Detailed Mechanism Funding and Narrative

Years of mechanism: 2013 2014 2015 2016 2017

Details for Mechanism ID: 16750
Country/Region: Ethiopia
Year: 2013
Main Partner: World Health Organization
Main Partner Program: NA
Organizational Type: Multi-lateral Agency
Funding Agency: HHS/CDC
Total Funding: $1,000,000

This is a follow on activity to the WHO mechanism that provides technical support to the FMOH and RHBs to strengthen the ability of the GOE to control the HIV/AIDS and TB epidemic. The partner has provided technical assistance to the FMOH and Regional Health Bureaus (RHBs) to strengthen their comprehensive response. WHO has supported the development of national policies and guidelines, training manuals, training of trainers programs, and capacity building for TB and HIV control at the national and regional level. The TBD partner will work with the GOE and provide technical assistance for TB lab support and surveillance activities and will also play a key role in keeping the national TWG's active and functional, and will continue to work with the FMOH to identify research priorities and generate HIV drug resistance information to better inform programs in the country. The partner will continue to assist FMOH to strengthen technical capacity and leadership skill at the central and program levels. It will assist FMOH to design appropriate evidence based TB and HIV disease control interventions. These activities are in support of the goals of the GOE's National Strategic Plan (SPMII), and will align activities with the goals of the GOE and USG HIV/AIDS Partnership Framework and Global Health Initiative. WHO has been providing technical assistance to the FMOH and RHBs to establish efficient and sustainable national blood transfusion services that assure the quality, safety and adequacy of blood and blood products, and meet the needs of all patients requiring transfusion in Ethiopia. WHO has also been providing technical assistance for the process of transferring blood transfusion services from the Ethiopian Red Cross Society to the management of the FMOH.

Funding for Care: TB/HIV (HVTB): $500,000

In FY 2012, WHO provided support to the FMOH to finalize the programmatic and clinical guidelines for TB, Leprosy and TB/HIV. These new guidelines address all components of TB and TB/HIV interventions, including TB infection control and MDR TB. In addition, in collaboration with partner organizations, WHO has supported the development of an assessment tool for TB/HIV, MDR-TB and TB infection control in prisons and other overcrowded settings as per the WHO recommendations and guidance. In FY 2012, WHO also supported the development of a five year strategic plan for the expansion of MDR TB diagnostic and treatment services and MDR TB training material for midlevel health workers In COP 2013, the TBD partner will:

1. Continue to strengthen human resources for the TB/HIV program at both the national and regional-levels by seconding TB program officers who will provide "hands on" technical assistance in the implementation, coordination, and monitoring of TB/HIV, pediatric TB/HIV and MDR TB programs.

2. Organize and mobilize international technical assistance to support the MDR-TB program evaluation and scale up and assist the national TB program in the development and revision of TB/HIV, MDR-TB and TB infection control related policy and strategic documents, guidelines, and training manuals.

3. Assist the FMOH in strengthening TB/HIV strategic information including maintaining and updating TB and TB/HIV information on the FMOH website.

4. Assess the feasibility of introducing tuberculin skin testing, gastric aspirate, string testing, induced sputum and other technologies at select hospitals to improve diagnosis of TB among children.

5. Provide technical assistance to EHNRI in TB surveillance and lab support activities including validation of new diagnostic technologies

6. Support the revision of TB diagnostic algorithms incorporating new diagnostic technologies.

7. Work with the FMOH and regional health bureaus to advocate and promote TB infection control activities including development of regional infection control plans as well as standard operating procedures for health facilities; make periodic joint site assessments to oversee the status of TB infection control at health facilities and make recommendations for improvements.

8. Coordinate and collaborate with other partners to supply N95 masks to MDR-TB treatment centers for addressing equipment problems in times of shortages or supply interruptions.

Funding for Biomedical Prevention: Blood Safety (HMBL): $300,000

Since 2004, WHO has been supporting the FMOH/NBTS to strengthen the national blood transfusion system through the development of a national blood policy, guidelines and standards, a five year strategic plan, monitoring and implementation of the plan, and provision of technical assistance. The TBD partner will continue to provide technical assistance with the aim of establishing an efficient, sustainable, nationally coordinated blood transfusion service that can assure the accessibility, quality, safety and adequacy of blood and blood products to meet the needs of all patients requiring transfusion in Ethiopia. In COP 2013, the TBD partner will support the implementation of blood safety in the following areas:

1. National coordination and development of basic components for management of blood safety services will be supported through supportive supervisions, provision of training, and implementation of planning and review meetings at national and regional levels. The partner will track the implementation of the blood safety program at the NBTS /Addis Ababa Blood Bank, and coordination of blood safety program activities at the FMOH/NBTS.

2. Enhancement of blood donor recruitment to meet national requirements for safe blood supply. This will be achieved through support to expand regular voluntary non-remunerated blood donors via development of strategies and plans for improved community mobilization. The partner will also improve communication mechanisms via training of journalists, community mobilizers and staff.

3. Establishment of 31 mobile collection teams (7 under NBTs and 24 under regional blood banks) with the aim of collecting 120,000 units of blood in 2013.

4. Provision of training on blood banking and technical areas to NBTs and regional blood bank staff, and support the training of trainers and mentors from USG universities and NBTS. About 350 individuals will be trained.

5. Cost-effective quality testing and processing will be achieved through support in establishment and strengthening of the blood bank laboratory functions, particularly in the regions. This will include scale up of component production and improved cold chain maintenance.

6. Support the reduction of unnecessary transfusions to reduce waste and avert adverse transfusion events and reactions by training 150 clinic staff selected from federal and regional hospitals in the use of blood and safe bedside practices.

7. Strengthen the ability of NBTs and regional systems to regularly capture, document and report blood safety data, and use the data for monitoring and evaluation, as well as for re-planning.

8. Support the improvement of the quality management system and its roll out to the regions and support the FMOH/NBTs in procurement and distribution of key blood bank supplies and equipment.

Funding for Treatment: Adult Treatment (HTXS): $200,000

Scaling up of HIV care and treatment services requires the establishment of surveillance for HIV drug resistance (HIVDR). Due to the high mutation rate of HIV and the lifelong treatment of the disease, it is expected that some degree of HIVDR will occur among persons on treatment even if appropriate regimens are provided with good adherence. As part of ART scale-up, WHO is putting a system in place to assess ART program factors that may be associated with HIV drug resistance and to monitor the emergence of HIV drug resistant strains. WHO has supported the development of the national HIVDR strategy working group, the HIV drug resistance Early Warning Indicators (EWI) survey, sentinel monitoring of HIV drug resistance in treated populations and associated ART program factors, threshold surveys to evaluate the transmission of HIV drug resistance, the HIVDR database, and the WHO-accredited HIVDR genotyping laboratory at EHNRI. In COP2010/2011, WHO provided HIVDR training to facility and regional health bureaus staff in the five regions accounting for the regions with the highest prevalence of HIV in Ethiopia. WHO has also supported EHNRI on the EWI protocol development, data collection and processing, report writing and technical assistance in conducting ANC based HIV surveillance and STI/TB/HIV surveillance. In COP 2013, the TBD partner will continue to:

1. Provide technical assistance to EHNRI on HIVDR and EWI survey data collection, report writing, and result dissemination.

2. Support EHNRI in data collection and analysis on HIVDR Threshold and Prevention Monitoring surveys at selected ART sites,

3. Provide technical assistance to FMOH/FHAPCO to conduct pre-ART treatment adherence and outcome studies.

4. Provide technical assistance on ANC, TB HIV/STI, MARPs surveillance and ANC/PMTCT data assessments.

5. Provide support to FMOH/FHAPCO/EHNRI to conduct assessments and program review on HTC, ART, PMTCT, STI and MC.

Cross Cutting Budget Categories and Known Amounts Total: $220,000
Human Resources for Health $220,000
Key Issues Identified in Mechanism
Increase gender equity in HIV prevention, care, treatment and support
Child Survival Activities
Safe Motherhood
Tuberculosis