Transcript USAID TB Technical Assistance Model

USAID TB Technical
Assistance Model
June 19, 2014
Overview
• TA in the Context of USG TB Strategy
• Accomplishments and Approach of TB Strategy
• USAID TA Model
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USAID TB Funding Trends 1998–2013
* FY funds including all accounts
By 2012, TB prevalence in 27 USAID-supported countries decreased by 40%.
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By 2012, TB mortality in 27 USAID-supported countries decreased by 41%.
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Treatment Success Rate in Select Countries
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Case Detection Rate in Select Countries (all forms of TB)
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New patients with MDR TB initiated on treatment each year:
Number of Patients (thousands)
(USAID focus countries)
Target
* These numbers differ from the past reports because they are adjusted to
include only the current USAID countries to accurately reflect the trends.
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USG TB Strategy: Key Approaches
Approach
Examples
Promote country
ownership
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Develop 5-year NTP Strategic Plans
Support development and implementation of GF grants
Support NTP routine monitoring and supervisory systems
Support participatory MOH led external evaluations
Joint annual work planning with NTP and other partners
Sustainable systems
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Strengthen drug/supply chain management
Strengthen facility level routine M&E system
Develop/improve lab network at all levels
Build primary health care capacity
Leverage resources
• Develop GF proposals to cover unmet needs in NSPs
• Coordinate TB/HIV funds through PEPFAR
• Expand health platforms (community, lab, drug mgmt.)
Provide global
technical leadership
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Develop and pilot new tools, policies, guidelines
Provide TA to countries/in targeted technical areas
Participate in WHO core working groups and STAG-TB
Lead USG international TB efforts
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Country Level Focus – supporting the field
Field level support:
• Response to local needs/gaps based on NTP
Strategic Plan, GF grant, and PEPFAR COP
• TA to MOHs, private sector, and NGOs; coordinate
with other partners
• Expansion of new approaches/technologies (e.g.,
PMDT and Xpert)
• Global Drug Facility (GDF)
Field and
Regional
84%
GH/regional bureaus support:
• Global policy and guideline development
($188 in FY13)
• Global operational and implementation research
• Technical support for evaluation, program design,
monitoring, mentoring, and project management
GH 16%
Implementers: STB Partnership, WHO, CDC, TB CARE
I and II, TO 2015, TREAT TB, SIAPS, USP, TB Alliance,
GLC, TB TEAM
($36m in FY13)
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In FY13, Washington managed 51% of the total USAID TB funding and
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36% of the field support resources.
USAID TB Technical Assistance Model
• USG convenes and leverages existing USAID bilateral
program support to NTPs, preventing duplication, optimizing
areas coverage and dovetailing
• Focus and concentrate in response to the GF changes,
the new funding model, and evolution of the TB grants
Principles of Approach
• Mirrors the inherently disease-specific NFM
• Focus on development and implementation of National
TB Strategic Plans
• On-going Country dialogue
• Development of a disease-specific concept note and
funding envelope – assist with technical trade-offs
• Disease-specific TA to ensure quality programming
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Convener: Model focuses on actively triangulating information among all
partners
In-country
technical
partners
GF/FPM
USAID TB Team
Convener Role
• Regular country phone calls with
key stakeholders
• Ensure clear roles and
responsibilities of stakeholders
• Monitor and evaluate progress
PR/NTP
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USG Approach to Address GF grant TA support
• Shift in prioritized focus on a number of countries covering:
• 70% of the total GF grant funding for TB
• 88% of TB prevalence
• 88% of MDR-TB
• 84% of TB/HIV co-infection
• Focus on quality programming and areas of technical
expertise required
• Focus on more in-country approach: more consistent TA
providers that less fly-in and fly-out TA
• More strategically wrap around USG bilateral program and
USG TB working group partners
Priority Country Selection & Analysis
Criteria:
• Burden (TB, MDR-TB, TB/HIV)
• Global Fund Performance Data (rating, disbursement
rate, expenditures)
• Number and size of grants
• For MDR-TB: minimum of 1,000 projected treatments
for 2012-2014
Analysis of types of TA needed:
• Burden and performance thus far (are things moving?)
• Review types of TA currently available through USG
mechanisms
• Review of issues within countries based on past
performance, stakeholders meetings/calls, discussions
with partners and FPMs
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PRINCIPLES TO RESULTS
USG TA
Model
In-country TA:
• TB CARE I and II
• PATH TB TO
Targeted TA:
• GDI (GLC)
• CDC
Multi-partner TA:
• TBTEAM
• SIAPS
• GDF
Accelerated
impact
RESULTS
1. Full Implementation of National Strategic Plan
2. Meets GF grant targets with quality
3. Expends funds appropriately
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USAID Country Mapping Example: Bangladesh
Technical experts
visit countries to
provide MDR-TB
TA, and then
project in country
follows up.
Experts provide
additional virtual
assistance to
ensure things are
moving forward
Bangladesh
MDR Short-Term TA
(NTP& GF)
CDC
Grant
Management/Program
Expansion TA
USAID
In-country advisor (hired
through TBCARE 2, builds
coordination)
Drug Management
TA
MSH/SIAPS Project
(Mission funded)
Assists with partner
coordination
meetings/calls and
Phase 2 renewal
preparation
Coordination TA (bringing
partners together)
TBTEAM
In-country advisor
works with
partners/USG project
to ensure that grant is
moving forward and
expanding, and
identifies any TA
needs. Also ensures
that countries
understand all CPs
Ensures that country
is doing proper
quantification and
that there is an
adequate supply of
drugs. Works with
in-country advisor on
any GF grant
bottlenecks related
to drug management
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THANK YOU!