Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012 2013 2014

Details for Mechanism ID: 11605
Country/Region: Vietnam
Year: 2010
Main Partner: U.S. Centers for Disease Control and Prevention
Main Partner Program: NA
Organizational Type: Implementing Agency
Funding Agency: HHS/CDC
Total Funding: $215,000

The U.S. Centers for Disease Control and Prevention (CDC) implements PEPFAR programs by supporting HIV/AIDS prevention, treatment and care, strategic information, human resources for health (HRH), and program and policy development through an evidence-based manner. These activities are accomplished through the provision of direct technical assistance, working through a total of 10 cooperative agreements that have been established between the CDC and the government of Vietnam, an international NGO, and a U.S.-based university. All activities are developed in coordination with the government of Vietnam and U.S. Government agencies implementing PEPFAR programs in Vietnam.

The two largest and most comprehensive of the 10 cooperative agreements are with the Vietnam Ministry of Heath's Vietnam Administration for HIV/AIDS Control (VAAC) in Hanoi and the Ho Chi Minh City Provincial AIDS Committee (HCMC PAC). These two cooperative agreements provide direct support to implement a comprehensive strategy on HIV/AIDS through; 1) prevention programming; 2) provision of care, support and treatment programs; and 3) strengthened infrastructure, human resources and information systems. The Hanoi School of Public Health (HSPH) is one of the U.S. Government's oldest and closest partners in Vietnam. Through CDC support to HSPH, critical public health activities are developed in program management, informatics and epidemiology. This represents an important contribution to HRH as increasing numbers of highly qualified public health professionals graduate and enter the public health field. The General Statistics Office receives support to strengthen key cross-cutting capacity in public health evaluation and data analysis.

Another key strategic element for CDC Vietnam is the provision of technical assistance to strengthen the laboratory infrastructure for improved diagnosis of HIV and opportunistic infections (OI) such as tuberculosis. CDC has partnered with three government of Vietnam agencies including the National Institute of Hygiene and Epidemiology (NIHE), the Vietnam Administration for Medical Services (VAMS) and the Pasteur Institute to strengthen laboratory systems and infrastructure. Because the epidemic in Vietnam is driven primarily by intravenous drug use, addressing the epidemic will require a multi-sectoral commitment and a collaborative approach. CDC has a cooperative agreement with the Ministry of Labor, Invalids and Social Affairs that address the addictions issues related to the unique nature of the HIV epidemic in Vietnam. Through partnerships with international organizations, such as Family Health International and the Harvard Medical School AIDS Initiative in Vietnam, HRH and institutional capacity are strengthened through the implementation of clinical mentorship programs.

In addition to the technical, financial and systems strengthening support provided through the cooperative agreements, CDC Vietnam works closely with regional technical staff. Thailand has one of the most developed healthcare systems in Southeast Asia and Thai technical experts are highly respected throughout the region. The CDC Thailand program is well placed to assist in the identification of technical resources within the Thai Ministry of Health to support the PEPFAR Vietnam laboratory program, specifically in the provision of training and technical support to Vietnamese laboratorians in the areas of HIV diagnostics (i.e., regional workshops and post-market surveillance of test kits), external quality assessment program development (in the areas of HIV serology, CD4 and HIV viral load), laboratory auditor programs, OI diagnostics, sexually transmitted infections (STI) diagnostics and equipment calibration (pipette). CDC's Division of Tuberculosis Elimination (DTBE) contributes to the focus and strategy of Vietnam's TB/HIV program, advancing the evidence base for planning and evaluating program, and assists in coordination with the National Tuberculosis Program, the Ministry of Health and VAAC. CDC Vietnam is able to access Atlanta-based expertise, as well as Bangkok-based regional staff from CDC's DTBE. To further support the laboratory programs, CDC Vietnam procures diagnostic test kits (HIV, STI, OI and TB) and laboratory consumables to support CDC-IRB-approved research and surveillance and internal/external quality assurance.

CDC and the PEPFAR Vietnam team are working closely with the government of Vietnam to coordinate activities around a Partnership Framework, which will be developed in the coming year. CDC is committed to building local capacity to ensure sustainable programming through all of its activities and collaborations. CDC Vietnam also recognizes that developing and establishing programs for long term sustainability can only be attained by dedicated and technically driven expertise in country. CDC and PEPFAR Vietnam are therefore committed to strengthening the leadership, management and technical skills of locally employed staff. Technical and management/leadership training opportunities, supporting attendance at conferences, and providing mentorship and skills training are some of the ways in which these goals can be accomplished.

Given the relatively low prevalence of HIV in the general adult population in Vietnam (0.43%), prevention efforts that target most-at-risk populations remain the top priority for CDC and PEPFAR-supported programs. This is central to preventing the further spread of HIV and to identifying individuals with the greatest HIV care and treatment needs.

CDC's key contributions to health systems strengthening include: 1) continued partnerships with the government of Vietnam to build the capacity of its technical staff at the central, provincial and district levels; 2) support to the government of Vietnam to improve the quality of its national health delivery systems, manage technical strategies and health policies; 4) focus on pre- and in-service training and professional staff development opportunities across all program areas; and 5) focus training to strengthen management, harmonization and coordination of health programs.

Program Efficiency: CDC's strategy of working directly and in a bilateral fashion with the government of Vietnam is a strategy intended to build country-based, country-run and country-owned delivery systems. In building the capacity of the government, CDC feels that in the long run, the broader health needs of the country will be met, resulting in efficiencies.

Monitoring and Evaluation (M&E) activities are systematically built into all programming supported by CDC. As the cornerstone of program planning, implementation and improvement, all M&E activities will continue to focus on evidence-driven programming to strengthen quality and efficiency. Through the staffing for results exercise, CDC was designated as the technical working group lead for SI. Working together with the other U.S. Government agencies implementing PEPFAR in Vietnam, CDC promotes the development and use of standardized M&E tools, including surveillance, program monitoring and evaluation, and management information systems.

Funding for Strategic Information (HVSI): $25,000

May 2010 Funds in the amount of $25,000 are being Programmed to support a Fellow in the CDC International Experience and Technical Assistance Program (IETA) to be based for 3 months in the Thailand CDC Global AIDS Program (GAP) Asia Regional Office (ARO) to coordinate the development and writing of a manuscript which summarizes the program activities and implications HIV incident assays in the Asia region. The amount requested in this programming represents the anticipated costs for hotel, meals, and incidentals for the Fellow for 2-3 months. Specifically the Fellow will:

1) work with CDC-GAP ARO and country-level staff to design and conduct a systematic review of the published and grey literature to assess the availability of HIV incidence data from countries in the Asia region, 2) engage in follow-up communication with country-level technical staff in order clarify outstanding issues, get additional information, etc. 3) document the results of the review and analyze and interpret the available data, 4) make recommendations on the implications of the results for surveillance and prevention planning and the lead in writing a manuscript together with GAP-ARO staff, 5) complete a draft ready for clearance manuscript for review suitable for publication in a peer-review journal.

Funding for Laboratory Infrastructure (HLAB): $190,000

$140,000 for Technical Assistance from Thailand

Thailand has one of the most developed healthcare systems in Southeast Asia and Thai technical experts are highly respected for their expertise throughout the region. The CDC Thailand program is well placed to assist in the identification of technical resources within the Thai Ministry of Health to support regional programs. Resources can be identified in Thailand's National Institute of Health HIV External Quality Assurance (EQA) Laboratory and the Center of Excellence for Flow Cytometry, among other institutions. Due to the geographic proximity of Thailand to Vietnam, and the low cost of regional travel, technical assistance from Thailand is a fraction of the cost of other international technical assistance. In FY 2010, CDC Thailand will provide training and technical support to Vietnamese laboratorians in the areas of HIV diagnostics (e.g., internal quality assurance programs, regional workshops and post-market surveillance of test kits), EQA program development (HIV serology, CD4 and HIV viral load), creation of laboratory auditor programs, opportunistic infections diagnostics, sexually transmitted infections (STI) diagnostics and equipment calibration (pipette). Training will be provided both on-site in Vietnam and in Thailand.

$50,000 Test Kits

In FY 2010, the CDC Vietnam Laboratory program will require funds to procure diagnostic test kits (for HIV, STI, TB and opportunistic infections) and laboratory consumables to support the following activities: research (CDC IRB-approved), surveillance (CDC IRB-approved) and internal/external quality assurance. In general, government of Vietnam partners are provided funds for procurement of test kits, however the amount of $50,000 from CDC is needed to fill urgent, one-time gaps in those systems.