This is the TRP's report regarding a proposal that was reviewed by the Global Fund board at its November 2006 meeting. Because the board has made its decision, this document is no longer confidential, and has been placed in the public domain by Aidspan (www.aidspan.org), an independent watchdog of the Global Fund. This document may only be copied or circulated in its entirety, without alteration.
TRP Review Form - Round 6 Proposal Name Applicant Type Applicant Name Component WHO Region Applicant Funding Request * Expanding and implementing the Stop TB Strategy in Papua New Guinea CCM Country (ies) Papua New Guinea
National Country Coordinating Mechanism Tuberculosis EMRO Year 1 $ 2,225,570 Years included in Proposal Global Fund Cluster Year 2 $ 2,782,342 Phase 1 Total * $ 5,007,912 5 East Asia & Pacific Total over Proposal Term* $ 20,869,303
* This amount represents the Applicant’s maximum funding request for this disease component. The Phase 1
amount (and therefore the total upper ceiling for the Program) may be reduced as a result of the TRP clarification process and/or grant negotiations. Funding requested beyond Phase 1 is subject to the Global Fund’s policy on continuation of grants beyond Phase 1 from time to time.
Country Disease & Income Level Contextual Information • World Bank Classification: Low income • GDP: $2,418 per capita (HDR 2005) • HDI: rank 137 out of 177 countries (HDR 2005) • Total population: 5,670,544 (World Fact Book) • Land mass area is 461,691 square kilometers with the mainland making up 85% and approximately 600 smaller islands constituting the remaining 15%. Administratively, the country has 20 provinces and 87 districts. • More than 750 languages are spoken, translated into as many different cultures. Brief description/summary of Component Proposal • In 2004 13,394 TB cases were detected (229 per 100,000 people notification rate) with 1,896 new smear positive cases (33 per 100,000 people). The estimated number of TB cases is 13,455 (case detection rate 95% for all forms) and 6,025 new smear positive cases (315 case detection rate). • This proposal is a resubmission of the Round 5 proposal which was not recommended for funding (Category 3). The goal of the proposal is to reduce prevalence and death rates due to tuberculosis in Papua New Guinea by implementing 4 objectives and 10 different service delivery areas. The objectives are: o To achieve high quality expansion and implementation of DOTS in order to increase the DOTS coverage rate to at least 80%, case detection rate to at least 70% and treatment success rate to at least 85% - in 66 out of the 87 districts by Year 5 o To address the challenge of TB/HIV co-infection by implementing collaborative TB/HIV activities - in 16 major districts (which account for 30% of the population) by Year 5 o To assess the MDR-TB situation in 2 major provinces (which account for 16% of the population) in Years 3-4 o To contribute to the health systems strengthening (HSS) in 66 out of the 87 districts (which account for 80% of the population) by Year 5. It aims to implement the DOTS strategy “package” through a phased approach, and address the new components of the STOP TB strategy (MDR TB, TB/HIV, strengthening health systems, empower patients and communities) in a reasonable and feasible manner. The Principal Recipient (PR) is the National Department of Health. •
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This is a strong proposal which is recommended for funding in Category 1. The sustainability of the proposal needs to be ensured by the end of year 5, through increased domestic funding, mainly for the human resources (HR) component. This component is due to increase over the 5 year project life, representing 22% of the overall budget, but the present proposal does not articulate how HR sustainability will be assured.
Strengths
Weaknesses
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High political commitment – in 2006, the MoH reprioritized TB as a tier-one priority in the in the Medium Term Expenditure Framework and the Strategic Plan for the PNG Health Sector (2006-2008). The proposal is based on the country’s strategic Plan to STOP TB (2006-2010) (based on the Global and Regional Plans to STOP TB). The proposal is a resubmission of the proposal rejected in Round 5 and addresses in detail all the weaknesses identified by TRP. The proposal is very well written and justified including clear descriptions of the national health system, disease control initiatives, epidemiological situation, identification of constraints and gender issues. Very good programmatic and financial needs assessment – with budget based on the 5 year costing done for the Country strategic Plan to STOP TB. The activities proposed are linked with the proposed indicators, very clearly described and justified. Very good community based activities, using the pre-existing structures. Clear and detailed plan for monitoring and evaluation (M&E) and a very good plan for procurement and distribution of drugs. Excellent and extremely detailed budget and work plan.
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Recommendation (Insert Numerical digit in right hand column) Category 1: Recommended for approval without changes (no or minor clarifications) Category 2: Recommended for approval provided clarifications or adjustments are submitted within a limited timeframe Category 3: Not recommended for approval in its present form but encouraged to resubmit following major revision Category 4: Rejected
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Specific issues to be clarified or adjusted (Category 1 and 2 only):
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