Thailand experience: process to develop Global Fund TB proposal

1
Thailand experienceprocess to develop Global
Fund TB proposal

• Sirinapha Jittimanee, PhD
• Public Health Officer
• Tuberculosis BureauDepartment of Disease
  ControlMinistry of Health

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Country information

• Population with 63.4 millions
• One of 22 high TB burden countries.
• An estimated 90,000 all TB patients
• 100 DOTS coverage in MOPH hospitals
• 1.6 MDR-TB in new TB patients
• 0.9 of HIV infection
• in pregnant women and
  
• 18 HIV infection in TB pts.
• An estimated 556,848 PHA in 2009
• ART is available at community level

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Global Fund grants

• Round 1 HIV grant, 109 million USD
  (2003-2008)
• Round 1 RCC HIV grant, 98 million USD (2008-2013)
• Round 1 TB grant, 11 million USD
  (2004-2009)
• Round 2 Malaria grant, 6 million USD
  (2005-2010)
• Round 2 HIV grant, 15 million USD
  (2004-2019)
• Round 2 HIV grant (non CCM proposal), 15 million
  USD (2004-2007)
• Round 3 HIV grant, 6 million USD
  (2005-2010)
• Round 6 TB grant, 19 million USD
  (2006-2011)
• Round 7 Malaria grant, 32 million USD
  (2008-2014)
• Round 8 HIV grant, 106 million USD
  (2009-2015)
• Round 8 TB grant, 32 million USD
  (2009-2015)

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Country process to prepare Global Fund proposal

• Programme Review
• National TB Strategy
• Programmatic and financial gap analysis
• Technical areas to be included in proposal
• Decision to apply for Global Fund grant by CCM
• Call for contributions to proposal / potential
  PRs, SRs
• Writing team
• Capacity building
• Technical assistance
• Timeline
• Planning activities
• Budget
• Guiding principles for implementation

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Programme Review and National TB Strategy

• National TB strategy 2006-2010
• Broad direction
• All programme activities in line with strategy
• Multi-stakeholder external review of all TB
  programme activities
• Essential to justify programmatic needs based on
  sound recommendations
• Review report provides concrete direction
• Used as annex to proposal

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Technical areas to be included in proposal

• Based on programmatic gaps identified in
  Programme Review and national TB plan
• Activities that are not covered by other
  financial resources
• Government budget
• Other Global Fund grants
• Other bilateral donors

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CCM structure

• CCM

TB technical advisory group
HIV technical advisory group
Malaria technical advisory group
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Decision to apply to Global Fund

• National TB Programme is the lead
• NTP proposes technical areas to TB technical
  advisory group of the CCM
• TB technical advisory group presents to CCM
• CCM approves
• CCM calls for partners (potential Principal
  Recipients/Sub-Recipients) in public media

9
Capacity building of writing team

• Participation in proposal preparation workshops
• Mentors
• Technical assistance
• Mock review by external experts

10
Writing Team

• PR and SRs represented on writing team
• Lead/dedicated person
• Establish timeline
• Deadlines
• Clear roles and responsibilities
• Technical Assistance
• Useful to dedicate time as huge work
• External view helps flag issues that internally
  we don't see

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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.

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Financial Gap Analysis
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Planning Activities
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Checklist of activities that are needed to
implement components of the Stop TB Strategy ?
Decision on activities based on country
experience, context and feasibility (e.g. scale
up of pilot projects, regional differences)
A matrix tool
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Budget preparation (1)Global Fund template or
modified
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Budget Preparation (2)

• Standard unit cost (training, meetings, printing,
  incentives, computers, etc.) across SRs and
  grants.
• Supporting document for standard price
  (specification, source of information-receipts
  from previous experience)
• Check list for standard budget items Procurement
  fee for 3 of first line drugs and 7 for second
  line drugs Annual GLC fee for 50,000 USD,
  biological follow-up for MDR patients, etc.

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Procurement Preparation

• Country regulations and policies
• Process that PR checks that SRs do all
  procurement according to the rules
• Standard of Procedure drug distribution, drug
  storage, drugs that are expired, etc.
• Specification of heath equipment (digital x-ray
  computers, microscopes, etc.) and reference of
  price from 3-4 companies.

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Performance framework (PF)

• ME tool kit of GFATM
• Matrix tool
• 10-15 indicators

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Technical assistance

• Thailand MOPH-US. CDC Collaboration for
  implementing pilot projects, helping with policy
  development, developing training materials,
  conducting training, developing GF proposal, and
  documenting achievements
• World Health Organization
  for helping with proposal development,
  reviewing country program performance, providing
  capacity building for proposal writing and
  implementing.

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Good Luck!