Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 9269
Country/Region: Malawi
Year: 2010
Main Partner: Johns Hopkins University
Main Partner Program: Center for Communication Programs KNCV TB Foundation
Organizational Type: NGO
Funding Agency: USAID
Total Funding: $0

Summary Previously USG had provided technical assistance (TA) and support for TB/HIV through the MSH-TB Control Assistance Program (TBCAP) with child health funding. The activities were focused on ensuring quality of TB and HIV diagnosis and treatment at the Central TB Reference Laboratory (CRL) and local laboratory sites in Zomba and Mangochi districts. The overall objective of the project was to strengthen management and technical systems for the delivery of TB/HIV services in Malawi. In recognition of the needs of the National TB Program (NTP) in Malawi, USG also provided direct support to NTP beginning in FY 2008. USG plans to re-compete an integrated award to include TB/HIV in 2009.

Background The National TB Program (NTP) in Malawi has attempted, and failed, to conduct an MDR-survey since 2001. The central obstacle to successful completion of this survey was the non-functional Central TB Reference Laboratory (CRL), particularly the lack of competent leaders and managers within the laboratory. Additional difficulties in the health system around sample collection and case detection though important, are non functional in some local labs.

PEPFAR funds and other wrap around funding will be used to rebuild and strengthen the capacity of CRL and selected local labs to implement the MDR-TB survey. The proposed key activities to be funded with PEPFAR funds by TBCAP will include the complete refurbishment of CRL and selected local labs in Zomba and Mangochi districts, improving the management and technical capacity of CRL staff through international TA and sub-contracting of sample collection, data entry, and analysis aspects of the MDR survey by a dedicated Malawian research team to work with the NTP. In addition, a basic "TB/HIV package" will be implemented in selected health facilities that will help build capacity for joint TB/HIV planning, monitoring and evaluation (M and E), and surveillance of HIV prevalence in TB patients in Zomba and Mangochi districts. Malawi recently received a $35 million TB Grant through the Global Fund Round 7 call for proposals.

Key previous achievements using USG support have included • Drafting the Terms of Reference (TOR's) defining the working relationship between TBCAP and the

National TB Program (NTP) • Drafting the TOR's defining the working relationship between TBCAP, REACH Trust, and the Liverpool School of Tropical Medicine (LSTM) • Conducting the baseline survey in Zomba and Mangochi from the 22nd to 27th May 2007 • Conducting orientation meetings of 400 Health Center health workers on the role and function of TBCAP

TBCAP started activities in April 2007. During the three months start-up period, the project team focused on organizing the administrative and logistics support as well as providing orientation to the MoH district teams. Now they are shifting focus to technical activities.

Budget Summary PFIP Year 1 Funding - $400,000 PFIP Year 2 Funding - $0

Key Issues Identified in Mechanism