TB REACH TB REACH. A new funding source for TB case detection

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A new funding source for TB case detection

Background Only 61% case detection in 2008 Large and persistent gap in case detection 3.7 million cases undetected in 2008 Important to develop and implement new ways of detecting more TB cases and that too early

What is? Funding initiative for early and increased case detection Promotes innovative interventions/approaches Rounds-based funding, US$ 0.5 to 1 M per year (smaller budgets could be considered if justified) Targeting populations with limited access to health services in eligible countries One or multiple applications from eligible countries from NTP, MoH, other ministries, NGOs, FBOs Applicant should have in-country presence Letter of support from NTP

Target countries Poor countries Eligibility criteria Countries with low case detection Target populations Population with limited access to TB services Targeted budget Cost per additional ss+ treatment success under US$350 (could be higher in certain settings, e.g. high HIV setting)

Eligible countries for first round Countries with GNI per capita US$2000 Further prioritization of countries with GNI per capita US$1000 (at least 70% projects in such countries) Source World Bank 2008 GNI figures Countries with low case detection Case detection (new ss+) 70% Source WHO TME Other HBCs to be considered on a case-to-case basis applicants to discuss with secretariat

Criteria for "limited access to TB services" At least 70% of the target population for each project should fall under the criteria of "limited access to TB services". Definition of "limited access to TB services" for first call for proposals developed (downloadable from website)

Summary of eligible countries Criteria A. Countries eligible by the criteria of GNI per capita 2000 or less B. Of A. those with best estimate of CDR 70% or less No. of countries 68 60 No. of HBCs 16 16 C. Of B. break up by WHO Region AMR AFR SEA WPR EUR EMR 2 34 6 7 3 8 60 0 8 3 3 0 2 16

List of eligible countries (60) Afghanistan Eritrea Madagascar Senegal Bangladesh Ethiopia Malawi Sierra Leone Benin Gambia Mali Solomon Islands Bhutan Ghana Mauritania Somalia Burkina Faso Guinea Mongolia Sudan Burundi Guinea-Bissau Mozambique Tajikistan Cambodia Guyana Myanmar Togo Central African Republic Haiti Nepal Uganda Chad India Niger United Republic of Tanzania Comoros Iraq Nigeria Uzbekistan Congo Kenya Pakistan Viet Nam Côte d'ivoire Kyrgyzstan Papua New Guinea West Bank and Gaza Strip Democratic People's Republic of Korea Lao People's Democratic Republic Philippines Yemen Democratic Republic of the Congo Lesotho Rwanda Zambia Djibouti Liberia Sao Tome and Principe Zimbabwe

structure Implemented by TBP Guided by Programme Steering Group (PSG) 1 st meeting held on 15 Jan 2010 Proposals selected by Proposal Review Committee (PSC) Monitoring by an M&E agency (to be selected)

First call for proposals Open 25 January 2010. Closing date 5 March 2010. Initial screening by secretariat Proposals review by PRC - 16 to 19 March 2010. Successful applicants announced in April 2010 Start of individual project activities June to Aug 2010

Examples of suitable projects Contact investigation - household/workplace/ other risk groups Screening of clinical risk groups people people living with HIV (intensified TB case finding among people with HIV), diabetics, malnourished, smokers, previous TB patients Screening of vulnerable and at-risk population groups E.g. urban slum-dwellers, homeless, elderly, migrants, prison inmates, certain workplace settings Intensified TB screening in health facilities Innovative approaches for involving private sector health care providers Innovations in sputum collection and transportation to the laboratory; strengthening and optimizing smear microscopy services Improved referral, transfer and tracking systems for suspected TB cases and patients especially in urban settings and in large hospitals Innovative ACSM approaches for early diagnosis and treatment seeking Interventions already proven to detect additional TB cases in a cost-efficient and timely manner

Proposal grading and selection for funding Proposal review committee in place (9 members) Meeting 16-19 March 2010 Grading of proposals based on: Criteria related to technical issues, cost effectiveness, feasibility, sustainability and impact Proposals graded into four categories: Category-1 can be funded immediately and Category-2 upon receiving clarifications

M&E Establishment of baseline case detection figures and indicators For target areas and comparator areas Reported by applicant in application form Validation by M&E agency at the start of the project Mid-term (months 3 and 9) and annual (month 12-15) reporting by grantee Technical report and financial report Monitoring of the reported achievements against activities in the respective workplan and expected outcomes Evaluation of the project by the independent M&E agency 12-15 months after first disbursement Second year funding based on results of first year

Thanks