Development of a Joint TB and HIV Concept Note Lessons Learned from Haiti

1. Development of a Joint TB and HIV Concept Note Lessons Learned from Haiti Susan Maloney, MD, MHSc Global TB Coordination Office US Centers for Disease Control and Prevention Annual TBTEAM Meeting, Geneva 18 June 2014 Office of the Director Center for Global Health

2. General Lessons and Observations • Start early; as with many things, time will quickly run out • Overall (TB and HIV) budget allocation < than expected • Other sources of funding decreasing (PEPFAR) • GOH not able to absorb any sizable part of programs • TB budget expected to be < than HIV budget; important when examining % input to understand extent of GF financing dependency • Alignment between GF and PEPFAR funded TB and TB/HIV activities is increasingly crucial • HQ-level reviews including detailed cross-referencing of PEPFAR COPS (1-2 yr periods) imperative • Always note if program qualifies for incentive funding and how to appropriately tailor applications • Verify (many times) that #s in CN match #s in modules, strategic plans, budgets and gap analysis

3. Collaboration • Fund Portfolio Manager (FPM) should stress importance of collaboration between programs • Get both programs together well in advance of application process • Recommend programs complete respective national strategic plans (NSPs) --including costed operational plans--earlier in process • Better coordination of joint approach • Time to review activities to identify areas of TB/HIV overlap and mutual priorities (e.g. health information systems, lab diagnostics) • Filling elements of CN faster and more easily aligned

4. Consultants • CCM and MOH need to be aware that consultants face pressure from various groups • Stakeholders should have continuous follow-up on consultant activities • Ensure documents representative of national program goals • Recommendations • Weekly or bi-weekly consultant meetings to review materials and progress • Map out partners consultants should visit • List all organizations working in TB and HIV field and provide contact information; notify organizations

5. Activities • All TB and HIV activities should be listed and linked appropriately to NSPs/operational plans • GOH needs to know all partner/stakeholder activities, to better understand overall TB and HIV programs and monitor progress • Ideally, partners share also outside funding sources to inform future work plans and budgets • If time-limited funding, ensure future funding if essential activities for NSPs (also PEPFAR “core” , “near-core”, and “non-core” activities) • One of the most useful approaches was generating a list of program indicators and mapping goals for next 5 years • Incorporated into NSPs and used to generate budget estimates • Important to tie the CN back to well formulated NSP to guarantee all program activities communicated • GF modular template without space to list all activities planned

6. Understanding Requirements and Documents • NFM has many components, and is a new, evolving process Further training at early stages of application warranted • National programs and consultants need to understand components and verify application materials throughout process • Discuss with FPM and project officers often to assure documents completed in proper manner • Modular Approach • Consult modular approach template during work on NSPs and outlining future activities; NFM requires submission in specific format, and including designated indicators important • CN has many components; review throughout process • Define Principal Recipient (PR) early and agree and/or vote as a CCM on this aspect before final vote on entire CN • Include information on HSS and risk management in CN

7. Acknowlegements/Contacts • CDC staff (Haiti and HQs): David Fitter, McArthur Charles, Barbara Marston, David Lowrance • Available to provide more detailed review comments at the level of the technical/programmatic proposals for TB and HIV, if needed • Smaloney@cdc.gov