Detailed Mechanism Funding and Narrative

Years of mechanism: 2008 2009

Details for Mechanism ID: 3497
Country/Region: Rwanda
Year: 2009
Main Partner: National Reference Laboratory - Rwanda
Main Partner Program: NA
Organizational Type: Host Country Government Agency
Funding Agency: HHS/CDC
Total Funding: $1,532,948

Funding for Laboratory Infrastructure (HLAB): $1,532,948

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

1. Elaboration of activities:

In FY 2009, PEPFAR will continue to maintain a cooperative agreement with the NRL for direct funding of

certain key reference laboratory functions. As the lead institution in Rwanda's national laboratory network,

the NRL plays a critical role in the successful expansion of HIV prevention, diagnostics, training of

laboratory technicians and other health care workers, and care and treatment services nationally. The NRL

has been a close collaborator in PEPFAR efforts for many years and has benefited from PEPFAR technical

and financial support through several implementing partners. Substantial resources have already been

invested in NRL by CDC and Columbia including, support for infrastructure, technical activities and

management capacity. Support will continue in FY 2009 through CDC direct technical support, laboratory

coalition partners (ASCP, ASM and APHL) and through continued funding of the NRL cooperative

agreement.

NRL cooperative agreement activities in FY 2009 include support for human resources (new positions for

laboratory managers, technical positions and training), infrastructure maintenance and select QA activities.

In FY 2009, NRL activities will again focus on selected infrastructure maintenance of the tiered laboratory

system, human resources and QA activities. One of the major responsibilities will be to continue the

decentralization of the laboratory referral system at two levels of the laboratory network. NRL will continue

to support early infant diagnostic PCR testing and HIV viral load testing, TB culture and identification plus

susceptibility testing to first-line drugs and extra pulmonary TB diagnosis at the CHUB and CHUK referral

laboratories. The NRL cooperative agreement funds will support building repairs needed to maintain the

NRL laboratory and the training of laboratory network staff. NRL will strengthen five district hospital

laboratories that will provide services to the region. The NRL will also continue a maintenance contract for

all of its central and laboratory network equipment through the MOH (ACM) and NRL maintenance unit, as

well as conduct small repairs and preventive maintenance in the ART site laboratories, secure warehouse

storage space and transport laboratory equipment and reagents to sites. The NRL will continue to

strengthen the national referral system for patient specimens.

NRL will support technical staff needed to carry out surveillance and M&E activities that have laboratory

components; these include ANC sentinel surveillance, HIV drug resistance and the national ART program

evaluation activities. Laboratory staff supported by the NRL cooperative agreement performs a range of

tasks to support the national laboratory system. One of those activities is to evaluate new techniques and

technologies for the clinical diagnostic services to improve the care and treatment of HIV-infected patients.

Once these technologies are approved, staff transfers the new diagnostic techniques to lower level

laboratories in the laboratory network. A modest amount of funding will be made available to support

participation of key senior technical staff in international trainings and conferences directly relevant to

increasing capacity for HIV-related laboratory techniques.

Throughout the national laboratory network, NRL will train 200 laboratory technicians in good laboratory

practices and HIV-related techniques, including CD4 testing, biochemistry, hematology and HIV and OI

diagnosis. This will include two-week trainings for technicians at new ART sites and two-day refresher

trainings for all previously trained lab technicians. These trainings will be carried out by a national team of

trainers/supervisors placed both centrally and in regional laboratories. As part of its QA activities for TB

diagnosis, NRL will also provide refresher training for laboratory technicians in health centers and district

hospitals to maintain skill levels in sputum examination for TB by direct AFB smear microscopy. A

continuing activity in FY 2009 will be the implementation of a laboratory information system to manage

laboratory data and support HIV and AIDS patient care. A new activity for FY 2009 will be to work toward

accreditation of the NRL to WHO standards.

To ensure quality HIV-related services, this NRL cooperative agreement will continue to fund operational

costs (such as specimen transport, supervision costs) associated with HIV QA/QC/QI activities in peripheral

lab sites for HIV serology, CD4 testing, biochemistry/hematology, OIs, TB, malaria and good laboratory

practices. Commodities needed to conduct all of the above activities will be procured through the SCMS

activity in FY 2009. Continuation of laboratory tool standardization and maintenance and expansion of the

national laboratory information system will be supported.

New/Continuing Activity: Continuing Activity

Continuing Activity: 12863

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

12863 4976.08 HHS/Centers for National 6318 3497.08 National $1,400,000

Disease Control & Reference Reference

Prevention Laboratory Laboratory

7224 4976.07 HHS/Centers for National 4341 3497.07 National $630,000

Disease Control & Reference Reference

Prevention Laboratory Laboratory

4976 4976.06 HHS/Centers for National 3497 3497.06 National $600,000

Disease Control & Reference Reference

Prevention Laboratory Laboratory

Emphasis Areas

Construction/Renovation

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $300,000

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.16:

Cross Cutting Budget Categories and Known Amounts Total: $300,000
Human Resources for Health $300,000