USAID TB Technical Assistance Model June 19, 2014

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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:

(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

Promote country ownership

Examples

• 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 • 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

• 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 and

Regional

84%

($188 in FY13)

GH 16%

($36m in FY13)

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)

GH/regional bureaus support:

• Global policy and guideline development

• Global operational and implementation research

• Technical support for evaluation, program design, monitoring, mentoring, and project management

Implementers: STB Partnership, WHO, CDC, TB CARE

I and II, TO 2015, TREAT TB, SIAPS, USP, TB Alliance,

GLC, TB TEAM

• 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 t ypes 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

Accelerated impact

In-country TA:

• TB CARE I and II

• PATH TB TO

Targeted TA:

• GDI (GLC)

• CDC

Multi-partner TA:

• TBTEAM

• SIAPS

• GDF

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

Assists with partner coordination meetings/calls and

Phase 2 renewal preparation

Bangladesh

MDR Short-Term TA

(NTP& GF)

Grant

Management/Program

Expansion TA

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 CDC USAID

In-country advisor (hired through TBCARE 2, builds coordination)

Coordination TA (bringing partners together)

TBTEAM

Drug Management

TA

MSH/SIAPS Project

(Mission funded)

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!

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