Today’s Presentation Building Blocks for Resource Mobilisation 2. Critical Success Factors 3. Summarising the Costing Scenarios 4. Financing gap for full scale and modified Model 5. Sustainability

Building blocks for Resource Mobilization Partners’ Commitment Clear Management/ Integrated Management Guidelines Future Expectations: Stakeholder Involvement Sound Implementation strategy Planning Foundation built on public health principles and regional priorities Future expectations : stakeholder involvement Strategy for Achieving cost effectiveness Sound Implementation strategy Clear management/Integrated Management guidelines Partners’ Commitment Strategy for Achieving Cost Effectiveness Planning Foundation built on Public Health Principles & regional Priorities

CARPHA Strategic Process Program Plans Results Management CARPHA Strategic Direction Planning Foundation Mission Baseline Costing Assumptions Where are we now? Future Expectations Vision Values Strategic Priorities What do we want to be? Strategy Transition How will we achieve our expectations? Implementation Program Objectives Activity/ Resource Linkages Who must do what? Integrated Management Performance Measurement Audit Evaluation How well are we doing? Slide 4 4

Critical Success Factors Agreement by Government of Trinidad and Tobago to host CARPHA Establishing CARPHA Governance Structure and Implementation Team Active engagement of RHI Directors in process for decommissioning RHI’s Resource mobilisation Contribution of stakeholders – agility, capacity Slide 5 5

Costing Overview – 2007-08 Current Resource Levels (USD) RHI MC Quota Quota Expend. Other Income Other Expend. Total Income Total Expend. CAREC 2,436,028 2,273,434 2,062,765 1,815,589 4,498,793 4,089,023 CFNI 373,933 292,446 1,638,449 1,634,413 2,012,382 1,926,859 CEHI 473,340 473,341 262,311 398,861 735,651 872,202 CHRC 355,000 445,664 242,946 27,964 597,946 473,628 CRDTL 289,455 183,721 3,456 - 292,911 3,927,756 3,668,606 4,209,927 3,876,827 8,137,683 7,545,433 % 48% 52% 100% Notes: 1) CRDTL data April 07 to March 08, CAREC, CFNI, and CHRC data Jan .to Dec. 08, CEHI data Jan to Dec. 07 2) CHRC Other Income includes quota arrears income of $214,982 Slide 6 6

CARPHA Operating Costs Projections The 3 Scenarios: The Full Services Model: This table is available on page 16 of the Supporting establishment of CARPHA document. In the document there is a final total colunm which does not appear on this slide. HR costs have been calculated using CCS grades and scales – first calculated at current estimated cost then “cost of living” index applied annually to reach full budget in Year 5 Programme Delivery are travel costs for undertaking interventions Facility and Lab Operating Costs include laboratory supplies (e.g. Reagents) as well as other supplies and utilities An allocation for equipment replacement and amortization of the facility (50 years) is also included Resource mobilisation US$8.8m Slide 7 7

Implementation Costs Resource mobilisation need: $US55m This table is avaialable on page 14 of Supporting the Establishment of Carpha document.In the booklet the bottom 2 rows have been removed for simplicity Resource mobilisation need: $US55m Slide 8 8

Facility Resource Mobilisation US$0 Cost of a new facility for 213 people Total capital cost is estimated at US $49.5 million – for BSL1,2 and 3 Additional allocation for laboratory equipment of US $2.5 million above the FFE Total Costs Facility   Building/Construction $ 25,272,375 Architectural and Engineering Design Costs (10% ) $ 2,527,238 Architectural and Engineering On-site (2%) $ 505,448 Site Infrastructure and Parking (20%) $ 5,054,475 Construction Contingency (15%) $ 3,790,856 FFE (40%) $ 10,108,950 QA and Commissioning (9%) $ 2,274,514 TOTAL $ 49,533,855 Resource Mobilisation US$0 Slide 9 9

CARPHA Laboratory Network International Cooperation CARPHA Country A Country B Country C Low hanging fruit 10

Summary Figures in US$ Slide 11 11

Modified Summary Figures in US$ Slide 12 12

CARPHA Financing Gap Implementation costs: US$ 55.9M overall cost US$ 52M Raised ___________________________________ US$ 3.9M Required Operating Costs (over 5 yrs): US$ 46.6M overall cost US$ 19.6M Raised US$ 26.96M Required

Sustainability of CARPHA

Integrated Management Integrated Management System (IMS) Context Assumptions Costing Implementation Integration Slide 15 15

CARPHA TRUST FUND CARICOM Contribution Automaticity Formula + Modiified Technical Assist ance Automaticity Harmonization of Donor Resources Traditional CARICOM Contribution Formula + Grants Preferred CARPHA TRUST FUND Investment Services Analytic and Advisory services Partnerships & Capacity Building Development policy operations Technical Assistance Harmonization of Donor Resources El Traditional CARICOM financing Structure: Make an assessment of the total operational costs of CARPHA per annum and assess member states contribution based on a formula (per capita income/debt ratio/ population). This traditional formula is currently used by the five RHIs which supplement their recurrent costs with grants funds that range between 30-80 percent of their respective for an average of 60 percent of overall annual budgets CARPHA Trust Fund: These funds primarily provide financing support for activities and programmes such as CARPHA where donors and the CARICOM Community Secretariat in this instance collaborate to form a partnership. These programmes are generally supported by four mechanisms: investment lending, development policy operations analytic and advisory services and technical assistance. It is therefore a most comprehensive financing mechanism. The establishment of such a fund has demonstrably worked for one of the CARICOM institutions (the Caribbean Community Climate Change Centre) . Such a fund has also been in operation for the Caribbean Court of Justice. While it is recognised that both legal and fiduciary stringency are required for the effective application of Trust Funds, the CARPHA Steering Committee is of the view that in principle it would provide a common vehicle for blanket contributions or support by partners for specific functional areas or specific activities. In this way it is expected that any of these modalities of support is likely to assist in building capacity in innovative areas such as research and development, training public health leadership and in relation to governance. 16