ECSA 10 TH ANNUAL BEST PRACTICES FORUM 10 TH 12 TH APRIL 2017 MT. MERU HOTEL Global Fund Regional TB Lab Strengthening Project Grant Number: QPA-T- ECSA (890) Lab Managers Side Meeting 10 th April 2017
Presentation Outline 1. The Regional Grant 2. Project Countries 3. Application Process 4. Needs Assessment/Gap Analysis 5. Goals & Objectives 6. Expected Outcomes 7. Benefits of a Regional Grant 8. Implementation Arrangements 9. Achievements 10. Progress Update & Disbursement Request (PUDR) 11. Challenges 12. Lessons Learnt 2
Total funding USD 6,136,774 1. The Regional Grant To Network and support National TB Reference Laboratories in 18 countries in the ECSA Region Grant Life: 2015-19 (4 years) Principal Recipient: ECSA; Sub-recipient: SRL, Uganda
2. Project Countries ECSA MS Kenya Lesotho Malawi Mauritius Swaziland Tanzania Uganda Zambia Zimbabwe Non- ECSA MS in the GF Project Burundi Botswana Eritrea Mozambique Namibia Rwanda South Sudan Seychelles Somalia
3. Application process Uganda SRL, ECSA countries, Partners Letter of interest (April 2014) LOI acceptance (June 2015) WHO, Regional Dialogue (18), CCMs CN development (July Dec 2014) Approval of CN and award (May 2015) Grant making (June-Oct 2015) Regional Initiation (16) Signing of Grant (Nov 2015) Health Ministers Project Launch (Dec 15)
4. Needs Assessment/Gap Analysis Lack of an expanded regional network of National TB Reference Laboratories in the region Regional Training center for TB laboratory tests Quality Assurance for TB Lab services- weak EQA systems for microscopy & Culture Inadequate Capacity to perform Culture & Drug susceptibility Testing (DST) for quality assured 1 st and 2 nd line anti-tb drugs Slow Accreditation of National TB Reference laboratories (NTRLs); only Botswana and Uganda are accredited Inadequate Capacity for monitoring of TB burden (TB Prevalence surveys) and Drug resistance surveys
5. Goals of Regional Project Build a regional network of National TB reference Laboratories (NRLs) for inter-state laboratory quality assurance and management in ECSA Region. Improved Laboratory service provision for quality assured 1 st and 2 nd line Drug susceptibility testing (DST) accessible to all people in the ECSA region Build capacity of NRLs to undertake epidemiological/monitoring surveys such as DRS and TB disease prevalence
6. Expected Outcomes 1. Established Regional Network of TB NRLs in the ECSA Region: Information and Knowledge exchange and sharing Laboratory quality assurance and management Inter-government collaboration and thus South to South cooperation 2. Improved diagnostic capacity and quality of TB diagnostic Services in 18 NRLS in ECSA Region Quality assured Laboratory tests for the region, within acceptable TATs, will provide additional thrust for NTPs to manage MDR and XDR TB patients. Lab accreditation Cost-effective laboratory services to the region (3 times savings/annum) if support is from inside the region/neighbourhood lab- rather than from outside AFRICA) 3. Improved capacity of the NRL staff in conducting TB diagnostic services in participating countries 4. Improved capacity of the NRL staff in conducting operational research (TB Surveillance, DRS, Prevalence Surveys, )
7. Benefits of the Regional Grant Address regional priorities using local technical capacities Promotion of South to South Collaboration and capacity building Cross Border Collaboration & Networking for knowledge sharing and exchange Complement National level Efforts
8. Implementation Arrangements PPM Global Fund Local Fund Agent ECSA HC- Principal Recipient Other SRLS: Milan, Antwerp, Copenhagen, Johannesburg Uganda SRL- Sub-Recipient Country NTRLs Regional Project Advisory Panel: Donors, RECs, Partners, TB Experts Regional Project Steering Committee (RSC): NTRLs, NTPs, PMU, PIU Kenya, Uganda, Tanzania, Rwanda, Burundi, South Sudan, Somalia, Eritrea, Botswana, Namibia, Mozambique, Seychelles, Mauritius, Zambia, Zimbabwe, Malawi, Swaziland, Lesotho Level 1 National TB Reference Labs (NTRLs) & subnational TB laboratories Somalia, South Sudan, Eritrea, Seychelles, Mauritius, Burundi Level 2 National TB Reference Labs (NTRLs) & subnational TB laboratories Lesotho, Malawi, Mozambique, Swaziland, Zambia, Tanzania, Zimbabwe Level 3 National TB Reference Labs (NTRLs) & subnational TB laboratories Kenya, Namibia, Uganda, Botswana, Rwanda
9. Achievements Conducted Baseline assessment in all the 18 countries Supported External Quality Assurance (EQA) for microscopy and Culture and Drug Susceptibility Testing (DST) in 10 out of the 18 countries Provided short term Technical Assistance to support impact assessment of Gene-Xpert and other rapid TB diagnostics in seven countries (Mozambique, Kenya, Burundi, Somalia, Rwanda, Botswana and Zimbabwe) Established an online community of practice/platform for knowledge sharing and exchange in TB Lab Services
Achievements Supported TB Lab Managers to participate in two ECSA Best Practices Forums to share promising/best practices and success stories as a result of the Support from the Regional Global Fund Provided Technical Support to five Countries on Lab Quality Management Systems in readiness for ISO accreditation (Kenya, Rwanda, Burundi, Botswana & Mozambique) Conducted one regional training on Laboratory Quality Management Systems (LQMS) for Quality Officers from 17 out of the 18 countries
Achievements Conducted project monitoring visits in three countries (Botswana, Malawi & Burundi) Provided Technical Assistance for Drug Resistance Survey in Swaziland, Lesotho and Malawi Established and convened two meetings of the Regional Steering Committee (RSC) in Mauritius and Dar Es Salaam in 2015 & 2016 respectively
Achievements Produced three quarterly Newsletters for the project Provided Long Term Assistance in Culture and Drug Susceptibility Testing (DST) in Five Countries (Mauritius, Somalia, Burundi, Tanzania, Zimbabwe) Three Newsletters
Achievements Three Grant Management Solutions (GMS) Technical Support for both PR and SR in the following key areas: ooverall Grant Management ofinancial Management omonitoring & Evaluation oprocurement and Supply Management
10. Progress Update & Disbursement Request (PUDR) The purpose is to provide an update on the programmatic and financial progress of a Global Fund-supported grant, as well as an update on fulfillment of conditions, management actions and other requirements. Includes the Disbursement Request and programmatic indicators Two progress updates: For period ending 30 th June 2016 due 15 th Aug. 2016 For period ending 31 st Dec 2016 due 15 th Feb. 2017
Progress Update 1 st Progress Update (PU) due 15 th August 201 oa1 : Exceeds expectations oa2 : Meets expectations- ECSA 1st Progress Update ob1 : Adequate ob2 : Inadequate but potential demonstrated oc : Unacceptable.
11. Challenges The main challenge was the delayed signing of the PR and SR sub-agreement which delayed recruitment of new SRL staff and hence delay in implementation of some activities. Low Burn Rate- improved from 31% at PU to 41% at PUDR o Delayed Procurement odelayed Recruitment of new SRL Staff
12. Lessons Learnt The regional Global Fund grant has demonstrated that regional organizations play an important role in cross border and regional programming in health Coordination of a regional Program requires buy-in and cooperation from all the relevant stakeholders. Political buy-in and support is critical There is need for harmonization and synergy in regional programming to avoid duplication of efforts- e.g. Joint planning and supervisory visits to countries, Joint program reviews ECSA and Uganda SRL collaboration has demonstrated the importance of South to South Collaboration that is cost efficient and effective in supporting countries.
Thank You for Your Attention 25