TB Technical Assistance Mechanism (TBTEAM) Annual Report 2013

I will talk about "Mission" Data from the Website Reviews National Strategic Plan updates Regional Workshops Global Fund – New funding – Existing funding – Consultant orientation – TB and HIV concept note Challenges for the coming year

What is TBTEAM  A global technical assistance (TA) coordination mechanism TBTEAM works through a network of 35 technical and financial TB partners to coordinate TA to improve implementation of TB programmes

Global TB Program (WHO) Who is TBTEAM Global TBTEAM Regional TBTEAM International Partners In-country staff (WHO & Partners) NTP/national TBTEAM Coordinator The Mechanism The core Support Strucuture Located in 6 WHO Regional Offices

TBTEAM partners technical assistance is provided mostly within country (supplemented when needed by external missions) PATH Country: DRC, Tanzania, Myanmar:Develop, introduce, and expand the use of innovative health technologies to diagnose TB and drug-resistant TB. India Strengthen health systems and build collaboration across sectors. Bangladesh; Making TB a notifiable disease. Nigeria: Foster enabling environments that involve communities in TB efforts.

80% of all TA funding is from USG/mainly USAID

From the website 2013 Reports With Report Total mission % with mission reports USG / TBTEAM276641% TBCARE % NA % Global Fund - Fonds Mondial85515% USAID64613% Others % Total % Getting mission reports onto the website remains a challenge

Reviews 29 Country Reviews supported by TBTEAM partners since June 2014, a further 9 are planned this year. In many of these preceding Epi analyses were carried out and this is becoming a standard requirement for sound reviews. – updated WHO Guidelines on NTP Reviews and on Epi analyses have been produced.

Reviews Between June 2013 and May country Reviews were supported by TBTEAM partners. DR Congo, Nepal, Yemen, Central African Republic, Tajikistan, Burundi, Liberia Cambodia, Thailand, Ethiopia, Philippines, Uganda, Djibouti,South Africa, Pakistan. Papua New Guinea, Congo, Kenya, Tanzania, South Sudan, Bhutan, Romania, Bangladesh, Swaziland, Benin, Malawi (mini), Togo, Uzbekistan, DPR Korea A further 9 reviews are planned in the remaining part of this year and TBTEAM partners are already engaged in supporting the preparations for these. Bulgaria, Sri Lanka, Côte d’Ivoire, Kyrgyzstan, Madagascar, Armenia, Mozambique, Myanmar, Comoros. EPI analysis has been supported in last twelve months. (Nigeria, Rwanda, Cote D’Ivoire, Togo, Tanzania, Ethiopia, Kenya, Bangladesh, Zambia)

National Strategic Plans updated: 3 global meetings: Cepina, Divonne Rabat: – 34 countries supported and trained on reviewing their NSP processes in 3 National Strategic Planning workshops organised by TBTEAM secretariat and partners. – Countries going for new funding model prioritised. – Peer review and critique of NSPs. – Consultants paired with countries. – Civil society representatives engaged with TBP advice. – GF country teams invited along and co funded.

Regional Workshops EURO, The Hague, Netherlands, May 2013 (9 countries) WPRO Manila, Philippines, Aug 2013 (7 countries) SEARO,Bangkok, Thailand, Sept 2013 (11 countries) AFRO, Nairobi, Kenya Oct 2013 (21 countries) – Updates on latest WHO guidelines/developments – Global Fund colleagues explained the New Funding Model – Countries TA needs were assessed (roadmaps)

New Funding from the Global Fund TBTEAM Partners support Global Fund grant renewals 46 Global Fund grant renewal processes in 36 countries that went through the Grants approval committee 2013 were supported by TBTEAM partners. $687,332,610 of funding for TB was approved by the Global Fund Board.

Grant renewals countries Angola Bangladesh, Belarus Benin Colombia Congo Dominican Republic Ecuador Egypt Eritrea Georgia Guinea Guinea-Bissau Haiti Honduras India Indonesia Kenya Lao (Peoples Democratic Republic) Macedonia (Former Yugoslav Republic) Mongolia, Myanmar, Namibia Nepal Nicaragua Pakistan Papua New Guinea Rwanda Senegal Somalia South Africa, Ukraine, Viet Nam, Yemen, Zambia, Zimbabwe.)

Existing Funding: TBTEAM partners support to country programs with existing grants contributed to the release of 726 million US dollars from the Global Fund in TBTEAM partners and the secretariat engaged proactively with Global Fund country teams and country partners. Over 160 country discussions and conference calls were held to discuss improving the grants- and coordination of technical assistance.

Consultant orientation I)Orientation of around 45 consultants and TBTEAM partners on the New Funding model in July 2013, and 15 TB consultants trained together with UNAIDS consultants on the New Funding Model in Nairobi in April Follow up webinars have been held.

TB and HIV single concept note Global Fund Guidance notes issued Johannesburg Workshop WHO, GF, UNAIDS, and Pepfar with TB and HIV country teams in High TB/HIV burden countries in East & Southern Africa (February 2014). Joint consultant orientation in Nairobi April. Meetings with WHO HIV, UNAIDS, GF technical advisors to exchange information Over 70% of Global TB Burden with GF funding now needs to develop single concept notes.

GenXpert roll-out Mainly for HIV clinics: Ratio 3:1 or more From the TB clinicFrom the HIV clinic (pre & ART) TB retreatment: Cat 1 failure and contacts from MDR patients 10,000 All TB suspects referred from ART/pre ART clinics Assumption (total 2 million people) assume 10% per year referred as TB suspects All HIV tested and positive TB suspects presenting to TB programme 90,000 TOTAL100,000TOTAL 200,000 66% of costs of GenXpert roll-out likely to be generated by HIV treatment clinics. ENCOURAGE HIV PROGRAMMES TO COST SHARE

Challenges for the coming year TBTEAM partner support for Global Fund Concept notes 58 countries are applying for TB in the New Funding model in 2014 TBTEAM Partners are engaged in supporting 30 countries undergoing TB concept note development this year and another 28 countries submitting single TB/HIV concept notes. WHO/GF agreement for 29 million to support processes leading up to concept note development 2014/2015 (9 million for TB).

Challenges for the coming year Global Fund: funding constraint Overall around 2.56 billion of funding is available for TB from the Global Fund for the next 4 years- most of this is tied up in already approved funding: – Existing TB funding: US 1,672,468,360 – Additional funding:US 896,699,923 TOTALUS 2,569,168,282 Represents 642 million allocations per year. (Plus 10% of GF money is set aside for incentive funding) if proportionately distributed would give TB 64 million a year extra) Funding constraints – Global Funding is flat-lining for the next 4 years – 2/3 of funding gap will not be provided by the global fund grants. – Laboratory expansion preceding MDR expansion – Costed NSPs give us a chance to monitor at country level

Challenges for the coming year (cont.) Keeping the eye on the ball for existing funding – Roll out of the new funding model… preserving the gains made in existing funding: Eg Mozambique focus on 3 million (27 not yet signed) Single Concept notes for TB and HIV – Ensure that TB component is quality product. – Early engagement technical assistance support. Meeting with HIV counterpart – Ensuring that TB priorities in timing, and funding allocations are not unduly changed. Post 15 Global TB strategy – Partners and TA providers engagement with the roll out of post 15 Global TB Strategy

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