Global Fund grant (January 2018 to March 2021) Strengthening sustainable Laboratory Diagnostic Network of RNTCP and Improving universal access to TB services for patients engaged with the private sector FIND India update January-December 2018

Global Fund project – PR FIND Duration of the project Jan 2018 – Mar 2021 Total Budget : $33.14mn Lab strengthening Establishing Culture and DST labs across the country 10 labs during 2018-19 and 10 labs during 2019-2020 Supply of lab consumables for LPA and liquid Culture and DST Support for annual maintenance of TB lab equipment Establishing the Lab Information Management System Project JEET Engaging private sector and supporting notification and treatment adherence of TB patients

TB Liquid C&DST facility establishment Upgradation of 20 TB labs : 10 in phase 1; 10 in phase 2 Status of labs in phase 2: Initial joint assessment visits of the following 9 sites completed: Chhattisgarh, Raigarh Meghalaya, Shillong Telangana, Warangal Uttar Pradesh, Kanpur Nagar Uttar Pradesh, Jhansi Nagaland, Kohima Pawapuri, Bihar Sambalpur, Odisha Gaya, Bihar ( Lack of infrastructure at Gaya. need an alternate site from Bihar) Site visit planned on Bangura, WB (March 2019) – Site yet to identify the suitable place for the Lab upgradation. Status of labs in phase 1: Initial joint assessment visits of the following 10 sites completed: Chittoor, Andhra Pradesh Bhopal, Madhya Pradesh Akola, Maharashtra Aizawl, Mizoram Bikaner, Rajasthan Coimbatore, Tamilnadu Allahabad, Uttar Pradesh Murshidabad, West Bengal Rohtak, Haryana Faridkot, Punjab

TB Liquid C&DST facility establishment Process for establishing 10 C&DST labs initiated RFP and pre-bid meeting, Technical bid evaluation report –Completed. Financial bid opening- Completed. Finalisation of vendor under process The following three labs the work to be done by the site/state has not started yet. This will delay the lab upgradation process. Allahabad: Fund transferred from DTC to the Principal MLN Medical College but the civil and electrical work related to upgradation of TB LC&DST Lab is not yet initiated. Coimbatore: The cost estimate submitted to NHM for the approval. Approval is pending. Hence, the civil and electrical work related to upgradation of TB LC&DST Lab is not yet initiated Tirupathi: Fund transferred from State to the Medical College but civil and electrical work related to upgradation of TB LC&DST Lab is not yet initiated

Maintenance of TB C&DST labs under RNTCP AMC of 21 type of critical equipment for 66 labs are covered Total number of equipment for PM and Calibration- 3738 Status of Preventive Maintenance and Calibration: Completed for 90% of equipment and 10% to be completed between by March 2019 Second round of Preventive Maintenance and Calibration for Refrigerated Centrifuge and pipettes (Semi-Annual basis) has been initiated by agency and will be completed by March 2019 Corrective Maintenance Total no. of complaint logged during 2018: 625 Completed calls: 487 In Process: 98 Irreparable: 40 Frequent breakdown: Autoclaves, Walk in Cold Room, BSL 3 Lab, Biosafety Cabinet, Walk In Incubator, Incubator, Hot Air Oven

Establishing the Lab Information Management system (LIMS) Core LIMS software developed and piloted Logistics module under development Hardware provided to 61 labs There has been some delay in implementation of LIMS due to the pending integration with Nikshay. This has been discussed with CTD and the onsite trainings for LIMS have been initiated while the integration with Nikshay is being done simultaneously. The trainings will be completed for all labs by June 2019. FIND is working with the Nikshay team at CTD on the integration of LIMS by April 2019.

Target vs achievement Jan-Dec 2018 Indicator Target Achievement Identified Laboratories to be upgraded for TB containment laboratories Jan-Sep2018 Laboratory assesment in finalized in 10 Labs (Fist Batch) 10 Labs assesment completed (100%) Oct 18- Mar 19 Renovation of the 10 Labs. Initiated. Finalisation of vendor under process. Delayed due to Received the site list Mid June 18 Lack of Pre-requisite/infra structure facilities at Gaya(BI), Pawapuri(BI) and Sambalpur(OD) Approval delay

Challenges and Mitigation Delay in activities to be carried out by Site/State Suboptimal support from the site/state Delay in release of money from state for the activities to be carried out by the site Lack of coordination from Civil and Electrical department of the site Change of an administration in the site Regular follow up with Site and State and provide regular updates to the CTD for the support. We need support from CTD to coordinate with the respective states to expedite activities to be carried out by the site and State Transition of AMC service In coordination with CTD, MGIT machine transition plan from 1 April 2019 submitted to CTD

Status Update of Action points from last PR Coordination committee meeting Sr. No. Action Item Responsible Stakeholder Agreed Timeline Current Status/ Remarks 1 Laboratory establishment in Gaya is getting delayed due to non-preparedness of site. It was requested for change of site, for which FIND need to send formal communication to the State. For such change, States need to be on board. FIND India Immediate Communicated to STO Bihar vide e-mail dated 29 Nov 2018 . Follow up with CTD and State for the alternate site for Bihar. 2 DDG-TB suggested that since attrition of staff was noted as a common problem among all PRs, it needs to be documented and communicated to the Global Fund. All JEET PRs Nov 2018 Communicated to TGF in Progress Update submission. Review for revisiting salaries under process. 3 There is overlapping of activities among THALI project and JEET in West Bengal which needs to be taken care of. Discussed with USAID & SR partners & there’s no activity overlap between THALI & JEET

Jan - Dec 18: Budget Vs Expenditure (INR) and Major Reasons for Underspend Human Resource (HR): Delayed onboarding of Sub-grant recipients of JEET grant has impacted the expenditure on account of phased recruitments of field staff. The recruitments are being  expedited. Travel Related Cost (TRC): This is on account of delayed recruitment which in in turn has impacted the expenditures pertaining to travel related costs (travels, meetings, trainings, CMEs etc.). Proportion of the said un-executed activities have been rationally carried forward & we expect that the same would be executed in subsequent quarters. External Professional services (EPS): Most of the costs pertain to Lab Information Management System (LIMS) & is part of our current commitments which will be booked in subsequent quarters. Budget in INR Budget in USD Expenditure in INR Expenditure in USD Proportion of Expenditure(%) Variance in INR Variance in USD Proportion of variance (%) 43,07,79,198 66,27,372 26,47,05,908 39,47,624 61% 16,60,73,291 26,79,749 39%

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