PROGRAM GRANT AGREEMENT BETWEEN THE GLOBAL FlJ~-n TO FIGHT AIDS, TUBERCULOSIS AND MALARIA ("Global Fnnd") AND THE m.tfed NATIONS DEVELOPMENT PROGRAMME ("Principal Recipient") 1. Country: Democratic Republic ofcongo 2. Program Title: Tuberculosis Prevention, Support and Capacity-Building 3. Grant Number: ZAR-202-GOI-T-OO 13A. Modification Number 5 (AmendmentAgreement) July 312005 4. Program Starting Date: 15~ Program Ending Date: 6. Proposal Completion Date: 1 August 2003 I 31 July 2006 31 July 2006 6A. Condition Precedent Terminal 6B. Condition Precedent Terminal 6C. Condition Precedent Terminal 'Date: 1 September 2003 Date: 1 November 2003 Date: I November 2004 6D. Condition Precedent Terminal 6E. Condition Precedent Terminal 6F. Condition Pre-~entTerminal Date: 30 October 2005 Date: Date:. 7. Global Fund Grant: US$ 7,625,773 (Seven million Sb(Hundred Twenty Five Thousand Seven Hundred and Seventy Three United States Dollars) 8. Program Coverage: IDV!AIDS -L Tuberculosis - Malaria HIV/AIDsn"uberculosis - - 9. Information for Principal Recipient Bank Account into Which Grant Funds WillBe Disbursed: l. The fiscal year ofthe Principal Recipient runs from! January to 3! December 11. Local Fund Agents (''LFA"'): PriceWaterhouse Coopers Adress hnmeuble MIDEMA, 13 avenue Mongal~BP. 10185- Kinshasa: Tel _(243) 8844 435 Fax (243) 88 00 075 Attention: Benjamin B.Nzailu E-mail: beniamin.nzailu(cllcd.owc.com 12 Principal Recipient Additional R...=presentative 13. Global Fund Additional Re~""llt2rive: Name: Babacar M. Cisse Name: Wm. Bradfort Title UNDP Country Dir~i.Oi Title ChiefofOperations Adress Immeuble LOSO'NL~BId du 30 Juin- Chemin de Blandonnet 8- Kinshasa 1214 Vernier, Swit:z:Iand Tel.: (243) 817100064- Tel.: +41 22 791 1700 Fax:: (243) 8843 675 Fax:: + 41-22-791-1701 E-mail: babacarm.cisse!{i:-m:6-0!'!!. 14. This Agreement consists ofthenvo pages ofthis face sheet and the followmg: Standard Terms and Conditions Annex A - Program Implementation Annex B - Program Proposal (for reference)
AMENDMENT TO THE PROGRAM GRANT AGREEMENT (the "Grant Agreement") BETWEEN THE GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS AND MALARIA (the "Global Fund") WHEREAS, AND UNITED NATIONS DEVELOPMENT PROGRAMME (the "Principal Recipient") 1. The Global Fund entered into the Grant Agreement for Grant Number ZAR-202-GOI-T-00 with the Principal Recipient effective on 18 June 2003 for the purpose ofproviding funds to implement a tuberculosis program in the Democratic Republic ofcongo described more fully in the Grant Agreement as "Tuberculosis Prevention, Supporfand Capacity-Building" (the "Program"); 2. In accordance with Article 12 and 20 ofthe Standard Terms and Conditions of the Grant Agreement, the Grant Agreement was amended by Implementation Letters dated 26 August 2004,21 February 2005 and 2 May 2005; 3. Section 3.d ofthe Standard Terms and Conditions ofthe Grant Agreement states that "[u]nless the Global Fund agrees otherwise in writing, the Global Fund will not authorize disbursement ofthe Grant after the 'Program Ending Date' (specified in block 5 ofthe face sheet ofthis Agreement)"; 4. The "Program Ending Date" specified in block 5 ofthe face sheet ofthe Grant Agreement is 31 July 2005; and 5. Subject to certain conditions, the Global Fund wishes to increase the amount ofthe Grant, to continue disbursement offunds under the Grant and to extend the Program Ending Date, NOW, THEREFORE, in consideration of the mutual covenants and agreements contained herein and intending to be legally bound, the parties hereby agree to amend the Grant Agreement as follows: 1. The existing face sheet ofthe Grant Agreement is replaced by the face sheet attached hereto.
2y Article. Qofthe Srandard Terms and ConditioilS of the: GrantAgreemenWnti1led <:'jjisbtjrs~n=is. amende(rhyadding th Jollow.lngt$bsection: =d- From.tiwe to time.~.tqe.(ijqq~ l'nj~a.will!we tbe-prirn;jpai Recipiemguidance,throu,gh JiIiplemerlfationUffers,;onffie acceptable - ft~~ IOITIi an~ contenf-dfteque8ts'.for,d1snurseinents;." ~.AttjC)~ii~6" Qf~~anQard. ":'ARBITRATIO~:is; amended'by' adding 'thedfollo.win,g"woros to end ofthe,:first paragiapic"theiar!gnage oftlie arbitration shall 00 HbgliSli.n- Ttmn~ an~ GQnQitiqps 9r~~ Qt@t.~~~t entmed Lh,,:.OOme~_A pf~ A~ent r ~c:1u_siv~, G:t(lny"@lt~~hm~:th41'baye f9rm rly:~~:a~,to::sq~p;ap,iie~,al;~~:r?pla.g~tr-wiw Th.~'w~~_ADJ1e~.A attachedhereio entitled~~exa: PirogramJiriiplementation AbStraet:'?~ 5,~,,Thecli()c.1itl1ent~ "Attaclrtnent'3::Ihdicatots?,tar$.ts' and.rerioo?'a:ttached here,tc)is att~ 4 -wanne~a,gflhe G~~tAgl'~,erp, 'P.t, :~$~t~ 1$. ~ by~.~ed,dn1e~~., ni;wrtn:ess~1vrere()f". th~ gatt1.es have ~e.e;m,d tjii$. :AItte.lidmetlt::9n the, date a.;s'~su eii belpw~
AnnexA Program Implementation Abstract Country: Original Proposal Name: Original Proposal Number. Grant Program Title: Grant Program Number. Disease: Principal Recipient Democratic Republic of Congo Support Program to the Congolese initiative regarding HIV/AIDS, TB and malaria prevention, support and capacity building # 236/1 Tuberculosis Prevention, Support and Capacity-Building ZAR-202-G01-T-00 Tuberculosis United Nations Development Programme A. Program Description 1. Summary: The Democratic Republic of the Congo ranks 11 th out of the 22 countries most affected by tuberculosis. Only 53 per cent of patients with expected positive microscopy are detected, and 30 per cent of the patients detected are not undergoing DOTS (Directly Observed Treatment Short course). The main aim of the Program is to reduce infection, morbidity and mortality due to tuberculosis while raising the cure rate to 80 per cent of sick people given treatment and the detection rate to 65 per cent of the tubercular cases expected following microscopy by/greater expansion of the DOTS strategy covering 90 per cent of the population. The Program wihfinance, over a three-year period, a wide range of interventions drawn from the National Program to Fight Tuberculosis in the Democratic Republic of the Congo consistent with the multi-year strategic plan established by the country in October 2001 in an effort to: increase the cure rate for tubercular patients under case management from 70 per cent to 80 per cent, increase the detection rate for cases of persons testing positive for pulmonary tuberculosis following microscopy from 53 per cent to 65 per cent, thanks to quality-controlled microscopy, mobilise target communities and groups with a view to improving the detection and cure of tuberculosis, and improve the technical and institutional capacities at the national level and the 22 provincial coordination schemes of seven provinces. The attachment or attachments to this Annex Aset forth the main Program objectives, key indicators, intended results and targets and the planned Program budget applicable to the stated period or periods of the Program. The attachment or attachments to this Annex A shall be an integral part of this Annex A 2. Goal: To reduce of infection, morbidity and mortality due to tuberculosis by raising the cure rate for patients undergoing treatment to 80 per cent, and the detection rate for smear positive tuberculosis cases to 65 per cent, through a broader extension of the DOTS strategy to cover 90 per cent of the population and DOTS PLUS to cover 90 % of multi-drug-resistant (MDR) cases. 3. Target Group/Beneficiaries: Persons living with tuberculosis MDR cases Persons suspected of being affected by tuberculosis 1
4. Strategies: Improving the patient case management procedure for treatment Improving the screening of cases with special focus on the detection of patients spitting Koch tubercle bacillus with intensified microscopy by regular quality control of reading slides Providing a fresh impetus to social mobilisation throughout the country, in all the layers of the community, with tuberculosis information, education and communication activities Strengthening the technical skills of the personnel and institutional capacities at both the national and provincial levels 5. Planned Activities: Rehabilitate 4 laboratories of MDR. Make available first line and second line anti-tuberculosis drugs, equipment and reagents to improve screening and recovery. Train 30 staff of 4 sites in management of MDR cases Train the stakeholders at all levels. Supervise activities in the field. Ensure quality control. Perform operations research on upgrading case management. Conduct a Knowledge, Attitude and Practice Study to determine the current level of tuberculosis awareness among the population. Organize community-based awareness-raising structures to involve the community, by counselling suspected cases and by monitoring patients undergoing treatment to prevent default. Monitor and evaluate the Program. 6. Initial Country Coordinating Mechanism Members The composition of the Country Coordinating Mechanism may change from time to time. 2005, the Country Coordinating Mechanism included: As of June Ministry of Health Ministry of Plan Ministry of International Cooperation Ministry of Finance Parliament Army Police National Association of Public Enterprises National NGOs of the AIDS forum National Committee of Health NGOs Persons living with HIV/AIDS National League against Tuberculosis Congolese Federation of Private Enterprises United Nations Development Programme United Nations Children's Fund United Nations Population Fund Joint United Nations Programme for HIV/AIDS World Health Organization European Union Deutsche Gesellschaft for Technische Zusammenarbeit United States Agency for International Development BASICS DAMIEN Foundation School of Public Health La Communaute Musulmane Church of Christ of the Congo 2
Kimbanguist Church Bishops' Conference of Catholic Church Trades Union Council 7. Technical Partners include: National Tuberculosis Program World Health Organization United States Agency for International Development DAMIEN Foundation The Leprosy Mission International American Leprosy Mission Congolese National Coalition Against Tuberculosis Union Baptiste Suedoise Ecole de Sante Publique B. Conditions Precedent to Disbursement 1. Conditions Precedent to First Disbursement (Terminal Date as stated in block 6A of the Face Sheet) Prior to disbursement under the Grant, the Principal Recipient will, except as the Global Fund and the Principal Recipient may otherwise agree in writing, furnish to the Global Fund, in form and substance satisfactory to the Global Fund,. a. a statement confirming the bank account into which the Grant funds will be disbursed and from which the Principal Recipient shall draw funds to implement the Program; b. a letter signed by the Authorized Representative of the Principal Recipient setting forth the name, title and authenticated specimen signature of each person authorized to sign disbursement requests under Article 6 of the Standard Terms and Conditions of this Agreement and, in the event a request for disbursement may be signed by more than one person, the conditions under which each may sign; and c. evidence that the recruitment of key staff of the coordinating and monitoring unit of the Principal Recipient is underway and will be completed no later than one month after the first disbursement is made. 2. Condition Precedent to Second Disbursement (Terminal Date as stated in block 68 of the Face Sheet) Prior to disbursement under the Grant, the Principal Recipient will, except as the Global Fund and the Principal Recipient may otherwise agree in writing, furnish to the Global Fund, in form and substance satisfactory to the Global Fund, a detailed plan for the monitoring and evaluation of Program accomplishments and a detailed plan for the auditing of Sub-recipients. 3. Conditions Precedent to Disbursement for Procurement in Phase 1 (Terminal Date as stated in block 6C of the Face Sheet) Before disbursement or use of Grant funds for the procurement of goods or services (except for goods and services related to administration and support of the Program), the Principal Recipient shall, except as the Global Fund and the Principal Recipient may otherwise agree in writing, furnish to the Global Fund, in form and substance satisfactory to Global Fund, a. a procurement plan clearly describing the strategy, management, timing, roles and accountability of every entity involved in procurement under the Program; and 3
b. a plan for monitoring the performance and sustainability of procurement and supply management systems (the monitoring plan to include tracking of procurement prices, distribution costs, additionality of Global Fund resources to domestic and other international sources, and other measures of procurement and supply system performance and sustainability). 4. Condition Precedent to Eighth Disbursement (Terminal Date as stated in block 6D of the Face Sheet) Prior to eighth disbursement under the Grant, the Principal Recipient shall provide to the Global Fund, in form and substance satisfactory to the Global Fund, evidence that the Principal Recipient has conducted a study on Knowledge, Attitude and Practices (KAP) with regards to tuberculosis; and c. Forms Applicable to this Agreement: 1. For purposes of Article 6, "Disbursements," the Principal Recipient shall use Sections 1 and 3 and Appendix 1 of the Global Fund form entitled, "Disbursement Request and Progress Update" available upon request from the Global Fund. 2. For purposes of Article 13b(1), "Periodic Reports," the Principal Recipient shall use Section 2 of the Global Fund form entitled, "Disbursement Request and Progress Update", available upon request from the Global Fund. D. Special Terms and Conditions for this Agreement: 1. The annual report required under Article 13b(2) of this Agreement shall be submitted by the Principal Recipient to the Global Fund not later than 90 (rather than 45) days after the close of each fiscal year of the Principal Recipient. 2. The requirement to submit the Interim Assessment Report under Article 13b(3) of this Agreement is hereby deleted. E. Program Budget The attached budgets set out anticipated expenditures for the Program term. Changes to the budget shall only be made pursuant to written guidelines provided by the Global Fund or as otherwise authorized in writing by the Global Fund. 4