Dr A.D.M. Bryceson, Hospital

for

Tropical Diseases, London, NWI OpE, United Kingdom Food and Agriculture ation

of

the Uni Nations

Mr

Cyril

G. Groom, Senior Progranming

Officer, 0ffice of

the Director, Agricultural Services Division, FA0,

via

derre terme

di

caracarla,

r -

oo10o Rome,

rtaly

,"

ltl rt E_,{ '3

JPC9.3

(oCP/EAo/BB. 1 )

page 4

Committee'of SponSorinF Agencies

Mr Bruce Benton, Onchocerciasis Coordinator, Population and Human Resources Division, Sahelian Department, _The World Bank, Washington, United States

of

^America

Dr Bernhard H. Liese, Principal Tropical Disease Specialist, Population and Human

Resources Department, The

liorld

Bank, Washington, United States

of

America

JPC9.3

( OcP/EAC/88. 1 )

page ₅ EXECII]IVE SI]MMARY

The

ninth

session

of

the Expert Advisory Committee (EAC) was held

in

Quagadougou

at

the OCP Headquarters from

1l to

7'l June 1pBB. The session was preceded by an

informal

briefing

session on the afternoon

of

¹¹ June which enabled the Committee to nove

directly to

the agenda

at

the opening meeting on the morning

of 1l

June.

The sudden and untimely death

in

Ouagadougou

of

one

of

the EAC members, professor

Patrick participants Hamilton, on the

in

the Committee's meetings day before the session and cast a opened, shadow deeply over saddened

its

proceedings.

all

the The Committee hras appraised

of

the considerable progress _achieved

in

the

field

of vector

control,

both

in

the Original OCP area where

virtual

interruption of

transmission had been maintained

for

another year and

in

the Extension areas where

operations were no!, catching up with the delay

in

the implementation

of

the plan of operations foreseen a year ago (paragraphs 27 and

22).

The progranme had coped

successfully with instances

of

lowered

susceptibility to

temephos which continued to be (paragraph used whenever

2J).

Some the

larvicide

concern was rotation expressed scheme

in

resulted regard

to in

the a reversion

possibility of of

resistancea change

in aerial

contractor by the end

of

1989 with the inherent

risk to

the efficiency oi vector control operati.ons; the Committee encouraged the Programme

to

ensure with aI1

parties concerned

that

a ^procedure woutd be followed

that

would

entail

the least disruption

or

reductj.on

of its

cost/efficiency

of aerial

spraying (paragraphs ZJ to

28) .

The Committee noted with satisfaction the accelerated pace with which vector control was being ^pursued

in

the Extension

areas. It

was concerned, however, about

recent

identification of foci of

invasion

of blackflies into

Guinea

in

areas south of the provisional OCP boundary

in

Sierra Leone, and the implication

of

Simulium

Sggllglsg blinding form

in

that

of

onchocerciasis.

part of

the ^programme The Committee area as a urged potential

that further

transmitter investigations

of

the be

undertaken as a matter

of

urgency (paragraphs 33

t;

35).

The achievements

in

the

field of

epidemiological evaluation as reported

to

the Expert Advisory Committee were impressive. _{Thev comprised} the prepar.tio.,

of

^an epidemiological map

of

the Western Extensio.,

"re.,

ctmpletion

of

an ophthalmologieal survey

in

the Original OCP area, a comparative study between the severity of

onchocercal blindness

in

savanna and forest areas, Lonsiderable progress i.n

immunodiagnosis and

in

the

specificity of

DNA probes

of

O. volvuiusl as

well

as the completion

of

a simulium feeding and transmissio., e*perirnent (paralraphs l+r

t.-+6i.

The Committee was

particularly

interested

in

the

grelt

strides made

in

large-scale application

of

i-vermectin and

in

the analysis

of

ihe data accumulating therefrom which

wilt

help determine the future

role of

chemotherapy

in oCp.

The ^programme hras

encouraged

to

continue along the

lines of

the plan

of

action developed by the Epidemiological Evaluation

Unit

(paragraphs _49-

to

_55).

A

draft

modification

of

the Plan

of

Operations

for

the Third Financiar ^phase was

approved by the Committee with the inclusion

of

a few amendments (paragraphs

!6

^to

59)'

^The Expert Advisory _Committee also reviewed the accomplishments and future strategy

of

the Onchocerciasis Chemotherapy Project _and commended the project _on

its

work (paragraphs 60

to 65).

The committee paid special attention

to

the subject of devolution (paragraphs and laid^dohln 73

to 78). After

a ^procedure a review

for its of

ocP future

activities in

consideration the

field of of this

applied issue and

operationar research a

list of priority

_subjects

for

the research programme was drawn

up (paragraphs

/0 to

72).

JPC9.3

(ocP/EAc/BB. 1 )

page 6

Some very prelininary results from exploratory simulations by the epidemiological model were shown

to

the Committee which encouraged the ^Programme

to

continue

its efforts to

develop and

utilize

the roodel

for

the ^purpose

of facilitating

future planning and progranming (paragraphs 66

to

69).

Following

its

considelations

of

the various agenda

itens

the Expert Advisory Committee made the following recommendations:

The

aeriql

spraying contract

(i)

The Programme

staff

should make a detailed appraisal

of

the whole subject of tendering and contract awarding processes, contracting options and contract duration.

A1so,

this

matter should be taken up as a matter

of

^urgency with

all

concerned,

especially the Director-General

of

^{WHO and} the Committee

of

Sponsoring Agencies (CSA),

to

determine what procedures might be followed

to

ensure the least disruption

of efficient aerial

spraying operations (paragraphs 27 & 28).

Control

of

sources

of

reinvasion

(ii)

New sources

of

reinvasion, the widespread

distribution of

savanna vectors in Siema Leone and the possible vector

role of

S. soubrense should receive further detailed study, especially with a view

to clarifying

the southern boundary

of

the Extension area which might need

to

be moved further south than

originally

^planned with possible operational and

financial

implications (paragraph 35).

EpidemioloEical evaluation

(iii)

Ttre Prograrome's collaboration with outside laboratories should be continued

in

order

to

develop an immunodiagnostic technique applicable under

field

conditions and

to refine

the DNA probes

for

diagnostic purposes (paragraph 48).

Large-scaIe ivermectin distqibution

(iv) Activities

related

to further trials of

ivermectin should be given the necessary

priority

and every

effort

be made

to

complete the plan

of

action as

presented so as

to

provide information

in

time

for its

next session

to

enable

decisions

to

be made on the further integration

of

ivermectin

into

the control

strategy.

Also the Mectizan Comnittee should be approached

to

streamline the

delivery

of

ivermectin

to

the Programme which would act

in this

respect on behalf of the Participating Governments and stressed the need

for

^NGOs supporting ivermectj-n

distribution in

the Participating Countries

to

adhere

strictly to

^{OCP procedures}

(paragraphs 54 & 55).

Modifications

to

the Plan

of

Operations

for

the

third

^Financial Phase (1986-1991)

(v)

The modified Plan

of

0perations should be adopted (paragraph 59).

Onchocerciasis Chemotherapy Project ^(0CT)

(vi)

The mandate

of

^OCT should remain unchanged and due

priority

should be given

to

the development

of

a macrofilaricide. ^OCT should be supported as fu11y as

available funds would permit and every

effort

be made

to

obtain external funding for other

justified activities

whenever

possible.

OCT should take advantage

of

drug screening

facilities

and

its

clinical-

trials

centres

to identify

and evaluate further potential drugs,

particularly

those ^compounds which have proved

activity

against nematodes

of

veterinary importance about which some j.nformation

is

available on drug metabolism, pharmacokinetics and

toxicology.

The ^CSA should take the necessary steps

to

stengthen the EAC membership

to

enable

it to

monitor and revieh, OCT

activities

^for the JPC (paragraphs 64 a

6l).

JPC9.3

(ocP/EAC/88.1 ₎ page ₇

EpidemioloEical modelling

(vii)

Development

of

the model should continue with emphasis on

its

potential role

in

^planning, management and, eventually,

training

(paragraph 68).

Research

(viii)

Internal research meetings

to

review operational research and plan future

activities

should be continued

to

ensure maximum coordination

of

research

efforts

and

collaboration within OCP.

It

also recommended

that

the applied research essential to

the functioning

of

the Programme acti-vities be maintained (paragraph 72).

Devolution

(ix)

liHo/AFRo, with

its

knowledge and technical resources

to

support national health service planning, should give greater attention

to

^OCp participating _Countries

in

preparing

for

devolution

to

them

of

responsibility

for

maintaining control of onchocerciasis.

fn

order

to

bring discussions on devolution

to

a more operational leve1 the EAC

should be provided

with

the following

prior to

EAC.10.

a)

an overview

of

the technical aspects

of

devolution;

b)

a clear indication

of

^what

is

understood by recrudescence, what type of epidemiological surveillance

will

be required and the

criteria for

using ivermectin;

c)

the view

of

IrIHO/AFRO concerning devolution now and

after

1ppl;

d)

the report from the World Bank on the health infrastructure situation.

Alternative _systems

of

motivation other than cash incentives should be developed

so as not

to

burden the countries with responsibilities _they might not be able to

continue (paragraphs

after 75,77

1997 & 78).which could prejudice the continuing success

of

devolution Forest OnchocerciasiS

(x)

A detailed comparison should be made

of

the observations

of

a USAID mission and OCP

staff

on forest onchocercj.asis

in

C6te

d'Ivoire

with a report submitted to EAC.10 (paragraph

J!).

JPC9.3

(ocP/EAcl88.1) page B

A. OPENING OF THE SESSION

1.

The ninth session

of

the Expert Advisory Committee (EAC) was held

in

the headquarters

of

the Onchocerciasis Control ^{Programme (OCP)}

in

Ouagadougou from

1l to U

^{June 1988. The session} was opened by the Programme Director who referred to the technical

briefing

which had been provided

to

the nembers two days previously.

He introduced and welcomed

six

new ^EAC rnembers, Dr Y. Aboagye-Atta,

Prof.

^D.H.

Mo1yneux, Dr D. Qui116v6r6, Dr

J.L.

Stockard, Professor A.M. Tdnium and Dr ^P.

Viens, and continued by introducing Dr A. Moudi, the representative

of

Dr G.L.

Monekosso, WHO Regional Director

for Africa,

and Dr A. Bryceson, Chairman

of

the last

OCT Steering Committee.

2.

^Referring

to

the

tragic

^and untimely death

of

Professor Patrick Hanilton in

Ouagadougou on 12 June 1988, the ^Programme Director said

that

^{OCP had}

lost

one

of its

dearest friends. A nan

of

^honour and a gentleman, Patrick Hanilton had always ^been devoted

to

service and through

his

dedication

to

serving the Programme, had died in the

field.

Speaking on behalf

of all

present, the Programme Director referred

to

the

utter

^shock with which the news

of

Patrick Hamilton's death had been received by menbers

of

the EAC and

of

OCP

aIike.

Referring

to

the very valuable contribution ^that, Patrick Hanilton had nade

to

the Programme, the Director considered

it

appropriate

that

the EAC and the OCP should establish a sma1l token ofl memory and acknowledge- ment.

In this

respect

it

was agreed

to

^make a

collection,

which would be used

for

the purchase

of

^some appropriate equipment

to

be donated

to

the Yalgado Ouedraogo

Hospital, Ouagadougou,

in

^which Patrick Hanilton had spent the

last

^hours

of

his

life.

3.

^{Professor T.A.} Freyvogel, Chairman

of

EAC.B, said that he had been deeply ^moved by the death

of

Patrick Hanilton. He considered himself honoured

to

have had the personal opportunity

to

work with Patrick Hamilton, which had enabled them

to

^{get to}

know each other and

to

establish deep and mutual

trust.

More than

that,

a true friendship had developed and lasted

until

the previous day. Echoing the feelings of the Progranne Director, Professor Freyvogel reminded participants

that

they had

all lost

a

friend,

a highly competent colleague and a ^person who was

totally

^{dedicated to}

his profession. At

the present time, the most appropriate

tribute that

could ^be paid

to

Patrick Hanilton was

to

continue with the work

in

hand,

in

the same

spirit

^as that which had been so characteristic

of

him.

4.

With regard

to

the present situation

of

the Programme, the Programme Director stressed

that

the many technical and financial worries

of

1987 had been largely

superseded by very positive attitudes and approaches, which now permitted the

Progranme

to

view the future with considerable optimism. He hoped

that

the ^Committee would

reflect

on three topics

of

cument concern

to

the Programme, as follours:

(a)

Recalling

that larviciding

^had been the sole

tool

available for onchocerciasis

control, it

^{now had}

to

be acknowledged

that

the

microfilaricide,

ivermectin, had been demonstrated

to

be a safe and useful supplementary measure

for

onchocerciasis

control.

The most appropriate ^and effective means

of

interlocking these control methods now needed

to

^be carefully defined.

(b) In relation to this

^same subject,

it

had

to

be recognized

that

^some parts of the Programme area would, from now on, receive only ivermectin

admj-nistration, while others would receive a combination

of

ivermectin ^and

larviciding,

with the

latter

^probably becoming less intensive and gradually being ^phased

out.

Eventually blackflies would return

to

onchocerciasis controlled areas, but

this

should not be allowed

to

imply

that

there would be a return

of

the disease.

It

was now becoming a matter

of

^{some urgency}

that this

be

fuIly

explained

to

the populations concerned who would be

faced increasingly with

this

^new

situation; in this

^{respect, National}

Onchocerciasis Committees had an important

role to

^pIay.

JPc9.3

(ocPlEAc/88. 1 )

page ₉

(c)

Devolution hlas a subject which had received nuch attention and thought by

arr

concerned, especially with regard

to

the handing-over

of

certain

responsibilities to

the Participating Countries. The Committee was assured

that

the Progranme would continue,

untir it

ca-me

to

an end

in

1997, to collaborate closely with Participating Countries

to

ensure the progressive and conplete transfer

of

responsibil-ities. During

this

period, OCP would always be available

to

^provide advice

to

and coLlaborate with the various

national authorities concerned.

B. ELECTION OF CHAIRMAN

5- In his

^{opening address,} the

retiring

Chairman reaffirmed

that

the EAC as a Committee should remain functional

for

a long as the Programme was

officially

active. He considered

that

the three main tasks

of

the Committee remained unchanged,

as follows:

(a)

To monitor

critically

and constructively the

activities of

the ^progremme, keeping

in

mind

its

primary objective. To

fulfit this

function

effectively

,

the ^EAC would need

to

receive the ^maximum amount

of

information and

feedback, and would have

to

view OCP

activities

with a considerable ^emount

of

imagination.

(b)

To

offer

sound advice and guidance

to

the Progranme, which the Committee

could do

effectively

by

virtue of it

being independent

of

^WHO and

of

any

other organization. This independence was a very important feature

of

the Committee and must remain unchanged

if truly

valuable advice was

to

be made

available

to

the ^programme.

(c)

To maintain the confidence

of

the Sponsoring Agencies and

of

the Joint

Progrnmme Committee.

It

was

to

be noted

that,

during the

last five

or ^more years' _{both the} CSA and the JPC had sought increasingly the opinions and

advice

of

the EAC.

It

was thus very important

for

the irogramme

that

the ^EAC continue

to

provide welr-founded reports _{and good advice.}

6.

He also underlined

that

the next ten years

of

the ^progrsmme would witness some

very

significant

developments: the

availability of

ivermectin

for

onchocerciasis

control and the possible development

of

a macrofilaricide, the development

of

an

effective

diagnostic

test for

the detection

of

early

infections,

and the increased

transfer

of activities

from the Progra.mme

to

Participating Countries.

It

^was

therefore important

to

the Programme

that,

during

this

^phase, there be a reasonabl-e degree

of

continuity

in

the membership

of

the EAa. However, he maintained

that

the chairmanship ought

to

be

rotating,

with a two-year duration,

if

possible.

Finally,

the

retiring

Chairman expressed

his

deepest gratitude

to

^{EAC members} and to

OcP

staff for

the opportunity he had been given

to

work closely with them over the

l-ast three years.

7.

^Professor A.S. Mu1ler was elected Chairman, and,

to

maintain continuity and

ensure EAC representation

at

other meetings Professor T.A. Freyvogel was elected Vice-Chairman

for

the ninth session

of

the EAC.

JPC9.3

( ocPlEAc/BB. 1 )

pa8e 10

C. ^ADOPTION OF THE AGENDA

B.

The following agenda was adopted by the Committee:

1.

Opening

of

the session: Statement by ^Programme Director

2.

Election

of

^Chairman

l.

^Adoption

of

agenda

4.

Follow-up

of

recommendations

of

eighth session

of

^EAC

5.

^Matters

arising

from the eighth session

of

the JPC

5.

Report

of

the ninth session

of

the Ecological Group

/.

^Review

of

vector control operations

8.

Review

of

epidemiological evaluation

activities t.

Ivermectin and results

of trials

10. Modifications

to

the Plan

of

Operations

for

the

third

^{Financial Phase}

( 1986-91 ₎

11. Review

of

the Onchocerciasis Chemotherapy Project 12. Progress report on epidemiological modelling 11. Research

14. Devolution 15. Other matters:

-

Forest Onchocerciasis

-

Management Seminar

-

^EAC members'

visits to

OCP area

16. Recommendations

1J. Date and place

of

^EAC.10 18. Adoption

of

the report

1!.

Closure

of

the session

D. FOLLOW-UP OF EAC.B RECOMMENDATIONS

9,

^{As the}

five

EAC.8 recommendations requiring follow-up reporting by the Programme

were

all

covered by individual agenda items,

it

was agreed

that

^{OCP would respond}

when the appropriate agenda items were given consideration.

E. MATTERS ARISING FROM THE EIGHTH SESSION OF THE JPC

10. One member

of

the EAC reported that he had attended the eighth session

of

the JPC

(Rome,

l0

^November

- I

^{December 1987) and had} introduced the report

of

the eighth session

of

the EAC. A11 the ^EAC vj-ews, including the recommendation

that

control operati.ons continue

to

^be based on larvicj.ding

for

the present and the immediate

future

in

order

to

^protect the core area, were accepted by the ^JPC.

11.

In

response

to

a question from EAC members, the ^Progremme Director stated that during

its

eighth session, the JPC had approved the supplementary budget

for

¹⁹⁸⁷ without comment.

12. The EAC was reminded

that

the JPC

in

1986 decided

to

^give responsibility for

socioeconomic development

to

^CSA which would report regularly

to

the JPC on progress

in

implementing the socioeconomic development programme endorsed by JPC.7.

Socioeconomic developnent was therefore no longer

within

the mandate

of

the ^EAC.

Based upon the JPC's decision,

it

was reported by ^OCP

that

the function

of

^the

Socioeconomic Development

Unit

^(ECO) supporting the CSA by

collecting,

analyzing ^and disseminating socioeconomic information, and acting as

liaison

between the CSA,

National Onchocerciasis Committees ^(NOCs) and Participating Government

officials,

woufd be transferred

to

the

office of

the Director.

JPC9.3

(0cP/EAc/88. 1 )

page 11

F.

REPORT OF THE NINTH SESSION OF THE ECOLOGICAL GROUP

13. The report

of

the ninth session

of

the Ecological Group (Annex

I)

was presented

to

the Committee. The following points were noted

in

particular.

14. The Group had been reassured by the

efforts

^made by the Progranme's Vector Control

Unit

^(VCU)

to

nake tarviciding operations more

efficient

with a resultarrt reduction

in

pesticide pressure on aquatic environments. Sone key factors had been

the greater use

of

improved and cheaper formulations

of

Bacillus thuringiensis H-14

and the increased

util-ization of

teletransmitted hydrological data

for

the refinement

of larvicide

dosages.

11. The Group was pleased

to

acknowledge the great

efforts

^made by national

hydrobiological teams

in

the Original OCP area and

in

^part

of

the Western Extension

area (western Mali and eastern Guinea)

to

prepare annual reports on

their

^aquatic monitoring and evaluation

activities.

16. _Although

to

a certain degree

toxic to

aquatic invertebrates, carbosulfan had not been shown

to

have a

significant

impact on

fish in field

conditions. The Progranne would contj.nue

to

study the effects

of this larvicide

on invertebrates, and,

additional information would be obtained from

riterature

searches.

1J. The Group had requested the University

of

Salford

to

conduct an independent and

complete analysis

of all

the Programme's hydrobiological data, with special attention being given

to

the possible side-effects

of

permethrin and carbosulfan. Comparisons would also be made

of

the short-term and long-term monitoring techniques and

results.

18. The Group had recommended

that

additionaf information on non-target organisms be

collected

in

the Western Extension area, that ngh, gnmpling

sites

be selected

in

that area, and

that

screening

of

^new

larvicide

compounds and formulati-ons be continued

until larviciding

operations could be

significantly

reduced

or

discontinued. ^The

Group was pleased

to

report

that

a ten-year summary

of fish

sampling data had been

published and

that

a

similar

summary on invertebrates had now been submitted for publication.

1p. The Committee commended the Group on

its

report and on the recommendations contained therein.

It

noted with satisfaction the increased responsibility for hydrobiological monitoring given

to

^national teams (composed

of scientific

^and technical

staff) in

the Western Extension area. While stressing

that

the time would soon come when research on the environmental

effect of

^new larvicides and

formulations would have

to

be phased-out, the Committee agreed

that, for

the time- being, such research should continue, especially on new formulatj.ons

of B.t.

H-14 and

other compounds which might be able

to

replace chlorphoxim now out

of

production (see

also section M. "Research,).

20. The Committee expressed the view

that

future reports

of

the Group should place

rather less emphasis on current vector control operations, but provide more detailed information on the results

of

some

of

the more

critical

monitoring

activities.

G. ^REVIEW OF VECTOR CONTROL OPERATIONS

21. The EAC was informed

that in

an endeavour

to

catch up on time

in

the

implementation

of

^planned

activities in

the Extension areas, large-scale vector control operations had been leunched

in

early 1!88 throughout the Southern Extensj,on area and

in

the Senegal River Basin

of

the lrtestern Extension area (involving much of western MaIi and part

of

eastern Guinea). Seasonal and selective larviciding

operations were also being conducted

in

the Upper Niger Basin, Guinea,

to

suppress known sources

of

reinvasion.

At

the same time technical and infrastructural

JPC9.3

(0CP/EAC/88.1 ₎ page t2

preparatory

activities

were being extended throughout the remaining

part of

the Western Extension area.

22. 'Ihe Conmittee was also assured

that larviciding

coverage was being maintained in the Original Progranme area, except

for

a large

part of

Burkina Faso where no aerial treatments had been made

for

several years. Over much

of

the Original Programme area

it

had been possible

to

reduce the

intensity of

vector control operations and to increase the number

of

treatment interruptions, without adversely affecting the entomological _and epidemiological achievements.

At

the same time, and by improved management

of

the entonological evaluation network, the Programme had reduced

significantly

the number

of

vector collector teams as

well

as

their

composition from

three ^persons

to

^two.

Insecticide resistance

23. The EAC was informed

that,

resistance

to

temephos

in

savanna species now occurred

in

most

of

the Original Programme area and

in

a very considerable proportion

of

the Southern and Western Extension

areas.

However,

this

resistance was stable and permanent

in

only a few localized

areas. In

the majority

of river

basins, there was

a reversion under the

larvicide

rotation scheme, such

that

^temephos could be used

seasonally

at

high water when

it

was economicalty advautageous

to

do

so.

Recently, there had been a

particularly

dramatic reversion

in

the Upper Niger Basin

in

Guinea.

Susceptibility

to

temephos had returned

to

pre-treatment (1985)

levels.

This was

probably _due

to

an outright population replacement with the new blackfly population coming from Sierra Leone. Susceptibility tests conducted on savanna, mixed

savanna/forest and forest vector populations

in that

country had demonstrated normal

susceptibility to

a range

of

larvicides.

24. tatci.ng a broad overview

of

the resistance problem, the Committee commended the Programne on the ingenuity and

intensity of its efforts to exploit

fu1Iy the

rotational use

of its ful1

arsenal

of

larvicides

to

contain and,

in

some cases, to reverse the resistance problem.

Aerial operations

25. The ^EAC was reminded

that

from the time the new

aerial

contractor had assumed

responsibility

for aerial

operations

in

January 1987, the ^Programme had experienced a

number

of

^problems, especially with regard

to larvicide

release equipment

fitted

to helicopters. However, as a resurt

of

^many equipment modifications, and, of

considerable

efforts

on the

part of

both the

aerial

contractor and the Programme

staff,

there had been an appreciable improvement

in aerial

operations over the last several nonths.

26.

In

response

to

a recommendation

of

the eighth session

of

the EAC ( L9B7), and, in the

light of

experience

in

the past eighteen months

in

changing from one contractor

to

another, the Progremme was

in

the ^process

of

revising the

Invitation to

Bid to

make

it

nore precise

in relation to

technical and other specifications.

27.

In

addition, consideration was being given

to

^how the existing bidding procedure

for

the selection

of

the next

aerial

contractor could be improved upon. The EAC commended the advance action being taken by the Programme

to

tighten up the

specifications

of

the

Invitation to

Bid and the selection process and recommended

that Progranms sf,gff make a detailed appraisal

of

the whole subject

of

tendering and

contract awarding processes, contracting options and contract duration.

28. Noting

that

the current three year

aerial

spraying contract would

finish at

the end

of

1989, the Committee expressed concern

at

the Programme being faced again with a possible change

in

contractor

at

a time when

aerial

spraying operations were under considerable pressure with the implenentation

of

vector control

activities into

the

JPc9.3

( ocP/EAc/88. 1 )

page 13

Western Extension

area.

While recognizing

that

a certain procedure had

to

^be followed

in

accordance with ^WHO ru1es, the Committee was deeply concerned about the

implications,

in

reLation

to

cost and

risk to

the efficiency

of

the operations,

of

^a

change

of

contractor

at

such a

critical

^period.

It

recommended

that this

matter be

taken up as a natter

of

urgency with

all

concerned, especially the Director-General

of

^WHO and the Connittee

of

Sponsoring Agencies,

to

deternine what procedures night be followed

to

^ensure the least disruption

of efficient aerial

spraying operations.

29. With regard

to

the operational aspects

of

^vector control

activities,

the EAC was

informed

that

considerable progress had been made during the

last

year, especially with regard

to

^inproved cost-efficiency

ratios.

Atthough the ^Progranme had been faced

with an expanded insecticide resistance problem, which required greater reliance on

B.t.

^H-11+ and an increasing insecticide consumption overa11, and,

it

had launched

ful1-sca1e vector control operations

in

the Extension areas,

aerial

operations had been conducted nore economically than during the ^previous

year.

The most important

factors contributing

to this

success were:

(a)

reduced cost

of

^some

larvicides,

especially

B.t.

H-14, resulting from

competitive bidding

in

the procurement procedure;

(b)

greater use

of B.t.

H-14 during the dry season when the use

of this

^product

beceme cheaper than

that of

temephos;

(c)

more economical use

of all

larvicides and

of aircraft flight

hours, nade

possible _by:

(i)

maxinal

utirisation of

teretransnitted hydrological data and the computerization

of all aerial

operations data, which had improved dosage accuracy,

aircraft utilization

and

logistical

support

administration.

In

addition, sound predictive approaches had been made

possible with regard

to larvicide

dosages under changing

river

conditions and

to

the interruption

of

treatments;

(ii) daily

^(hourly,

if

necessary) radio transmission

of

hydrologicar and dosage data

to pilots in

the course

of their

treatment

circuits,

in order

to

compensate

for

changing hydrological conditions and

to

^reduce

pilot

error.

30. ^{EAC members} were unanimous

in

acknowledging

that

the improvements

in

the

efficiency

of aerial

operations were extremely impressive and a

tribute to

the Programme

for

the

efforts

that were being made

to

compensate

for

financial constraints.

Entomological results

]1.

^Although there were some parts

of

the ^Progrcmme area

in

which problems

continued because

of

stabilized insecticide resistance, replacement

of

forest vectors by savanna vectors

in

high

rainfall

areas, peculiar hydrological conditions along

river

stretches below dnms,

etc.,

the overall control situation was currently very acceptable.

32.

^{From the} end

of

1987 there had been a marked improvement

in

the Annual Transnission Potential (ATP) values over a large

part of

the ^programme area, with ATP's

in

most

localities

being below the 100 1evel

of

acceptability. Although

reinvasion was not completely prevented, dranatic reductions

in

^ATP values

in

the

classical southern Mali reinvasion zone had been recorded as a

result of

a selective

and seasonal

larviciding of

^sources

of

reinvasion located

in

the Upper Niger Basin,

Guinea. Regrettably, the delayed

start of

selective and seasonal treatment

of

^rivers

in

the Southern Extension area

in

1987, had permitted

significant

reinvasion

of

^a