N/A

New/Continuing Activity: Continuing Activity

Continuing Activity: 18484

Continued Associated Activity Information

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

System ID System ID

18484 18484.08 U.S. Agency for Elizabeth Glaser 7998 7998.08 Partnership for $667,000

International Pediatric AIDS Family Centered

Development Foundation HIV AIDS

programs

Emphasis Areas

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $404,400

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Estimated amount of funding that is planned for Food and Nutrition: Policy, Tools $32,800

and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Program Budget Code: 02 - HVAB Sexual Prevention: AB

Total Planned Funding for Program Budget Code: $2,089,476

Total Planned Funding for Program Budget Code: $0

Program Area Narrative:

The sexual prevention program area for Swaziland is comprised of activities funded under the HVAB and HVOP budget codes.

All activities are linked to a comprehensive strategy, combating the generalized epidemic. Several partners receive funding under

both budget codes. Swaziland has the world's highest HIV prevalence. The 2007 DHS+ indicates that 26% of adults (15-49) are

HIV-positive. There are no major differences between rural and urban areas, or among the country's four regions. Given the

generalized epidemic, the entire population is considered at risk. The epidemic is driven by multiple, concurrent sexual partnering

in an extremely traditional, patriarchal society. The modern trend is to engage in sexual partnerships that lack traditional social

sanction (casual partnering, not traditional polygamy). High-level leadership on prevention remains insufficient despite persistent

stakeholder efforts.

The National HIV/AIDS Strategic Plan (NSP) (2006-08) emphasizes the need to reduce multiple concurrent sexual partnering,

along with improved access to services for sexually transmitted infections (STIs), post-exposure prophylaxis (PEP), and HIV

counseling and testing (HTC), as well as the need to strengthen national capacity to ensure that quality male and female condoms

are available, accessible, acceptable, affordable, and used. PEPFAR's plan mirrors the NSP in calling for expanded prevention

programs, including support for a comprehensive ABC approach, with linkages to HTC and care. A new NSP is currently under

development and will become the National Strategic Framework (NSF) for 2009-2013. PEPFAR Swaziland HVAB and HVOP

partners and activities will be in line with this plan. NERCHA has used its Global Fund resources to support AB-focused mass

media campaigns over the past few years. Recent campaigns have focused on the issues of intergenerational and transactional

sex, multiple concurrent partnerships or extramarital affairs, and delay of sexual debut. Global Fund resources have also

supported AB programs for youth, including life skills programs. UNFPA is also a major supporter of youth prevention programs

and ABC services for youth. National Emergency Response Committee on HIV/AIDS (NERCHA) plays the major role in trying to

improve AB leadership with the royal family, traditional rulers, and other national leaders.

Consistent condom use continues to be low, especially in regular partnerships. PEPFAR partners distribute condoms at

community level, at workplaces and in the military, and are beginning to work with the Ministry of Health and Social Welfare

(MOHSW) to promote and distribute condoms part of service delivery. National-level distribution and tracking is problematic, but

the UN agencies are working to assist the government with this, particularly UNFPA who works with the Sexual and Reproductive

Health Unit (SRHU). Gender issues affect all aspects of the HIV epidemic in Swaziland. Rape and sexual violence are a

widespread problem and have been associated in some settings with increased risk of HIV. Prevailing attitudes and customs

marginalize women culturally and legally. Male behavior retains the role of women as generally passive sex partners. Young

women are particularly vulnerable to transactional sex or non-consensual sex to help meet basic needs, along with desires for

consumer items. PEPFAR supported activities in sexual transmission prevention are addressing several priority gender factors

that contribute to the spread of HIV. However, gender messages are yet to be systematically integrated into prevention messages

and programs.

PEPFAR has continued to fill a major gap by promoting sexual prevention at community-level, and with increased attention to

prevention as a Swaziland PEPFAR compact priority, will raise this to the national level. PEPFAR's sexual prevention programs

for adults are integrated ABC programs, but with a very strong emphasis on partner reduction and gender issues. Youth issues

will become a stronger focus as well in FY09. The overall PEPFAR strategy is to promote ABC prevention through faith-based

organizations/churches, community-based organizations (including some schools, youth centers and youth groups), traditional

rural ruling structures, and the private sector/workplaces nationally. Swaziland has been designated as a FY08 Compact Country.

Prevention is one of the five key areas under development with the government, and better coordination for national prevention

efforts - including correct and consistent condom use - will be integrated in this work. Stronger national coordination of AB

programs, Behavior Change Communication (BCC) strategy development, and other activities to achieve national scale up will be

included.

Partners working in PMTCT and Care and Treatment (C&T) sites will integrate ABC prevention into patient-provider interactions

regardless of patient HIV status. Prevention with Positives (PWP) will be promoted as part of community-based care activities.

Condom availability at PMTCT and C&T sites will be supported. Male Circumcision (MC) related information has been moved to

its own program area with this COP. Partners working in this field continue to ensure that all MC messaging contains strong AB

principles and is integrated with HVOP guidance on correct and consistent condom use.

For FY09, partners working in sexual prevention will continue their work with an eye towards supporting a cohesive national

approach. Partner activity descriptions follow.

1) C-Change received funding in Swaziland through FY 08 reprogramming in order to assess and begin early strategy planning

for how they will support the national scale up of prevention services. In FY09 their focus will be on coordinating national efforts to

implement BCC strategies that will target youth, multiple concurrent partners, and other key topics. They will assist in the

standardization of curricula and facilitation guides for faith and community based groups to ensure evidence based massages are

developed and disseminated widely and correctly. C-Change will partner with local groups like Population Services International

(PSI), NERCHA and the National HIV and AIDS Information and Training Centre to build capacity in Swaziland to carry prevention

efforts forward.

2) PSI will continue its work expanding the reach and improving the quality of sexual prevention activities by focusing on the

following: Support Swaziland National AIDS Program (SNAP) to revive the HIV prevention technical working group and conduct

seminars to collaborate on the development of communication messages to improve the coordination of BCC in the country;

Target the national yearly cultural events and work with local partners to promote primary and secondary abstinence and be

faithful messages to the young women attending these activities; Interpersonal Communication (IPC) agents will continue to

provide community based and door to door targeted and integrated messages focusing on ABC, HTC and MC activities; Contract

three sub awards to promote AB messages and adoption of safer sex practices through the promotion of be faithful messages

emphasizing concurrency as the driver of the epidemic in Swaziland; Identify a private local or external advertising agent to

support the development of a Multiple and Concurrent Sexual Partners' campaign; Support one tertiary institution to model

excellence and give an award of excellence for the best peer education program based on indicators that will be developed with

technical assistance support; Working with three sub-partners, PSI will continue to support the availability and accessibility of

condoms to promote the adoption of safer sex practices

3) As an umbrella grant mechanism, Pact will continue to build the technical and institutional strength of its grantees to promote

sexual prevention activities in Swaziland: Family Life Association Swaziland (FLAS-AI) aims to reduce HIV prevalence through

behavior change by promoting AB messages with a strong focus on faithfulness and partner reduction; Nhlangano Aids Training,

Information, and Counseling Centre (NATICC) aims to reduce the rate of youth HIV prevalence in 17 chiefdoms-NATICC operates

in underserved areas of the Shiselweni region and has a strong program emphasizing male involvement; Swaziland Action Group

Against Abuse (SWAGAA) will continue to play a national role in prevention through education, outreach and counseling activities

that focus on the links between HIV, gender issues, domestic violence and gender-based violence (GBV); In FY09 Swaziland

Business Coalition Against HIV/AIDS (SWABCHA) will shift focus from developing workplace policies to focus on AB prevention

activities through increased follow-up and mentorship for peer educators, while forming sustainable linkages with the International

Labor Organization (ILO) and Department of Labor (DOL) to provide support for workplace policies; For FY09, The Salvation

Army (TSA) will scale up pastor prevention activities by training 25 pastors within their sites to ensure that the prevention program

is complementary and effectively engaging their congregants; Voice of the Church (VOC) is a Trans World Radio partner,

broadcasting faith-based programs throughout Swaziland. The organization is currently implementing a project entitled "Be

Faithful" consisting of a dedicated one hour broadcast transmitted three times a week to communities broadcasting AB-based

radio programs; World Vision (WV) activities will focus on the underserved Shiselweni region. Pastors will be mobilized and

sensitized on World Visions' Channels of Hope model, which seeks to mobilize the infrastructure, organizational capacity, pool of

current and potential volunteers, local churches and faith communities toward positive action on HIV and AIDS.

4) HIV prevention has been and remains a focus of Peace Corps' programming efforts at the community level. All volunteers

serving in Swaziland - including those supported with HKID funding - will be trained on sexual prevention issues and will conduct

prevention activities as part of their standard course of work. The ‘Walk the Nation' activity with NERCHA will be repeated after its

success at bringing HIV prevention messaging and HTC to all corners of Swaziland. Stronger linkages between volunteers and

other PEPFAR funded prevention partners at the community level will also be fostered.

5) Twenty-four enterprises from the agriculture, retail, manufacturing, information and textile sectors are currently collaborating

with the DOL/ILO project. In all these enterprises HIV/AIDS Focal Points and Committee members have been appointed by the

management and trained by ILO to coordinate HIV/AIDS workplace programs. The main goal of this project is to overcome

discrimination, change behavior and subsequently refer a greater number of workers to VCT, PMTCT, MC, anti-retroviral therapy,

treatment for TB and sexually transmitted infections. A BCC strategy has been developed for all sectors and an HIV workplace

program is implemented in each partner enterprises. Workplaces from the public sector will join the partnership. New materials

will be developed to support the work of the peer educators and new activities will be implemented in the area of prevention

focusing on AB, with integration of correct and consistent condom use as well. Condom availability of both male and female

condoms will be ensured by distributing condoms to all participating enterprises monthly. Quality assurance checklists are filled

out by HIV/AIDS focal points. Condom cans will be placed and refilled where access is guaranteed.

6)DOD prevention activities are to be conducted as follows: build on the peer educator structure in the USDF and Swaziland

Uniformed Services Alliance for HIV/AIDS (SUSAH) to promote correct and consistent condom use, and reduce the number of

partners and concurrent partnerships; address gender relations; provide adapted DOD-partner military IEC materials appropriate

for the USDF; conduct PWP training consisting of Training of Trainers instruction and distribution of training curriculum and

materials to peer educators and clinic educators; provide small, durable laptops which can be loaded with prevention training

materials, VCT information, and C&T resources; connect to the internet for email and Skype connectivity and supportive

supervision; and support the collection and transmission of monitoring and evaluation information.

7) URC, working in collaboration with SNAP and the Swaziland National Tuberculosis Control Programme (NTP) to increase the

uptake of HTC in the country's health care facilities, will assist TB diagnostic centres and selected medical wards in promoting

consistent and correct condom use. This drive will direct a portion of prevention efforts towards TB patients and suspects to

reduce missed opportunities for HIV prevention, C&T and support and further reduce spread of HIV in the country. The approach

will include: condom use education, demonstration and distribution integrated in TB clinics and medical wards for both HIV+ and

HIV- persons in prevention of new infections and re- infections. The URC supported facilities will source condoms from SNAP.

List of national products/outcomes: Renewal of national prevention committee, Development of national BCC campaign,

Development of a national condom distribution strategy development

Sexual prevention is one of the five key areas identified for national scale up in the Compact Concept paper. With pre-compact

funding levels, PEPFAR would continue to support successful NGO work in specific communities and workplace programs, but

would only provide minimum levels of support at the national level. National scale up, including the establishment of a locus for

prevention leadership, the development a BCC strategy and the standardization of evidence-based messages around reducing

MCP, changing gender norms and other key prevention issues are largely dependent on Compact funding and are key to

Swaziland being able to reduce new HIV infections.

Table 3.3.02:

New/Continuing Activity: New Activity

Continuing Activity:

Emphasis Areas

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $6,000

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.08:

New/Continuing Activity: New Activity

Continuing Activity:

Emphasis Areas

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $6,000

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.09:

N/A

New/Continuing Activity: Continuing Activity

Continuing Activity: 19140

Continued Associated Activity Information

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

System ID System ID

19140 19140.08 U.S. Agency for Elizabeth Glaser 7998 7998.08 Partnership for $166,500

International Pediatric AIDS Family Centered

Development Foundation HIV AIDS

programs

Emphasis Areas

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $15,000

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Program Budget Code: 12 - HVTB Care: TB/HIV

Total Planned Funding for Program Budget Code: $1,034,400

Total Planned Funding for Program Budget Code: $0

Program Area Narrative:

According to the World Health Organization (WHO) the TB incidence in Swaziland is the highest in the world. In 2007, Swaziland

registered a total of 9,636 TB cases. The 2007 TB notification rate stands at 1,155 cases per 100,000 population - up from 236

cases per 100,000 population in 1997 - an almost five-fold increase in just ten years. TB is a massive contributor to national

morbidity and mortality and is a large burden on the overstrained health sector. Approximately 80% of TB cases are estimated to

be HIV-infected.

The Ministry of Health and social Welfare's (MOHSW) National TB Program (NTP) has a history of being highly vertical with weak

performance. The overall case detection rate is estimated to be as low as 58%, well short of the 70% WHO target. The treatment

success rate is 43%, far short of WHO's treatment success target of 85%. The proportion of cases that default from treatment is

unacceptably high. However, efforts are being made to address these issues and to rapidly improve program outcomes.

Currently, 67% of TB cases (up from 0% less than 2 years ago) and 10% of TB suspects (also up from 0%) are HIV tested and

efforts are being made to also test their families. 93% of TB cases who are HIV positive receive CMX preventive therapy. Actual

HIV/AIDS care is not currently available at TB treatment clinics. However, in most cases an ART clinic is available within the same

health facility. Referrals are being made with mixed results.

Equally, the MOHSW's ART Program, under the Swaziland National AIDS Program (SNAP), has been implemented in a highly

vertical fashion. While close to 30,000 people have been initiated on ARV treatment, integrated TB services are still virtually non-

existent. Systematic TB screening is not available. A TB screening tool has been developed and is currently being piloted at three

ARV treatment sites. However, there are no clear protocols on how to handle and/or refer TB suspects and indeed TB patients on

treatment. Interventions to prevent or control TB transmission at the ARV treatment centers are limited and inconsistent. TB

preventive Isoniazid (INH) therapy is also not available.

Given the extremely high HIV prevalence, there is a potential for explosive outbreaks of multi-drug resistant (MDR) and extensive

drug resistant (XDR) TB among HIV-infected individuals in Swaziland, as has been seen in South-Africa and in other countries.

WHO and the International Union against TB and Lung Disease (IUATLD) recommend that countries closely monitor anti-

tuberculosis drug resistance, either through ongoing surveillance or periodic surveys. In Swaziland, however, the lab capacity for

TB culture and drug susceptibility testing is inadequate. A rapid MDR/XDR-TB assessment in collaboration with WHO and South

Africa Medical Research Council (SAMRC) was conducted in 2006 (which revealed existence of XDR-TB in Swaziland) but there

are no nationally representative data on anti-tuberculosis drug resistance available in Swaziland.

To date, PEPFAR assistance has played a major role in making crucial improvements to the NTP at large. PEPFAR has

strengthened the NTP's basic operations, guiding organizational restructuring and building managerial capacity. PEPFAR has

helped MOHSW finalize a five-year National Strategic Plan for TB Control and National TB Program Guidelines, with strategic and

program planning. In addition to mentoring of the NTP management, PEPFAR support has included extensive training of public-

and private-sector personnel at all levels on basic TB Program operations. PEPFAR made considerable contributions to the

strengthening of TB diagnosis through sputum smear microscopy (see HLAB), and supported the NTP with the estimation of TB

drug needs, rational drug procurement (including through the Global Drug Facility) and supply chain management for drugs and

other commodities (see HTXD).

PEPFAR has played a major role in initiating integration of certain TB and HIV services. PEPFAR has facilitated the establishment

of a TB/HIV Technical Working Group (jointly chaired by NTP and SNAP) and the development of a TB/HIV Policy document.

These, however, have not yet been translated in effective integration of actual services for patients across the two programs.

Nevertheless, PEPFAR has been successful at supporting HIV counseling and testing services for TB patients and suspects,

through training and mentoring of all TB clinic personnel (see HVCT). PEPFAR has also supported the implementation of Co-

trimoxozole (CMX) preventive therapy for all HIV-positive TB patients. Actual HIV/AIDS care and treatment are not yet available at

TB treatment facilities. Referrals are being made with mixed results. PEPFAR has started training personnel at ANC, MCH and

ART clinics for the screening and early detection of TB and is supporting a pilot project on the implementation of INH preventive

therapy for HIV-positives. PEPFAR has also supported the development of draft guidelines for TB infection prevention and control,

implementation of which is lacking.

PEPFAR has provided assistance to start addressing the imminent problem of drug-resistant TB, resulting in plans for the

development of MDR and XDR TB management guidelines, MDR and XDR TB case recording, and MDR and XDR TB laboratory

surveillance. In addition, CDC has leveraged with WHO for a joint high-level program review, and technical assistance, to assist

Swaziland in working toward meeting the requirements to apply for assistance of the Green Light Committee for the procurement

of cheap and quality-assured second-line TB drugs.

PEPFAR support has played a crucial role in improving the performance of Swaziland's Global Fund (GF) TB grant. The Round 3

grant was placed on the Early Alert and Response System due to poor performance. The Principal Recipient (NERCHA), senior

MOHSW leadership, the NTP program staff, and the GF's Swaziland Portfolio Manager in Geneva widely acknowledge that

dramatic improvements in meeting targets, reporting, and spending disbursements were due in very large part to PEPFAR

assistance. Additional PEPFAR leadership and support included assistance with the applications for Round 6. (which was

unsuccessful) and Round 8 (which was recently recommended for approvel).

In FY09, the PEPFAR will continue to support the NTP with programmatic and managerial improvements, including building lab

capacity and quality assurance, drug tracking and drug supply management strengthening, and monitoring and evaluation

support. Most of the support, however, will focus on specific TB/HIV collaborative activities. PEPFAR support will be in line with

the new National Strategic Framework for HIV/AIDS (NSF) for 2009-2013 that is currently under development.

1) University Research Corporation (URC), Centers for Disease Control and Prevention (CDC), and other PEPFAR Care &

Treatment partners will continue assisting the NTP, SNAP, and the ART Program with the developing of national policies and

guidelines and their dissemination. These will include, but will not be limited to, TB Policy Guidelines, TB/HIV Policy Guidelines,

TB Control Guidelines, TB/HIV Control Guidelines, TB/HIV Workplace Guidelines, MDR/XDR-TB Control Guidelines, TB Infection

Prevention and Control Guidelines, etc.

2) The Global Fund (GF) is the most important external source of funding for TB and TB/HIV activities. URC and CDC will

continue to assist the NTP in meeting the objectives of the GF TB grants for the country. This will include, but will not be limited

to, assisting with the implementation planning and implementation of GF Round 3 and Round 8 TB grant activities, addressing

conditions precedents, monitoring of GF indicators, and developing the periodic GF submissions and reports. PEPFAR will also

support any future GF TB grant applications.

3) URC will continue to build the capacity of the NTP to manage its overall TB control program activities, through continued

guidance and mentoring of key personnel at different levels. URC will work with the NTP to finalise the Directly Observed Therapy

Short Course (DOTS) scale up plan, decentralisation of treatment to the primary health care clinics, institutionalisation of both

facility and community DOTS, and implementation of defaulter tracing strategies. URC and Management Sciences for Health

(MSH) will assist the NTP and the MOHSW Central Medical Stores in ensuring an uninterrupted supply of reliable first-line and

second-line anti TB medicines and other commodities (such as N95 respirators) and the implementation of an adequate supply

chain management system (see HTXD). URC and the National Institute for Communicable Diseases (NICD) will also continue to

work with the NTP and the MOHSW National Laboratory Services in strengthening the capacity of laboratory staff in TB smear

microscopy and TB culture and first-line drug susceptibility testing (see HLAB).

4) PEPFAR will continue to work with the NTP, SNAP, and the ART Program to ensure the implementation of TB/HIV

collaborative activities. URC and other PEPFAR Care & Treatment partners will continue to support the TB/HIV working groups at

national, regional and health facility level to ensure their effective functioning, leading to the actual implementation of integrated

TB/HIV activities.

•URC will continue to train and mentor TB clinic staff on HIV Testing and Counselling (HTC) and will assist with the provision of

adequate consultation space (where needed) to ensure confidential and quality HTC services (see HVCT).

•URC will continue to promote the provision of CMX preventive therapy for all HIV-positive TB patients

•While HIV/AIDS treatment may become available at some of the higher-volume TB clinics, this will not be the case at most sites.

URC and other partners will explore different models of collaboration where there are TB and ART clinics in the same health

facility, and support the development of an effective two-way referral and feed-back system for patients to have easy access to all

treatment they require

•URC and other PEPFAR Care & Treatment partners will train HIV/AIDS clinic staff, including all ART providers, on the early

detection of TB. At the same time, ICAP and EGPAF will work to implement TB detection activities in PMTCT, ANC and MCH

settings. A TB screening tool will be finalized and clear protocols for the management of TB suspects and TB patients will be

developed. Both will be widely implemented

•PATH will assist with issues of TB infection prevention and control by carrying out infection control assessments at all the main

TB treatment facilities, HIV/AIDS treatment facilities and diagnostic laboratories in the country, and developing TB infection control

guidelines and recommendations (as there are curriculum development, training, equipment, etc.) and their implementation.

•Depending on the outcome of the ongoing pilot project, URC will further support the development of guidelines, training and

implementation of INH preventive therapy for HIV-positives.

•The implementation of a viable integrated TB/DOTS and HIV comprehensive care program in the community remains a

challenge. Increased support to community mobilisation especially to well organised community groups is envisaged to improve

treatment outcomes based on community support systems (see HTXS, HBHC).

5) URC will continue to assist the NTP to respond to the threat of MDR/XDR-TB and risk of increased mortality associated with

MDR/XDR-TB and HIV co-infection. URC will assist with the further development of the MDR/ XDR-TB patient management

guidelines, with curriculum development and training for TB program personnel, and with the work planning for the implementation

of specific MDR/XDR-TB management activities by the NTP. Through COHSASA and URC, PEPFAR will continue to support the

swift and effective utilization of the new TB hospital (once it opens) for the management of MDR/XDR and other complicated TB.

URC will also continue to leverage for the assistance of the Green Light Committee for the procurement of cheap and quality-

assured second-line TB drugs.

6) PEPFAR has assisted with the development and implementation of data collection and analysis tools, including the ‘Electronic

TB Register', to help the NTP with the monitoring of its TB and TB/HIV collaborative activities. PEPFAR will continue to train and

support health facility staff in the use of these tools and the utilization of the data for improving their services.

7) PEPFAR will also assist the NTP with the implementation of a nation-wide anti-TB drug resistance survey and the consequent

development of an information management system for the routine utilization of TB drug susceptibility test data (see HVSI).

8) TB in the workplace is a major challenge, and often related to HIV. Employees with TB frequently miss considerable amounts of

work, which negatively impacts livelihood and productivity. Issues of TB transmission in the workplace are also important. Several

PEPFAR partners already conduct workplace programs on HIV/AIDS. They will start updating their education and training

programs and integrate TB information, TB screening and TB treatment support in the workplace.

9) Through the Department of Defense (DOD), and with the assistance of URC, PEPFAR will also support implementation of the

above mentioned TB and TB/HIV integration activities for some of the uniformed services such as the Umbutfo Swaziland

Defence Force, the Swaziland Police and His Majesty's Correctional Services.

10) URC and the Human Capacity Development coalition (SAHCD) will work with training institutions for health care workers to

incorporate TB/HIV in their training curricula. Working with nursing schools will be the starting point, but this may eventually

expand to other health cadre training institutions.

Products/outputs: National policy, National Strategic Plan, Guidelines, recording and reporting systems for TB, TB/HIV, and

MDR/XDR-TB, training curricula, study protocols/data/reports.

There were no significant plans for expansion of TB/HIV activities under the Compact. PEPFAR is a key partner with substantial

achievements and will continue to be so with pre-Compact funding levels.

Table 3.3.12: