"That the secretariat, together with the Programme Committee, consider ways to establish an e-mail network to improve communications between the coordinators, the secretariat and advisory groups to enhance the functioning of the Programme."
WHO hope to partially solve the problem of e-mail networking through the use of "Healthnet", an NGO operated network. The possibilities of extending this to meet the needs of the programme should be further investigated by the secretariat. The basis on which the network should be established is the lists of Coordinators and the FAO national liaison officers. The meeting was also informed that the proposed EC funded regional programmes could, once implemented, make provision to assist in communication strengthening between participating countries.
" The Programmes' logical framework should include a system for monitoring and evaluation, with well defined OVIs. This should be drafted by the secretariat for acceptance by the Programme Committee".
The recommendation was endorsed on the basis that the programme show tangible benefits over time with recorded means to verify the progress. It was left with the secretariat to draw upon the voluntary assistance and experience of RTTCP personnel and to draft the proposal. A subsequent decision was that this exercise be finalised through a logical framework workshop involving members of the Programme Committee.
"In specific cases funds should be made available to enable coordinators to attend meetings and to gather the required information in their areas of responsibility".
Although sympathetic to the need to support the activities of donors the consensus of the meeting was that the provision of funds should in this case remain as a responsibility of the secretariat organisations, the countries concerned and/or with national/regional donor supported programmes. The issue remains to a large extent unresolved, the exception being in SADC countries where RTTCP funds may be made available to facilitate the travel of Southern African based coordinators. The regional office of the RTTCP will follow-up in consultation with the secretariat.
"The programme information, collation, analysis and dissemination of data functions, as provided by FAO, require major strengthening in the form of human resources for data management".
The meeting recorded their full support to these activities and of the value of the results which facilitate decisions as to where funds and effort may be focused to achieve maximum benefit. It was further agreed that, as recommended by the coordinators meeting, the central focus of these activities should be FAO who, in close collaboration with WHO, should ensure the inclusion and amalgamation of data on sleeping sickness.
In appreciation of the expertise required and of the demands that these activities would place on the resources available to the secretariat discussion then turned to the mechanisms for implementation. Two alternatives were identified: i) an Associate Professional Officer (APO) to be seconded to the programme secretariat at FAO by one of the donor countries or, ii) the provision of extra-budgetary support for the recruitment of a high level experienced and qualified data management Officer for a period of up to 30 months. It was concluded that the secretariat should define in greater detail the work proposed, the inputs required and the objectives and outputs to be realised. On the basis of this information requests for extra-budgetary support could then be submitted to potential partners for further consideration.
"The factors which determine and influence the sustainability of tsetse control in various scenarios of cost-recovery, land tenure, farming systems, ecological and socio-cultural conditions should be further investigated and clarified. This should be initiated through the secretariat".
The meeting agreed in principle to the concerns raised by this recommendation and to the responsibilities vested in the secretariat in this respect. The matter was raised again later in the meeting due to its close association with economic situations and the options for devolution of control responsibilities to the beneficiaries and for privatisation.
"Effective surveillance systems should be initiated to clarify the worsening sleeping sickness situation in a number of foci, and to facilitate the prediction of further epidemics".
The meeting, in agreeing with the recommendation, stressed that it be amended to include disease prevention. It was also cautioned that due to the dramatic recrudescence of the disease in many areas, the resurgence of a number of historic foci, particularly in Ethiopia and Tanzania, the regional EC programme for East Africa should also address the human disease through surveillance and prevention measures.
In the ensuing discussion on the actions being taken and the problems being experienced in those countries where Sleeping sickness is now endemic, or near epidemic levels, concern was expressed over the inability of certain states to initiate and sustain active surveillance and implement the necessary control measures. It being noted that in Zaire disease prevalence of over 70% was now being recorded in some villages. The Committee agreed to give its support in encouraging the investment of bilateral aid to the countries concerned, in particular Zaire and Angola.
"It is recommended that the development of strategies for tsetse control programmes take into account all available technical options and thus enhance approaches to Integrated Disease Management".
The meeting fully endorsed the recommendation whilst at the same time emphasising the need to agree on an appropriate definition of the term" Integrated Disease Management". This topic was then discussed, in more detail, later in the meeting.
"The meeting recommends that funding for the World Acaricide Resistance Reference Centre (WARRC) be assured to address concerns over the possible development of insecticide resistance in tsetse ( and ticks as a result of tsetse control operations ) and to facilitate the integration of tsetse with tick and tick borne diseases control".
This recommendation was tabled based on technical concerns over the increasing popularity of insecticides, mostly in "pour-on" formulations, for tsetse control and their increasingly haphazard application as many veterinary services were losing the capacity to exercise supervision over their use. The committee therefore, recognised the crucial role of standardised procedures for monitoring of drug resistance in both tsetse and other target species, such as ticks and screw-worm flies, and expressed concern over the imminent closure of WARRC due to lack of funds. It was recommended that the various possibilities for retention of this facility be investigated, i) that suitable regional centres be identified and, ii) that IAEA consider its incorporation into the new Codex Alimentaris Centre once this has been constructed in Vienna iii) an approach be made to the WHO Pesticides Unit (WHOPES) of the Division of Control of Tropical Diseases where similar work is presently being done by one of their reference centres.
"The programme should utilise its resources to investigate the feasibility, and pursue the progressive privatisation, of tsetse and Trypanosomosis operations".
Although the subject was accepted as an important issue that needed to be addressed the meeting was divided on their views as to the practical possibilities for, and the advisability of, moving in this direction. Animal Trypanosomosis control using drugs was one area where privatisation may more easily be achieved. However, it was felt by many participants that tsetse control may be most effectively delivered by well planned and organised schemes that would demand public sector involvement. It is therefore, seen as a question of obtaining the optimal balance between private and public sector involvement. In conclusion it was agreed that the issue be the subject of further study within the secretariat and advisory groups. Their findings to be presented to the next Committee meeting in the form of a Position paper.