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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* 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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(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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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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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.

and leverages existing USAID bilateral program support to NTPs, preventing duplication, optimizing areas coverage and dovetailing
in response to the GF changes, the new funding model, and evolution of the TB grants
• 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
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Regular country phone calls with key stakeholders
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Ensure clear roles and responsibilities of stakeholders
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Monitor and evaluate progress
PR/NTP
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• 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

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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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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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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