Objectives for the Annual TBTEAM Meeting

1. Examine why the Global TBTEAM data base is effective in coordinating TA at country level– Review and explore reasons for TBTEAM TA trends and action to address these.

– Understand the importance of entering (and uploading) missions, updates, mission reports, experts.

– Explain the quarterly feedback mechanism and possible uses by partners of the database for management.

2. Understand the key elements of a National TB Strategic Plans (NSP) with comprehensive Technical Assistance Plans. – Review Global Fund TA plan strategies: How to compromise

3. Understand the grant renewal processes and importance for funding and reprogramming.– Review the provision of TA tailored to the Global Fund cycle – providing effective TA – Review the evidence linking TA to global fund grant performance.

1) Progress to date

Annual TBTEAM meeting20 - 21 June 2012

Geneva, Switzerland

Outline of the presentation

1) Progress since the last Annual TBTEAM meeting• TBTEAM strategic objectives – Country capacity building to develop TA plans

strategic plans– Global Fund: informing provision of quality TA

• Achievements & successes2) TBTEAM website trends• How can we improve/disccussion points

TBTEAM's strategyObjective 1: To strengthen the capacity of NTPs to better plan the TA needs and establish a platform to coordinate TA among relevant partners (including for GF supported activities)

National Capacity building to ensure TA is country driven– Recruit and train National TBTEAM coordinators/ focal persons– Develop annual technical assistance plans – Engaging with all technical partners & donors and the NTP in the driving seat.– based on updated strategic plans and external reviews.

Objective 2: To provide strategic and systematic analysis of GF grant performance, technical area priorities and available TA funding to inform the provision of quality TA

TA supporting Global Fund processesRaise it: Support to Round 11 and subsequently TFM processesSpend it well: removal of bottlenecks CPs and implementation of programme. Fullfilling performance framework objectivesRetain it: Support to phase 2 renewal processes with consultants, conference calls and a Pre phase 2 implementation workshops

Achievements• Development of technical assistance plans and strategic plans

supported through:1. Regional workshops (AFR, EMR, SEAR to date planned in EUR, AMR,

WPR)2. Direct country technical assistance provision (also developed and

updated as a result of Round 11 preparations)3. Monitoring by sharing of TA (32) and strategic plans (28) on TBTEAM

website• TA planning framework disseminated• Online training of 53 country TBTEAM coordinators on the first

TBTEAM Module : Education on TBTEAM (resulting in more knowledge, increased website use, advanced TA planning

• Framework on guidance to strategic plan review (in process and results from regional workshops)

Example: Consultant to a country to help with R11, but after it was canceled, country took the opportunity to have the consultant expand the plan into an NSP.

Successes• TBTEAM and Global Fund every Thursday to discuss issues related to Global

Fund grant implementation, including upcoming grant renewals.• This approach is improving communications at all levels relieving

bottleneck implementation, securing disbursements to countries and avoiding drug stock outs.

Results:

GF grant disbursements being rapidly processed following clarification of information provided by the country or the provision of required plans (e.g. MDR scale up plan);

First and/or second line drug orders being processed after clarification of quantifications or other requirements for the GF to make a direct disbursement;

Development of TA plans and missions being conducted in support of grant implementation;

Joint GF and partner missions and submission of sound requests for phase 2 continued funding.

Plans to address difficulties in Round 10 grant signing.

Round 11 preparation: • consultant workshop in Geneva• consultant and country webinars on technical areas• regional preparatory workshops AMRO EMRO SEARO AFRO

• Teleconference calls & TA provision to 16 priority countries TFM preparation (21 countries):• regular webinar calls• consultants continued in countries already supported• Desktop reviews offered to all• Mock review workshop• Collaboration through: Global, consultants, Regional staff

Global fund: support in raising new funding

www.stoptb.org/countries/tbteamtbteam@who.int

• 60 countries expressed interest to apply for round 11 TB.• 21 countries applied to TFM/TB

requesting 130 million US (20% of a total of 615 million for all three diseases)• This is 1/3rd less per country/year on

average than in round 10. Only essentials were covered.• TRP is meeting this week to review

Result

Global Fund grant support: spend it well and retain it (Phase 2 renewals)

TBTEAM has– Supported countries successful round 10 grant negotiations.– Regular weekly face to face contact with GF portfolio

managers to discuss performance, bottlenecks as identified– Teleconference calls with country and regional TBTEAM

partners to discuss grant TA needs– Better prepare for renewals– Provide TA to countries in support of Phase 2 CCM

applications– Support to Reviews and Strategic plan updates synchronized

with Phase 2 renewals. (Nigeria and Lesotho)– Workshops for countries in Phase 1 (Harare 19 countries)– WHO representation through STB & Partnership attendance

on the Phase II panel giving increased input

2) TBTEAM TrendsThe global picture

Coordination

Collaboration

Global trends in tuberculosis missionsBy purpose by end of 2011

• 2938 completed missions • The number of events entered peaked in 2009 (at

around 66 missions per month) and by 2011 this has fallen back to 50 missions per month.

• For technical areas such as MDR/XDR TB and laboratory capacity strengthening, mission numbers peaked in 2010.

• Paediatric TB, and operational and basic science research and infection control, show a recent continuing upward trend.

2007 2008 2009 2010 2011MDR-TB / XDR-TB 7 36 119 129 85Drug and commodities management 61 75 89 68 52Global Fund grant negociation processes

implementation 6 75 86 69 68

TB programme planning and review / regional meetings 12 45 75 104 62Laboratory strengthening 3 16 52 77 52M&E/supervision/ impact measurement 3 22 46 62 62Human Resources Development 1 19 27 39 23ASCM & Partnering/Political commitment 3 7 33 30 30Infection control 3 26 34 35TB/HIV 3 15 13 17 27PPM, ISTC 3 13 10 2 7Operational and basic science research 4 9 17 28PAL 2 6 11 11 6Childhood TB 3 4 7Others 210 133 196 103 50

0100200300400500600700800900

Global trends in tuberculosis technical support missions by subject area : 2007 to 2011

SOURCE: TBTEAM website database

Global trends in tuberculosis missionsBy partners

• The major contributors to the TBTEAM database have all had reductions in number of missions between 2009 and 2011

• For KNCV, this fell from 123 to 63 missions/yr • the Union from 100 to 87• the GDF from 86 to 44 • However new partners getting active• CDC, GMS and ICN all increasing in last 2 yrs.Reasons?

How can we improve?

• Why is there a downward trend?• Is there a decrease in TA being provided?• Is there no need?• Are there no funds?• Is restructuring and decentralization affecting

TA?• Misconstrued ideas on sharing reports?• Funding secrets?

2007 2008 2009 2010 2011Others 18 49 89 44 20TBREACH 7 16PATH 1 1 9 4 15Grant Management Solutions Project (GMS) 12 21International Council of Nurses (ICN) 17 17GLI 1 27 7The Global Fund 7 9 8 13 2Damien Foundation 1 2 14 11 14Center for Disease Control and Prevention (CDC) 25 52GLC 2 11 72 64 7National TBTEAM , NTP, WHO country office 7 24 23 55 54WHO/HQ 9 59 33 34 43GDF 65 73 83 61 39KNCV 14 30 123 101 68The Union 48 43 100 112 87WHO REGIONAL TBTEAMS 142 168 240 179 132

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eTrends in numbers of technical mission entered by Partners

on the TBTEAM website 2007 to 2011

Geographical distribution of missionsquantity

• The proportions of missions carried out in the different regions match the burden of disease except

• South East Asia which appears underrepresented• Europe which is over represented. • This is likely due to India which has much internal

TA not captured on the website and the additional focus on laboratory and MDR missions in Europe.

Many missions are Global Fund related

FUNDING SOURCE OF MISSIONS TBTEAM WEBSITE 2011 Q4 % of totalUSG / TBTEAM 25 25%USAID 11 11%GDF Unspecified 10 10%Eli Lilly MDR Partnership 6 6%TBREACH 6 6%GLC / OGAC 5 5%TBCARE 5 5%National Budget / Budget national 1 1%UNITAID 1 1%NA or Blank 16 16%Other, specify / Autres, spécifiez 15 15%TOTAL 101

Mission reports to help inform future missions

• TBTEAM offers an opportunity of ensuring storage and controlled but ready access to previous mission reports by experts/agencies who need them.

• Only 11% of missions resulted in a mission report in 2011. (either confidential or public)

• This is slightly better than in previous years, but nowhere near to what we need to make the TBTEAM website

• There is great variation in partners putting up reports with Project Hope leading with 79% of all their reports on the website.

• Overall only 39 % of USAID/TBTEAM funded missions were uploaded by partners in 2011.

2007 2008 2009 2010 2011 Missions completed 314 469 795 766 594 Reports uploaded 6 13 46 78 67 Percentage 2% 3% 6% 10% 11%

USG / TBTEAM 34 87 39%Global Fund - Fonds Mondial 4 13 31%USAID 6 46 13%NA 4 37 11%TBCARE 2 30 7%Other, specify / Autres, spécifiez 6 100 6%(blank) 6 110 5%GLC / OGAC 2 50 4%Eli Lilly MDR Partnership 2 53 4%GDF Unspecified 1 41 2%Gates Foundation 0 2 0%National Budget / Budget national 0 5 0%TBCAP 0 2 0%TBREACH 0 16 0%UNITAID 0 2 0%Grand Total 67 594 11%

Data for 2011 uploaded reports by completed mission by Funding source

Data for 2011 uploaded reports by completed mission

by PartnerProject Hope 7 9 78%RIT/JATA 4 6 67%WHO/HQ 16 43 37%WHO/WPRO 13 50 26%WHO/CO 8 31 26%WHO/EMRO 5 23 22%PATH 1 15 7%WHO/AMRO 1 17 6%WHO/SEARO 1 18 6%WHO/EURO 1 23 4%The Union 3 87 3%TBREACH 0 16 0%The Global Fund 0 2 0%WHO/AFRO 0 1 0%Grand Total 67 594 11%

Easily see if a mission report exists and accessible through TBTEAM or contact

Next steps

• TBTEAM will provide regular quarterly feedback from data in TBTEAM to partners and donors on TB TA for quality control

• TBTEAM will submit annual data to Global TB report to provide a measure of reported TB TA

• TBTEAM will be more proactive with partners to follow up on TA data entry. (Ideas of improving data on database?)