JOINT ACTION FORUMOffice of the Chairman

JAF-FAC: Eleventh sessionParis / France December 2005

FORI.]M D'ACTION COMMUNEBureau du Pr6sident

t

African Programme for Onchocerciasis ControlProgramme africain de lutte contre I'onchocercose

18 000 000

16 000 000

14 000 000

12 000 000

10 000 000

8 000 000

6 000 000

4 000 000

2 000 000

I

1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Plan of Action and Budget 2006

Item 22 ofthe provisional aeenda

World Health Organisation

JAF 11.6ORIGINAL: FrenchOctober 2005

0

JAFl1.6Page i

JAF 1 1.6

AIzuCAN

PROGRAMME

FOR

ONCHOCERCIASIS

CONTROL

PLAN OF ACTION

AND

BUDGET FOR2OO6

WORLD HEALTH ORGANISATION

JAFl 1.6

Page ii

2

2.1

2.2J

3.1

3.2J.J

3.43.53.63.73.83.9

4

4.t4.24.34.44.54.64.7

TABLE OF CONTENTS

1 INTRODUCTION: Context and previous activitiesContext.......Recall of 2005 activities and overview of national projects

oBJECTIVE ................Recall of overall Programme objectiveSpecific Objectives of the Plan of Action and Budget of 2006.......2006 PLANNED ACTIVITIES .............

CDTI ActivitiesIEC Materials ............Evaluation and monitoring of Programme activities...Vector EliminationInitiating disease mapping (REVIO)Initiating the mapping of loa loa (RAPLOA)...........Activities of long-term impact assessment of operations........ResearchProgramme management and administration...........FORECASTING BY PROGRAMME ACT[VITY............ ...... 10

Activities, Expected outcomes, Indicators and projected costs for 2006..................... 10

Costs by activity and by country... ...18,.,20...2t...22...23

...24

LIST OF TABLES AND FIGURES

Table l: National Projects......Table2: Activities by country in 2006.......Table 3: Operational Costs by country in 2006Table 4: Proposed 2006 Budget in relation to that of 2005 and2004....Table 5: Proposed 2006 Budget by category of budget line item as compared to that of

2005 and 2004...........Figure 1: Graph representation of2006 budget by category ofbudget line itemFigure 2 :2006 administrative and operational costs ..........Figure 3 : Trend ofnumber ofapproved projects from 1996 to 2006Figure 4 : Trend of budgets from 1996 to 2006.......

LIST OF ANNEXES

1.1

t.2

Ii1

6

6

66

6

8

8

8

8

8

9

9

9

2006 Budget in relation to that of 2005 and20042006 Budget by category of budget line item in relation to that of 2005 and2004 ...

Graph representation of 2006 budget by category of budget line item

Budget Breakdown by major budget category items .........

Evolution/trend ofnumber ofprojects approved and the budgets approved or

submitted from 1996 to 2006

ANNEX 1: AVERAGE LTNIT COSTS USED FOR BUDGET CALCULATIONSANNEX 2 : ORGANISATION CHART OF APOC PROGRAMME............

2l22232424

2526

.518

...19

...20

JAFlI.6Page I

1 INTRODUCTION: CONTEXT AI\ID PREVIOUS ACTMTIES

1.1 Context

This Action Plan and Budget for 2006 (PAB 2006) is the eleventh of its kind to be presented by the

African Programme for Onchocerciasis Conhol (APOC) for review and approval by the Joint ActionFonrm (JAF). As obtained under the previous plans, the fifttr year of Phase [I of the Programme willbe characteraed by the implementation of activities of Community-Directed Treatment withIvermectin (CDTI) of five new projects distributed over South-Sudan (l), Democratic Republic ofCongo (2) and Angola (2), as well as the consolidation of the six-year gains under Phase I, and the

first four years of Phase tr involving 96 projects in Malawi (2), Uganda (4), Nigeria (27), Tanzania(7), Sudan (4), Cameroon (15), Chad (l), CAR (l), Equatorial Guinea (l), DRC (15), Liberia (3),

Ethiopia (9), Congo (2), Burundi (3) and Angola (2). Activities will also include vector eliminationthrough entomological surveillance in project areas in Uganda (2),Tanzarria (l) Equatorial Guinea (l).Seven central secretariats of National Onchocerciasis Control Programmes (NOCP) will benefit fromtechnical and financial assistance for the implementation of projects in Cameroon, DRC, TanzaniqNigeria, Sudan, Ethiopia and Angola. Overall, one hundred and five (105) CDTI and vectorelimination projects and seven NOTF (National Onchocerciasis Task Force) secretariats supportprojects, distributed over 15 countries will benefit from scheduled activities in line with the 2006specific objectives set hereunder, by virtue of the mission assigned to the Programme.

The year 2005 was marked by the following major activities.

1.2 Recsll of 2fi15 activities and overview of nationel proiects

o The activities conducted under CDTI projects in 2005 are summed up as follows:

(i) Implementation of first year activities of fourteen (14) new CDTI projects (4 in Angola,2 inBurundi, I in Uganda, 4 in DRC and 3 in Sudan).

(iD Continuation of activities in sixteen (16) CDTI projects in their second year ofimplementation (2 in Angol4 5 in Cameroon, I in Burundi, I in Congo,2 in Sudan, 3 inDRC, I in Liberia and I in Tanzania).

(iiD Intensiffing implementation of twenty (20) CDTI projects in their third year ofimplementation (1 ) in Angola (1) in Cameroon, (9) in DRC, (6) in Ethiopia, (1) in Liberia,(l) in Nigeria, and (1) in Tanzania), and a reinforcement project of the NOTF secretariat inAngola.

(iv) Continuing implementation of six (6) CDTI projects in their fourth year of implementation (1

in Cameroon, 2 ln Ethiopia, 3 in Equatorial Guinea).

(v) The completion of reinforcement activities under the implementation of ten (10) projects intheir fifth implementation year, of which 9 are CDTI projects: I in DRC, I in Nigeria, I inTanzania,2 in Cameroon, I in Congo, I in Malawi, I in Uganda and 1 in Liberia), as well as Ireinforcement project for the NOTF secretariat in Ethiopia.

The results obtained are significant, and have to do with training and re-training of 161 503

community distributors (CDDs), 15 651 health workers, and capacity building of 500nationals on tools and facilities used in CDTI activities. A supervision rate of more thanTSYowas also recorded, with respect to the CDDs and health workers trained, and 85%o of 86 377communities benefited from sensitisation on CDTI. Other achievements are, among others,the organisation of 212 sessions of mobilization, sensitisation and advocacy conducted in 45%o

of the districts/LGAs; the development of IEC materials/strategr to ensure compliance with

JAFI I.6Page2

treatment in almost 60% of ongoing projects; the management of 85% of identified/reportedSAE (Severe Adverse Events) cases; and the conduct of KAP studies for the integration ofreproductive health and Vitamin A Supplementation into CDTI. Overall, the number ofpersons teated, which was 37 307 000, is gone up to about 41 407 000 in 2005.

CDTI sustainability evatuation exercises, Iong-term impact assessments ofProgramme operations enabled the following actions to be taken:

(vi) On the basis of plans drawn up by the countries, support was given to reinforcement activitiesfor enhancing CDTI sustainabitity in forty-five (45) CDTI projects in their sixth, seventh and

eighth year of implementation (6 for Cameroon, I for Equatorial Guineq 1 for Malawi,25 forNigeria, 3 for Ugand4 I for Sudan" 4 for Tanzania, I for CA& I for Ethiopia, I for DRC and

I for Chad). The enhancement of CDTI sustainability was mainly done through extensive

integration into health systems, and through the use of the Community-Directed Treatrnent(ComDT) approach so as to take up the challenges thrown by other health interventions, such

as Vitamin A distribution campaign, the bilharzias control campaign, the distribution oftreated bed nets under malaria control, the fight against sexually transmitted diseases and

HIV/AIDS, for instance in "Oncho" zones.

(vii) On the basis of country plans, sustainability enhancement activities were carried out in five(5) projects to strengthen secretariats of NOTFs in their sixth, seventh and eighth years ofimplementation (Cameroon, Nigeri4 Sudan, DRC and fqnzqnia). This is mainly done throughthe covering of costs of the secretariats and support of their activities of coordination and

supervision of onchocerciasis control, by the Ministries of Health (MoH) of APOCparticipating countries.

The impact study data collected on 12 sites were analysed and used in articles submitted tovarious scientific journals for publication.

(viii)

o Vector elimination activities continued through:

(ix) The consolidation of entomological evaluation activities in four foci of vector eliminationprojects (two in their sixth implementation year in Uganda (Itwara and MpambaNkusi) one inits seventh year of implementation in Equatorial Guinea (Bioko island) and another in itseighth implementation year in Tanzania (Tukuyu focus). The results recorded show thatvector biting rates are nil everywhere, except in the Tukuyu focus.

a Other activities undertaken in 2005

Continuation of assistance to NOTFs for drawing up their sustainability plans, on the basis ofevaluation results.

(xi) Continuation of training of field technical staff on the technique of developing and conduct ofoperational research, and the use of the results in decision-making.

(xii) Continuation of coordination by APOC Management of REMO (Rapid EpidemiologicalMapping of Onchocerciasis) surveys in the following APOC member countries: Burundi,DRC, Angola, Sudan, Liberia, CAR; continued refinement of these REMO surveys in the

countries concerned, and the integration of survey data into the Geographic lnformationSystem (GIS).

(xiii) Continuation of coordination by APOC Management of the mapping of Loa loa in: Congo,

DRC, Cameroon and South-Sudan to determine areas of onchocerciasis/Loa loa co-

endemicity, where the risk of SAEs after treatment with ivermectin is likely to be high.

o

(x)

JAFI I.6Page 3

(xiv) Continuation of the Phase tr long-term impact assessment of APOC operations on themajor indicators of the endemicity of onchocerciasis, on the epidemiological,dermatological, ophthalmologic and entomological levels.

(xv) Continuation of participatory follow-up/monitoring of ivermectin distribution projects byindependent scientifi c experts.

(xvi) Continuation and enhancement of self-monitoring of CDTI implementation bycommunity members

(xvii) Management of possible severe adverse events (SAEs) in areas that are co-endemic foronchocerciasis/Loa lo4 and support for operational research proposals aimed at sheddinglight on all SAE-related issues.

(xviii) Continuation of advocacy, Information, Education and Communication (IEC) activities,through the production of a guide on the stratery of developing IEC messages adapted tothe local context as well as the production of tools for underpinning the IEC activity.

(xix) Continued consolidation of the scientific bases of the Programme through operationalresearch, in close collaboration with the special prograrnme of Research and Training onTropical Diseases (mR)..

(xx) Continuation of collaboration between Programme Management WHO Regional Ofticefor Africa, WHO countr5r offices in participating counffies, the World Bank Oncho Unitin Washington, the WHO Administration and Finance office in Geneva, and theProgramme for the Prevention of Blindness and Deaftress (PBD) of WHO Headquarters inGeneva, which, as obtained in the past, will see to liaison and coordination with the groupof NGDOs.

(v.xi)

(xxii)

Support for the AFRO/APOC liaison office based at WHO Headquarters in Geneva.

Covering of consultant costs, of half of the operational costs of the office of the NGDOcoordinator based in Geneva, including half of the cost of a secretary of the office basedin Genevq and travel costs, as well as the cost of office supplies.

(xxiii) Continuation of support for the search for a macrofilaricide in close collaboration withTDR.

(xxiv) Continuation of vector elimination-related activities in identified foci in three APOCmember countries: Equatorial Guine4 Uganda" and Tanzania.

(xxv) The implementation of a policy of support and follow-up of treatment of Oncho patientsliving in hypo-endemic areas not eligible for CDTI.

(xxvi) Continuation and enhancement of the collection of statistical data on ivermectindistribution and progress in CDTI implementation in APOC member countries. To thisend, the Programme will continue training national top-level statistics personnel for datacollection, analysis and interpretation.

(xxvii) Covering salaries/emoluments of Programme staff based in Ouagadougou, follow-upmissions, evaluation and coordination missions in participating counffies by Programmestaff and by consultants.

JAFI I.6Page 4

(xxviii) Participation of APOC Management in sessions of the Committee of Sponsoring

Agencies (CSA), as well as missions of advocacy and fundraising organised by the World

Bank

(prix) Preparation and holding of two TCC ordinary sessions in Ouagadougou @urkina Faso),

and the l lh JAF session of the Programme in Paris, France.

As part of scheduling of activities to be undertaken in 2006, the overview of projects is as follows:

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2 'OB.IECTTVE

2.1 Recatl of overall Programme objective

The 2006 Plan of Action and Budget is centred on the overall Programme objective as follows:"To establish, within a period of 12 to 15 years, effective and self-sustainable, communitydirectedivermectin treatment throughout the endemic areas within the geographic scope of the Programme, and, ifpossible, in selected and isolated foci, to eradicate the vector by using environmentally safe methods. The

attainment of this objective is expected to contribute towards the elimination of onchocerciasis as a

disease of public health and socio+conomic importance throughout Africa and so improve the welfare ofits people."

Given this overall objective, and the progress chalked by the Programme for the past ten years, it plans

achieving in 2006 the 16 objectives listed hereunder:

2.2 Spccific Objectives of the Plan of Action and Budget ot2U0,6

a) Implement l0l CDTI projects and treat, at least, 45 507 000 persons;

b) Conduct entomological evaluation in 4 onchocerciasis vector elimination project areas;

c) Support and reinforce 7 central NOTF Secretariats;

d) Evaluate the sustainability of six (6) projects

e) Conduct independent monitoring of l0 CDTI projects, and the monitoring of

implementation of l0 sustainability plans;

f) Conduct selGmonitoring of l0 projects;

g) Conduct REMO/REA exercises in 4 countries, and RAPLOA exercises in two;

h) Support four countries in managing severe adverse events (SAEs)

i) Publish the results of the long-term impact assessment of APOC operations, and conduct

treatnent compliance surveys in three countries;

j) Support a review meeting on the situation in the four vector elimination foci;

k) Continue Operational and Macrofilaricide Research activities;

D Continue giving administrative and technical support to projects;

m) Build institutional capacity of countries in several areas (CDTI stratery, GIS, Finance,...);

n) Continue administrative collaboration with WHO/Genev4 WHO country offices and

NGDOs;

o) Provide Programme with adequate materials and equipment;

p) Bear overhead costs of Programme headquarters.

3 2006 PLAI\NED ACTTVTTIES

3.1 CDTI Activities

They will be centred on the following:

JAFI I.6PageT

(i). Implementation of five new first-year CDTI projects: (1) in South-Sudan, (2) in DRC and' (2) in Angola.

(ii) Continuation of activities of twenty-two (22) CDTI Projects in their second year ofimplernentation: Sudan (3), Cameroon (3), DRC (9), Liberia (1), Burundi (3), Congo (l) and

Angola (2)

(iii) Enhancing the implementation of thirteen (13) CDTI projects in their third year ofimplementation: Nigeria (l), Tanzania(2), Cameroon (2), DRC (l), Liberia (1), Ethiopia (6).

(iv) Continuation of the implementation of seven (7) CDTI projects in their fourth year: Malawi(l), Nigeria (l), Cameroon (1), and DRC (2), ETHIOPIA (2)-

(v) Continuation of reinforcement activities under the implementation of six (6) CDTI projects intheir fifth year of implementation: Nigeria (l), Tanzania (2), Cameroon (l), DRC (2).

(vi) Giving limited financial support from APOC Trust Fund towands the reinforcement of forty-eight ASl projects in their 6^ ,7* or 86 year in the following countries: Malawi (l), Uganda(4), Nigeria (24), Tanzania (3), Sudan (l), Cameroon (E), Chad (1), CAR (l), EquatorialGuinea (l), DRC (l), Liberia (l), Ethiopia (l) and Congo (l).

(vii) Training and re-training sessions of CDDs will be organised in the form of workshops in ten

CDTI projects in Nigeria, Congo and Cameroon with a view to addressing the low CDD-treated population's ratio.

Meetings and training sessions will also be organised to:

(viii) lmprove data collection and processing competence, and the statistical data processing ofCDTI and other health projects for ease of decision-making;

(ix) Enhance the popularisation of the APOC philosophy through workshops that bring allstakeholders to the implementation of CDTI;

(x) lmprove knowledge on modalities and recording of statistical data on CDTI in Congo, DRCand Ethiopia;

(xi) Harmonise the content of messages to be delivered to learners, and enhance the skills oftrainers / training of trainers (health workers, primary health nurses) in four countries:Cameroon, Malawi, Tanzaniu and DRC.

(xii) Training of managers and Oncho control activity coordinators in four countries on operationalresearch and on EPI-INFO so as to promote and attain a l5o/o increase in operational researchproposals;

(xiii) Identiff and involve local NGDOs in new CDTI projects in three countries (DRC, South-Sudan and Ethiopia) and ensure enhancement of ownership of projects through communitiesin Cameroon, Chad, Liberia and Equatorial Guinea.

(xiv) To better share with national partners the APOC stratery and philosophy, two workshops tobe organised in Burundi, South-Sudan and Ethiopia.

(xv) Ensure transfer of skills in statistical data analysis and follow-up of financial management ofprojects, computer skills of nearly 90 persons in 5 countries for better interaction.

JAFI I.6Page 8

(xvi) Provide technical assistance to NOTF central secretariats through CDTI project rcviewmeetings with a view to improving the performance of 20 CDTI projects in six countries:DRC, Sudan, Nigeria, Cha4 Angolq CAR.

(xvii) Bring together top decision-makers of the health, finance and planning sectors, NGDO and

donors to brainstorm on the approach of integrating neglected diseases at the national health

level, namely through the integration of Oncho control per CDI (Community-DirectedInterventions) into the PRSP (target countries: DRC, Malawi, Ethiopia).

3.2 IEC Materials

(xviii) IEC materials will be improved and illustrated for use by illiterates, and pre-tested infour countries (Cameroon, DRC, South-Sudan and Uganda) in a bid to improvecomrnunication with the communities and facilitate data collection.

3.3 Evaluation and monitoring of Programme activities

(xix) Six CDTI projects will be evaluated on the basis of sustainability indicators with a view tomeasuring progress made, and facilitating the phasing out of the APOC Trust Fund. Theprojects selected are in Ethiopia, DRC, Liberia and Uganda.

(pr) Ten projects will conduct independent monitoring exercises of CDTI. These are projects inAngola, Burundi, Cameroon, Congo, Tanzania, South-Sudan, Liberia and DRC-

(xxi) Ten other projects will conduct monitoring of the implementation of sustainability plans, withthe participation of members of their governments in order to build the capacities of their top-level health officers. These exercises will lead to taking appropriate action towards the

effEective implementation of for onchocerciasis contnol integrating other community-basedprogrammes in Cameroon, Nigeria, Tanzania, Congo, Malawi and Sudan.

(:orii) Summary studies will be conducted by non-NOTF' nationals so as to detennine the

geographical and therapeutic coverage rates of l0 projects in 5 countries: Nigerig Cameroon,

DRC, Ethiopiq Uganda

3.4 Vector Elimination

The following will be organised:

(xxiii) Entomological surveillance/evaluation in the vector elimination project areas in Bioko

@quatorial Guinea); Tukuyu (Tanzania); Mpamba-Nkusi & Itwara (Uganda)-

(xxiv) A review meeting on vector elimination projects to assess their progress, and put in place

practical modalities for the cessation of surveillance activities, especially in the foci ofUganda.

3.5 Initiating disease mapping EEMO)

(prv) Refining activities will continue in four countries (Sudan, Liberia, Angola, DRC) so as toestablish updated data on the number of infected persons, and develop last DCTI projects.

3.6Initiating the mapping of loa loa (RAPLOA)

(xxvi) RAPLOA surveys will be conducted in two countries, and maps made available for CDTIprojects suspected to be co-endemic for onchocerciasis/Loa loa in the DRC and Sudan.

JAFI I.6Page 9

3.7 Activities of long-term impact assessment of operations

(xxvii) The outcomes of the long-term impact assessment of APOC operations will be published inscientific journals.

(xxviii) Longitudinal studies will be conducted on treatnent compliance. A hundred thousand (100000) persons will be involved in these studies in three CDTI projects in Cameroon (l),Nigeria (l) and in Tanzania (l).

3.8 Research

(ptix) Collaboration between TDR and the Prograrnme will be pursued so as to take stock of theprogress made on the research on integrating CDTIC into health systems; the attainment andmaintenance of high treafinent coverage rates, and Oncho treatnent compliance; the use ofthe "community-directed treatment" approach for other health interventions (Malaria,Tuberculosis, Vitamin A Supplementation), and for the development of treatment strategies inareas co-endemic for onchocerciasis/Loa loa.

(xxx) Programme's continued support for the search for a macrofilaricide. This will have to do withthe pre-clinical and clinical development of macrofilaricides against onchocerciasis, and alsothe development of diagnostic methods capable of detecting molecular resistance toivermectin n O. votvulus.

(:o<xi) The Programme could support six (6) rpsearch initiatives under the subventions granted bythe Director of the Programme, and ten (10) operational rcsearch proposals submitted by theNOTF to the TCC for its appraisal and funding by the APOC Trust Fund.

3.9 Programrne management and administration

(xxxii) Continuation of collaboration between APOC Programme Managemen! the WHO AfricaRegional Office, the WHO county offices in participating countries the Oncho Unit of theWorld Bank in Washington, the WHO administrative and finance offrce in Genev4 and theProgramme for the Prevention of Blindness (PBD) of the WHO Headquarters in Geneva,which, as in the past will ensure coordination with the NGDO goup.

(xxxiii) Continuation of Programme contribution to the maintenance of the AFRO/APOC liaisonoffice based at the WHO Headquarters in Geneva.

(xxxiv) Covering of costs of consultants, a greater percentage of operational costs of the office of theNGDO coordinator based in Geneva, including: half of the cost of a secretary, and travelcosts as well as the cost of office supplies.

(xxxv) Payment of salaries and emoluments of staff of the Programme based in Ouagadougou (seeorganisation chart in annexe 2), follow-up, evaluation and coordination of activities inparticipating countries by Programme stafi consultants and temporary advisers.

(mxvi) Participation of APOC Management in sessions of the Committee of Sponsoring Agencies(CSA), as well as in advocacy missions and fundraising organised by the World Bank.

(xxxvii)Preparation and holding of two TCC ordinary sessions in Ouagadougou (Burkina Faso) andthe 126 JAF session in a participating country of the Programme.

JAFI I.6Page l0

4 , FORECASTING BY PROGRAMME ACTTVTIY

4.1 Activities, Expected outcomes,Indicaton and projected costs for 2fi)6

Ac'tivities Expected Results Indicaton Estimstedcosts$us

l. CDII activities

a Training ofCommunityDistributors(CDDs)

a Training ofHealthworkers

a Ilealtheducation

a Productionanddistribution ofIEC materials

- 185 000 CDDs trained/retrainedto maintain a therapeuticcoverage rate of70Yo.- List of projects with lowCDD/treated population ratiodrawn up.

* Number of CDDs trained/re-trained increased qualitativelyand quantitatively, i.e. more than100 personVCDD, ildworkshops organised in at leastl0 CDTI projects in threecountries: Nigeri4 Congo,Cameroon* Number of projects with lowratio of CDD/population treated

l 400 000

- l8 000 local health workerstrained/re-trained, i.e. an increaseof llYo of workers that learntskills on CDTl-related statisticaldata collection and processingand that of other projects, toenable decisions to be made,

namely in Congo, DRC and

Ethiopia.

- Capacity of health workersimproved in the field of advocacyand community participation in atleast three countries (Nigeria,Congo, Cameroon)

- APOC philosophy reinforcedand popularised with parhersthrough three workshops inEthiopia, South-Sudan and

Burundi

* A number of local healthworkers trained/re-trained :

- on statistical data collection andprocessing

- on advocacy and communityparticipation

- on the popularisation of theAPOC philosophy and CDTIstrategy

700 000

- 65% of communities (nearly 95

000) reinforced and benefitedfrom health education.

* Number of sessions conductedand communities reached

514 000

- IEC materials improved,illustrated for use by illiterates,pre-tested in DRC, South-Sudan,printed and distributed in nearly50oh of implemented projects,and 75 000 CDDs trained on theuse of these materials, namely inCongo, DRC and Ethiopia

* Format of IEC materialsimproved, illustrated and pre-

tested

+ Number of CDDs trained on theuse of IEC materials

* Quality and number of IECmaterials distributed, used andquality/number of reports _

772 000

JAFII.6Page ll

Activities Erpected Results Indicators Estimstedcosts$us

received on communication withcommunities.

a Supenision andtraining of CDDstreiners

- 60% of CDDs trained /supervised for better assistance inprimary health care in Cameroon,Tanzanig Malawi and DRC

+ Number of supervisors CDDson the increase 354 000

o

o

Mobilisation,sensitisation &advocacy

Management ofSerious AdverseEvents (SAEs)

- Nationals and local partnerssensitised on CDTI stratery andAPOC philosophy; 170mobilisation and advocacysessions organised in districts andLGAs in DRC, South-Sudan,Ethiopia, and six local CBOsand/orNGDOs taking part inCDTI activities in targetcountries: Cameroon, Chad,Liberia, Equatorial Guinea

* Number ofmobilisation/sensitisation andadvocacy sessions organised;Number of local NGDOsidentified and involved in newCDTI projects, and the number ofmeetings organised on CDTIstratery in three countries: DRC,South- Sudan and Ethiopia

669 000

- 85Yo of SAE cascs are quicklyidentified and brought undercontnol by better informed, welltrained and equipped medicalteams in DRC and Angola

* Number of Severe AdverseEvent cases (SAEs) decreasingand better managed

257 000

a Capecity buildingof, and skilltransfer toprojects

- 400 nationals trained in variousareas (APOC strategy andphilosophy, GIS, Finance,...) 90persons at least, of these aretrained on statistical and spatialanalysis, and produce statisticalreports

* Number of persons trained onthe analysis ofgeographicaUstatistical data, andthe follow-up of project financialmanagement; expertise availab lefor implementing and owningCDTI.

s 14 000

a Integration ofCDTI and otherintenentions (Vitd ReproductiveEeaIth,Hfv/AIDS,Malaria...)

- 15 pilot experiments and/orsurveys conducted on theintegration of CDTI and otherdisease control interventions (inCameroon, DRC, Tanzani4Nigeria)- Eighty (E0) high-level decision-makers in health, frnance,planning, NGDOs and donorsmeet on the approach ofintegrating neglected diseasesinto the national healthdevelopment plans, in Malawiand Ethiopia.

Number of projects that carriedout the integration exercise, andlessons leamt available.

* Reports and recommendationsmade on the integration ofonchocerciasis control per CDIinto the PRSPs approach

360 000

2. SuoporUassistanceto CentralSecretariats ofNOCPs

- Seven more dynamic NOCPSecretariats on the field workingtoward the sustainability of CDTIin Angol4 Burundi, Cameroon,

* Number of central secretariatsof NOCPs active in thecoordination of activities of theProgramme

326 000

JAFI I.6Page 12

Activities Expected Results Indicetors Estimetedcosts$us

Ethropia Nigeria, DRC, South-Sudan, Uganda Chad andTanzania

- Ten managers and coordinatorsof onchocerciasis activitiestrained on EPI-INFO in order todevelop operational researchproposals in Cameroon, NigeriaDRC and Uganda

- Five accounting, computer andfinancial review training sessions

organised in the countries:Nigeria, Cameroon, DRC,Ethiopia and Uganda

Technical assistance made

available to central secretariats ofNOTFs during CDTI projectreview meetings and NOTFmeeting minutes available; CDTIproject performances improvedfor 20 projects in at least sixcountries: Burundi, Sudan,Nigeria, Chad, Angola CAR.

+ Training held, and l0operational research proposalssubmitted and approved

a Rate of technical andfinancial reporting and

the rate of CDTI projectsusing the APOC Website andstandard computer softwarein the follow-up of funds andreal estate of APOC is higherthanTOYo of funded projects

a

* Number of professionals, TCCmembers, and temporary advisorstaking part inNOTF reviewmeetings

+ Number of projects thatimproved their performance

3. Monitorinerctivities

- Independent monitoringexercises conducted in ten CDTIprojects in Angola, Burundi,Cameroon, Congo, T arvani4South-Sudan, Liberia and DRC

- Monitoring exercises ofimplementation of l0sustainability plans completed forCameroon, Nigeria, T anzania,Congo, Malawi, and Sudan

Number of ls year monitoringreports available

*Number of sustainability planmonitoring reports available

+Number of districts and areas

contributing financially to CDTIactivities

160 000

JAFI I.6Page 13

Activities Expected Results Indicators Estimatedcosts$us

4.Vector Elimination Entomological surveillanceactivities carried out in vectorelimination project areas for alltarget areas: Bioko/ EquatorialGuinea, Tuku5nr/Tanzanix,Mpamba-Nuksi & Itwara /Uganda

Vector elimination project reviewmeetings organised, and data oftargBt proj ects examined.

+ Vector biting rate.

* Annual Potential Transmissionrate in all the areas

* Number of progress reportsreceived, and recommendationson entomological surveillanceavailable.

-Report on s&atus of control ineach focus

- Recommendations on theduration of entomologicalsurveillance

98 000

2. Evaluption ofsustrlnebility

- Six CDTI projects TIDCevaluated, and sustainabilityindicators of CDTI projects andsupport structures developed tofacilitate the gradual financialpullout of APOC in fourcountries: Ethiopia, DRC,Liberia, Uganda

- Report and status ofsustainability of projects andfeedback made to projects

100 000

6.Lone-term jlqplg!assessment of APOCoperatlons

Phase 2 of impact studiescompleted on 12 sites in eightcountries.

Longitudinal studies on treatmentcompliance conducted in threeCDTI projects, and a hundredthousand persons (100,000)surveyed in Cameroon, Nigeriaand Tanzania.

Reports of entomologicaldermatological, socio-demographic and ophthalmologicstudies produced on the data oflong-term impact study of APOCoperations (phase 2') and articlespublished in scientific reviews.

Data on treatment compliance arecollated and report written up foreach ofthe countries.

95 000

7. Disease manpinq - REMO surveys conducted inSudan, Liberia, Angola and DRCto bring to 94Y, the rate ofcompletion of mapping of APOC

Completion rate of diseasemapping in APOC countries

Number of infected persons

165 000

JAFI I.6Page 14

Activities Expected Results Indicators Estimatedcosts$us

countries, and providing updateddata on the number of infectedpersons in Programme anea.

updated.Ultimate Treatment Objective

drawn up per country

- RAPLOA surveys conducted intwo countries (Sudan and DRC)for 100% of the CDTI projectareas suspected to be co-endemicfor onchocerciasis/loa loa to be

mapped.

Co-endemicity mappingcompletion rate in APOCcountries and mapping of priorityCDTI updated in three countries.

E. Technical supnortto national oroiectsbvPrognmme units

- Permanent technical assistanceprovided for ll2 operationalprojects; support to countries inthe drawing up of projectproposals, implementation,follow-up and evaluation ofivermectin distribution projectsand vector elimination; liaisonwith the NGDO Soup, andnecessary support for statutorybodies of the Programme (TCCand JAF)

a Sustainable drug distributionUnit (7-members staff,including one proposal of aTemporary Staff Position(STP4) and a new regularFix-Term Staff Post (Pa) of" Science Specialist"

a Epidemiolory and VectorElimination staff ( I 2-memberstaff, including twoTemporary Staff Positions(STP3 and STP4) and a newregular Fix-Term Staff Post(P3) of " Information andCommunication TechnologyOfficer"

Reports available, and externalviews given by temporaryconsultants and advisors recruitedon a regular basis.

+ Number of missions an othertechnical services ensured byAPOC staff to national projectsand other auxiliary activities ofthe Programme

* Quality of submitted project orresearch proposals

+ Quality of presentations madeby projects during statutorymeetings.

Reports of services of temporaryconsultants and advisorsproduced for the Programme.

l 705 000

JAFI I.6Page 15

Activities Expected Results Indicaton Estimetedcosts$us

Consultant and advisor servicesaccessible to Programme and

projects.- Temporary professionalsidentified and recruited to assist

in Programme implementation.

- Recruitnent of temporaryconsultants and advisors tofacilitate meetings, missions toprojects, and brainstormingworkshops on subjects ofooilrmon interest for theProgramme.

External expertise available and

involved in technical support and

assistance to projects and

Programme.

9. Grent for theseerch for epecrolilericide

Continuation of support for thesearch for a macrofilaricide so as

to ensure pre+linical and clinicaldevelopment of macrofi laricidesagainst onchocerciasis, and alsothe development of methods fordetecting any possible resistanceof O. volvulus to ivermectin.

Report made to statutory bodiesof Programme.

Reports on activities conducted.

700 000

10. OncrationalReseerch

Report written up, and JAF I Iparticipants infonned of researchon the integration of CDTI intohealth systems. The attainmentand maintenance of hightherapeutic coverage andtreatnent compliance rates; theuse of the "Communit5r-DirectedTreatment" approach forinterventions in other health areas(Malariq Tuberculosis, VitaminA Supplementation...) and thedevelopment of treatnentstrategies in areas that are co.endemic for loaloa./onchocerciasi s ( in DRC,Cameroon, Nigeria, Uganda)

Collaboration with TDRcontinued, and results of CDIstudies (Phase 2) presented atJAF 12.

430 000

10 relevant areas underoperational research.

Number of operational researchschemes initiated by NOTFs onthe increase by 15-20%

SUBTOTAL -I (OPERATIONAL COSTS) 9 319 000

JAFI I.6Page 16

Activities Expccted Results Indicetors Estimatedcosts$us

ll. ProerrmmeManasement

Programmcstatutorymeetings

* TCC sessions to be held inMarch and September 2005 toexamine new project proposals,and to take cognisance ofprogress made in projectimplementation.

+ Twelfth JAF session preparedand held, including translation ofrelated documents.

Statutory meetings wellorganised:

* Two TCC session reports.

* JAI] 12 final communiqu6 andreport.

180 000

a Iflenrgement endadministration ofthe Programme

Managernent and coordination ofadministrative and fi nancialservices carried out by 46-member staff, made up of:- The Director and his directsecretariat (6 members)

- Office of the Coordinator ofProgramme Director (40 members,including two Temporary StaffPositions (STP3) and a new regularFix-Term StaffPost (P4) of *Budget

& Finance Officef'

- Temporary staffhired, andovertime hours regularly paid.

tHuman and financial resourcesavailable for fulfilling mandate ofProgramme.

- Number of advocacy andsensitisation visits- Number of internal auditmissionsNumber of additional projectsimplemented

- Number of recruitment dossiersof temporary staff processed

- Number of materiaUequipmentorders processed.

- Number of letters of agreementmanaged- Number of personnel dossiersmanaged

Man/month of temporary staff.No. of overtime hours of generalservices stafftaken care of byProgramme

l 260 000

a Collaborationwith WIIO/AFRO\ilHO/Genevaand the NGDOcoordinationoffice

- Administrative assistance takencare of by WHO and NGDOs at

international, regional andnational levels.

- Number of fund transfersfacilitated by WHO/AFRO (viaWHO country offices andWHO/Geneva

- NGDO reports

Number of mission travelauthorisations and plane ticketsfor European and Americancollaborators of Programme

315 000

O

JAFII.6Page 17

Activities Expected Results Indicators Estimatedcosts$us

o Olficial Missionsand travels forassistance toprojects

- Training carried out withtechnical, administrative andfinancial assistance on the fieldfrom Management.

APOC Management representedat statutory meetings ofProgarme partners.

* Number of support visitsconducted to countries (training,re-training, review)

* Number of participations ofManagement in statutorymeetings of Programme partners.

30 000

a Meintenance ofequipment & andcomputernetwor*of APOCheadquarters

Maintenance work on equipmentcarried out. * l0 vehicles in good running

statet Buildings and equipment wellmaintained.* Security outfit in place.t Utilities (water, electricity and

telephone bills settled on time.

130 000

a Equipment,supplies, logistics,Printing andoIficeconsumables

Computer network managers

trained on routine interventions,and Management computers are

connected to system network and

operating normally; all incidentsare detected on time.

Office materials and supplies and

miscellaneous consumables, and

computer equiPment;maintenance of computernetwork.

Statutory documents produced ontime.

Temporary staff hired, andovertime hours regularly paid.

a Guaranteed electronicinformation system.

Quality of routineinterventions.

a

* Materials and offrce furniture ingood state, and consumablesavailable.* Number of materials and

equipment operational.* Number of out-of-stock cases

reduced.

* Number of documents producedand distributed to Programmepartners.Mar/month of temporary staff.

No. of overtime hours of generalservices stafftaken care of byProgramme

15 000

SITB.TOTAL . II (ADMIMSTRATTVE COSTS) I 930 000

OVERALL TOTAL: SUB-TOTAL (I) + (II) 11 249 000

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JAFI1.6Page 20

4.3 2006 Budget in relation to that of 2fl)5 and 2004

Table 4: Proposed 2006 Budget in relation to that of 2005 and 2004

Amount

Proposed Approved ApprovedBudget line item20,}6 2005 2004

RECTIRRENT CHARGES

I 257 000Personnel services I 260 000 t 257 000

Consultants and technical assistance I 53E 000 1792000 I 734 000

Travels 163 000 200 000 200 000

700 000Macrofil Project 700 000 700 000

Contracts (research and others)

(i) PBD - forNGDO liaison

(ii) TD& APOC countries and otherinstitutions

(iii) cDs (REMo/Grs)

430 000 589 000 619 000

140 000Operational costs 145 000 148 00040 000 62 000 20 000Supplies

180 000 170 000 170 000Statutory meetings

National CDTI Projects, including in some cases

other health activities in the form of pilot projects. 6 066 255 7 119000 6 675 854

460 000National vector elimination projects s8 000 s57 000

Training, Workshops, Mobilisation, Advocacy220 807 485 000 450 000

390 000Administative support : WHO/AFRO/HQ

Geneva, NGDO and WHO offrces in APOCcountries

386 000 390 000

Subtotal tt 1E2062 13 466 000 12923854Fixed assets

Office equipment 36 000 39 000 45 000

Computer equipment 29 000 15 000 l5 000

Technical equipment I 938 24 000 30 000

Subtotal 66 938 78 000 90 000

TOTAL 11249 000 13 s44 000 t2 913 854

JAFI 1.6

Page 2l

4.4 2006 Budget by category of budget line item in relation to that of 2005 and 2004

Table 5: Proposed 2006 Budget by category ofbudget line item in relation to that of2005 and2004

$USAmount

ApprovedProposed Approved2005 2004

Budget line item2006

RECTJRRENT CHARGESWHO/APOC staff

l 80 000 232 400 232 400Director and Secretariat

l 080 000 1 024 000 l 024 000Office of the Coordinator of Programme Director'soffice

1 260 000 | 256 400 t 2s6 400Sub-total

1 s38 000 | 792 600 t 734 600Consultants and technical assistance (fromsustainable drug distribution Unit and

epidemiology and vector control Unit)

200 000 200 000Travels163 000

700 000700 000 700 000Macrofil Project

148 000140 000 145 000Operational costs

619 000430 000 s89 000Contracts (research and others)

(i) PBD - for NGDO liaison

(ii) TDR, APOC countries and otherinstitutions

(iii) cDS (REMO/GrS)

106 938 140,000.00 1 10 000Supplies and Equipment

6 675 854National CDTI Projects, including, in some cases

other health activities in the form of pilot projects6 066 255

7 119 000

460 000National vector elimination Proj ects 58 000557 000

220 807 485 000 450 000Training, Workshops, Mobilisation, Advocacy

170 000Statutory meetings 1 80 000 170 000

390 000Administrative support WHO/AFRO/HQ Geneva,NGDOs and WHO offices in APOC countries

386 000 390 000

TOTAL 11249 000 13,544,000.00 12 913 854

JAFl 1.6Page 22

Kev:

statutory Meetings2%

Administrative supportWHO/AFRO/HQ GenevaNGDO WHO Offices in

APOC countries3o/o

Travels1%

Supplies and Equipment1%

Gontracts (research andothers)

4Yo Operational Expenses1%

Macrofil Project6Y,

Personnel Services11%

Training WorkshopsMobilisation Advocacy

2o/o

Consultants andTechnical assistance

14Yo

Budget by category of budget line item ( $us) oh

National project (CDTI * Vector elimination +HQs)

Consultants and technical assistanceTraining, Workshops, Mobilisation, Advocacy

Personnel services

Macrofi laricide Proj ect

Contracts (research and others)

Administrative support WHO/AFRO/HQ GenevaWHO Offices in APOC Countries

Statutory MeetingsTravels

Supplies and Equipment

Operating costs

54,440/o

13,670/0

1,960/0

11,200/o

6,220/o

3,820/o

3,430/0

1,600/0

1,450/o

0,95%1,240/0

6 124 2551 538 000

220 807

1 260 000

700 000

430 000

386

180

163

106

t40

000

000

000

938

000

Total 11 249 oool 1oo, oo%

4.5 Graph representation of 2006 budget by category of budget line item

Figure I : Graph representation of 2006 budget by category of budget line item

National Projects (CDTI+ Vector Elimination)

55o/o

JAF11.6Page 23

4.6 Budget Breakdown by major budget category items

Figure 2 : 2006 Administrative and operational costs

ADMINISTRATIVECOSTS17.160/o

OPERATIONALCOSTS82.84o/o

L-

JAr'1 1.6

Page 24

4.7 . Evolution/trend ofnumber ofprojects approved and the budgets approved orsubmitted from 1996 to 2006

Figure 3 : Evolution of number of approved projects from 1996 to 2006

-+ Number of approved projects per year

--r- Total of approved projects140

120

100

80

60

40

20

1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Figure 4 : Evolution/trend of budgets approved from 1996 to 2005 and submitted for 2006

18 000 000

16 000 000

14 000 000

12 000 000

10 000 000

8 000 000

6 000 000

4 000 000

2 000 000

1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

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JAFI I.6Page25

a

ANNEX 1: AVERAGE TINIT COSTS USED FOR BUDGET CALCULATIONS

I

2fi)6 2005 2004 2003 2002 2001

Steff

Professionals

-PGD2 190 000 170.000 170.000 155.000 rs5.000 15s.000

- P4-P5 165 000 145.000 145.000 145.000 145.000 145.000

- P2-P3 I 10 000 I15.000 I15.000 I15.000 I 15.000

-STP4-STP5 l2l 000 90.000 90.000 E5.000 85.000 85.000

STP2-STP3 90 000 65.000 65.000 65.000

- General scrrices 22 000 18.000* 18.000 14.000 20.000 20.000

. STG 8.800 8.800 8.800 6.000 4.000

- ConsultanVmonth 7 000 7.000 7.000 7.000 7.000 7.000

- Temporary staff(General services)

800 800 800 800 800 E00

Dollar equivalent

- CFA Francs 505 560 550 600 550 550

- Euros 0 .770 0.847 0.849 1.55 5.50** 5.50+*

- Swiss Franc l.l8 l.3l 1.30 1.42 1.42 1.42

- Pound sterling 0.554 0.584 0.610 0.58 0.58 0.58

- Canadian dollar t.23 1.35 1.38 1.38 1.38 1.38

- Japanese Yen I l0 r 12.00 118.00 l12.00 I12.00 112.00

* Average cost raised in relation to 2005 costs, taking into account reality of expenditure incurred** French Franc

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