TB CARE I - Botswana Year 4 Quarterly Report January – March 2014

The program's work plan timeframe is from October 2013 to September 2014, with a focus on achieving universal access to TB care, strengthening laboratories, and implementing PMDT. The program's quarterly report for January to March 2014 highlights several key achievements and challenges. The in-country Senior Technical Advisor supported the evaluation of a community TB Care (CTBC) research project, which aims to evaluate the effectiveness and acceptability of community TB care models implemented in the country. The study will guide the NTP/MoH to adopt an appropriate CTBC approach to be scaled up, taking into consideration the declining funding in the near future. TB Care I also supported the NTP to update the current TB Strategic Plan (2013 – 2017) in-line with the WHO post 2015 TB strategic plan and the Global Fund New Funding Model requirements. The Chief Medical laboratory technician supported the district laboratories with on-site supportive visits to strengthen external quality assurance and implementation of acid fast bacilli smear microscopy in Thamaga Primary Hospital, Bamalete Lutheran Hospital, Kanye SDA hospital, and Lobatse Mental Hospital. Site assessments were conducted and recommendations on identified gaps were shared with district laboratory teams. The regional laboratory consultant, Dr Valentina Anisimova, supported the review of drug sensitivity testing (DST) standard operating procedures (SOPS) with major input on drug preparation. TB Care I also supported the organization of World TB Day 2014, which was commemorated in a high TB burden district of Kweneng East, Molepolole. Activities included active participation in holding a press conference, panel discussion, and developing different IEC and promotional materials for commemorating World TB Day. The program's technical and administrative challenges include continued challenges with the procurement of supplies at the National TB Reference Laboratory (NTRL), which is being addressed by transitioning all procurement issues to the Central Medical Stores. The program's technical outcomes and activity progress are being monitored through various indicators, including population coverage with Community TB Care, laboratories with working internal and external QA programs for smear microscopy and culture/DST, and diagnostic sites offering advanced technologies for TB or drug-resistant TB. The program's support to the NTRL and TB laboratory network includes training in smear microscopy and technical input into quality assurance and external quality assurance. The program's support to the roll out of GeneXpert includes training of staff and selection of appropriate location for the placement of the machines. TB Care I's support to Global Fund implementation in Year 4 includes supporting the Country Coordinating Mechanism (CCM) for Botswana to develop a single TB/HIV concept note to apply for Global Fund under the New Funding Model. The in-country senior technical advisor, along with two NTP staff, attended a Global Fund/WHO workshop organized to align the National Strategic Plan with the post-2015 Global TB Strategy and the New Funding Model requirements. TB Care I has also supported the development and implementation of the grant closure plan for the previous round 5 Global Fund grant and transitional funding mechanism.