TB CARE I - CAR Tajikistan Year 2 Quarterly Report April-June 2012

The process of registration included finalization and authorization of registration documents, selection of office premises, signing of the lease agreement with the landlord, and submitting documents to Colibri Law Firm. The country Director was hired from June 10, 2012, and attended the PMU Workshop in Almaty, Kazakhstan on June 10-13, 2012, where she gained a better understanding of main aspects of M&E approaches, financial management principles, KNCV policy, and regulations. A national TB program review was conducted by the TB CARE I regional team from June 3-10, 2012. The main objective of the mission was to analyze the progress of TB control in general and penitentiary health sectors and to discuss priority directions in TB control for further planning and implementing TB activities under TB CARE I in the country. Two project sites, Dangara and Temurmalik, were visited during the mission, and priority interventions at NTP level as well as at district level were discussed at a round table with involvement of NTP authorities and key partners by the end of the mission. As a result of this assessment mission, a set of recommendations was made for TB CARE I activities in Tajikistan, including on TB in prison, PMDT, TB-HIV, and outpatient care. In the reported period, TB CARE I Country Director, with support of Regional Director and Regional staff, made necessary administrative activities, such as posting announcements of vacancies in local newsletters, newspapers, and un.tj website, and programmatic preparations for upcoming activities for the next quarter. However, due to the Branch office not being officially registered in the country and registration documents being under the Ministry of Justice consideration, it was impossible to stick to the schedule of planned activities. The MOH requested TB CARE I project to start implementation of MDR TB program in two pilots, Dangara and Temurmalik, and provide training and monitoring activities in the sites. However, due to the fact that the procedure of office registration is not completed, these activities were impossible to conduct before the formal office registration. The Global Fund's funds in Tajikistan are mostly directed to the procurement, storage, and distribution of 1st and 2nd lines anti-TB drugs, purchase of laboratory equipment, consumables, and reagents. There are also limited funds under GF grants allocated for carrying out monitoring and training activities. Currently, there are two Global Fund Principal Recipients in the country: PIU UNDP (GF Round 8, the program is active till October 2013) and Project HOPE (GF Round 3 RCC). Phase 2 of RCC has just been approved for the period October 2012 - September 2015. Tajikistan has applied to Global Fund for Transitional Funding Mechanism (TFM), but the response from Global Fund has not yet been received. TB CARE I has made progress in several technical areas. In the area of Universal and Early Access, the activity of coordination mechanism between civil and prison TB services is ongoing, with a joint MoH&MoJ order expected to be issued. In the area of Laboratories, the activity of setting up a system for Xpert MTB/Rif implementation in the country is ongoing, with a workshop on the development of Strategy for Xpert MTB/Rif implementation scheduled for August 2012. In the area of Infection Control, the activity of national TB-IC plan revision and addressing TB-IC activities in prisons is ongoing, with all activities related to TB-IC moved to September 2012 per MoH request. In the area of PMDT, the activity of PMDT in civil TB service and prisons has been assessed, with initial visit to assess the needs for MDR-TB activities conducted on June 3-10. In the area of TB/HIV, the activity of TB/HIV care in civil and prison sectors has been assessed, with gaps identified in the implementation and coordination of TB-HIV strategy, low level of skills of local staff on clinical management of co-infection, and NTP required assistance in the operational research of TB-HIV burden in TJ.