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Annex 2.1 Page 3 of 5

8.    The Program's accomplishments received considerable International recognition in

late 1992 when its director, Dr. Ebrahim Samba, received the Hunger Project Prize for African Leadership and the Italian and Swiss Balzan Prize for preventive medicine-the first African to receive this prize in its 35 year history. These awards explicitly recognize Dr. Samba's excellence in leadership and management. But they also reflect the commitment and dedication to this Program by the intemational community-the West African beneficiary countries, the donors, and the sponsoring agencies-as well as the Staff of the Program, 97% of whom are West African.

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9.    In February of last year, representatives of the Program's 22 donors and 11

beneficiary countries gathered at Bank headquarters for the signing of the Phase Four Fund Agreement which will take the Program through 1997. This agreement embodies the pledges of 22 donors enabling Phase Four to be launched with secure financing of US$165 million-94% of the required financing of US$175 million over the next six years. The World Bank bas pledged US$2.63 million per year for Phase Four, subject to annual approval by the Executive Directors. This represents 9% of the financing required over the 1992-1997 phase. In this period of increasing demands on aid budgets, this major multi-donor commitment to continued fonding is a tribute to the effectiveness of the Program, the quality of its management and the overall importance of the Program's objective in the context of other development priorities. During this last major operational phase, it is expected that the Program will largely eliminate riverblindness throughout the 11-country area. Following Phase Four, the Program will wind down to a definitive conclusion by about the year 2000. At that point total Program expenditures will have reached nearly US$580 millio’i in nominał terms-a cost which averages out to less than US$1 per person protected per annum c ver the Program’s 27 year history.

10.    A discemable shift in priorities was apparent at the Geneva JPC as the Program

enters its concluding phases. With the achievement of fuli control over the disease in sight and the winding down of Program operations, the donors and beneficiary countries are turning their attention to sustaining the Program's achievements and building upon new development opportunities arising out of successfol onchocerciasis control.

11.    A major challenge of Phase Four will be to put into place at the national level the

institutional infrastructure and knowledge base for ensuring the sustainability of the Program's achievements. This process, which has been labeled *devolution,‘ primarily involves transferring the Program's extensive skills in disease surveillance and treatment to the beneficiary countries. The Program is committed to assisting the beneficiary countries in establishing surveillance and response systems capable of preventing any major recurrence of the disease.

12.    This past year, the Program created a Devolution Unit to coordinate work in this

area. The Unit has already assisted in the preparation and revision of national devolution plans for eight of the beneficiary countries, most of which cali for establishing multi-disease surveillance and control systems that will extend the epidemiological expertise deveioped for controlling riverblindness to other diseases such as guinea worm, schistosomiasis and sleeping sickness. It is also coordinating Information campaigns to notify local populations of the consequences of the blackfly's return and the importance of Mectizan in the prevention of blindness.