Dr EdliraShara General Coordinator of GF Project Implementation Unit

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Dr EdliraShara General Coordinator of GF Project Implementation Unit Powered By Docstoc
					10 August 2007
Our ref: EECA/AT/253 -10/08/2007


Dr Edlira Shara
General Coordinator of GF Project Implementation Unit
Institute of Public Health
Aleksander Moisiu Street, 80
Tirana
Republic of Albania


Program Grant Agreement Number ALB-506-G02-T
Implementation Letter Number 3


Dear Dr Edlira Shara,

We are referring to the Program Grant Agreement between The Global Fund to Fight AIDS,
Tuberculosis and Malaria ("Global Fund") and the Institute of Public Health of the Republic of
Albania ("Principal Recipient"), with respect to the program entitled "Scaling-up the National
Response to Tuberculosis" effective 20 October 2006 and amended by letters dated 1 February
2007 and 11 April 2007 ("Grant Agreement"). Capitalized terms used but not defined in this letter
have the meaning given to them in the Grant Agreement.

      By signing this implementation letter, the Global Fund and the Principal Recipient agree to
amend the Grant Agreement by:

       (1)      replacing Attachment 1 & 2 to Annex A of the Grant agreement with the document
                of the same title that is attached to this letter;

       (2)      replacing Section E of Annex A              the Grant Agreement with the following:

                "E.      ANTICIPATED DISBURSEMENT SCHEDULE

                For the purposes of Article 10a. of the Standard Terms and Conditions of this
                Agreement, the anticipated disbursement schedule for the Program shall be
                quarterly starting from the Phase 1 Starting Date. The due dates for submission of
                disbursement requests are specified in Attachment 1 & 2 to this Annex A.

                For the purposes of Article 15(b)i. of the Standard Terms and Conditions of this
                Agreement, the Program shall have a quarterly reporting period with the defined
                periods and the due dates for submission of progress updates specified in
                Attachment 1 & 2 to this Annex A.";




                                 Chemin de Blandonnet 8, 1214 Vernier, Geneva -Switzerland
             Tel: +41 (0)22 791 1700 Fax: +41 (0)22 791 1701 - www.theglobalfund.org - info@theglobalfund.org
        (3)     replacing Section F of Annex A of the Grant Agreement with the following:

                "F.      PROGRAM BUDGET

                "The budget contained in Attachment 1 & 2 sets out anticipated expenditures for
                the Program Term (as defined in subsection (a) of Article 3 of the Standard Terms
                and Conditions of this Agreement).";

        (4)    amending Block 13 of the face sheet of the Grant Agreement as follows:

               Name:          Dr. Edlira Shara
               Title:         General Coordinator of GF Project Implementation Unit
               Address:       Institute of Public Health
                              Aleksander Moisiu Street, 80
                              Tirana, Republic of Albania
               Tel:           + 3554 374756
               Fax:           + 355 4 370058
               E-mail:        elda.sharra@gmail.com; and


        (5)    amending block 4A the face sheet of the Grant Agreement by updating as follows:
               Modification Number and Date: No.3 (Implementation letter dated 10 August
               2007).

        The face sheet of the Grant Agreement, as amended, is attached.

        Except as modified herein, the Grant Agreement remains in full force and effect.

       This amendment shall come into force on the date of signature of this letter by both parties.
Please confirm your agreement with the foregoing by signing both enclosed copies of this letter
and returning one to us, retaining one copy for your records.

       We thank you and your partners for undertaking this important effort in the global fight
against tuberculosis. We look forward to the successful implementation of the Program.


Yours sincerely,



                                                                                      2
Ndsa Orobaton, MD, DrPH, MBA
Director of Operations


Ag reed and sig ned:


For:    INSTITUTE OF PUBLIC HEALTH~.¢J:~J;JV1;~Nt~J~RYOF HEALTH


By:
        AuthOWorized ~epresen(ative: Dr. EdHfa shar~;"it~~~fai toordinator of GF Project
        Imple entation Unit, Institute of F?tabUc He·attl+ofth~i~lnistry of Health


Date:
Attachment:   Face Sheet of the Grant Agreement, as amended
              Attachment 1 & 2 to Annex A of the Grant Agreement, as amended
              Annex A of the Grant Agreement, as amended

cc:           Mr. Maksim Cikuli, Chair of Country Coordinating Mechanism
              Ms. Iva Todorova, KPMG Albania - Local Fund Agent
                                 PROGRAM GRANT AGREEMENT

1.    Country: Republic of Albania

2.   Principal Recipient Name and address: Institute of Public Health, Aleksander Moisiu Str, 80, Tirana,
Republic of Albania

3.    Program Title: Scaling-up the National Response to Tuberculosis

4.    Grant Number: ALB-506-G02-T                         4A. Modification Number: 03
                                                               (Implementation letter dated 10 August 2007)
5. Phase 1 Starting Date:               6. Phase 1 Ending Date:              7. Phase 2 Ending Date:
1 April 2007                            31 March 2009                        31 March 2012
7A. Condition Precedent Terminal        7B. Condition Precedent Terminal     7C. Condition Precedent Terminal
Date: 1 October 2006                    Date: 15 May 2007                    Date: 15 May 2007

7D. Condition Precedent Terminal        7E. Condition Precedent Terminal      7F. Condition Precedent Terminal
Date: 15 May 2007                       Date:                                 Date:

8.    Grant Funds: US$ 776,298 (Seven Hundred Seventy-Six Thousand Two Hundred and Ninety-Eight United
States Dollars)

9.    Program Coverage: Tuberculosis

10.




11. The fiscal year of the Principal Recipient is from 1 January to 31 December.

12. Local Fund Agent ("LFA"): KPMG
    Deshmoret e 4 Shkurtit Street, 8264 Tirana, Albania
    Tel: + 355 (4) 235532
    Attention: Mr. Gene Boga
    E-mail: gboga@kpmg.al

13. Narne/Address for Notices to Principal Recipient       14. Name/Address for Notices to Global Fund:

Dr. Edlira Shara                                           Dr. Urban Weber
General Coordinator of GF Project Implementation Unit      Eastern Europe and Central Asia
Aleksander Moisiu Str, 80,                                 Chemin de Blandonnet 6-8
Tirana, Republic of Albania                                1214 Vernier-Geneva, Switzerland
Tel: + 355 4 374756; Fax: + 355 4 370058                   Tel.: +4422 791 1700          Fax: +41 22 791 1701
E-mail: elda.sharra@gmail.com


This Agreement consists of the two pages of this face sheet and the following:
Standard Terms and Conditions                         Annex A - Program Implementation Description
                       ANNEX A to the PROGRAM GRANT AGREEMENT

                              Program Implementation Description

Country:                Albania

Proposal Name:          SCALING UP THE NATIONAL RESPONSE TO TUBERCULOSIS

Proposal Number:        72

Program Title:          SCALING UP THE NATIONAL RESPONSE TO TUBERCULOSIS

Grant Number:           ALB-506-G02-T

Disease:                Tuberculosis

Principal Recipient:    Institute of Public Health




A.     PROGRAM DESCRIPTION

1.     Background and Summary

In 2004, the reported tuberculosis (TB) incidence in Albania was 20/100,000. However, it is
likely that this figure underestimates the incidence of TB in poor rural areas and among
selected vulnerable groups.

Albania's national strategy for TB control is based on the World Health Organisation (WHO)
recommended DOTS strategy for TB control. In 2000, the National TB Program (NTP) and
the laboratory network were officially established with financing from the Albanian
Government. Programmatic indicators, such as low case detection rate and delayed diagnosis,
showed some critical gaps that needed to be addressed. The funds available in-country do not
support the implementation of key activities to cover these gaps. Closing the financial gap is
the reason for applying to the Global Fund.

2.     Goal:

To reduce the burden of TB in Albania to such an extent that it no longer constitutes a public
health problem.

3.     Target Group/Beneficiaries:
The most affected populations include:
  • Poor people living in the Northern and North-Eastern areas of the country, or
     people migrating from these areas;
  • Ethnic minority Roma population;
  • Prisoners;
  • Immigrant workers with little access to health services abroad; and
  • Unemployed youth population.

4.       Strategies:

     8   Strengthening the health systems for better TB control;
     8   Expanding and maintaining 100% DOTS coverage;
     8   Ensuring access to DOTS to vulnerable groups;
     8   Prevention of TB/HIV co-infection;
     8   Improving control of drug resistance.

5.       Planned Activities:

     8   Undertaking health promotion and patient education activities amongst targeted
         vulnerable groups;
     8   Strengthening the central and district DOTS coordination units;
     8   Strengthening the role of GPs and nurses as focal points in TB control;
     8   Training and building the capacity of health staff and services;
     8   Strengthening the DOTS recording and reporting system;
     8   Developing a surveillance system for TB;
     8   Expanding the network of quality assured laboratories;
     8   Improving and expanding TB drug resistance surveillance;
     8   Ensuring the regular supply of quality drugs to treat TB;
     8   Improving case detection in in selected groups;
     8   Rehabilitating and refurbishing health care facilities and laboratories;
     8   Purchasing laboratory equipment and supplies for drug resistance surveillance
         (DRS);
     •   Undertaking TB/HIV collaborative activities


B.       CONDITIONS PRECEDENT TO DISBURSEMENT

1.     Condition(s) Precedent to First Disbursement (Terminal Date as stated in block 7A of
the Face Sheet)

The first disbursement of Grant funds is subject to the satisfaction of each of the following conditions:

        a.       the delivery by the Principal Recipient to the Global Fund of a statement confirming
the details of a separate bank account into which the Grant funds will be disbursed as indicated in
block 10 of the face sheet of this Agreement;

       b.     the delivery by the Principal Recipient to the Global Fund of a letter signed by the
Authorized Representative of the Principal Recipient setting forth the name, title and authenticated




                                                                                                        2
specimen signature of each person authorized to sign disbursement requests under Article 10 of the
Standard Terms and Conditions of this Agreement and, in the event a disbursement request may be
signed by more than one person, the conditions under which each may sign; and

        c.       the delivery by the Principal Recipient to the Global Fund of evidence, in form and
substance satisfactory to the Global Fund, that the Principal Recipient has conducted a capacity
assessment of the Program Implementation Unit (Pill), and published advertisements for any
positions that need to be filled within the following functional areas of the PIU to enable the Principal
Recipient to comply with its obligations under this Agreement:
        1.       Program management and administration;
        2.       Financial management and accounting;
        3.       Procurement and supply management; and
        4.       Monitoring and evaluation.


2. Condition(s) Precedent to Second Disbursement (Terminal Date as stated in block 7B of the
Face Sheet)

The second disbursement of Grant funds is subject to the satisfaction of each of the following
conditions:

         a.      delivery by the Principal Recipient to the Global Fund of an operations manual, in
form and substance satisfactory to the Global Fund, that specifies policies and procedures for:
         1.      Program management (including Sub-recipient programmatic management);
         2.      Financial management and accounting (including Sub-recipient financial
                 management and accounting); and
        3.       Monitoring and evaluation (including monitoring and evaluation of Sub-recipients);
and
        b.       the delivery by the Principal Recipient to the Global Fund of evidence, in form and
substance satisfactory to the Global Fund, that the Principal Recipient has strengthened the capacity of
the PIU by hiring a sufficient number of persons with appropriate qualifications and experience to fill
positions in the following functional areas so as to enable the Principal Recipient to comply with its
obligations under this Agreement:
         1.      Program management and administration;
        2.       Financial management and accounting;
        3.       Procurement and supply management; and
        4.       Monitoring and evaluation.


3. Condition(s) Precedent to Disbursement to Sub-Recipients (Terminal Date as stated in block
7C of the Face Sheet)

The disbursement by the Principal Recipient of Grant funds to Sub-Recipients is subject to the
satisfaction of each of the following conditions:

        a. the delivery by the Principal Recipient to the Global Fund of evidence, in a form and
substance satisfactory to the Global Fund, that the Principal Recipient has complied with Article 14(a)
of the Standard Terms and Conditions of this Agreement in the assessment and selection of Sub-
Recipients; and

       b. the delivery by the Principal Recipient to the Global Fund of a copy of the Principal
Recipient's standard grant agreement with Sub-recipients.




                                                                                                       3
3. Condition(s) Precedent to Disbursement for Procurement of Health Products (as defined in
Article 19 of the Standard Terms and Conditions) (Terminal Date as stated in block 7D of the
Face Sheet)

The disbursement by the Global Fund or use by the Principal Recipient of Grant funds to finance the
procurement of Health Products (as defined in Article 19 of the Standard Terms and Conditions of
this Agreement), is subject to the following conditions:

        a.      the delivery by the Principal Recipient to the Global Fund of a plan for the
procurement, use and supply management of the Health Products for the Program as described in
subsection (c) of Article 19 of the Standard Terms and Conditions of this Agreement (the "PSM
Plan"); and

        b.      the written approval of the Global Fund of the PSM Plan.

C.      SPECIAL TERMS AND CONDITIONS FOR THIS AGREEMENT

In accordance with the Article 12 of the Standard Terms and Conditions of this Agreement entitled
"Taxes and Duties", the Principal Recipient shall ensure that required mechanisms are in place for
obtaining tax exempt status on all goods procured for the Global Fund program.

D.      FORMS APPLICABLE TO THIS AGREEMENT

For purposes of Article 15b(i) of the Standard Terms and Conditions of this Agreement entitled
"Periodic Reports," the Principal Recipient shall use the "On-going Progress Update and
Disbursement Request", available from the Global Fund upon request.

E.      ANTICIPATED DISBURSEMENT SCHEDULE

For the purposes of Article lOa. of the Standard Terms and Conditions of this Agreement, the
anticipated disbursement schedule for the Program shall be quarterly starting from the Phase 1
Starting Date. The due dates for submission of disbursement requests are specified in Attachment 1 &
2 to this Annex A.

For the purposes of Article 15(b)i. of the Standard Terms and Conditions of this Agreement, the
Program shall have a quarterly reporting period with the defined periods and the due dates for
submission of progress updates specified in Attachment 1 & 2 to this Annex A.

F.     PROGRAM BUDGET

The budget included in Attachment t&_2 sets out anticipated expenditures for the Program Term (as
defined in subsection (a) of Article 3 of the Standard Tenus and Conditions of this Agreement).




                                                                                                     4
M&E Attachment to Grant Agreement

Attachment 1 & 2 to Annex A: Indicators, Targets, and Periods Covered


                                    Alb'e<"

                                    ,TB ..    , " .. "   "''''
                                    iALB·506·G07-T
                                                      342    46016    21342   157842   16222    472     472     472    225542   17638    243180
                                          SOA2
                                                      735     3014     578     2152    1534    4252     472     472     6479     6730    13209
                                          SOA1
Objective 2: To ensure and maintain 100%
                                         SOA2        4935    5670     6363    10763    27300   9450    5523    4200    27731    46473    74204
     DOTS coverage in the country
                                                     68932   6930     4042     5986    8032    6930    4042    5986    85890    24990    110880
                                          SOA3
                                                              1680     210     210     7686    5460    5460    5460     2100    24066    26166
                                          SOA1
   Objective 3: To ensure and maintain
                                                              3044                     2232    3702     656     656     3044     7246    10290
  access to DOTS to vulnerable groups     SOA2
                                                             10416    5250     8841                                    24507             24507
                                          SOA3
 Objective 4: To properly manage drug
    resistant cases and control MDR                  1208    3412     1208     3098    5260    1208    1208    1208     8926     8884    17810
                spreading
                                          SOAl
                                  Total              95010   113572   67553   206952   97850   68408   71567   55386   483087   293211   776298




                            Human resources          17808   30335    21116   29579    39092   24255   17598   16693   98838    97638    196476

                      Infrastructure and Equipment   67200   45150    31500   157500   30056   21656   38456   21656   301350   111824   413174

                           Tralning&planning                  1890     840     4253    3045    6930    1154    1156    6983     12285    19268

                          Comodities/products        7980    31080    11655   11655    20013   11655   11655   11655   62370    54978    117348

                               Other costs           2022     5117    2442     3965    5644    3912    2704    4226    13546    16486    30032

                                  Total              95010   113572   67553   206952   97850   68408   71567   55386   483087   293211   776298

				
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