The First Regional Meeting Global Environmental Facility (GEF) Supported Countries in EMR Muscat, Oman, 6-8 March 2006 Vector Control Situation Within the Context of SC In Sudan Mustafa Y.H. Dukeen Ahmed M. El Hindi Ahlam H. Ahmed Hmooda Toto

CONTENTS: Fast Fact on Sudan, Principle Vectors of Disease & Distribution in Sudan, Multiple Preventions (Evidence-based & cost effective intervention), Vector Control Activities According to Stratification, The Current Vector Control Interventions (tools & methods used), Pesticide management practices, including policy and legislative frameworks, The status, quantities and management of obsolete pesticide stockpiles, current constraints and needs, The existing mechanisms for intersectoral collaboration on vector control.

Fast Fact on Sudan: Location: G. coordinates: N, E, N, E, Population: 34,475,690, Area:. total: 2,505,810 sq km. total: 2,505,810 sq km. land: 2,376,000 sq km. land: 2,376,000 sq km. water: 129,810 sq km. water: 129,810 sq km Climate: tropical in south; arid desert in north; rainy season (April to October), River Nile & tributaries: prominent feature.

Vector Control Program Focus: Vector Control Program Focus: Principle Vectors of Disease & Their Distribution in Sudan, The current vector control interventions (tools & methods); The pesticide management practices, The status, quantities & management of obsolete pesticide stockpiles (current constraints & needs); The existing mechanisms for intersectoral collaboration on vector control;

Principle Vectors of Disease & Their Distribution in Sudan 1. Malaria Vectors : Anopheles arabiensis:all over country, arid zones, Anopheles arabiensis: all over country, arid zones, Anopheles gambiae:more humid & forested habitats, Anopheles gambiae: more humid & forested habitats, Anopheles funestus :more humid & forested habitat, Anopheles funestus : more humid & forested habitat, Anopheles pharoensis & Anopheles nili:potential vectors Anopheles pharoensis & Anopheles nili: potential vectors

Principle Vectors of Disease & Their Distribution in Sudan 2. Leishmaniasis Vectors : Phlebotomus papatasi: savannah & desert fridges Phlebotomus papatasi: savannah & desert fridges Phlebotomus orientalis: Gedarif, Sennar, Phlebotomus orientalis: Gedarif, Sennar, Blue Nile, Unity & Old Upper Nile States Blue Nile, Unity & Old Upper Nile States 3. Onchocerciasis Vectors : Simulum damnosum & S. surbanum: Simulum damnosum & S. surbanum: South west Sudan (Bahr El Ghazal & Bahr Al Arab mainly) & South west Sudan (Bahr El Ghazal & Bahr Al Arab mainly) & Abu hamad focus Abu hamad focus,

Principle Vectors of Disease & Their Distribution in Sudan 4.Trypansomiasis Vectors (Gambiensis & Rhodesiensis): Glossina palpalis,G.moristans & G. foscus : Glossina palpalis,G.moristans & G. foscus : Mainly riverine & forest habitats in Mainly riverine & forest habitats in Southern Sudan, Southern Sudan, 5. Other vector-borne diseases: –Bancroftian filariasis : (mosquitoes), –Arboviruses: (mosquitoes mainly), –Other vectors/pests of PH importance: flies …

The Current Vector Control Interventions The Current Vector Control Interventions (tools and methods used)

Malaria & Other VBDs Control is based on: a variety of strategies to respond to the epidemiological heterogeneity of the disease

Malaria & other VBDs Burden in Sudan > 50% of malaria cases in EMR reported from Sudan The whole country is endemic with malaria All population at risk of malaria 80% of population live in epidemic-prone areas Annual records on malaria accounts for: million cases million cases deaths deaths - Loss in working days - Loss in working days - Treatment cost - Treatment cost Other VBDs (Leishmaniasis, Onchocerciasis, A. Sleeping Sickness and recently Y.F. & D.F.

Vector Control Management Strategies: Vector Control Management Strategies: IVM implementation: IVM implementation: Main IVM components according to stratification: ITNs, IRS, chemical Larviciding environmental & IPT. Focus at present: ITNs & DDT alternatives on VBDs control Implementation limitations: budget availability Malaria Control annual budget 3.2 million US$ Malaria Control annual budget ~ 3.2 million US$. VC comprising 1/3 of the overall budget,. VC comprising ~ 1/3 of the overall budget,. Proportion of ann. local budget 1.92 m US$. Proportion of ann. local budget ~ 1.92 m US$. Proportion of ann. Exter. budget 1.28m US$. Proportion of ann. Exter. budget ~ 1.28m US$ Monitoring & Evaluation Operational Research

Multiple Prevention (Evidence-based & cost effective intervention): Scale up ITNs Expand IPT use Selective Vector Control Options based on local Epidemiological Stratification : IRS: Indoor Residual Spraying IRS: Indoor Residual Spraying CL: Chemical Larviciding CL: Chemical Larviciding EM: Environmental Management EM: Environmental Management SIT: Sterile Insect Technique SIT: Sterile Insect Technique Biological Control (BC) Biological Control (BC)

perineal Irrigated Seasonal Urban Desert stratification INTERVENTIONS

INSECTICIDES RESISTANCE ASSESSMENT Summery Of Results: last update; 2006 Malathion : effective* all over the country except Kassala, GZR, KRT & SEN States Fenitrothion : effective* all over the country Deltamethrin : effective* all over the country Permethrin: effective* all over the country except KRT DDT : Effective all over the country except ; KRT,GZR, Kassala & States (restricted). Bendiocarb : effective* all over the country * > 98% mortality among tested mosquitoes ( An. arabiensis )

Insecticide Area Insecticide Area DDT 4% Permethri n 0.75% Bendeocarb % Malathion 5% Al Shigailab No. mosquitoes tested 100%75 96 % % 50 x El Giraif Ssharq No. mosquitoes tested Average 95.2% range: Average 95.8% range: 92 – %30077%325 Al Ameir No. mosquitoes tested 100% % 50 x 64% 50 Summery Results of Insecticides’ Susceptibility Tests at Khartoum, January 2006

Insecticide Area Insecticide Area DDT 4% Permethrin 0.75% Bendiocarb 0.1% Malathion 5% Al Salama Al Jadida No. mosquitoes tested 88%50 Average 96% range: %50x Soba Gharb No. mosquitoes tested x Average 95.4% range: %50x Al Faki Hashim No. mosquitoes tested x 92% % 50 x Summery Results of Insecticides’ Susceptibility Tests at Khartoum, January 2006 (contin.)

Insecticide Area Insecticide Area DDT 4% Permethrin 0.75% Bendiocarb 0.1% Malathion 5% Jabra No. mosquitoes tested xxx Shambat xx x7075 Arkaweet No. mosquitoes tested xx x Summery Results of Insecticides’ Susceptibility Tests at Khartoum, January 2006 (contin.)

Insecticide Area DDT 4% Deltamet hrin 0.05% Permethrin 0.75% Fenetrothion 1% Malathion 5% Soba 100 % 99.2%87.8%100%43% Burri 98.5 % 98%94%100%56.3% Kafori93% %100%44% Al Faki Hasim 94%98.5%xxx Summery Results of Insecticides’ Susceptibility Tests at Khartoum state, Oct. –Dec..,‘05

Insecticide Insecticidearea DDT 4% Permethr in 0.75% Bendioca rb 0.1% Malathio n 5% Kaptood (North DONGOLA) 97%(100)99%(105)100%(100)99%(100) Akja (DONGOLA town) 99%(100)100%(100)100%(100)100%(100) Ertidi (South DONGOLA) 100%(100)100%(100)100%(100)100%(100) Summery Results of Insecticides’ Susceptibility Tests at northern state-Dongola, Jan 06.

Insecticide Area Insecticide Area DDT 4% Permethrin 0.75% Bendeocarb % Malathion 5% New Halfa No. mosq. tested 97.6% % % % 260 El Girba No. mosquito. tested 96.9% % % 120 Kassala No. mosquito. tested 99.6% % % % 240 Summery Results of Insecticides’ Susceptibility Tests at New Halfa, Oct. –Dec.,‘05

Insecticide Resistance Management Use chemicals only when and where needed (IVM) Continuous use of a single product A shift to an other insecticide based on Resistance Rotation & mosaic ( Agr. & P.H. Gezira St.) Collaboration with Agriculture

Pesticide Management Practices (policy & legislative frameworks)

Pesticide Regulations in Sudan Pesticide Act Pesticide Act / 1974 amended to Pesticide and Pest Control Act / 1994; Regulates all activities related to pesticides import, transport, storage, uses, formulation …etc; NPC ; a multidisciplinary inter-ministerial committee, which includes representatives of all stakeholders; responsible for regulating Agric., Health and Vet. Pesticides, Chaired by Under Secretary of the Ministry of Agriculture & DG of PPD as repertoire and Registrar; Registrar is responsible for all administrative and executive functions; Abroad umbrella law with various explanations and specific details dealt with in seven relevant bylaws;

Pesticide Regulation in Sudan Pesticide Bylaws, 1.Trading and organization of the commercial handling of pesticides and pest control products bylaw for the year 2002; 2.Pesticides and pest control products inspection bylaw for the year2002; 3.Organization of the storage and transport of pesticides and pest control products bylaw for the year 2002; 4.Protection of personnel dealing with pesticides and pest control products bylaw for the year 2002; 5.Importation of pesticides and pest control products bylaw for the year 2002; 6.Registration of pesticides and pest control products bylaw for the year 2002; 7.Formulation of pesticides and pest control products bylaw for the year 2002;

The Registration System of Pesticides in Sudan: Form 1 for provisional registration submitted to NPC registrar; The NPC passes the form to the technical committee to review the information and either recommends to the NPC to reject or accept the provisional registration of the pesticide; Approval of provisional registration by NPC; Test by relevant research institutions under local conditions; Results of the test shall be approved by the NPDC which either recommends (or rejects) to the NPC the registration for commercial use; NPC reviews the recommendation of the NPDC and either approves it or rejects. Product registered for commercial use;

Registration System of Pesticides in Sudan: –Method of testing should follow the approved protocol; –Residues of the product tested in edible crops and/or the environment should be within acceptable limits; –Standard treatment (s) must be included in every field assay and the standard should be an already registered product; –Test products are only recommended if their biological performance is as good as or better than that of the standard products;

Application for provisional registration (form 1) Review and recommendation by the Technical committee of the NPC Consider the recommendation of the Technical committee by the NPC Provisional registration Field testing for 3 months to 3 years (form III and V for importation of samples for testing) Review of results of field testing by NPDC and recommendation for commercial registration Approval of commercial registration by NPC Commercial registration (form II and IV) Import & Formulation license Registration Chart

The Status, Quantities and Management of Obsolete Pesticide Stockpiles

Summary of Quantities POPS Pesticides, Contaminated Soil & Containers in Sudan* ItemPOPS Pesticides (Tons) Contaminated soil (Tons) Containers(Tons) Total , *Source: Multi-stake-holders National Coordinating * Source: Multi-stake-holders National Coordinating Committee (MNCC) Inventory Report (2005) Committee (MNCC) Inventory Report (2005) In addition to 901 Tons of cotton seeds dressed with POPs Pesticides

Quantities of Inventoried POPS Pesticides, Contaminated Soil & Containers Items in Different States of Sudan (2005) No.SitePOPS Pesticides (tons) Cont.soil(Ton)Containers(Ton) 1 Northern St River Nile St Khartoum St Gezira St White Nile St Sennar & Blue Nile States Red Sea St Kassala St

Quantities of Inventoried POPS Pesticides, Contaminated Soil & Containers Items in Different States of Sudan (2005) No.SitePOPS Pesticides (tons) Cont.soil(Tons)Containers(Tons) 8.2 Gedarif St (RAC.) Bahr Eljabal State (Juba) W. Bahr Elghazal St Upper Nile St a Gezira Sch. (Managil)

Quantities of Inventoried POPS Pesticides, Contaminated Soil & Containers Items in Different States of Sudan (2005) No.SitePOPS Pesticides (Tons) Cont.soil(Tons)Containers(Tons) 12.b Gezira Sch N. Kordofan S. Kordofan W.Kordofan N. Dar Fur S. Dar Fur W. Dar Fur

Current Status, Constraints & Needs Stockpiles of pesticides for public health use are not creating a problem at present Main stockpiles are agricultural pesticides Storage is poor, All stockpiles are piled together, Hence contamination of the total estimated quantity is inevitable No facility for local disposal, International efforts needed

The Existing Mechanisms for Intersectoral Collaboration on Vector Control

Existing Mechanisms for Intersectoral Collaboration on Vector Control in Sudan Coordination: Federal Ministry Of Health( National Malaria Control Program, Occupational Health Dept. & State M. of Health) Occupational Health Dept. & State M. of Health) Multidisciplinary National Pesticide Council ( NPC): Federal Ministry Of Health, Ministry Of Agriculture & Ministry Of Environment And Tourism,responsible for developing regulations governing use of all insecticides, including DDT, Cooperation: Ministry Of Agriculture & Ministry of Irrigation, water management, Partnership: Non- Governmental Organizations (NGOs), Community-based organizations (Sudanese Women Union (SWU) & Private Sector e.g. ITNs,

Vector Control (IVM) RESOURCE PERSON(S) M.of Science & Technology Community-basedOrganizations (Sudanese Women Union) Union) FEDRAL M. OF HEALTH M. OF ENVIRONMENT & TOURISM NGOs MINISTRY OF AGRICULTURE STATE M. OF HEALTH ACADEMIA PesticidesCompany WATERRESOURCES Sudan National Inter- Sectoral Committee for Vector Control Needs Assessment (VCNA) UN Agencies

thank you