This mechanism supports CARs PEPFAR Strategy Objectives 2 and 3. The primary goals of this award are to increase the capacity of the Republican Blood Center (RBC) in Kyrgyzstan to improve their blood safety program, ensure an adequate blood supply, perform accurate and appropriate blood screening for the KG population, and to sustain these program improvements over time. Challenges in blood safety in KG include lack of voluntary donors, inappropriate clinical use of blood, inadequate maintenance of the cold chain, inadequately trained staff, an outdated, unsustainable electronic blood donor database, and lack of a quality assurance management system (QMS), potentially hindering laboratory performance. Technical assistance will be provided to the KG RBC to improve these deficiencies and to develop a QMS covering all stages of the transfusion process. These improvements will allow the KG blood centers to improve their efficiency over time. Included in this project is implementation of a nationwide M&E system for blood services indicators, and training of staff on the system. The indicators will include number of donors served, number of donors tested, number of donors positive for transfusion transmissible infections, and number of trained people over time. Indicators will be monitored by review with the standardized checklist during regularly scheduled site visits. Sustainability of the program and country ownership will be fostered through training and capacity building of RBC staff, and development of effective and useful electronic databases for both QMS and M&E. These activities will allow the RBC monitor and improve quality and efficiency.

Global Fund / Programmatic Engagement Questions

1. Is the Prime Partner of this mechanism also a Global Fund principal or sub-recipient, and/or does this mechanism support Global Fund grant implementation? Yes2. Is this partner also a Global Fund principal or sub-recipient? Sub Recipient3. What activities does this partner undertake to support global fund implementation or governance?

Budget Code Recipient(s) of Support Approximate Budget Brief Description of ActivitiesHMBL Republican Blood Center 80000 Build capacity of health providers to introduce and scale-up transfusion committees for safe clinical use of blood

This ongoing Cooperative Agreement supports CARs PEPFAR Strategy Objectives 2 and 3.In 2007, CDC re-screened 7,500 samples from blood donors in CAR, confirming that contaminated blood is being administered in health facilities. Transfusion of HIV-infected blood is 100 times more efficient for transmitting HIV infection than intravenous injection with a contaminated syringe. An adequate supply of safe blood and the appropriate clinical use of blood are important components of the CAR PEPFAR prevention strategy, as well as a priority for the Government of Kyrgyzstan.Almost 60% of the blood supply in KG is based on the principle of donor replacement. The goals for this activity are to: (1) improve the KG strategy for voluntary blood donorship using international expertise and results of a KAP survey; (2) help to establish a quality management system (QMS) for blood banking, including screening for transfusion transmitted infections (TTI), blood compatibility and typing; (3) assure cold chain maintenance, including expansion to the rural areas; (4) reduce non-evidence-based clinical use of blood products; (5) establish national norms, standards and organizational structures for a national blood service; (6) improve information systems and standardize databases for tracking blood donors and donated blood units; and (7) strengthen professional development of blood services staff.Technical assistance (TA) will be provided to assist with the establishment of a sustainable electronic database to track blood donations (ongoing activity using prior year funding) and scale up this activity nation-wide (new activity using FY12 funds). Scale-up will include on-site workshops, implementation of a bar code system at the Oblast level, and trainings on cold chain maintenance for all levels of blood services. These activities address the 1st (Policy), 5th (Training), 6th (Monitoring and Evaluation) and 7th (Sustainability) key elements identified by the Medical Transmission TWG.The KAP surveys will inform the national strategy on voluntary donorship, including IEC campaigns for donor recruitment. Trainings and recruitment materials will be developed for donor recruiters on republican, oblast and rayon levels, who will also collect basic donor information. These activities are related to the 1st, 2nd and 5th and 7th elements identified by the TWG.TA will be provided to assist with the establishment of a KG National Transfusion Committee using FY12 funds. TA activities to assist the committee include development of guidelines, protocols, SOPs and data collection tools. These activities are related to the 1st, 3rd-7th elements identified by the TWG.These activities will be conducted in the context of a QMS, currently being developed by the MOH, spanning the entire chain of blood services. They will be integrated with other HIV/AIDS related services, as potential donors who test positive for TTIs will be referred to the KG AIDS Center for further counseling and testing and treatment. Sustainability of the program and country ownership will be fostered through capacity building (training the KG government to improve their blood safety program) and technology transfer (the electronic database).