The TB TEchnical Assistance Mechanism (TBTEAM)
Overview
With a high-quality, well organized network of technical partners, countries could more easily implement the Stop TB Strategy, move closer to the achievement of the 2015 Millennium Development Goals and make most effective use of Global Fund and other external resources. Created by the Stop TB Partners in 2007, TBTEAM (the TB TEchnical Assistance Mechanism) helps all stakeholders that implement TB control activities (e.g. NTP, NGOs, CBOs, FBOs, patients groups, etc.) access such a network of technical partners and well-coordinated technical assistance (TA) through the following, four-pronged approach:
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It facilitates access to assistance by gathering and publicizing current information about country needs and helps countries find the most appropriate TA provider for a given request. Where countries are unable to finance needed assistance, TBTEAM helps match their needs with existing sources of funding. It supports the rational use of human and financial resources, sharing a global overview of the TA activities that are planned, in progress or have been completed. TBTEAM makes it easier for countries to plan activities that are well coordinated with ongoing work and for partners to design assistance that builds on work already done or leverages synergies with planned work. It encourages high-quality impact of assistance to countries by advocating that all providers adhere to internationally-accepted standards for TB control and care and by assessing the quality of assistance once a mission has been completed. It promotes capacity in countries by facilitating planning for TA, thus reducing redundant assistance, and makes it possible for partners to build their capacity by subsidizing, where appropriate, the costs of assistance.
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3.
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In addition to its support staff, TBTEAM offers a platform of Tools1 to make it easier for partners to deliver and receive quality assistance, including tools for tracking missions and training opportunities around the world, a roster of experts who are available to help, and a directory of technical partners in each country of the world. Countries may apply for TA through standard WHO channels, by submitting requests to country offices, or through TBTEAM focal points.
Structure
TBTEAM operates at global, regional and national level. Global/Central TBTEAM complements Regional and National TBTEAM, which take the lead on partner coordination, TA planning and identification of funding for TA. Where a National Partnership or similar collaborative entity exists, National TBTEAM functions as a mechanism for TA coordination among these partners.
Activities
Since the beginning of 2008, TBTEAM has provided support to partners implementing TB control in countries through more than 100 missions to help improve patient care and the implementation of National TB Program activities. It has also financed and planned 1,000,000 US$ of TA to nearly 100 countries in order to assist with the preparation of proposals to the Global Fund to Fight AIDS, Tuberculosis and Malaria or to build the country capacity to implement grants.
1
To achieve the objectives, TBTEAM promotes the use of these web-based tools (http://extranet.who.int/tbteam): Stop TB missions and events including open requests for assistance Stop TB experts Stop TB partner mapping
May 2009
Stop TB Partners under TBTEAM have proven effective in supporting development of successful Global Fund proposals and supported the highest success in implementation of Global Fund projects. The Global Fund analysis of Performance-Based Funding for Health states, "TB programs … performed particularly well …, probably as a result of the important support of the STB Partnership in coordinating partner roles clearly and providing a full package of managerial as well as technical assistance.… Such support is not just needed when problems arise".2 Following recommendations made in an external assessment conducted in October 2008, TBTEAM has begun to undertake a number of activities to improve the impact/effectiveness of TBTEAM: 1) Increased information-sharing among stakeholders: TBTEAM focal points’ use of the Tools has increased substantially since its inception (see below). New partners have also recently established focal points, further contributing to the increase in mission entry and helping TBTEAM move closer to a comprehensive mapping of global TA mission activity. a. Since 2007, 1172 missions and events have been entered into the Tools, with a significant increase in 2009 thus far. To date, 425 entries have been made in 2009 (quarters 1 and 2) as opposed to 457 in all of 2008. Of 110 requests for assistance (“open requests”) made directly to TBTEAM, to date 101 have been successfully addressed. b. TBTEAM is in the process of developing new software to further improve coordination and information-sharing among stakeholders.
TBTEAM Tools Usage 2007 – 2009
Number of Missions/Events Added by Each User Account
2007
2008
2009
Secretariat GLRA UNDP EMRO
GDF TBCAP Civil society SEARO
GLC ATS Infection control WPRO
KNCV PATH Project Hope EURO
ACSM Damien PAL AFRO
Union HSI AMRO
2) Country capacity-building: Central-level TBTEAM has attended NTP manager meetings in the African and Western Pacific regions to strengthen/formalize National TBTEAM, comprised of both public sector and non-governmental sector actors. National TBTEAMs will discuss and create a TA plan, in line with the National TB Plan, which will help to identify quality experts and organize funding in a timely manner. 3) Mission expert quality assessment: The quality assessments will allow countries to evaluate technical assistance providers and ensure that experts meet an acceptable standard of quality. 4) Expert capacity/training: A mentoring program is intended to help enlarge the pool of high-quality experts by coupling junior professionals with more experienced consultants on country missions.
Challenges
In order to have a full picture of global TA provision and country needs TBTEAM would require greater internal capacity and collaboration with partners to gather and share information surrounding TA activities. For more information on TBTEAM, please contact us at tbteam@who.int.
2
Daniel Low-Beer, Houtan Afkhami, Ryiuchi Komatsu, Prerna Banati, Mosuke Sempala, Itamar Katz, John Cutler, Paul Schumacher, Ronald Tran-Ba-Huy, Bernard Schwartländer. Making Performance-Based Funding Work for Health. PLos Medicine. August 2007. Volume 4. Issue 8. e219. 1308-1311.
May 2009
Global Fund TB proposals, Round 9
TBTEAM has recorded 59 countries to apply for TB in Round 9 of the Global Fund. Following the Global Fund Board decision taken at the November 2008 Board meeting, we all need to ensure that countries respond to the challenge to prepare robust and sound TB proposals that will enable us collectively to reach the Stop TB Partnership targets set out in the Global Plan to Stop TB 2006-2015. Weaknesses observed in previous proposals were poor description of linkages between all components of the Stop TB Strategy and budget requests. The other weaknesses are to address robustly and with ambition the needs posed by the emergence of drug resistant TB including adequate laboratory facilities and infection control measures. All countries are being supported directly by Stop TB partners to facilitate proposal preparation and partnership building in countries. In addition, partners will facilitate proper planning in areas such as laboratory strengthening, management of MDR-TB, infection control, and to ensure that the involvement of all care providers are sufficiently addressed. In addition to the Round 8 proposal resubmission workshop held in November 2008, the following proposal finalization workshops are being organized by WHO to support the finalization of proposals with country teams and external assistance.
Africa, Anglophone Africa, francophone Eastern Mediterranean Americas South East Asia 17-19 March, Nairobi 30 March - 4 April, Ouagadougou 5-9 April, Cairo 5-9 May, Bogota 4-8 May, New Delhi
Stop TB Planning Matrix and Frameworks
Countries are encouraged to refer to the Stop TB Planning Matrix and Frameworks. This tool was developed by Stop TB Department, World Health Organization, to guide TB proposal development and TB mid-term strategic planning according to the 6 objectives and the 20 sub-components of the Stop TB Strategy, also called Service Delivery Areas (SDAs). Planning starts with a situational analysis to identify progress to date and remaining major challenges/gaps in implementation; definition of targets to be achieved within five years; and definition of the objectives and associated main activities that need to be implemented to achieve the targets based on the R9 Stop TB Planning Matrix and Frameworks.
Involving all stakeholders
All stakeholders (NTP, civil society, private sector, donors, international NGOs) that implement TB control activities should be systematically involved in planning and ensuring sufficient funding (through Global Fund or other sources) for all implementing bodies. TB proposals could consider including capacity building activities for civil society organizations (NGO, CBOs, FBOs, etc.) who are involved in health-related activities at community level.
Preparing budgets
There are two tools available for budgeting R9 TB proposals: the WHO TB Planning and Budgeting Tool and the Global Fund budget template. The Stop TB Planning and Budgeting tool helps to cost a TB proposal or a TB midterm strategic plan, and identify financial gaps. The Stop TB Planning and Budgeting Tool should be used following a situational analysis to identify progress to date and remaining major challenges/gaps in implementation; definition of targets to be achieved within five years; and definition of the objectives and associated main activities that need to be to be implemented to achieve the targets based on the Stop TB Planning Matrix and Frameworks. The Stop TB Planning and Budgeting tool is fully in line with the Stop TB Planning Matrix and Frameworks. It also provides the possibility of identifying the funding source of activities and will provide reports that break down the budget according to the categories used by the Global Fund. The Global Fund budget template is an empty template designed to present a detailed budget for the unfunded components of a national strategic plan to the Global Fund. The TRP is familiar with this simple template. Countries using the WHO Stop TB Planning and Budgeting tool should use this work as the basis for identifying the inputs/activities that still need to be funded, and then enter the relevant budget data into the Global Fund template.
To access the tools and guidance: http://www.who.int/tb/dots/planningframeworks/en/index.html May 2009