Detailed Mechanism Funding and Narrative

Years of mechanism: 2011 2012 2013 2014 2015 2016 2017

Details for Mechanism ID: 13530
Country/Region: Ethiopia
Year: 2011
Main Partner: U.S. Centers for Disease Control and Prevention
Main Partner Program: NA
Organizational Type: Implementing Agency
Funding Agency: HHS/CDC
Total Funding: $2,789,170

The HHS/CDC Office was established in 2001 and is part of a "one USG" approach in Ethiopia. Through PEPFAR, the HHS/CDC Global AIDS Program (GAP) supports Ethiopia's vision to strengthen HIV services and to increase local ownership and oversight which is fundamental to sustainability. CDC-E provides technical support in 13 of the 18 PEPFAR program areas, with particular emphasis on prevention of sexual transmission in MARPS, blood safety, male circumcision, PMTCT, HCT, care/treatment services for adults and children, laboratory, TA for health infrastructure, strategic information, and human resources for health. Half of the 43 CoAgs managed by CDC provide direct funding to local partners, including 14 GOE institutions. CDC-funded partners supported sites accounting for 69% of all patients on ART in Ethiopia as of October 2009.

CDC-E's six branches (prevention, care/treatment, laboratory, strategic information, health systems strengthening, management/operations) work primarily "government to government" and provide technical assistance to the Ethiopian Ministry of Health (MOH), Ethiopian Health and Nutrition Research Institute (EHNRI), HIV/AIDS Prevention and Control Office (HAPCO), universities, uniformed services, regional health bureaus, and other government partners. CDC-E's non-governmental partners, including local professional associations, fill gaps and complement GOE activities to enhance HIV/AIDS service delivery. Technical assistance from CDC Headquarters is also readily available to address specific issues, such as prevention of sexual transmission in MARPS, expanding blood safety, enhancing PMTCT efforts, costing studies, improving TB detection and TB infection control, expanding access to pediatric care and treatment, improving ART regimens, and supporting a range of surveillance and laboratory activities.

Strengthening laboratory systems and networks. CDC-E is co-located with the EHNRI which oversees all clinical laboratories in Ethiopia through the national laboratory master plan. CDC's unique expertise and laboratory training opportunities, investment in equipment and facilities, and ongoing focused technical assistance strengthens the nation's entire health system through improved laboratory services and corresponding capacity to serve patients and conduct surveillance.

Building of public health workforce capacity. CDC-E engages numerous local and US-based universities as well as the private sector to bring innovations to expand and retain the health workforce, including clinicians, epidemiologists, laboratory scientists, ICT and SI specialists, managers, and other personnel. CDC's Sustainable Management Development Program (SMDP) partners with the government, academic institutions, and NGOs to promote organizational excellence in public health through strengthening leadership and management capacity. A new generation of epidemiologists and public health leaders will emerge from CDC's support to the Field Epidemiology and Laboratory Training Program (FELTP), a collaboration of EPHA, AAU, and EHNRI.

Leveraging established domestic and global platforms. CDC links EHNRI and others with relevant domestic and global disease detection, management, and informatics programs to build capacity to identify and respond to a range of public health challenges (e.g. Novel H1N1). CDC also links Ethiopia with numerous US-based academic institutions, professional associations, and promotes south-to-south technical exchanges whenever an option.

Using strategic information for planning and decision-making. CDC-E's largest branch at EHNRI is strategic information to help provide an evidence-based approach to all PEPFAR efforts in Ethiopia. In addition to routine monitoring of progress towards reaching PEPFAR goals, CDC staff support the HMIS rollout and EHNRI's routine surveillance activities for HIV, HIV/STI, HIV/TB, MDR-TB, and drug-resistant HIV. In 2010 CDC staff will also support Ethiopia's first population-based survey of HIV, HSV-2 and Hepatitis B/C. A national MARPS seroprevalence and size estimation study will be critical for focusing combination prevention where and with which populations are in the most need. Technical support for ICT and health informatics within the MOH and EHNRI itself is also provided. CDC also supports training of local IRBs in standard ethical review procedures and local investigators in scientific writing methods.

Fostering country ownership and sustainability. Improving fiscal and administrative capacity of local government and non-government partners is the charge of CDC-E's Partner Management Group. CDC-E continues to strive to build technical expertise while simultaneously building fiscal and administrative expertise of local partners. This support serves to ensure that partners' thoughtful long- and short-term planning is also supported by quality fiscal systems and guided by programmatic and fiscal benchmarks.

Funding for Strategic Information (HVSI): $1,300,000

This activity has had a significant budget increase. The overall objective of this activity is to provide technical and key logistical assistance to partners in generating and disseminating quality HIV data from surveillance and surveys and monitoring and evaluation of programs for evidence based decision making. Activities will include:

Providing technical support to EHNRI to prepare and conduct the 2011/12 round of ANC Sentinel Surveillance. This will include engaging in site readiness assessment, providing training to the regional and central surveillance officers, supervising data collection, analyzing data, and writing the final report.

Continuing support on TB/HIV surveillance, AIDS mortality surveillance, and surveillance of HIV in STI patients. This includes providing technical assistance and engaging in updating and finalizing relevant protocols and guidelines, in sites selection and assessment, and in carrying out TOT to regional level surveillance experts. CDC will also provide supportive Supervision for the sentinel sites on a regular basis.

Providing logistical support to EHNRI in the implementation of population based survey for HIV and STI. CDC will procure laboratory resources and other supportive logistics to enable testing of more than 31,000 specimens for HIV, HBV, HCV and HSV-2. Moreover, CDC will provide TA to EHNRI in the analysis, report writing and dissemination of the population-based survey and the dissemination of the national MARPS survey.

Continuing support through TA from international subject-matter experts for the Field Epidemiology and Laboratory Training Program (FELTP), HMIS-related activities and AIDS mortality and vital event registration program.

Adapting PROMIS system that has been used by Tanzanians for partners' and USG data collection and reporting as we have been facing challenges in partners' timely reporting, completeness of data and data reliability in the past. Adapting a web based data collection and reporting system like Tanzanian's PROMIS system is a good opportunity for Ethiopia. OGAC SI team reviewed the database and recommends its use by country programs. The resource would be used for taking an Ethiopian team to visit Tanzanians PROMIS team, adapt the software, provide training to Ethiopia USG SI staffs and install and use the database

Surveillance and surveys staff at regional and national level will be trained in the electronic data processing skills using common statistical package including EPI-Info, SPSS, STATA, SAS, and EPP/Spectrum as appropriate. Information Communication Technology (ICT) support will be made available to the regions and assistance will be provided accordingly to ensure proper connectivity, sharing surveillance data and timely reporting.

Funding for Health Systems Strengthening (OHSS): $960,000


Funding for Laboratory Infrastructure (HLAB): $529,170

Cross Cutting Budget Categories and Known Amounts Total: $2,091,878
Human Resources for Health $2,091,878
Key Issues Identified in Mechanism
Addressing male norms and behaviors
Increasing gender equity in HIV/AIDS activities and services
Increasing women's access to income and productive resources
Military Populations
Mobile Populations