Challenge TB - Zimbabwe Year 1 Monitoring Report

The work plan was discussed with senior management from the Ministry of Health and Child Care (MOHCC), resulting in a commitment to support implementation. A consultative meeting was held on February 20, 2015, which brought together 22 managers, including the Permanent Secretary, to discuss the work plan and broader TB-HIV control efforts in the country. Implementation of the Challenge TB initiative was hindered by several technical and administrative challenges. The non-disbursement of Global Fund financial support from the Fund Administrator (UNDP) to the National TB Program (NTP) stalled the implementation of complementary activities funded by the Global Fund. This was caused by preconditions set by the Global Fund to conduct comprehensive assessments of Sub-Recipients. The funds were eventually disbursed on April 8, 2015. Understaffing of The Union Zimbabwe Country office technical and administrative staff resulted in constraints in facilitating program implementation due to increased workload. However, recruitment of technical staff, including a TB-HIV Officer, Capacity Building Officer, and Communication Officer, has been completed, and new staff are expected to assume duty on May 1, 2015. This will facilitate the acceleration of implementation of planned activities. The Challenge TB initiative also faced delays in the implementation of the TB Drug Resistance Survey (DRS) due to non-disbursement of funding to the World Health Organization (WHO) and emerging varying opinions among MOHCC staff on where survey specimens will be processed. Options are being explored to re-channel funds from WHO to the lead partner and accelerate implementation in the coming quarter. The Challenge TB initiative has made significant progress in the implementation of rapid diagnostics, including the installation of Hains machines at the National TB Reference Laboratory (NTBRL) and the training of laboratory scientists on the use of the Hain machine. A total of 13,684 tests were conducted from 74 out of 78 reporting Xpert sites, with 1,936 (14%) tests positive for MTB+. Among these, 133 (7%) test results had Rifampicin-resistant strains detected. The initiative has also made progress in the optimization of the use of Gene Xpert machines in existing sites through training of nurses in Manicaland province. A total of 175 nurses were trained, and 50 motorcycles were supported in the 3 cities and 42 districts, ferrying samples for Tuberculosis and other conditions for diagnosis and treatment monitoring to the laboratories. A total of 6,597 (21%) TB specimens were ferried out of 32,008 specimens during the first 2 months of the quarter under review.