Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 12346
Country/Region: Vietnam
Year: 2010
Main Partner: Not Available
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: USAID
Total Funding: $0

Vietnam has the 12th highest burden of tuberculosis in the world with an estimated 173 cases per 100,000 persons. For HIV-positive persons in Vietnam, TB is the primary cause of severe illness and death.

The new USAID TBD TB program will work to enhance existing TB programs and expand their reach. Consistent with the Vietnam National HIV/AIDS Strategy and the PEPFAR Vietnam 5-Year Strategy, the expansion of provider-initiated testing and counseling (PITC) continues to be one of the highest priorities. In HIV clinical care settings, the focus will be on reducing the burden of TB in HIV-positive persons by promoting the three "I's", consisting of intensified TB case finding, infection control and isoniazid preventive therapy (IPT). Special attention will continue to be paid to the development of a successful, evidence-based model for screening HIV patients for TB disease, strengthening human resources at the district level, and the provision of cotrimoxazole, antiretroviral therapy (ART) and other services for HIV-positive TB patients.

Human resource development is vital in order to ensure there is a sustainable HIV TB care system in the future. To meet this goal, PEPFAR will support direct technical assistance and additional training of individuals who will offer TB diagnosis and treatment, and ensure proper data recording and reporting practices. PEPFAR will expand TB laboratory capacity support and will support national efforts for training and quality assurance in smear microscopy.

The target populations are HIV TB co-infected individuals (in particular, those diagnosed with TB and not currently diagnosed with HIV, and those diagnosed with HIV and not yet screened for TB or receiving treatment for TB). The geographic coverage will be in the seven PEPFAR-focus provinces.

One of the primary goals of the USAID TB program is to strengthen the overall TB system, especially for those who are HIV positive. Activities in this program will involve laboratory strengthening within the Ministry of Health system and the training of key health personnel at the national, provincial and community levels on how to improve diagnosis, infection control and treatment of TB.

All Vietnam in-country activities are implemented through, by or with Vietnamese government partners, ensuring country ownership. PEPFAR Vietnam will continue to formally coordinate with the government of Vietnam and other relevant programs, including those supported by the Global Fund, WHO, other donors and other donor funded programs, to ensure that future PEPFAR investment in these areas is strategic and complementary.

All new activities will have strong monitoring and evaluation and quality and efficiency improvement components, as PEPFAR support gradually shifts to a more supervisory and, eventually, advisory role.

Funding for Care: TB/HIV (HVTB): $0

In FY 2010, the TBD TB partner will continue supporting TB activities initiated under the Tuberculosis Control Assistance Program (TB CAP) program, which ended in September 2010.

This activity will continue previous efforts by strengthening the implementation of TB infection control. Activities include expanding TB infection control into HIV/AIDS services, such as voluntary counseling and testing (VCT) sites and outpatient clinics.

This new TB activity will implement work practice, administrative control and environmental control measures by building capacity for health care workers, and providing TB infection control education to patients and caregivers. Other activities include developing standard operational procedures and conducting quality assurance/quality improvement (QA/QI) visits of facilities with large numbers of HIV-positive individuals.

These activities will be implemented in HIV counseling and testing centers, outpatient clinics, drug rehabilitation centers and in community and household settings.

This activity will be linked to other PEPFAR activities that focus on isoniazid preventative therapy (IPT) and intensive case finding.