Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012 2013

Details for Mechanism ID: 12273
Country/Region: Zambia
Year: 2013
Main Partner: Tropical Diseases Research Centre
Main Partner Program: NA
Organizational Type: Parastatal
Funding Agency: HHS/CDC
Total Funding: $357,131

Zambias ability to fight HIV/AIDS is compounded by HIV as a predisposing factor fueling Tuberculosis (TB) infection resulting in 50 to 70% of TB cases being co-infected with HIV. While the STOP TB Partnership global target detection rate is 75% of new TB cases and cure rates of 85%, Zambias performance is only at 49% and 75% respectively. This calls for strengthening evidence-based interventions to reverse this tide. Therefore, TDRC will strengthen laboratory efficiency in TB/HIV diagnosis, treatment monitoring, and surveillance of multiple drug resistant TB (MDR-TB) in FY 2012 and FY2013 to enhance Zambias ability to respond to the HIV/AIDS crisis in PLWHA co-infected with TB. TDRC will continue to participate in ongoing HIV surveillances. In FY 2012 and 2013, TDRC will participate in the Demographic and Health Survey (DHS) as well as the annual record review of the Prevention-of-Mother-to-Child Transmission (PMTCT) program data for HIV surveillance. TDRC will also commence incidence testing on specimens from the D HS. TDRC will be involved in the biologic testing of specimens in the Sinazongwe evaluation. In FY 2013 TDRC in partnership with UTH, CSO and MoH will commence preparatory activities for the AIDS Indicator Survey (AIS).TDRC will continue engaging policy and program managers in dialogue to identify more gaps in national HIV data. TDRC will increase laboratory capacity to identify opportunistic infections (IOs) in people living with HIV/AIDS and it will also increase the laboratory capacity to identify neglected tropical diseases (NTD) in people living with HIV/AIDS. TDRC will continue maintaining and upgrading information and communications technology (ICT) in order to serve laboratory scientists working in HIV and TB surveillance.

Funding for Laboratory Infrastructure (HLAB): $214,278

A strong laboratory support through external quality assurance (EQA) implementation is critical for quality results for early TB case detection. Zambias TB laboratory EQA activities roll out only to district hospital but not yet to health center level where the bulk of patients are diagnosed for TB. The implication is that most Zambians evaluated for TB at health centers are diagnosed by somebody without external oversight. This challenge demands regular monitoring and strengthening of TB smear microscopy proficiency of lab personnel in northern region. In FY2012 and FY2013, TDRC will scale up TB EQA for acid-fast bacilli (AFB) smear microscopy to health centers level laboratories. Specifically, TDRC will conduct on-site evaluation, proficiency testing, site visits for quarterly collection of TB smear slides for blinded rechecking, and on-site and group training of laboratory personnel in AFB smear microscopy. TDRC will use internet facilities to communicate feedback of EQA results. TDRC will immediately respond with remedial action under quality improvement (QI) after identification of errors and problems by carrying out on-site trainings at the affected sites. TDRC shall produce quarterly reports for submission to the Ministry of Health (MOH) National TB Program manager and national reference laboratory (NRL). TDRC shall submit semi-annual progress reports (SAPR) and annual progress reports (APR) to CDC. TDRC will participate in CDC TB coordination and MOH working group meetings, and preparation of national EQA materials at Chest Diseases Laboratory (CDL). National accreditation of TB laboratories is a process necessary to pursue for excellence, and it will be targeted during the proposed period. TDRC shall continue to participate in local and international microscopy and culture TB EQA. TDRC will strengthen internal quality control (IQC) towards international accreditation. TDRC will participate in trainings on good clinical laboratory practice (GCLP). TDRC will increase laboratory capacity to identify opportunistic infections (IOs) in people living with HIV/AIDS and it will also increase the laboratory capacity to identify neglected tropical diseases (NTD) in people living with HIV/AIDS.

Funding for Strategic Information (HVSI): $142,853

TDRC will continue to participate in ongoing HIV surveillances and providing capacity building for biologic testing in HI/AIDS surveys. In FY 2012 and 2013, TDRC virology will participate in the Demographic and Health Survey (DHS), an activity in which they will be collaborating with other partners. A team of laboratory scientists and technologists will participate in the field work and will provide onsite HIV and Syphilis testing and provide results to participants within their homes. CD4 testing will be done on all reactive specimens and the results will be given to all consenting individuals within their homes. TDRC will participate in the collaborative activity with UTH and the Ministry of Health (MoH) in conducting the annual record review of the Prevention-of-Mother-to-Child Transmission (PMTCT) program data for HIV surveillance which replaces the sentinel surveillance survey for HIV and Syphilis (HIVSS), and incidence testing on specimens from the Demographic and Health Survey. TDRC will be involved in the biologic testing of specimens in the Sinazongwe evaluation and will analyze the PMTCT program data collected for assessing the utility of these data in lieu of the HIVSS. In FY 2013 TDRC in partnership with UTH, CSO and MoH will commence preparatory activities for the AIDS Indicator Survey (AIS).TDRC will continue engaging policy and program managers in dialogue to identify more gaps in national HIV data. TDRC will continue participating in international quality assurance, and provide quality control systems for sentinel sites to sustain quality of data. TDRC will outsource training for TDRC staff in survey and laboratory methods. TDRC will also continue providing training to field staff in good clinical and laboratory practice (GCLP), ethics, laboratory, and survey methodology. TDRC will outsource expert training for TDRC staff with a view of establishing a core monitoring and evaluation (M&E) group at TDRC. TDRC will facilitate training workshops for TDRC scientists in scientific research methods, data management and statistical analysis, and reporting. TDRC will continue upgrading the data processing unit (DPU) infrastructure, providing training in data management, and annual renewal of licenses for statistical software. TDRC will continue maintaining the local area network (LAN) servers and ICT related assets, initiate capacity building for basic internet infrastructure for sentinel and TB sites facilitates information dissemination for clinicians and laboratory personnel, provide in-house ICT training for staff and LAN administration training for ICT staff, and generally strengthen ICT infrastructure at TDRC with new equipment and necessary software. TDRC ICT unit will extend fire/smoke detection system to the TB laboratory. Additionally, TDRC will increase bandwidth usage and expand the service, and upgrade the central electronic specimen tracking and repository for surveys. TDRC will increase laboratory capacity to identify opportunistic infections (IOs) in people living with HIV/AIDS and it will also increase the laboratory capacity to identify neglected tropical diseases (NTD) in people living with HIV/AIDS.

Cross Cutting Budget Categories and Known Amounts Total: $357,131
Human Resources for Health $357,131
Key Issues Identified in Mechanism
Increase gender equity in HIV prevention, care, treatment and support
Tuberculosis