November-December 2012 Trip Highlights

See some picture of this trip on our Facebook page

Government Registration efforts

I found out while inquiring about the process for obtaining tax exemption for importing medical equipments and supplies into DRC that in addition to registering UFAR with the Ministry of Health in 2005, registration of UFAR with the Ministry of Justice, the Ministry of Planning and at the Commune of Ngaliema in Kinshasa where our office is located were also required in order to legally operate as a nonprofit organization in the country. Registration with the Ministry of Planning is the last step, contingent to prior registration with the Ministry of Justice and the Commune of Ngaliema. It's a long process that requires ministerial approval and signature for completion. As such, a temporary certificate of registration is routinely issued to allow an organization to operate while waiting for the final document. This certificate is required as part of the application package for opening a bank account by a nonprofit organization, and grants the right to hire local employees as well as provides temporary tax exemption for imported goods. Registration certificates with the Ministry of Justice and the Commune of Ngaliema were obtained at the end of the summer of 2012. I resume efforts for registration with the Ministry of Planning immediately upon my return to Kinshasa on this trip, resulting in the certification being issued on November 28, 2012. Unexpected requests by several international banks represented in Kinshasa for copies of notarized French versions of the IRS letter classifying UFAR as a 501 ( c ) 3 organization and the UFAR Bylaws delayed once again opening a UFAR bank account in the country.

Joint Action Forum

The Joint Action Forum (JAF) of the WHO's African Program for Onchocerciasis Control (APOC) is the governing or decision making body of APOC, made up of the Ministry of Health of each endemic country, the World Bank, the donor countries, NGDOs, WHO/APOC staff, etc. JAF meets once a year, usually during the first or second week in December. The hosting of JAF alternates between endemic countries and donor countries. This year's meeting was hosted by the Government of Burundi and was held in Bujumbura, the capital city. The meeting was chaired by Dr. Sabine Ntakarutimana, Minister of Public Health and AIDS in Burundi, and vice-chaired by Dr. Caroline Harper, CEO of Sightsavers.
Several recent epidemiological and entomological studies have clearly and convincingly showed that onchocerciasis can not only be controlled, but more importantly eliminated as a major public health and socio-economic problem. Study analysis suggested that with adequate support, a total of 23 out of 28 oncho-endemic African countries may achieve elimination of the disease by 2020. The new paradigm shift from control to elimination of onchocerciasis necessitated the extension of APOC mandate which was expected to end in 2015. Several major decisions were made by JAF in this regard, including the following:

  • JAF approved in principle the additional transitional budget of $6.6 million proposed by APOC to intensify activities related to elimination of onchocerciasis in Africa in 2013, and the Plan of Action and additional Budget of $25.8 million for 2014-2015.
  • JAF endorsed in principle the Concept Notes on the role of APOC in the new paradigm of onchocerciasis elimination, co-implementation with lymphatic filariasis and other health interventions, and strengthening of community level health systems, and the related Strategic Plan of Action and Budget for 2016-2025.
  • JAF commended APOC for carrying out integrated mapping of NTDs and strongly encouraged completion of mapping in the remaining regions, with particular reference to DRC.
  • JAF endorsed the proposal to increase the level of reimbursement to NGDOs for their increased technical support of the projects in the transition from control to elimination of onchocerciasis from 7.5% to 12.5% starting in 2014.

Dr. Paul Lusamba, the current director of APOC, informed JAF of his planned retirement from WHO at the end of December 2012. The announcement was immediately followed by applause and standing ovations. The JAF wholeheartedly thanked Dr. Lusamba for his commitment in ensuring that the gains of APOC over the years in the fight against onchocerciasis are sustained and taken to greater heights, especially with the new paradigm shift control to elimination of the disease and integration with other health interventions related to NTDs.

Sightsavers inaugural trip to Ituri, 15-18 December 2012

A unique Memorandum of Understanding (MOU) between Sightsavers and UFAR was established in August 2011 through which Sightsavers, with no prior involvement in DRC, agreed to support through UFAR 2 CDTI projects in DRC previously without NGDO support, namely CDTI Lubutu and CDTI Ituri North. At the request of Mr. Simon Bush, Director of Neglected Tropical Diseases at Sightsavers, a special trip to Ituri-north in the Province Orientale of DRC was planned immediately following the JAF 18 meeting in Bujumbura. News of major insecurity concerns in the neighboring Kivu provinces did not deter or dampen Simon's interest and commitment to go on with the mission. Fortunately, none of the security concerns materialized during our trip. In addition to Mr. Bush, the visiting team included Dr. Tony Ukety (NTD/Onchocerciasis NGDO Group Coordinator, Geneva/ Switzerland) with deep-rooted origins in the region and Mrs. Amanda Hitchins (a former UFAR student intern).

Our flight itineraries took us from Bujumbura/Burundi to Entebbe/Uganda to Arua/Uganda and then by vehicle from Arua airfield to Aru/DRC. Aru is the capital of the Ituri-north health district and the headquarters of Ituri-north CDTI project. The various activities of the visit were organized by our host, Dr. Leonard Lopay, medecin chef de district and the coordinator of the Ituri-north CDTI project. They included:

  1. Slide presentation giving an overview of the Ituri-north project
  2. Visit to the dilapidated skeleton of the ophthalmologic service in Aru General Hospita, turned into gynecological department
  3. Visit to the Centre d'Education et de Rehabilitation a Base Communautaire in Aru (CERBC)
  4. Meeting the Tujenge Association, an inspiring self-help and self-sustaining group in Aru
  5. Field trip to Bholi health center and observation of a theatrical demonstration of the Mectizan distribution program by the community directed distributors.
  6. Field trip to Biringi health zone and observation of several people with skin and ocular manifestations of onchocerciasis.
  7. Field trip to Mahagi health zone and interviews with several village chiefs along the way.
  8. Recording of several case studies of people whose lives have been changed by the Mectizan donation program.

Time constraints for a mission made so close to Christmas and from anticipated poor road conditions caused the cancellation of a planned trip to the pygmies region in the Ituri Forest and another trip to Lake Albert region suspected of high endemicity for schistosomiasis. Integrated mapping for NTDs in this region as in many other regions in DRC is significantly behind schedule.

A very nice report on several of these activities has been prepared by Simon Bush. Case studies are being consolidated for sharing with our partners. Indeed, this was a wonderful and very informative trip, the first of what undoubtedly will be followed by many more like it. Simon's report leaves the reader with a very positive impression on Sightsavers' future involvement in providing sustainable comprehensive eye care programs integrated with other health interventions in this region of DRC