Detailed Mechanism Funding and Narrative

Years of mechanism: 2008 2009

Details for Mechanism ID: 5918
Country/Region: Democratic Republic of the Congo
Year: 2009
Main Partner: U.S. Centers for Disease Control and Prevention
Main Partner Program: NA
Organizational Type: Own Agency
Funding Agency: HHS/CDC
Total Funding: $350,000

Funding for Biomedical Prevention: Prevention of Mother to Child Transmission (MTCT): $75,000

Not applicable

New/Continuing Activity: Continuing Activity

Continuing Activity: 18474

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

18474 18474.08 HHS/Centers for US Centers for 8062 5918.08 CDC-GAP $75,000

Disease Control & Disease Control

Prevention and Prevention

Table 3.3.01:

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $10,000

N/A

New/Continuing Activity: Continuing Activity

Continuing Activity: 18533

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

18533 18533.08 HHS/Centers for US Centers for 8062 5918.08 CDC-GAP $10,000

Disease Control & Disease Control

Prevention and Prevention

Table 3.3.03:

Funding for Biomedical Prevention: Blood Safety (HMBL): $25,000

Not applicable

New/Continuing Activity: Continuing Activity

Continuing Activity: 18354

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

18354 11846.08 HHS/Centers for US Centers for 8062 5918.08 CDC-GAP $63,719

Disease Control & Disease Control

Prevention and Prevention

11846 11846.07 HHS/Centers for Center for Disease 5918 5918.07 CDC GAP $20,000

Disease Control & Control and BASE

Prevention Prevention,

Department of

Sexually

Transmitted

Diseases

Program Budget Code: 05 - HMIN Biomedical Prevention: Injection Safety

Total Planned Funding for Program Budget Code: $19,115

Total Planned Funding for Program Budget Code: $0

Table 3.3.05:

Funding for Care: Adult Care and Support (HBHC): $25,000

Not applicable

New/Continuing Activity: Continuing Activity

Continuing Activity: 18478

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

18478 18478.08 HHS/Centers for US Centers for 8062 5918.08 CDC-GAP $25,000

Disease Control & Disease Control

Prevention and Prevention

Program Budget Code: 09 - HTXS Treatment: Adult Treatment

Total Planned Funding for Program Budget Code: $645,072

Total Planned Funding for Program Budget Code: $0

Table 3.3.09:

Funding for Treatment: Adult Treatment (HTXS): $40,000

NOT APPLICABLE

New/Continuing Activity: Continuing Activity

Continuing Activity: 18356

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

18356 11802.08 HHS/Centers for US Centers for 8062 5918.08 CDC-GAP $40,000

Disease Control & Disease Control

Prevention and Prevention

11802 11802.07 HHS/Centers for Center for Disease 5918 5918.07 CDC GAP $26,500

Disease Control & Control and BASE

Prevention Prevention,

Department of

Sexually

Transmitted

Diseases

Table 3.3.09:

Funding for Care: TB/HIV (HVTB): $20,000

Not applicable

New/Continuing Activity: Continuing Activity

Continuing Activity: 18480

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

18480 18480.08 HHS/Centers for US Centers for 8062 5918.08 CDC-GAP $20,000

Disease Control & Disease Control

Prevention and Prevention

Table 3.3.12:

Funding for Prevention: HIV Testing and Counseling (HVCT): $10,000

Not applicable

New/Continuing Activity: Continuing Activity

Continuing Activity: 18512

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

18512 18512.08 HHS/Centers for US Centers for 8062 5918.08 CDC-GAP $10,000

Disease Control & Disease Control

Prevention and Prevention

Table 3.3.14:

Funding for Strategic Information (HVSI): $145,000

Not applicable

New/Continuing Activity: Continuing Activity

Continuing Activity: 18357

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

18357 11818.08 HHS/Centers for US Centers for 8062 5918.08 CDC-GAP $145,000

Disease Control & Disease Control

Prevention and Prevention

11818 11818.07 HHS/Centers for Center for Disease 5918 5918.07 CDC GAP $11,800

Disease Control & Control and BASE

Prevention Prevention,

Department of

Sexually

Transmitted

Diseases

Program Budget Code: 18 - OHSS Health Systems Strengthening

Total Planned Funding for Program Budget Code: $527,321

Total Planned Funding for Program Budget Code: $0

Program Area Narrative:

Health Systems Strengthening

Overview

In the DRC, the health sector has demonstrated a strong institutional commitment to HIV/AIDS prevention and control. However,

a common vision and clear roles from other GDRC ministries are needed for a comprehensive, multi-sector response. USG

agencies are well-positioned to promote integrated policy development within key ministries including the Ministries of Health,

Planning, Education (Primary and Higher), Defense, Social Affairs, and Agriculture.

In the DRC, civil society has been significantly weakened by conflict which has contributed to deteriorating infrastructure and

limited local capacity. The USG-supported 2006 Kinshasa School of Public Health (KSPH) HIV Services Mapping Exercise found

that few local organizations working in HIV/AIDS have the capacity to organize, design, implement, and manage programs). Local

NGOs involved in health and HIV services require technical assistance in planning, implementing, and reporting. Lack of access

to donor-sponsored projects in the 1990s has limited their experience and capacity to manage resources and achieve results. The

Global Fund CCM and Principal Recipient (UNDP) have begun addressing these issues.

Leveraging and Coordination

USG assistance will target the implementation of the "Three Ones" to assure a more coordinated and results-oriented national HIV

response. The "Three Ones" are: one coordinating body, one national strategic plan, and one monitoring and evaluation plan.

Working with the GF, MAP, as well as other donors and implementing partners, the USG will promote improved local capacity with

a focus on quality proposal development and effective program implementation. As most donor agencies' HIV programs are

limited in scope, strong coordination is paramount to ensure a continuum of care from prevention, to diagnosis, to care and

treatment.

The USG will continue to work with GDRC structures to refine strategic plans of action and strengthen the overall systems. The

USG will also promote improved donor coordination in policy development, dissemination, and implementation. Some donor

agencies lack sufficient technical expertise and have requested USG assistance in developing and improving their HIV programs

(Global Fund, DFID). In 2007, the USG provided to the Global Fund CCM to improve coordination and collaboration. This

assistance helped the CCM to successfully secure three awards: (1) $70M Phase 2, Round 3 grant; (2) $22.6M Phase 1, Round 7

grant; and (3) $262,911,091 Round 8 funds.

Current USG Support

USG support focuses on integrating quality HIV service delivery into the existing health care system, a priority recently articulated

by the MOH. USG also promotes a National HIV Strategic Framework that uses data for decision making and institutionalizes the

national response. This approach is taken to reduce duplication of efforts as well as minimize ad hoc approaches to human

resource development and supply/distribution systems. The USG contributed technical expertise to develop the MOH 2008-2013

National HIV Strategic Framework which was completed in June 2008. The USG continues to be actively engaged in the

development, dissemination, and implementation of other key HIV documents which will serve as the foundation for strengthening

health systems:

•Five-year HIV Multi-Sector Strategic Framework;

•Condom, Prevention, and Communication Policy (approved by prevention technical working group and awaiting MOH signature);

•Provider Initiated Counseling and Testing (PICT) & Couple Counseling and Testing Policy (technical assistance underway);

•Anti-stigma Policy for PLWHA (adopted by Parliament and signed by the President);

•Policy on the Sustainable Financing of ART (in progress);

•Policy for Interruption of ART (in progress);

•National Plan of Action for OVC (in progress);

•PMTCT Protocol revision shifting from single dose Nevirapine to a combined ARV regimen (adopted by the PMTCT task force

and awaits MOH signature);

•"Three Ones" Implementation Framework (in progress); and,

•TB/HIV Co-infection Policy (developed).

Related to capacity building, one priority is the development of a comprehensive approach to pre-service, in-service, and

continuing education to provide quality HIV services. Training is currently done on an ad hoc basis by each implementing partner

in the areas of clinical care, community-based services, program management, and strategic information. In support of the

National Programs, the USG will advocate for the development of pragmatic training programs that are based on standardized

international and national policies, guidelines, and training curricula. Training for coverage, access and monitoring of HIV services

is limited and therefore a priority. Training will focus on clinical and support services, community-based services, program

management, and strategic information.

The military, through USG technical assistance and funding to the PNMLS/MAP-WB, developed the PALS, its three-year sectional

strategic plan covering the 2007-2009 period. In addition, technical assistance will be provided to the Ministry of Defense to create

and implement a comprehensive HIV management policy and funds will sponsor the attendance of military commanders at

regional military conferences on HIV/AIDS policies to address HIV stigma and discrimination.

The USG will advocate for dialogue among public and private partners to engage civil society. This approach will create a platform

for policy implementation and a national HIV response. USG is helping to open up the public dialogue through innovative mass

media channels. Radio call-in shows and televised interviews with well-known Congolese provide an opportunity to reach large

audiences with appropriate HIV prevention and testing promotion messages. These mass media approaches also provide

opportunities to increase public awareness and an understanding of Living Positively while reducing the stigma of HIV. These

efforts complement and reinforce USG supported BCC programming.

The USG is providing technical assistance to the Ministry of Social Affairs to develop a national OVC assessment to inform a

national action plan. The assessment will also enhance the Ministry's OVC response at the national, provincial, and local levels.

The USG will also support capacity building in strategic information, advocacy, civil society engagement, and policy making. The

USG's support on the national OVC action plan is in collaboration with UNICEF (UNICEF co-funds the local costs of activities via

direct support to MINAS). The USG support to MINAS has focused on assessment of provincial MINAS' offices and leadership

support through MINAS' Direction of Planning. The USG engaged MINAS in a south-south exchange on OVC issues with the

Ivory Coast. USG supported MINAS' delegates from national and provincial offices, civil society delegates and representatives

from the MINAS cabinet levels to exchange lessons learned on OVC interventions with the OVC team in Ivory Coast. It was an

opportunity to learn from this francophone PEPFAR focus country since the context is similar to that of DRC. Both countries are

developing National Action Plans for OVC.

The USG-supported community-based programs are also providing capacity building to more than 100 organizations in Matadi,

Lubumbashi, and Bukavu, as well as along transport corridors through the ROADS II program.

In October 2008, USG conducted an assessment on the DRC pharmaceutical and logistics system. Preliminary findings reveal

that pharmaceutical products enter DRC through numerous channels including private wholesalers, local drug manufacturers,

NGOs, FBOs, and donors. However, none of these channels are working effectively. Private wholesalers are the main source of

pharmaceutical products, however, with variable drug quality. In addition to the major donors who supply ARVs and ACTs, few

private vendors are approved by the government to supply these drugs. Most donors supply pharmaceutical products through

their own channels, but these are disparate and uncoordinated. Overall, the pharmaceutical situation in DRC is bleak: stock-outs

of critical products are commonplace; the number of private vendors which can procure certain drugs is limited. And, often,

privately procured drugs are of questionable quality. The USG will build a program to strengthen the DRC pharmaceutical system

based on recommendations from this assessment.

USG FY09 Support

The USG will continue to assist the DRC national programs to refine policies and treatment protocols as well as disseminate these

key documents to health development partners. Specifically, the USG will provide technical support to update the national

guidelines for VCT algorithms. Revised guidelines will also integrate couple CT and PICT as well as standardized training,

supervision, and reporting. The USG will contribute to support the development of the National Multi-sector HIV/AIDS Strategic

Framework. The KSPH has conducted workshops on the application of public health principles to the National HIV response and

the DOD will provide TA to the Ministry of Defense to create and implement a comprehensive HIV management policy addressing

stigma, male norms, violence and alcohol issues. The DOD will also provide support for HIV prevention, counseling and testing,

care and treatment programs. Support to the MINAS will continue to inform the development of OVC policy based on the RAAAP

findings, standardizing services, and monitoring and evaluation systems.

Additionally, the USG will continue to support capacity building and institutional strengthening (both technical and managerial) of

indigenous organizations such as Amo-Congo and Foundation Femme Plus. These organizations are among the few local health

development partners engaged in wide-reaching HIV/AIDS programming. Presently, these partners have CT, OVC, and palliative

care programs in Lubumbashi, Matadi, and Bukavu. The ROADS II activities in the Eastern Corridor initiative will continue to

support 93 different associations, women's groups and CBOs with technical assistance in monitoring and evaluation and

community mobilization /advocacy. The USG will aim to identify other CBOs and FBOs to support with similar capacity building

approaches. These efforts will aim to provide local partners with strong enough managerial and technical expertise to be in a

position to receive direct donor support by 2012.

FY09 support will continue to strengthen the DRC pharmaceutical and logistic system to ensure availability of HIV related

commodities at the service delivery sites. *

Program Area Downstream Targets:

14.1 Number of local organization provided with technical assistance for HIV-related policy development: 7

14.2 Number of local organization provided with technical assistance for HIV-related institutional capacity building: 115

14.3 Number of individuals trained in HIV-related policy development: 4

14.4 Number of individuals trained in HIV-related institutional capacity building: 1,167

14.5 Number of individuals trained in HIV-related stigma and discrimination reduction: 239

14.6 Number of individuals trained in HIV-related community mobilization for prevention, care and/or treatment: 1,640

Table 3.3.18: