Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 5010
Country/Region: Zambia
Year: 2007
Main Partner: U.S. Centers for Disease Control and Prevention
Main Partner Program: NA
Organizational Type: Own Agency
Funding Agency: HHS/CDC
Total Funding: $2,914,000

Funding for Care: TB/HIV (HVTB): $124,000

This activity will link to activity #9021.

In FY 2006, the US Government (USG) provided technical and financial support to the National TB program for the development of guidelines related to the implementation of TB/HIV activities. Further support was provided for a national TB review meeting that reviewed national progress in the implementation of TB control strategies. This meeting, which was attended by all nine Provincial TB coordinators and other management staff from the Provincial Health offices and other cooperating partners, was utilized as a platform to sensitize the staff in relation to the planned TB/HIV activities. Further support was provided for the development of the national TB strategic plan to ensure incorporation of TB/HIV activities at all levels of the health care system. Technical support supervision visits to three provinces were carried out by the Ministry of Health (MOH) with technical support from the USG to monitor the implementation of TB/HIV activities. The MOH has recently reviewed the structure and increased the number of staff in the TB unit from two to five staff. In order to further strengthen this unit, the USG will second a TB/HIV officer to the Ministry by the end of FY 2006. This officer will be based within the MOH and coordinate the implementation of TB/HIV activities as part of the TB unit, working with all other partners providing support to the Ministry such as World Health Organization (WHO), Tuberculosis Country Assistance Plan (TBCAP), Japanese International Cooperation Agency (JICA) and other USG funded partners such as Zambia Prevention Care and Treatment (ZPCT).

In FY 2007, the United States Government will continue to provide direct technical assistance to the Ministry of Health (MOH) for the implementation and coordination of tuberculosis (TB) and HIV program implementation. This activity includes the following components; 1) development and dissemination of guidelines, manuals, and the production of other relevant documents; 2) supportive supervision and technical support; and 3) continued support for a full-time national level TB/HIV coordinator that is placed within the National TB Program (NTP).

Following the development if the TB/HIV guidelines in FY 2006, the USG will continue to provide technical and logistical support to the central TB unit of the MOH for the dissemination of the guidelines, updating the national TB manual to include TB/HIV and other recent changes in TB management and development of guidelines for the management of MDR TB.

As part of the national TB unit, the TB/HIV officer will provide support supervision for the implementation of TB/HIV activities to the nine Provincial TB officers through quarterly technical assistance visits to the provinces and other to districts as necessary. These visits will be coordinated with other partners working in TB/HIV. These visits will be used to guide TB/HIV policy and guideline development as well as program implantation to the various areas of the country. Provincial and district level quarterly review meetings to monitor the progress in implementation of the activities will be supported through this activity. Additional support will be provided for the inclusion of TB/HIV in activities such as World TB Day at national level as well as in selected districts in four Provinces.

Funding for Management and Operations (HVMS): $2,790,000

Since 2001, CDC has operated in Zambia under the Global AIDS Program (GAP), primarily providing technical assistance and logistical support to the Ministry of Health (MOH) and other national institutions for HIV/AIDS and tuberculosis (TB) programs. At the end of FY 2006, the CDC-Zambia staffing pattern included 40 positions. Current staffing levels include 38 individuals. Two positions are in the process of being filled, including one USDH position. The current staff includes 11 support staff and 27 technical staff, which are comprised of four United States Direct Hires (USDH), four contract positions, and 19 Foreign Service Nationals (FSNs). Under the leadership of the US Ambassador, the CDC Director provides the overall guidance and direction for the PEPFAR activities managed by CDC-Zambia. The leadership team consists of the Deputy Director for Management and Operations, the Associate Director for Science, and three Branch Chiefs (Epidemiology and Strategic Information; Care, Treatment and Prevention; and Laboratory and Infrastructure Support). The technical staff has expertise in the areas of antiretroviral treatment (ART), HIV prevention, prevention of mother to child transmission (PMTCT), TB/HIV, sexually transmitted infections (STI)/HIV, strategic information, epidemiology, and laboratory infrastructure.

CDC-Zambia has focused primarily on technical and financial assistance to build the capacity of Zambian organizations. To facilitate the achievement of the PEPFAR goals in FY 2007, CDC-Zambia plans to hire additional staff that includes one new USDH and seven additional FSNs. The new hires will provide additional support toward the technical implementation of activities that have been established with the MOH, University Teaching Hospital, National AIDS Council, Tropical Disease Research Center, HIV/TB/STI national laboratories in Zambia, and a growing number of non-government organizations and faith-based organizations and university partners. CDC plans to focus on program areas that make optimal use of its institutional strengths, and to concentrate on funding and assisting programs that will yield maximum impact on HIV prevention, care, and treatment. In FY 2007, CDC will also continue to employ one fellow through the Association of Schools of Public Health (ASPH) program, taking advantage of newly acquired technical skills of a recently graduated public health masters-level professional.

The total staffing of CDC-Zambia will be brought to 48 in FY 2007. All CDC-Zambia staff will spend at least 90% of their time on PEPFAR activities. Additional staff will be hired to carry out and scale-up activities in the area of pediatric and adult ARV services, strategic information, laboratory infrastructure, TB/HIV, and program support. CDC will continue to provide national support for the development of laboratory capacity to monitor and manage the treatment of HIV and opportunistic infections. Management and staffing will support logistical and administrative requirements in Zambia as program implementation requires coordination across geographically diverse locations.