To combat HIV/AIDS, tuberculosis and malaria.

SEA/SPPDM-Meet.2/2.3 Page 53 Strategic Objective 2: To combat HIV/AIDS, tuberculosis and malaria REGIONAL PLANNING BRIEF (SO-02) 1. Major work of WHO for this SO in the region (RO and countries) during 2008-2009: HIV/AIDS All member countries have developed medium term national strategic plan. Capacity building on programme management has been strengthened in all countries through inter- country and national training on AIDS programme management and human resource development. HIV surveillance, estimation and projection of HIV/AIDS has been strengthened in 10 member countries. Antiretroviral treatment programme and HIV targeted interventions including harm reduction, management of STIs have been scaled up in all member countries. WHO assisted all member countries in proposal development, implementation and monitoring of the Global Fund supported programmes. Tuberculosis WHO continued to technically support the national TB control programmes in the Region through information exchange, assistance with planning, policy and strategy development, resource mobilization and capacity building including of the laboratories. As a result, case detection and treatment rates at the end of 2008 were 68.5% and 87.5%. Six countries in the Region have established MDR-TB services under their national programmes. Seven Member States developed national policies and strategies, and expanded services for TB/HIV. Collaborative services for TB control through private-public partnerships have been further expanded in all countries where health care services are provided through this sector. All countries access to quality assured affordable anti TB drugs through grants or direct procurement agreements with the Global Drug Facility; no stock-outs of TB drugs were reported over the past two years. Additional funding was mobilized through bilateral agreements and GF rounds 8 and 9 through assistance in proposal development. All countries, with the exception of Myanmar and DPR Korea, have presently sufficient funds for TB control. In country technical support and/or monitoring missions were conducted to all member countries. Operational research projects were supported and several models and approaches for community based TB care are in place in all 11 Member States. Malaria Most malaria endemic countries have revised the national malaria control strategy towards the Revised Malaria Control Strategy (RMCS)of SEAR 2006-2010. There are two countries that are expected to revise the national strategy by end of 2009. Two out of 10 target countries initiated integrated vector management (IVM) as part of the RMCS. Four out of 10 endemic countries are scaling up the key prevention measures (House Spraying and Insecticide treated nets). All endemic countries with falciparum malaria have successfully revised the national drug policy and adopted artemisinin-based combination therapy (ACT). Surveillance has been strengthened and all member countries could submit malaria surveillance report at the Regional and Global Level though quality of data and completeness of data need to be further improved. Eight countries have successfully SEA/SPPDM-Meet.2/2.3 Page 54 mobilized significant resources for malaria control whereas two members are yet to achieve this target at the end of 2009 or in the 2010-2011. Collaboration with the Global Fund secretariat has been sustained and further expanded through the development of joint operational plans. An additional USD ……Million was mobilized for the 3 Diseases during 2008-2009. Health system strengthening components have been included in all proposals to GAVI and the GF. An intercountry workshop on cross border interventions was organized and as a result Joint operational plans across six member countries were drafted. 2. Scope of work and major results planned for 2010-2011 HIV/AIDS Countries will be further supported to strengthen AIDS programme management through inter-country and national training. Some Member Countries will need to develop medium term strategic plans for the next 5 years. Presently, 2 to 3 countries have comprehensive Human Resource Development (HRD) plans for HIV/STI in place and an additional 4 countries will be supported to develop their HRD plans. Antiretroviral therapy (ART) for 50% of those who need it will be further expanded to cover 5 Member Countries. HIV/STI surveillance including drug resistance surveillance will be strengthened. Essential HIV prevention package for injecting drug users is in place in one country and this will be extended to 4 more countries in the Region. Initiatives to eliminate congenital syphilis in SEAR countries will be l aunched in 5 member countries. WHO will assist member countries to implement and monitor Global Fund supported programmes. Tuberculosis WHO Regional and Country offices will continue to support national TB control programmes in all Member states in further improving quality of services through several activities including developing national strategies and plans for the expanded scope of interventions under the stop TB strategy including for HIV/TB and M/XDR-TB. The focus on capacity building, laboratory strengthening, infection control, improving procurement and supply management, TB surveillance and operational research will continue. As a result all countries will have five year plans for TB control upto 2015 including HRD plan. National reference laboratories in at least 8 member countries will have quality assured culture and newer diagnostics in place; at least nine countries would have established widely available interventions for TB/HIV and M/XDR-TB including infection control; continue to benefit from GDF procurements of quality assured drugs. At least six countries will have undertaken national population based TB surveys including surveillance for HIV co-infection and drug resistance. Community based care would be established in all member countries. Joint monitoring missions will be undertaken to all member countries during the biennium. Malaria The Member Countries will further implement the revised malaria control strategy and scale up key interventions (Indoor residual spraying and/or Insecticide treated nets within the broad umbrella of integrated vector management). Training modules on malaria control at district level will be developed and three regional training courses will be implemented. A network on insecticide resistance which has not been successfully set up in 2008-2009 will be established in 2010-2011. The drug resistance monitoring in Mekong SEA/SPPDM-Meet.2/2.3 Page 55 countries will be further strengthened whereas a network of drug resistance monitoring in Non-Mekong countries will be established. ACT will be further scaled up by all countries with falciparum malaria. Containment of artemisinin- resistance has been initiated in one country in the Region in 2008-2009. The will be further expanded to cover another country in the Region. Capacity building in resource mobilization and operational research will be further implemented. Collaboration with the Global Fund will be sustained and countries more effectively supported to mobilize and implement activities through the joint operational plans for 2010- 2011. The bilateral plans for cross border interventions across six Member countries will be supported through enhanced focus on technically supporting these. 3. Budget information for the Strategic Objective for Country Offices (CO) and the Regional Office (RO) (in USD thousands) PB 2008-2009 PB 2010-2011 Country offices Regional office SO Component Planned Resources* Planned Resources* CO RO Guidelines, policies and strategies including approaches to increase coverage 7,161 3,677 3,371 2,925 Policies and technical support to improve delivery of programmes including labs and integration with other programmes 40,604 35,420 5,937 7,281 Guidance and technical support for access to medicines, diagnostic tools and health technology 8,947 5,517 385 73 Surveillance, monitoring and evaluation 11,495 8,660 1,618 1,388 Advocacy, political commitment and resource mobilization 1,953 834 1,813 1,736 New knowledge, intervention tools and strategies developed 3,446 2,801 765 323 TOTAL 73,606 56,908 13,889 13,726 66,268 13,700 *Resources as of May 15, 2009 SEA/SPPDM-Meet.2/2.3 Page 57 South-East Asia Regional Expected Results for Regional PB 2010-2011 Strategic Objective 2: To combat HIV/AIDS, tuberculosis and malaria Organization-wide Expected Result Regional Expected Results Indicator Baseline Target Number of countries with endorsed national policies and medium term strategic plans for HIV/STI, TB and malaria TB: All countries have national policy manuals and 4 countries have 5- year plans of action completed for 2011-2015; HIV: All countries have policies & medium term strategic plan. TB: All countries have 5-year plans of action for 2010-2015; HIV: 5 countries supported in the revision of the plan. MAL: 10 endemic countries MAL: Number of countries implemented the national strategies and workplan in line with the Revised Malaria Control Strategy (RMCS) 2006-2010 MAL: 8 countries Number of countries with comprehensive Human Resource Development (HRD) Plans for HIV/STI and TB TB: 4 countries have HRD Plans in place; HIV 2 – 3 countries All Member countries have comprehensive HRD Plans in place; HIV – 6 countries 1. Guidelines, policy, strategy and other tools developed for prevention of, and treatment and care for patients with, HIV/AIDS, tuberculosis and malaria, including innovative approaches for increasing coverage of the interventions among poor people, and hard-to-reach and vulnerable populations. 1. Region specific evidence based policies, strategies, guidelines, training and operational materials for strengthening the health sector response for the prevention and control of HIV/STI, TB and Malaria. MAL: No. of guidelines, training modules and tools developed in line with the Revised Malaria Control Strategy for SEAR 2006- 2010 MAL: Presently, guidelines are available for clinical management of malaria, Integrated Vector Management (IVM) and manual on malaria control for district malaria officers MAL: Training modules on malaria control at district level developed. 3 Regional Training Courses implemented. SEA/SPPDM-Meet.2/2.3 Page 58 Organization-wide Expected Result Regional Expected Results Indicator Baseline Target Number of countries reaching 50% of ART for those who need it 3 5 Number of countries reaching 50% of injecting drug populations with essential HIV prevention interventions 1 5 Number of countries launching initiative to Eliminate congenital syphilis 0 5 Number of countries reporting having reached or maintaining both TB case detection and treatment success targets 8 countries report achieving both targets All countries report achieving both targets 2. Policy and technical support provided to countries towards expanded gender-sensitive delivery of prevention, treatment and care interventions for HIV/AIDS, tuberculosis and malaria, including integrated training and service delivery; wider service-provider networks; and strengthened laboratory capacities and better linkages with other health services, such as those for sexual and reproductive health, maternal, newborn and child health, sexually transmitted infections, nutrition, drug-dependence treatment services, respiratory care, neglected diseases and environmental health. 1. Expanded and decentralized service delivery for the prevention, treatment and care of HIV/STI, TB and Malaria through capacity building, strengthening of national laboratory networks, collaboration with other related programmes, and across borders Number of countries with quality controlled national laboratories offering TB diagnostics, including for culture and drug susceptibility testing (DST). 5 At least 8 SEA/SPPDM-Meet.2/2.3 Page 59 Organization-wide Expected Result Regional Expected Results Indicator Baseline Target Number of countries that have established TB/HIV interventions according to their national policy 5 countries have scaled up TB/HIV interventions At least 9 countries would have established interventions for TB/HIV jointly under national TB and HIV/AIDS programmes Number of countries that have established MDR-TB case management Green Light Committee approved MDR-TB case management projects in place in at least 8 countries; scaling up in 3 Member countries All countries would have established MDR-TB interventions under national programmes Number of countries that have developed and implemented integrated Vector Management (IVM) as a part of the revised malaria control strategy targeted at population at risk 2 10 (all endemic countries except Maldives) Number of countries with significant increase in coverage of ITN/LLIN and IRS targeted at population at risk 4 10 SEA/SPPDM-Meet.2/2.3 Page 60 Organization-wide Expected Result Regional Expected Results Indicator Baseline Target Number of countries that scaled up countrywide ACT for falciparum malaria 6 9 Number of countries contained spreading of ACT resistance 1 2 Number of countries implementing integration of prevention and management of STIs/HIV/AIDS pregnancy into RH/MNH services. 2 5 Number of cross- border projects supported 2 6 3. Global guidance and technical support provided on policies and programmes in order to promote equitable access to essential medicines, diagnostic tools and health technologies of assured quality for the prevention and treatment of HIV/AIDS, tuberculosis and malaria, and their rational use by prescribers and consumers, and, in order to ensure uninterrupted supplies of diagnostics, safe blood 1. Equitable access to essential medicines and rational use of quality drugs, diagnostics and commodities for HIV/STI, TB and Malaria Number of countries that have updated information on access to affordable antiretrovirals and opportunistic medicines and procurement and supply management 7 11 SEA/SPPDM-Meet.2/2.3 Page 61 Organization-wide Expected Result Regional Expected Results Indicator Baseline Target Number of countries reporting no stock-outs of one or more anti-TB drugs at national level during a calendar year 8 countries have adequate stocks of drugs at national level including adequate buffer stocks All countries would have adequate stocks of drugs at national level including adequate buffer stocks Number of countries that have established quality control systems for RDT and antimalarial drugs 3 6 and blood products, injections and other essential health technologies and commodities Number of countries implemented ban of Artemisinin monotherapy through public and private partnership 1 9 4. Global, regional and national systems for surveillance, evaluation and monitoring strengthened and expanded to keep track of progress towards targets and allocation of resources for HIV/AIDS, tuberculosis and malaria control and to determine the impact of control efforts and the evolution of drug resistance. 1. Strengthened surveillance including of drug- resistance, monitoring of programme performance and assessing the impact of interventions on HIV/STI, TB and Malaria, to more accurately report on progress towards targets under the Millennium Development Goals Number of countries that regularly review and validate national guidelines for HIV surveillance and programme monitoring, including HIV drug resistance surveillance where applicable 10 11 SEA/SPPDM-Meet.2/2.3 Page 62 Organization-wide Expected Result Regional Expected Results Indicator Baseline Target Number of countries with data management systems in place to ensure complete accuracy and timely reporting on core TB indicators to central level 9 11 Monitoring and evaluation missions undertaken, including evaluation of TB surveillance mechanisms 0 Monitoring and evaluation missions at least once to all countries during the biennium Number of countries that undertake TB and TB/HIV surveillance 5 At least 7 Number of countries that undertake and/or participate in drug resistance surveillance 5 countries would build capacity and commence drug resistance surveillance At least 6 countries would undertake regular national drug resistance surveillance Number of countries timely reported achievements of the Revised Malaria Control Strategy at the end of biennium 0 10 endemic countries SEA/SPPDM-Meet.2/2.3 Page 63 Organization-wide Expected Result Regional Expected Results Indicator Baseline Target Number of countries that would have conducted internal or external evaluation of malaria control programme 2 countries conducted malaria programme evaluation in one biennium 4 countries conducted programme evaluation in one biennium Number of Regional networks on insecticide resistance, drug resistance drug quality monitoring functional. One network on drug resistance and drug quality monitoring functional in Mekong Two regional networks would have been established on insecticide resistance, drug resistance and drug quality Number of countries that would have access to funds from GFATM and other sources for HIV programme 10 11 5. Political commitment sustained and mobilization of resources ensured through advocacy and nurturing of partnerships on HIV/AIDS, tuberculosis and malaria at country, regional and global levels; support provided to countries as appropriate to develop or strengthen and implement mechanisms for resource mobilizati on and utilization and increase the absorption capacity of available resources; and engagement of communities and affected persons increased to maximize the reach and performance of HIV/AIDS, tuberculosis and malaria control programmes. 1. Enhanced commitment, and adequate resources mobilized through advocacy and partnerships, for the full and effective implementation of all planned interventions, including through involvement of the private sector, and community participatory approaches. Number of countries regularly reporting on, and evaluating, TB interventions undertaken in partnership with other public and private providers 5 11 SEA/SPPDM-Meet.2/2.3 Page 64 Organization-wide Expected Result Regional Expected Results Indicator Baseline Target Number of countries reporting less than 5% funding gap in resources for TB control 9 11 Number of countries reporting ACSM initiatives at community level for TB and TB/HIV interventions beyond pilot projects 6 countries have established ACSM initiatives at community level All countries have widespread community-based interventions in place Number of countries supported in resource mobilization and successfully received increase resources for malaria programme 8 10 Number of countries with WHO- supported HIV operational research programmes 4 6 6. New knowledge, intervention tools and strategies developed and validated to meet priority needs for the prevention and control of HIV/AIDS, tuberculosis and malaria, with scientists from developing countries increasingly taking the lead in this research. 1. Research for the formulation of policies, strategies a nd improved interventions including through developing new tools, to enhance the efficiency and effectiveness of HIV/STI, TB and Malaria programmes Number of countries with operational research projects on TB guided and supported by WHO At least 9 11 SEA/SPPDM-Meet.2/2.3 Page 65 Organization-wide Expected Result Regional Expected Results Indicator Baseline Target Number of countries with operational research projects on malaria supported by WHO 7 10 (all Malaria endemic countries) SEA/SPPDM-Meet.2/2.3 Page 66 Country Planning Brief: Bangladesh (SO-02) 1. Major work of WHO for this SO in country during 2008-2009: HIV/AIDS • Technical assistance to conduct HIV/AIDS sero-surveillance and behavioral surveillance provided • National strategy for prevention of HIV among SW and clients, MSM and other high risk groups developed • TOT trainings on HIV Counseling and Testing (HCT) for the ANC, TB and STI clinic nurses provided Tuberculosis • Development of country guidelines: revised national guidelines, guidelines for childhood TB, laboratory, MDR-TB, revised PPM guidelines, TB/HIV guidelines, SOP for drug management • Provision of TA in the field of laboratory, ACSM, human resources, epidemiology, PPM, resource mobilization, survey • Facilitating of nationwide prevalence survey • Building capacity through organizing international study tours and facilitating attending international trainings and meetings • Channeling major funds from GFATM for implementing the bulk of NTP activities • Providing access to first-line and second-line drugs Malaria • Revision of National Strategic Plan done and implementation is in progress • Technical staffs under Global Fund support recruited; procurement of drugs (ACT); diagnostics (RDT); Long Lasting Nets (LLINs) and K-O Tab for treatment of nets completed. • Training of medical officers and nurses on manage ment of severe malaria been completed. • Community-based IEC/advocacy and community sessions for treatment/re -treatment of nets done for transmission risk reduction. • Programme management capacity improved and partnerships with NGOs strengthened. 2. Scope of work and major results planned for 2010-2011 (by SO component): HIV/AIDS • Capacity building for prevention, treatment and care services, surveillance, and monitoring and evaluation systems strengthened with enhanced equitable access to essential medicines and laboratory support for HIV/AIDS and STI. SEA/SPPDM-Meet.2/2.3 Page 67 Tuberculosis • Strengthening surveillance systems through routine reporting and special studies including drug resistance survey and TB/HIV survey • Strenghtening programme monitoring through conducting programme review and rapid assessments of various components of the programme • Role of WHO technical staff will include providing technical inputs in NTP activities but no longer channel the funds for NTP activities • Pilot sites established for PAL and model TB treatment facility with adequate infection control • Documentation of model for linkages with nongovernmental health care facilities • Further strengthening of capacity of NTP, both technical and managerial. Malaria • Technical guidelines and SOPs will be updated and approaches for prevention and treatment improved • Increased access to quality diagnosis and treatment and prevention by using effective means of prevention promoted • Programme management capacity strengthened 3. How the scope and results are related to the Country Cooperation Strategy HIV/AIDS • Strategic actions: 2.1 Strengthen national capacity for effective management of major communicable diseases (HIV/AIDS, tuberculosis, malaria) and diseases targeted for elimination/eradication particularly leprosy, filariasis, kala-azar, and dengue Tuberculosis • BAN CCS Strategic Action 2.1: Strengthen national capacity for effective management of major communicable diseases and diseases targeted for elimination/eradication. • BAN CCS Strategic Action 2.3: Support for effective integrated disease surveillance system for communicable and non-communicable diseases. Malaria • BAN CCS Strategic Direction-2 and Strategic Actions-2.1: Strengthen national capacity for effective management of major communicable diseases (HIV/AIDS, tuberculosis and malaria) and diseases targeted for elimination,/eradication particularly leprosy, filariasis, kala-zar, and dengue). SEA/SPPDM-Meet.2/2.3 Page 68 4. Budget information for the Strategic Objective (in USD thousands) PB 2008-2009 PB 2010-2011 SO Component AC VC planned VC actual* AC VC Guidelines, policies and strategies including approaches to increase coverage 416 180 180 Policies and technical support to improve delivery of programmes including labs and integration with other programmes 195 10,977 8,443 Guidance and technical support for access to medicines, diagnostic tools and health technology 106 827 441 Surveillance, monitoring and evaluation 127 1,600 1,249 Advocacy, political commitment and resource mobilization 8 329 152 New knowledge, intervention tools and strategies developed 16 140 0 TOTAL 868 14,053 10,465 934 2,990 Breakdown by programmes HIV/AIDS 156 803 0 85 600 Tuberculosis 30 6,639 4,120 50 1,510 Malaria 269 6,044 5,900 160 740 TOTAL 455 13,486 10,020 295 2,850 *Available as of 15 May 2009 5. Possible VC funding through new or continuing projects HIV/AIDS • Nil Tuberculosis • GFATM • TBCAP (USAID) • CIDA Malaria • GFATM • WHO-TDR • World Bank SEA/SPPDM-Meet.2/2.3 Page 69 6. Staff requirements for 2010-2011 (short and long-term HIV/AIDS • Temporary International Professional Tuberculosis • Medical Officer • National Professional Officers (2) • Temporary National Professional Officer for TBCAP and CIDA projects Malaria • National Professional Officers SEA/SPPDM-Meet.2/2.3 Page 70 Country Planning Brief: Bhutan (SO-02) 1. Major work of WHO for this SO in country during 2008-2009: • 20 malaria technicians from endemic districts were provided refresher training on malaria diagnostic specially on BSC slide; correctly differentiate the PV, PF and mixed diagnosis and use of rapid diagnostics kits. • Survey protocol for TB prevalence/mortality survey and guidelines for training the surveyors and supervisors. Observed the Global Malaria Day with advocacy to sensitize the general population on prevention and control of malaria. 2. Scope of work and major results planned for 2010-2011. Provide technical and policy support • For prevention, diagnosis, treatment and care of HIV/AIDS patients so as to halt the HIV/AIDS epidemic and control STIs • for reviewing policies, strategies and guidelines through surveillance and assessments • For prevention, diagnosis, and control including MDR through DOTS and appropriate interventions. • For review, prevention and control of malaria and other vector-borne diseases 3. How the scope and results are related to the Country Cooperation Strategy Strategic Priority #05 • Help reducing the Burden of Diseases through key interventions focusing on Health Promotion and risk factors with a multi-sector approach • Communicable and emerging diseases (MDG #6) SEA/SPPDM-Meet.2/2.3 Page 71 4. Budget information for the Strategic Objective (in USD thousands) PB 2008-2009 PB 2010-2011 SO Component AC VC planned VC actual* AC VC Guidelines, policies and strategies including approaches to increase coverage 11 62 0 Policies and technical support to improve delivery of programmes including labs and integration with other programmes 11 57 0 Guidance and technical support for access to medicines, diagnostic tools and health technology 3 20 0 Surveillance, monitoring and evaluation 10 59 0 Advocacy, political commitment and resource mobilization 8 27 0 New knowledge, intervention tools and strategies developed 6 19 0 TOTAL 49 244 0 14 204 Breakdown by programmes HIV/AIDS 16 100 0 5 68 Tuberculosis 17 100 0 5 68 Malaria 16 44 0 4 68 TOTAL 49 244 0 14 204 *Available as of 15 May 2009 5. Possible VC funding through new or continuing projects: None 6. Staff requirements for 2010-2011 (short and long-term): None SEA/SPPDM-Meet.2/2.3 Page 72 Country Planning Brief: DPR Korea (SO-02) 1. Major work of WHO for this SO in country during 2008-2009: Malaria: • Access of population at risk to effective diagnosis and treatment of malaria • Effective preventive measures and integrated vector control interventions • Strengthen of surveillance system and response for early detection and rapid response for malaria outbreak Tuberculosis • Reasonable coverage of DOTS program(success rate/cure rate)achieved HIV/AIDS • Routine surveillance & monitoring system against HIV kept operational by support of HIV testing Kits 2. Scope of work and major results planned for 2010-2011 (by SO component): Malaria • Strengthen activities for containment of malaria transmission through enhanced preventive measure and integrated vector control • Updated and improved surveillance system to establish early warning system for potential outbreak of malaria Tuberculosis • DOTS expanded with improved implementation • Introduction of e-monitoring of DOTS implementation • Introduction of pediatrics DOTS • Pilot for MDR-TB management HIV/AIDS • Surveillance strengthened • Strengthening system for Transfusion transmissible infections and strengthening of laboratory system • Increased awareness for prevention and control • Counseling and testing and youth friendly services introduced and expanded 3. How the scope and results are related to the Country Cooperation Strategy • Strategic Priority 3: Sustaining achievements made and further addressing communicable diseases (2009-2013) SEA/SPPDM-Meet.2/2.3 Page 73 4. Budget information for the Strategic Objective (in USD thousands) PB 2008-2009 PB 2010-2011 SO Component AC VC planned VC actual* AC VC Guidelines, policies and strategies including approaches to increase coverage 17 452 0 Policies and technical support to improve delivery of programmes including labs and integration with other programmes 164 1,652 0 Guidance and technical support for access to medicines, diagnostic tools and health technology 0 0 0 Surveillance, monitoring and evaluation 95 585 0 Advocacy, political commitment and resource mobilization 0 0 0 New knowledge, intervention tools and strategies developed 0 0 0 TOTAL 276 2,689 0 80 2,812 *Available as of 15 May 2009 5. Possible VC funding through new or continuing projects Malaria and Tuberculosis • GFATM- Malaria and TB per Round 8 approval • RoK – Towards elimination of malaria and for strengthening cross border collaboration and filling the gap from the GFATM • Global Drug Facility-TB drugs • UNAIDS • SIDA 6. Staff requirements for 2010-2011 (short and long-term) • Medical Officer (2) • National Professional Officer (4) SEA/SPPDM-Meet.2/2.3 Page 74 Country Planning Brief: India (SO-02) 1. Major work of WHO in country during 2008-2009: Tuberculosis • Technical assistance (TA) for development of a number of new/ revised policy and technical guidelines for RNTCP, e.g. revised DOTS-Plus guidelines, revised TB/HIV framework, new policy on diagnosis of smear positive TB, new guidelines for involvement of NGOs and private practitioners, etc. • TA for expansion of MDR-TB management under RNTCP and for development of a plan to scale-up MDR-TB management in order to achieve universal access. • Technical support for evidence -based TB/HIV collaborative activities. • TA for revision of the recording and reporting system in TB, including piloting and training on a new electronic MIS system. • Advocacy and technical support for resource mobilization for TB control in India, including for Global Fund proposals. • Conduction of the 3-yearly Joint Monitoring Mission of RNTCP in April 2009. • Technical support provided at state and district levels for quality improvements in RNTCP services and for introduction of newer components of the Stop TB Strategy. This was done via a network of field consultants, the management of which was successfully outsourced in 2008. • Enhanced technical support to the Central TB Division for specialized functions by 10 consultants. • Technical support for impact assessment in collaboration with TRC, Chennai and NTI, Bangalore (both WHO CCs). • Operational research in collaboration with TRC, Chennai. • TA provided for laboratory scale-up, including the validation and evaluation of new diagnostics in collaboration with FIND. • TA for engagement of professional medical associations and medical colleges in RNTCP. HIV/AIDS • Adapted WHO IMAI approach and training module to support strengthening of district capacity in delivery of HIV services • Successfully field tested the IMAI module in TamilNadu and Karnataka and disseminated among stakeholders • Expert trainer module successfully implemented in Kanataka and TamilNadu to establish relationship with local health care providers • Developed guidelines, training modules and technically supported the implementation of sentinel surveillance • Capacities of state level surveillance officers in estimations and projections of the HIV epidemic developed • Supported TOT in Thailand and capacity building of senior physicians from ART centers of excellence in training health care providers • Refresher training for ART centers including second line treatment, provided • Implementation of ART, PPTCT and Blood Safety components of the National Program supported through technical consultants • HIV ART centers of excellence established in 11 places • Technical support provided for GFATM round VIII and RCC 2 SEA/SPPDM-Meet.2/2.3 Page 75 Malaria • Development of “Strategic Action Plan for malaria control in India (2007-12)” • Development of “Operational manual f or malaria control in India” • Development of “Standard Treatment Guidelines for malaria” • Development of training modules for: o District Vector Borne Disease Control Consultants o MO-PHCs o Malaria Technical Supervisors o Multipurpose Health Workers • ASHAs • Provided Technical Assistance with 1 NPO and 4 consultants (M&E – 2; Finance – 1; Procurement – 1) • Evaluation of therapeutic efficacy of antimalarials in Maharashtra and Gujarat • Operational research on antimalarial drug use practice • Estimation of malaria burden in Jharkhand • Evaluation of Insecticide treated bednets • Conduct meeting for municipal health officers for urban malaria control • Conduct meetings for development of Public Private Partnerships for malaria control • Development of GFATM Round 8 and 9 malaria proposals 2. Scope of work and major results planned for 2010-2011 Tuberculosis • Technical support provided in the development and updating of policies, strategies, guidelines and training material. • Technical support for scaling up of MRD-TB management, laboratory capacity, TB/HIV collaborations, and other activities recommended in the WHO Stop TB Strategy to address new and emerging issues in TB control, while maintaining inputs on quality improvements in basic DOTS services. • Technical support provided on procurement and supply management of laboratory equipment and anti-TB drugs, including second line drugs. • Technical support provided in surveillance, data management, monitoring and evaluation, and impact assessment • Advocacy and assistance for resource mobilization and facilitation of partnerships to engage all care providers in TB control. • Support provided in conduction of operational research on finding better ways of applying existing tools and development of new tools. HIV/AIDS • Technical support provided in the development of policies, strategies and guidelines for health service delivery for HIV/AIDS • Technical support and capacity building of Adolescent Friendly Health Services and HIV Services to increase access for adolescents / YP • Capacity building for expanding service delivery of prevention, treatment and care for HIV/AIDS/STI including strengthening of laboratories • Support capacity building of healthcare providers (medical and paramedical staff) in HIV/AIDS including pediatric ART SEA/SPPDM-Meet.2/2.3 Page 76 • Enhanced technical capacity of the HIV programme to facilitate quality improvements in implementation of the programme at national, state and districts • Technical support provided in increasing access to better diagnostic tools in HIV/AIDS, forecasting and supply management to ensure uninterrupted supply and rational use of quality ARV drugs, safe blood and blood products and injections • Technical support provided in surveillance (including ARV drug resistance surveillance), data management, monitoring and evaluation of programme performance and impact of interventions of HIV/AIDS • Advocacy for sustained political commitment and adequate resources for HIV/AIDS programmes at national and state level • Involvement of PLHA in treatment adherence through IMAI (Integrated Management of Adult and Adolescent Illness) • Support provided in conducting operational research and utilizing findings to address programme needs Malaria • Technical support provided in the development and updating of strategies for service delivery of Malaria control in India. • Technical support provided to strengthening capacity for implementing preventive measures particularly in malaria endemic districts, including the integrated vector management (IVM) • Technical support provided to increasing access to rapid diagnostic and treatment, particularly in the remote areas through the revised national drug policy for malaria • Technical support provided in surveillance, including realistic estimation of malaria, particularly in high endemic states. • Advocacy efforts for sustained political commitment and adequate resources for Malaria control • Support of operational research on drug utilization and prevention in malaria. 3. How the scope and results are related to the Country Cooperation Strategy: Tuberculosis • In the CCS, sustaining progress in TB control and addressing emerging issues in TB control, including drug resistant TB, is included under the “High Priority Areas” that have been identified for the period 2006-2011. The activities planned in the workplan are consistent with the implementation strategy of the CCS. • TB is a major public health problem in India responsible annually for nearly 2 million new cases (more than any other country) and 0.33 million deaths. In addition, 130000 multi- drug resistant TB cases eme rge annually (more than any other country). WHO country office provides technical support to India’s Revised National TB Control Programme and works closely with two in-country WHO CCs in TB. HIV/AIDS • The planned products are in line with the WHO Country Cooperation Strategy Malaria • With a view to strengthening of health systems, the CCS emphasizes support for public private partnerships; development of regulatory framework, standards and technology assessment; promoting health information for evidence based decisions through SEA/SPPDM-Meet.2/2.3 Page 77 documentation of best practices, generation of data to support evidence based management and support for operations research on relevant issues. There is an increased need to support state level initiatives, by facilitating state-specific planning and support for capacity building at the state level. 4. Budget information for the Strategic Objective (in USD thousands) PB 2008-2009 PB 2010-2011 SO Component AC VC planned VC actual* AC VC Guidelines, policies and strategies including approaches to increase coverage 328 1,306 482 260 1,250 Policies and technical support to improve delivery of programmes including labs and integration with other programmes 60 9,008 11,171 70 15,800 Guidance and technical support for access to medicines, diagnostic tools and health technology 50 2,075 636 55 1,350 Surveillance, monitoring and evaluation 53 2,324 1,776 70 2,400 Advocacy, political commitment and resource mobilization 20 1,071 519 40 782 New knowledge, intervention tools and strategies developed 10 2,430 2,411 35 2,500 TOTAL 521 18,214 16,996 530 24,082 Breakdown by programmes HIV/AIDS 80 700 Tuberculosis 100 16,900 17,200 385 22,282 Malaria 75 1,100 TOTAL 530 24,082 *Available as of 15 May 2009 5. Possible VC funding through new or continuing projects Tuberculosis • USAID Umbrella Agreements for TB, 2009-10 and 2010-11 (Total US$ 10 Million) • Last year of the 2006-2010 DFID project (US$ 2 Million) • 2010 contribution of new DFID project via Stop TB Partnership (approx. US$ 2 Million) • First phase (2010-11) of Global Fund Round-9 project (approx. US$ 3 Million) SEA/SPPDM-Meet.2/2.3 Page 78 6. Staff requirements for 2010-2011 (short and long-term) Medical Officer - HIV Medical Officer - TB National Professional Officer – TB National Professional Officer – HIV surveillance Technical Officer – Surveillance Technical Officer – TB drugs National Professional Officer – HIV National Professional Officer – Malaria National Professional Officer – Administration National Professional Officer – Technical National Professional Officer – HIV care SEA/SPPDM-Meet.2/2.3 Page 79 Country planning brief: Indonesia (SO-02) 1. Major work of WHO for this SO in country during 2008-2009: HIV/AIDS • Support provided to strengthen national health system for delivery of, and collaboration with prevention and care, support and treatment services for HIV and associated infection and conditions (SO2) o Technical and operational support to MoH and NAC, ensuring technical relevance to, and implementation of, the WHO policies. o Preparation of a) national HIV/AIDS Strategic Plan of the health sector (08-12); and b) Strategic plan for control of STI in Indonesia (2008-2012). Assisted preparation of R8 and R9 of GFATM proposal for HIV/AIDS component. o Unit took leadership to design national Clinical Mentoring Program for AIDS care, assembled a team of national consultants to design peer-reviewed content, and horizontal clinical mentoring has been initiated in five cities. o Supported scaling up of ART at 150 hospitals (coverage 22,154/estimated 36,000), held training workshops for HIV drug resistance surveillance. o WHO partnership in the Joint UN Initiative for Papua comprises of STI services, 100% condom use in brothels, clinical mentorship, ECS and Yaws in partnership with MCH- RCH-School programs; e) one SSA based in Papua. o Assisted ICAAP in designing the scientific tracks, themes, and program. o Obtained ISAC-II grant $0.65m from GFATM for the period 9/08 to 3/10; negotiated ISAC-3 for $2.2 m from R8 that will be operational 6/09; • Support provided toward strengthening monitoring &evaluation system and 2nd generation surveillance for HIV-STI (SO2) o The operational plan to initiate ANC syphilis screening and Rx was developed with MCH-RCH programs of MoH & WCO, launched ahead of SEARO timeline in 7 high- prevalence provinces in 2008. Integrated PMTCT, ECS, Yaws. o Operational Research: WHO spear-headed the formation of National Working Group on HIV/AIDS Research under NAC. NWG triangulated A$0.5m of AusAID to mentor and fund fifteen operational research proposals for one year. Tuberculosis • Technical Support provided for TB surveillance, data management, monitoring and evaluation of program performance and impact assessments. o Two series of Tuberculin Survey were successfully completed in South Kalimantan and North Sulawesi in collaboration with University of Indonesia. o NIHRD supported by WHO has already completed the second phase establishment of Sentinel Sites for Special Surveillance of TB Mortality in 4 sentinels sites: Lampung, West Kalimantan, Gorontalo and Papua. o Improved surveillance system including TB-HIV data from high burden provinces � Tools for surveillance on TB-HIV were developed. � Capacity of central and provincial on TB surveillance have been strengthened through data management and analysis training. GIS training has been delivered SEA/SPPDM-Meet.2/2.3 Page 80 to central NTP team and partners along with some procurement of hardware and software to support the activities. � Hospital assessment study in Java & outer Java has been undertaken in collaboration with University of Gadjah Mada, to ascertain the TB case load in hospital sector, potential for TB-HIV collaboration & practices in dealing with MDR TB plus the quality of DOTS implementation. � Training for specialists has been conducted for Practical Approach to Lung Health (PAL) implementation and several steps have been taken. National working group on PAL have been established, followed by development of guideline and training materials which will be tested in pilot sites on the last quarter of 2009. • Technical assistance provided to the Nati onal TB control programme at central and provincial levels to sustain case detection and success rate plus new initiatives • TB national consultants and program assistants are placed at central and provincial level to support hospital DOTS linkages, laboratory, MDR-TB, TB-HIV collaboration, surveillance, ACSM activities, operational research and data management. • NTP manager and staff to attend NTP managers meeting and SEA TWG, DEWG and Union for DOTS expansion under MCA mechanism. Malaria and of other vector-borne diseases • Support for developing and implementing Global Fund Round 1, Round 6, and Round 8 was the most important activity, including successful conclusion of Round 1. Other major work involved collaboration with the Gates-funded Malaria Transmi ssion Consortium, integration of malaria with antenatal care, and capacity-building via training. 2. Scope of work and major results planned for 2010-2011 (by SO component): HIV/AIDS Health policy and system development of HIV-AIDS in Indonesia o Technical support to MoH and NAC o Preparation of national HIV/AIDS strategic plan (2011-2015) and review 2007-2010 national HIV/AIDS strategic plan. o Adapting SEARO, HQ guidelines to Indonesia o Strengthening surveillance & monitoring and evaluation plan o Strengthening management of STI clinics o Validate syndromic management protocols o Integrated PMTCT/ECS/Yaws eradication o Model 100% condom use by sex worker in brothel Prevention and control of HIV-AIDS in Indonesia o Scaling up clinical mentoring and socializing IMAI through clinical mentoring o activity o Scaling up ART o Capacity building of laboratories for detection of OI o Establish HIV DR o Strengthen harm reduction o Upscale national capacity building on operational research and mentoring SEA/SPPDM-Meet.2/2.3 Page 81 o Publication of the evidences o Founding a secretariat of national blood council and developing national policy on blood safety o Supporting GFATM funding allocation towards blood safety conducts o Prevention, care, and treatment of HIV/AIDS in Papua and NTT Tuberculosis • Technical assistance provided to the National TB control program at central and provincial levels in order to sustain TB program achievements. o Increment case detection, success rate and new initiatives. • Improved surveillance system (including TB-HIV data from high burden provinces) o Strengthen capacity of NTP on monitoring & evaluation of program performance to keep TB program on track against MDG by 2015. • MCA o Support NTP manager and staff to attend meeting SEA TWG, DEWG and Union for DOTS expansion. Malaria • Support for impleme ntation of GF Round 6 and 8, covering major portions of the country. Monitoring and evaluation of field work with emphasis on epidemiological analysis. Quality control of diagnosis. 3. How the scope and results are related to the Country Cooperation Strategy: There are six priority areas in the INO CCS; the scope and results are directly related to priority no. 2 (prevention and control of communicable diseases), as well as no. 3 (health of women, children and adolescents), who are directly and specifically affected by malaria. The strategic direction no. 2 (provide technical and management support to help sustain and strengthen key programmes to prevent and control communicable diseases) is a direct beneficiary of this activity. SEA/SPPDM-Meet.2/2.3 Page 82 4. Budget information for the Strategic Objective (in USD thousands) PB 2008-2009 PB 2010-2011 SO Component AC VC planned VC actual* AC VC Guidelines, policies and strategies including approaches to increase coverage 1,346 1,688 179 Policies and technical support to improve delivery of programmes including labs and integration with other programmes 213 2,806 951 Guidance and technical support for access to medicines, diagnostic tools and health technology 0 80 85 Surveillance, monitoring and evaluation 114 2,366 2,098 Advocacy, political commitment and resource mobilization 0 0 0 New knowledge, intervention tools and strategies developed 20 20 70 TOTAL 1,593 6,960 3,384 1,212 2,501 Breakdown by programmes HIV/AIDS Tuberculosis Malaria TOTAL 1,593 6,960 3,384 1,212 2,501 *Available as of 15 May 2009 5. Possible VC funding through new or continuing projects: HIV/AIDS • GFATM ISAC-3 TA, clinical mentoring, STI 2010-2011 US$2.2m approved R8 • GFATM ISAC-4 TA, blood safety 2011-2012 US$1.0m pending R9 Tuberculosis • TBCAP & ISAC SEA/SPPDM-Meet.2/2.3 Page 83 6. Staff requirements for 2010-2011 (short and long-term) HIV/AIDS • Temporary International Professional – STI, surveillance, monitoring and evaluation • Temporary International Professional – CST, research, interventions • Temporary International Professional – PMTCT, ECS, yaws (1/2 time) • Temporary International Professional – Blood safety, laboratories (1/2 time) • Medical Officer – Clinical monitoring • National Professional Officer - STI • National Professional Officer - CST • National Professional Officer – Surveillance, MONEV • National Professional Officer – Blood safety, labs • National Professional Officer – Research, interventions, HR • National Professional Officer – Clinical monitoring, ART Tuberculosis • Medical Officers (2) • National Professional Officers (2) • Temporary National Professional Officers (2, as required) Malaria • Medical Officer • National Professional Officers (2) SEA/SPPDM-Meet.2/2.3 Page 84 Country Planning Brief: Maldives (SO-02) 1. Major work of WHO for this SO in country during 2008-2009: HIV/AIDS • Expanded and strengthened VCT services at regional level • Nationals trained in monitoring and evaluation of HIV/AIDS programme Tuberculosis • Nationals trained in quality assurance and sputum microscopy • Conducted awareness programmes for communities on TB prevention and control Malaria • Nationals to be trained in vector control by end of 2009 2. Scope of work and major results planned for 2010-2011 (by SO component): HIV/AIDS • Strengthen prevention, surveillance, diagnosis, care and management of HIV/AIDS/STI • SIDAS system to include HIV/AIDS and TB • Strengthen capacity to implement HIV/AIDS Strategic Plan 2006-2011. Tuberculosis • Implementation of the National Strategic Plan for Tuberculosis Control 2008-2010 (*special emphasis on stigma removal) • Strengthen management and quality assurance of programme implementation including supervision to overcome the major challenge in sustaining its achievement. • Conduct active surveillance for TB/HIV co-infection - SIDAS system to include TB/HIV • Revising existing guidelines to include management of MDR/XDR-TB and TB/HIV co- infection Malaria • Strengthen capacity for vector surveillance and clinical management of malaria 3. How the scope and results are related to the Country Cooperation Strategy: Priority areas: 1 - Strengthening health systems 2 - Integrated communicable disease surveillance and control 7 - Environmental health SEA/SPPDM-Meet.2/2.3 Page 85 4. Budget information for the Strategic Objective (in USD thousands) PB 2008-2009 PB 2010-2011 SO Component AC VC planned VC actual* AC VC Guidelines, policies and strategies including approaches to increase coverage 0 0 0 Policies and technical support to improve delivery of programmes including labs and integration with other programmes 84 314 0 Guidance and technical support for access to medicines, diagnostic tools and health technology 0 30 0 Surveillance, monitoring and evaluation 26 93 0 Advocacy, political commitment and resource mobilization 3 35 0 New knowledge, intervention tools and strategies developed 6 30 0 TOTAL 119 502 0 98 318 Breakdown by programmes HIV/AIDS 63 287 0 41 158 Tuberculosis 43 88 0 41 70 Malaria 13 127 0 16 90 TOTAL 119 502 0 98 320 *Available as of 15 May 2009 5. Possible VC funding through new or continuing projects Global Fund 6. Staff requirements for 2010-2011 (short and long-term None SEA/SPPDM-Meet.2/2.3 Page 86 Country Planning Brief: Myanmar (SO-02) 1. Major work of WHO for this SO in country during 2008-2009: Tuberculosis • Capacity building of National Staff in prevention and management of Tuberculosis • Assist in un-interrupted supply of diagnostic supplies and anti -TB drugs • Surveillance, monitoring and evaluation of National TB Control Programme • Financial management to National TB control Programme and Myanmar Medical Association for 3 DF activities • Provide technical assistance in operational research HIV/AIDS • Technical support provided for strengthening HIV second generation surveillance; • Provided support for HIV prevention activities particularly on 100% Targeted Condom Promotion in selected townships and capacity building for STI management; • Technical support provided for prevention of HIV in health care settings in particular blood safety and implementation of EQAS for HIV testing in public and private (NGO) laboratories; • Technical support provided for building human resources capability for provision of HIV care including ART. This included training on IMAI, development of training modules, TOTs and multiplied trainings on Community Home Based Care for people living with HIV • Technical support for building capacity of networks of people living with HIV; • Support provided to build managerial capacity of NAP Malaria • Strengthen managerial and technical capacities of VBDC and Township Health Departments and other partners for malaria control • Scale-up, monitor and evaluate preventive measures against malaria • Empower health care providers to provide quality assured diagnosis and effective treatment of malaria • Research and monitoring of efficacy of anti -malarial drugs 2. Scope of work and major results planned for 2010-2011 (by SO component): Tuberculosis • In-country training for TMO, TB coordinators, BHS, Lab technicians • International training courses for TB laboratory management, Clinical Management of DR TB, Drug management, TB control programme management, Master in Epidemiology, etc • Expansion of high quality PPM DOTS implementation through partnership approached • Participation to international conferences • Recruitment of technical staff for NTP • Supporting the un-interrupted supply of quality anti -TB drugs and laboratory supplies for National TB control programme • Support to the surveillance, monitoring and evaluation of National TB control programme • Recruitment of national and international staff for the programme • Conduct WHO / NTP joint monitoring and supervisory visits • Operate financial management of 3 DF to NTP and MMA SEA/SPPDM-Meet.2/2.3 Page 87 • Provide technical support to engage and empower the people with TB and community by developing an effective TB strategy that incorporate advocacy, communication and social mobilization activities • Promote programme based operational research in identifying problems / challenges of intervention strategies for National TB control programme HIV/AIDS • To scale up HIV /AIDS treatment and care and accelerate and expand prevention interventions, including support to comprehensive health sector response to HIV / AIDS. • To strengthen information systems including data management and reporting for improvement of HIV / AIDS programme • To provide DOH/NAP with a continuous and sustainable supply of quality ART / OI drugs to prevent drug resistance and maintain quality of life of People Living with HIV / AIDS. • To strengthen capacity for Behavioral sentinel surveillance, and the implementation of the sexually transmitted disease/ HIV surveillance survey and ARV drug resistance survey. Malaria • Malaria risk villages stratified for better targeting of interventions • Populations in high risk areas protected against malaria using either LLINs or ITNs • Health care providers, including community health volunteers, trained to provide early diagnosis and treatment of malaria • Diagnostics and drugs provided to health care providers and trained volunteers • Quality assurance of malaria microscopy and RDT functional • Regulatory capacity of FDA to monitor fake / sub-standard anti-malarial drugs strengthened • Township Health Departments able to plan, implement and monitor malaria control program • VBDC staff trained on technical and managerial aspects of malaria control program • Computerized database on malaria control program functional in 100 priority townships • External program evaluation done • Efficacy of anti -malarial drugs studied • Innovative approaches for malaria prevention and control among forest related and migrant workers piloted 3. How the scope and results are related to the Country Cooperation Strategy: Tuberculosis • Reduce excess burden of disease • Improve health system performance HIV/AIDS • Prevention and control of HIV/AIDS directly relates to one of the priorities of the CCS in particular with regards to control of communicable diseases. • Additionally, WHO’s support on building capacity of human resources involved in the HIV/AIDS programme, including Basic Health Staff, contributes to the CCS priority related to Strengthening of Health Systems SEA/SPPDM-Meet.2/2.3 Page 88 Malaria • The CSS calls for reduction of excess burdens of communicable diseases such as malaria in Myanmar. The scope of work and the major results will contribute in addressing the high burden of malaria in this country. 4. Budget information for the Strategic Objective (in USD thousands) PB 2008-2009 PB 2010-2011 SO Component AC VC planned VC actual* AC VC Guidelines, policies and strategies including approaches to increase coverage 0 396 0 Policies and technical support to improve delivery of programmes including labs and integration with other programmes 500 8,268 6,275 Guidance and technical support for access to medicines, diagnostic tools and health technology 213 5,331 3,077 Surveillance, monitoring and evaluation 189 3,213 2,062 Advocacy, political commitment and resource mobilization 0 0 0 New knowledge, intervention tools and strategies developed 71 270 18 TOTAL 973 17,478 11,432 890 20,930 Breakdown by programmes HIV/AIDS Tuberculosis Malaria TOTAL 973 17,478 11,432 890 20,930 *Available as of 15 May 2009 SEA/SPPDM-Meet.2/2.3 Page 89 5. Possible VC funding through new or continuing projects Donors TB HIV/AIDS Malaria 3DF 3,600,000 2,638,334 4,200,000 3DF (FFM) 1,150,000 USAID 1,000,000 GFATM 1,727,000 4,000,000 500,000 3DF (NPS) 270,000 PSI/Gates (NPS) 358,000 PSI/USAID (NPS) 120,000 SEARO/HQ 396,000 UNCERF 500,000 Mekong Malaria 500,000 Other source 17,315,000 TOTAL 8,225,000 7,534,334 22,515,000 GRAND TOTAL 38,274,334 Note: NPS = National Prevalence Survey FFM = Fund Flow Mechanism 6. Staff requirements for 2010-2011 (short and long-term): HIV/AIDS • Medical Officer • Technical Officer Tuberculosis • Medical Officer • Technical Officer Malaria • Medical Officer SEA/SPPDM-Meet.2/2.3 Page 90 Country Planning Brief: Nepal (SO-02) 1. Major work of WHO for this SO in country during 2008-2009: HIV/AIDS: Within Strategic Objective 02, the HIV project focuses on promotion of HIV prevention interventions and expansion of ART ; Investment in Strategic Information systems; and promotion of Partnership with government and development partners including civil society for strengthened resources and programmes Key achievements: • Continued Study of CD 4 normal range ( healthy individuals ) in 2 additional regions as Nepal reference • Capacity Building of National AIDs Programme managers and policy makers participation in regional consultations, training, meetings ( International Harm Reduction Conference = 2 participants; HIV Estimations = 2 participants ) • Follow up, verification of HIV treatment, care & VCT data and mentoring of sites • Preparation of the Progress of the Health Sector Response 2008 Report through consultative workshop • Two SEARO guidelines on Oral Substitution Treatment and Primary Health Care for HIV positive IDUs translated for wider distribution • Participation and contribution from Nepal Experts to the Global and regional HIV estimations 2009 • Preparation of the National HIV estimations 2009 and UNGASS Report 2009 • Support for attendance of Nepal Member to the SEARO CCM Constituency meeting • Support of consultants and country process in the preparation of the Global Fund Rd 9 proposal for Nepal in joint collaboration with other UN partners • Support of country team to the SEARO “Mock “ TRP review for GF 9th Rd proposal • Continuing technical support provided to review and updating of treatment and prevention guidelines and training modules Tuberculosis: The major objective of SO 2 is to provide support for implementation of Stop TB Strategy. Stop TB strategy has six broad components: (i) pursuing high-quality DOTS expansion and enhancement; (ii) addressing TB/HIV, MDR-TB and the needs of poor and vulnerable populations; (iii) contributing to health-system strengthening based on primary health care; (iv) engaging all care providers; (v) empowering people with TB, and communities through partnership; and (vi) enabling and promoting program based operational research. Key Achievements: • National wide (75 district) and health institutional coverage (100% of the regional, district hospitals, all PHC, HP and SHP) of DOTS programme. • Achievement of both global targets for TB control: 88% treatment success during 2006/06 and 72% case finding during 07/08 • Smear microscopy laboratory network with permanent quality control through 724 laboratories operating under public sector and partner organizations. SEA/SPPDM-Meet.2/2.3 Page 91 • Expansion of MDR TB management programme in all five regions (10 treatment center, 34 sub centers). 560 cases registered for treatment by end March 2008 with 71% cure rate among patients who completed full course of treatment (2year) • Practical Approach to Lung Health piloted in two districts with Tobacco cessation component. • Developments of Standard Operating Procedures for smear microscopy and piloted at three sites as part of WHO global initiative. • Human resource development: o NTP and two MoHP staff trained on EPI Center software program for management of DOTS programme data. o Two NTP/MOHP staff participation in the IUATLD Conference with 2 scientific presentations. • Training on MDR TB Management, 35 staff including clinical staff, laboratory staff and storekeepers. • Developed of advocacy material for World TB Day 2008/2008 • Developed and printing of NTP annual Report 2006/2007 and 2007/2008 and NTP at a glance 2007 and 2008. Future activities to be implemented within 2009: • Two Private Public Workshops in Q2 and Q3. • Three NTP staff to be trained on TB/HIV in India or Thailand. • Conduct survey among MDR TB patients on identification of XDR cases. (sample size = 100 cases) • Procurement of first and second line TB drugs Malaria: The principle objective of WHO during the current work-plan is to ensure that technical assistance is maximised during a critical period in malaria programming; when strategic direction is of paramount importance as malaria control efforts are scaled-up in highly endemic districts as part of a coordinated response between EDCD/PSI/WHO through GFATM related programming. Key Achievements: • National technical working group for malaria control policies and SOPs initiated with full integration from WHO. • Procurement assistance to ensure the timely distribution of approved antimalarials for effective case management and malaria control commodities/consumables for timely and effective malaria control operations. • Re-establishing sentinel site entomological surveillance and insecticide resistance monitoring through effective collaboration with the entomological division within EDCD Nepal, proceeding applied based training of District Vector Control Officers, Malaria Inspectors, and national entomological associates. • Provision of technical guidance for a training work-shop on effective diagnosis and management of severe malaria for medical officers and nurses. • Continued advocacy through national workshops on the contextual aspects and challenges of malaria outbreaks and other vector-borne diseases in Nepal. • Technical assistance to the EDCD to enable regular antimalarial efficacy monitoring of Artemether-lumefantrine (Co-artem®) to ensure detection of any emerging drug resistance. SEA/SPPDM-Meet.2/2.3 Page 92 • Continued technical assistance to the PMU-GFATM Malaria unit within EDCD to ensure optimum malaria programming, Monitoring and Evaluation, and strategic direction. 2. Scope of work and major results planned for 2010-2011 (by SO component): HIV/AIDS • Support and strengthen systems for ART, VCT, HIV/AIDS prevention and care with health services, and to enhance capacity of public health workforce • Provide support for monitoring and analysis of HIV epidemic and response through strengthened HIV SGS system and through strengthening laboratory services and public health laboratory network. • Promote partnership with government and development partners including civil society for strengthening resources mobilization and programme implementation. Tuberculosis • Provide support for implementation of Stop TB Strategy based activities: o Pursuing high-quality DOTS expansion and enhancement o Addressing TB/HIV, MDR-TB o Contributing to health-system strengthening (iv) engaging all care providers o Empowering people with TB, and communities through partnership o Enabling and promoting program based operational research. • Provide support with procurement of first and second line TB drugs Malaria • Continued Procurement assistance to ensure the timely distribution of approved antimalarials for effective case manageme nt and malaria control commodities/consumables for timely and effective scaled-up malaria control operations in all highly endemic districts. • Continued technical assistance to the PMU-GFATM Malaria unit within EDCD to ensure optimum malaria programming, Monitoring and Evaluation, and strategic direction, along with ensuring that any future GFATM proposals have the technical rigour to maximise opportunity to secure continued VC revenues for national malaria control programming. • To ensure that the national malaria control strategic plan and supporting policy/guideline documents are reflective of the current context with regards to malaria transmission and adopt locally applicable but internationally approved standards and practices. • Aim to enhance and scale-up longitudinal sentinel site entomological surveillance and insecticide resistance profiling of operational insecticides through integration of activities into district work plans; to provide real-time information (from a national electronic entomological database) to effectively target vector management strategies, and appropriate selection of WHOPES approved insecticides for large - scale use in IRS or incorporation into LLINs. • Technical guidance for national based trainers to strengthen case management of malaria through the effective transference of knowledge on updated national treatment protocols and current confirmatory diagnostic options. SEA/SPPDM-Meet.2/2.3 Page 93 • Technical assistance to the EDCD to enable regular antimalarial efficacy monitoring of Artemether-lumefantrine (Co-artem®) from routine case management practices to ensure detection of any emerging drug resistance and revision of national treatment policy. • Incorporation of operational research activities (e.g. Anopheles sibling species identification, field evaluations of new vector-control tools/insecticide formulations, generation of pharmacovigilance data of artemether-lumefantrine) to provide output on which to guide future malaria control strategies from a local evidence base. • Enhance cross-border communication (Nepal-India) through SWOT analysis of key malaria control programming components in hope of establishing parallel activities to strengthen the fight against border related malaria transmission 3. How the scope and results are related to the Country Cooperation Strategy: HIV/AIDS The WHO CCS ( 2006 – 2011 ) Nepal had identified emergency and humanitarian action, reproductive health and HIV/AIDS are three priority areas identified as needing more technical support and focus from WHO. NEP HIV’s work for the period 2010–2011 followed strategic approaches identified in the CCS Nepal and keeping in the forefront the global agenda of WHO for HIV, highlighting the five strategic directions, where the health sector must lead if the country is to make progress towards achieving universal access . • Enabling people to know their HIV status through confidential HIV testing and counseling • Maximizing the health sector’s contribution to HIV prevention • Accelerating the scale-up of HIV/AIDS treatment and care • Strengthening and expanding health systems • Investing in strategic information to guide a more effective response Within the programme to control and prevention of disease and disability, HIV NEP will: 1. Maximize health sector’s contribution to HIV prevention ( including T & C) 2. Accelerate scale-up of HIV/AIDS treatment and care and strengthen and expand health systems 3. Invest in strategic information to guide a more effective response Tuberculosis Scope and results are related to the Country Cooperation Strategy Nepal Cooperation Strategic Agenda 6.2; Strategic Objective “Support capacity building of public health workforce and programme interventions for effectively addressing priority communicable diseases including malaria, tuberculosis and HIV/AIDS, and elimination of leprosy, kala-azar and lymphatic filariasis” and Strategic Approach “Support the quality assurance of DOTS expansion and the national strategy for MDR TB and TB HIV” Malaria The work to be completed in the prospective work-plan is in accord with strategi c approaches that stratify over two WHO strategic agenda’s (Strengthening the health system & Control and prevention of disease and disability) these are as follows; SEA/SPPDM-Meet.2/2.3 Page 94 • Support for the on-going process of health services decentralization from enhancing capacity of district based personnel in WP trainings/workshops. • Strengthening malaria control through evidence -based diagnosis, treatment, and district vector control, and promote compliance with the standard treatment protocol and carry out systemic monitoring of malaria drug resistance as per the revised national treatment policy 4. Budget information for the Strategic Objective (in USD thousands) PB 2008-2009 PB 2010-2011 SO Component AC VC planned VC actual* AC VC Guidelines, policies and strategies including approaches to increase coverage 10 496 374 Policies and technical support to improve delivery of programmes including labs and integration with other programmes 238 3,756 2,921 Guidance and technical support for access to medicines, diagnostic tools and health technology 0 60 903 Surveillance, monitoring and evaluation 66 276 765 Advocacy, political commitment and resource mobilization 10 87 44 New knowledge, intervention tools and strategies developed 0 0 0 TOTAL 324 4,675 5,007 580 4,607 Breakdown by programmes HIV/AIDS Tuberculosis Malaria TOTAL *Available as of 15 May 2009 5. Possible VC funding through new or continuing projects Tuberculosis • GFATM (1st May 2006-30th April 2011): USD $ 2,231,226.00 Malaria • GFATM Rd 7: Phase I (Year 2, Until Mid 2010-US$ 250,595 Approved). SEA/SPPDM-Meet.2/2.3 Page 95 6. Staff requirements for 2010-2011 (short and long-term): HIV/AIDS • Medical Officer • National Professional Officer Tuberculosis • Medical Officer • National Programme Officer Malaria • Medical Entomologist/Malaria Advisor • Epidemiologist • National Programme Officer SEA/SPPDM-Meet.2/2.3 Page 96 Country Planning Brief: Sri Lanka (SO-02) 1. Major work of WHO for this SO in country during 2008-2009: Malaria • Evidence -based policies, guidelines, strategies and other tools developed for strengthening health care system in malaria control. Prevention, treatment and care services malaria expanded and decentralized with strengthened laboratory support. Surveillance and monitoring of programme performance strengthened of malaria. Political commitment sustained and adequate resources mobilized for malaria programme. Operational research conducted on disease prevalence among different risk groups to strengthened targeted prevention and control activities. HIV/AIDS • Prevention, treatment and care services for HIV/STI, TB and malaria expanded and decentralized with strengthened laboratory support. Surveillance and monitoring of programme performance strengthened of HIV/AIDS, STIs. Tuberculosis • Prevention, treatment and care services for TB expanded and decentralized with strengthened laboratory support. Operational research conducted on disease prevalence among different risk groups to strengthened targeted prevention and control activities. 2. Scope of work and major results planned for 2010-2011 (by SO component): MOH-WHO collaborative activities will focus on: scaling up and improving prevention, treatment, care and support interventions for HIV/AIDS, tuberculosis and malaria so as to achieve universal access, in particular for seriously affected populations and vulnerable groups; advancing related research; and contributing to the broader strengthening of health systems. 3. How the scope and results are related to the Country Cooperation Strategy: Prevention and control of communicable diseases is one of the six priority strategies spelt out in CCS. Main emphasis is given to strengthening of surveillance system for existing, emerging and re-emerging diseases, address priority communicable disease progs., coordinate action for pandemic pre paredness. 4. Budget information for the Strategic Objective (in USD thousands) SEA/SPPDM-Meet.2/2.3 Page 97 PB 2008-2009 PB 2010-2011 SO Component AC VC planned VC actual* AC VC Guidelines, policies and strategies including approaches to increase coverage 18 96 0 Policies and technical support to improve delivery of programmes including labs and integration with other programmes 43 211 0 Guidance and technical support for access to medicines, diagnostic tools and health technology 3 50 0 Surveillance, monitoring and evaluation 30 229 0 Advocacy, political commitment and resource mobilization 9 206 0 New knowledge, intervention tools and strategies developed 8 140 0 TOTAL 111 932 0 90 316 Breakdown by programmes HIV/AIDS Tuberculosis Malaria TOTAL 111 932 0 90 316 *Available as of 15 May 2009 5. Possible VC funding through new or continuing projects: All the 03 diseases have got funding support from GFATM and there is a possibility of getting VC funding from those grants. 6. Staff requirements for 2010-2011 (short and long-term): LTS - National Professional Officer – (CDS-NO C), is working in this SO also. Shot-term staff may be recruited as and when required. SEA/SPPDM-Meet.2/2.3 Page 98 Country Planning Brief: Thailand (SO-02) 1. Major work of WHO for this SO in country during 2008-2009 HIV/AIDS • Guideline on HIV/TB practice has been developed. Integrated service for HIV and TB care has been provided through out the country. • An innovative model for case finding of Gonorrhea and Chalmydia trachomatis using self vaginal swab and PCR test among young female high-risk group has been develop and is under piloted trial. • Strengthening of HIV/AIDS activities at the Local Administration Organization level. • Support provided in the organization of National AIDS Seminar to enhance participation of stakeholders from various sector, including civil society partners. • Development of Harm Reduction Guideline for health care setting use. • Strengthening of HIV prevention among most-at-risk population such as MSM, SW, and youth. • Capacity building in several areas of works in HIV/AIDS program including program management, HIV prevention intervention and AIDS treatment, care and support. • Monitoring and evaluation of HIV/AIDS program, including the annual health sector evaluation and program review. • Assessment of nutritional status among HIV infected persons. • Development of Program and activities related to HIV Drug Resistance monitoring, evaluation and surveillance. • Assistance provided for the development of the Global Fund round 7 and 8 proposals. Tuberculosis • A model of integrated services for lung health has been developed and tested in the southern region of the country. • A model for continuing TB medication among released prisoners has been developed. • Community participation in the strengthening of TB control. • Capacity building in several areas of works in TB Control, including the management of information for strategic decision. • Assessment of TB infection control in health care setting. • Assistance provided for the development of the Global Fund round 8 proposal. Malaria • Strengthening of Malaria control activities along the border area both with Myanmar and with Cambodia borders. Cross border health related to HIV/AIDS, TB and Malaria • Workshop on the collaboration between Thailand and Myanmar in health matters including HIV/AIDS, TB and Malaria has been organized and joint action plan concerning border health has been developed. SEA/SPPDM-Meet.2/2.3 Page 99 2. Scope of work and major results planned for 2010-2011 • Strengthening of health care system across STIs, HIV/AIDS, TB and malaria. • Cross border interventions and interventions in STIs, HIV/AIDS, TB, and Malaria program for migrant population strengthening. • Strengthening of prevention programs for vulnerable population in STIs, HIV/AIDS, TB and malaria. • Strengthening of quality health care services in STIs, HIV/AIDS, TB and Malaria. • Strengthening of surveillance and use of strategic information for further development of STIs, HIV/AIDS, TB and malaria programs. • Support provided to ensure appropriate actions taken for surveillance of drug resistance problems on STIs, HIV/AIDS, TB and malaria, including measurements to prevent and rectify the problems. 3. How the scope and results are related to the Country Cooperation Strategy: The scope and results stated in 2. respond to the CCS 2008-2011 (Thailand): ‘(1) Enhancing primary prevention, surveillance and control of communicable diseases and epidemics; (5) Multi-sectoral approach to address health services for the poor and at-risk population, including those in border and conflict areas; (7) Strengthening the development of human resources for health through existing networks within and outside the country.’ SEA/SPPDM-Meet.2/2.3 Page 100 4. Budget information for the strategic objective PB 2008-2009 PB 2010-2011 SO Component AC VC planned VC actual* AC VC Guidelines, policies and strategies including approaches to increase coverage 212 227 203 Policies and technical support to improve delivery of programmes including labs and integration with other programmes 80 180 2,703 Guidance and technical support for access to medicines, diagnostic tools and health technology 0 100 0 Surveillance, monitoring and evaluation 0 40 0 Advocacy, political commitment and resource mobilization 10 90 50 New knowledge, intervention tools and strategies developed 40 220 125 TOTAL 342 857 3,081 347 947 Breakdown by programmes HIV/AIDS Tuberculosis Malaria TOTAL *Available as of 15 May 2009 5. Possible VC funding through new or continuing projects. 6. Staff requirements for 2010-2011 For HIV/AIDS: 1 NPO and 1 Program Assistant. For TB: 1 NPO and 1 Program Assistant. In addition, there is a need for 1 international staff to look after the cross cutting issue such as for the migrant and border issue. SEA/SPPDM-Meet.2/2.3 Page 101 Country Planning Brief: Timor-Leste (SO-02) 1. Major work of WHO for this SO in country during 2008-2009: Malaria • WHO Timor-Leste provides technical assistance to support the national malaria control programme in collaboration with other partners. Nationally, the number of malaria cases decreased by 38% in 2008 compared to 2007. This may be due to reduction of cumulative number of chloroquine resistant P. falciparum malaria cases who were treated as clinical malaria cases after introduction of Rapid Diagnostic Test kits (RDT) which detect P. falciparum to the Health Posts where there was no malaria microscopy available and treatment with Artemisinin Combination Therapy (ACT), stratification of the country according to the malaria risk and distribution of 110,912 LLINs (provided by GFATM and USAID) to the children under 5 and pregnant mothers in malaria high risk areas. • A revised Malaria treatment protocol was launched in 2007 and 85% of the health staff in all 13 districts were socialized in 2008. Health staff in all 13 districts has been implementing the protocol since middle of 2008. • WHO supported the ACT drugs to the Ministry of Health. In addition ACT drugs were also supported as part of the International Emergency Health Kit which used the funds received from the Korean Foundation for International Healthcare (KFIH) for epidemic preparedness and response. • Malaria microscopy is available 85% of the National hospital, 4 regional hospitals and 66 Community Health Centers and the malaria microscopy will be available in the all 71 health institutions after implementation of global fund round 7 in 2009. Quality control of the malaria microscopy was initiated with assistance from WHO and Asian Collaborative net work. • All the District Public Health officers (DPHOs) and 7 officers including 3 officers at national level and 4 DPHOs were trained on malaria vector control and entomological surveillance respectively by the WHO Sort term professional (STP). WHO assisted in development and implementation of Global Fund round 7 malaria proposal and received funding from GF round 7 from April 2009. All the DPHOs and environmental officers attached to 13 districts will be trained on vector control and entomological surveillance before the end of 2009. • During the peak of malaria transmission season in Dili, WHO provided support to conduct advocacy and community awareness on malaria promotion, prevention and control during an exhibition held for 2 days in April 2009. This is part of the World Malaria Day on 25th April 2009. It was heavily involved training of health volunteers for delivering prevention messages, malaria examination using RDTs and microscopy as well as treatment and demonstrating other methods and tools to combat malaria, such as long lasting insecticides treated bednets (LLNIs), and biological control methods. Campaign on source reduction of malaria vector was initiated through multi -sectoral approach which is now formally launched by the Prime Minister and the President. This will be carried out every Friday morning involving of intersectoral collaboration and community participations. It will be expanded across Timor-Leste. This initiave contributes to the massive community mobilization to control all vector borne diseases in Timor-Leste. SEA/SPPDM-Meet.2/2.3 Page 102 Tuberculosis • Strengthen data management system of and develop electronic database system for TB programme • Improve the capacity of national and district TB programme staff on the programme management including monitoring and supervision • Assist National TB programme train 11 TB laboratory technicians • Revised the TB laboratory guidelines including laboratory quality assurance and implement quality assurance for TB laboratory diagnosis • Developed guidelines and established linkage between TB programme and HIV/AIDS programme on integration of DOTS and VCT HIV/AIDS • Trained the trainers for STI syndromic management and health staff from district and subdistrict level on STI syndromic management. Currently all health facility is implementing STI syndromic management approach • Strengthen the STI surveillance in at least high risk districts • WHO contribute in the expansion of VCT testing facilities from 3 facilities to 15 facilities • Strengthen the data management system and develop electronic data management system for HIV/AIDS programme • Revised the guideline on HIV sentinel surveillance and assist in the implementation of HIV sentinel surveillance 2. Scope of work and major results planned for 2010-2011 (by SO component): Malaria: • All 13 district health staff trained in vector surveillance and control • 60 % health facilities have reliable malaria laboratory diagnosis (Microscopy or RDT) • One laboratory in each district established for quality assurance of malaria microscopy. Tuberculosis • Expand and strengthen quality assured delivery of prevention, treatment and care services for TB with high laboratory services, improved supply management of drugs and enhanced supervision, monitoring and evaluation. • Strengthen surveillance by linking to integrated disease surveillance and Health Management and Information System (HMIS). HIV/AIDS/STIs • Expand and strengthen quality assured delivery of prevention, treatment and care services for HIV/AIDS and STIs with high laboratory services, improved supply management of drugs and enhanced supervision, monitoring and evaluation. • Strengthen surveillance by linking to integrated disease surveillance and Health Management and Information System (HMIS). SEA/SPPDM-Meet.2/2.3 Page 103 3. How the scope and results are related to the Country Cooperation Strategy: In relation to Timor-Leste CCS, prevention of communicable disease and surveillance is one of the priorities indicated in Strategic Agenda 2. 4. Budget information for the Strategic Objective (in USD thousands) PB 2008-2009 PB 2010-2011 SO Component AC VC planned VC actual* AC VC Guidelines, policies and strategies including approaches to increase coverage 0 0 0 Policies and technical support to improve delivery of programmes including labs and integration with other programmes 68 1,719 1,299 Guidance and technical support for access to medicines, diagnostic tools and health technology 0 0 0 Surveillance, monitoring and evaluation 0 0 0 Advocacy, political commitment and resource mobilization 0 40 0 New knowledge, intervention tools and strategies developed 0 0 0 TOTAL 68 1,759 1,299 68 1,718 Breakdown by programmes HIV/AIDS Tuberculosis Malaria TOTAL *Available as of 15 May 2009 5. Possible VC funding through new or continuing projects: VC funds will be received through the GFTAM programme with the total of USD 1,200,000.00 which covers salaries for: 2 TIPs for Malaria and TB for 2 years and 1 TIP will be recruited using funds from UN HIV/AIDS team in Timor-Leste. 6. Staff requirements for 2010-2011 (short and long-term): Core staff: • National Professional Officer for SO1 and SO2 • One 24 person months TIP for Malaria funded using funds from GFTAM • One 24 person months TIP for TB funded using funds from GFTAM • One 12 person months TIP HIV/AIDS funded by UN Country team on HIV/AIDS SEA/SPPDM-Meet.2/2.3 Page 104