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SAARC TUBERCULOSIS CENTRE Monday 08th September 2008

SAARC-Canada Regional TB and HIV/AIDS Project
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Completion of the SAARC-Canada Regional TB and HIV/AIDS Project:

SAARC-Canada Regional TB and HIV/AIDS Project was initiated with the purpose of strengthening the capacity of SAARC TB Centre, Kathmandu and to support Regional & National responses to the TB & HIV/AIDS epidemics. The project completed in March

2004. Final report - To be Finalized.
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1.  Background
During a visit to Canada in the summer of 1997, the Secretary General of SAARC expressed interest in working with Health Canada to develop a project to address TB, HIV/AIDS and TB/HIV co-infection in SAARC member countries.   A Memorandum of Cooperation (MOC) between SAARC and CIDA was signed in July 1997 and provides the governing framework for the project.  In 1999, a Project Approval Document (PAD) was prepared by CIDA with the participation of all SAARC member countries.  The PAD was approved by CIDA in April 2000 and by SAARC member countries in September 2000.  ">SAARC-Canada Regional TB and HIV/AIDS project is a four-year (April 2000- March 2004) bilateral project funded by the Canadian International   Development Agency (CIDA) for a value of CDN $1.8M.  The project goal is to promote regional cooperation through the South Asia Association for Regional Cooperation (SAARC) whose member countries include Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan and Sri Lanka.  The project purpose is to strengthen the capacity of the SAARC Tuberculosis Centre (STAC) located in Kathmandu to support regional & national responses to the TB & HIV/AIDS epidemics. 

 

HC is the Canadian Executing Agency (CEA) for this four year project. With the STAC as the local partner, the Centre for Infectious Disease Prevention and Control (CIDPC) at HC is responsible for project implementation and technical content.  The International Health Policy and Communications Division (IHPCD) of HC are responsible for project management, coordination, administration, finance, reporting and monitoring. STAC as the local partner is also responsible for project management, coordination, administration and reporting to SAARC. The SAARC Director, Social Development Division, monitors the project at the SAARC Secretariat. In addition to the financial contribution from CIDA, both STAC and HC are contributing human resources and the STAC is also providing physical infrastructure facilities.  The Canadian Cooperation Office (CCO) located in Kathmandu is providing assistance to the project on administrative, financial and procurement activities.

 A Joint Steering Committee (JSC) chaired by the SAARC Secretary General with representatives from CIDA, SAARC, STAC and HC is the key governance structure of the project.  The JSC meets annually to review project progress, provide direction and facilitate implementation.
2.  Project Rationale

Policy makers need information on the state and trends of the dual epidemics, an understanding of how the epidemics interact and arguments to support practical steps that can be taken for effective TB control and HIV prevention.  This project contributed to the development of regional policies on TB and HIV/AIDS by:

1) reviewing trends of TB and HIV/AIDS as well as the co-infection in the region and their interaction and impact,

2) highlighting key regional issues,

3) recommending approaches for effective control of the dual epidemic and 4) identifying some of the main technical and managerial challenges. 

These activities are intended to support SAARC initiatives for dissemination of information, to foster collaboration between national TB and HIV/AIDS programs in South Asia and for coordinating national action plans to address the epidemics.

3.  Project purpose, inputs and expected results
The purpose of the project is to strengthen the capacity of the STAC to support regional and national responses to the TB and HIV/AIDS epidemics.  The Financial input of the project is from CIDA and human resources contributions are from both the project partners, the STAC and HC.

The expected results at the outcome and output levels are:

Outcome 100 - Regional TB & HIV/AIDS epidemiological networking 

Output 110:     Enhanced data sharing through STAC co-ordinated networking
Output 120:     Improved skills and opportunities for epidemiological (epi.) networking
Output 130:     Improved skills in gender sensitive analysis   

Outcome 200 - Improved accuracy in laboratory diagnosis of TB through better Quality Assurance (QA) in national laboratory networks

Output 210:        An operational SAARC Regional TB Reference Lab able to support regional QA activities
Output 220:        Improved networking skills, opportunities and infrastructure for a network of national TB Reference Lab

Outcome 300 - STAC supporting regional communications & policy development in TB and HIV/AIDS

 Output 310:       Improved STAC skills in communications and policy analysis.
Output 320:       Improved STAC ability to disseminate info to policy makers 

Outcome 400 - Project Management  

Output 410:  Administration, Finance & Procurement
Output 420:  Human Resources
Output 430:  Planning, Monitoring & Reporting
4.  Scope of work

4.1 Component 100 - Regional TB & HIV/AIDS epidemiological networking

The STAC is located in Thimi near Kathmandu and is the institution within the SAARC region mandated to improve and strengthen regional coordination of member countries with regards to TB and HIV/AIDS prevention and control.  Such coordination by the STAC of member countries allows for regional analyses of the epidemics required to enable SAARC to develop policies and communications on TB and HIV/AIDS.  The SAARC Secretariat is responsible for policy formulation and such policy development process requires sound data, trends, and information on the two epidemics from SAARC member countries.   The STAC is best positioned to co-ordinate networking and data analysis with countries of the South Asia region.  

The Regional TB & HIV/AIDS epidemiological networking is to enhance data exchange between SAARC member countries by using the epidemiological and laboratory networks to transfer and exchange data among countries and with the STAC.  Collaboration with Regional Offices of WHO and UNAIDS based in New Delhi is also part of the networking.  The dissemination of the results of the syntheses and analyses will accumulate the data evidence needed for generating regional situation analyses that can support communications and policy development.   

With the participation of Nodal Officers from each SAARC countries, the project is supporting the development of regional TB and HIV/AIDS epidemiological networking activities by strengthening capacity for sharing data between SAARC member countries and generating the analyses needed to support strategy development for the monitoring, prevention and control of TB and HIV/AIDS in South Asia.  More specifically, component interventions may provide training for data collection and analysis, including software training; co-ordinating data and related information collection and exchange on TB and HIV/AIDS to complement existing regional data collection mechanisms; undertake regional and gender sensitive analysis of the TB and HIV/AIDS epidemics; conduct workshops for strengthening skills in data synthesis and presentation and facilitate a regional communication through email or web-based epidemiological networking.

4.2  Component 200 - Improved accuracy in laboratory diagnosis of TB through better Quality Assurance in national laboratory networks.

This project component is to develop the SAARC Regional TB Reference Laboratory capacities in supporting National TB Reference laboratories of SAARC member countries in Quality Assurance (QA) of sputum smear microscopy networks.

Though the SAARC region includes TB reference laboratories of international renown, currently most national TB reference laboratories have not maximized their support to the National TB Programme (NTP).   For instance, no SAARC country today has a full QA program following the international standards and recommendations of the World Health Organizations (WHO) and the International Union Against Lung Disease (IUATLD) and involving the entire national network of sputum smear microscopy facilities.  

This project is establishing a regional networking between national TB reference laboratories in the SAARC region and is supporting QA activities of national networks of sputum smear microscopy.  This is done through the provision of supplies to the SAARC Regional TB Ref Laboratory (microscopes, equipment and furniture) and in providing training to the STAC Microbiologist in sputum smear microscopy and QA programs for national microscopy networks.  At the regional level, senior staffs of national TB reference labs are given training in the management of national TB reference labs and in national networks on sputum smear microscopy.  A regional network of national TB reference laboratories coordinated by the SAARC Regional TB Reference Lab has been established for the coordination of regional QA activities.

4.3  Component 300 - STAC supporting regional communications &     policy development in TB and HIV/AIDS

The SAARC Secretariat has the mandate to disseminate issues on TB and HIV/AIDS and to develop policy document related to these epidemics.  Such activities require skills and capacities in policy development and programme analysis as well as sound data, trends and analysis on the 2 epidemics from each SAARC countries.  This project component is strengthening the SAARC Secretariat and the STAC to develop capacities in policy development and communications with regards to TB and HIV/AIDS.  More specifically, the STAC is undertaking activities with representatives from SAARC countries aimed at regional communications and policy development on TB and HIV/AIDS and TB/HIV co-infection. 

The several situation analysis and epidemiological reports produced from the data and information gathered with the epidemiological networking and other acceptable sources (e.g., UNAIDS, WHO, NGOs and other regional networks) are providing SAARC with data and information that can be used as the basis for developing communications material and to inform and influence policy makers with respect to TB and HIV/AIDS in the region.  This includes the problem of migratory populations, both within and across national borders, TB / HIV co-infection, gender and socio-cultural issues, the drug trade and human trafficking.

A situation analysis of TB & HIV/AIDS national programmes has been conducted in the Summer 2003. This served as the basis for a consultation process undertaken with SAARC member countries in the Fall- 2003 aimed at developing a regional SAARC TB/HIV co-infection strategy. 

4.4  Project Management

The project is a bilateral development assistance project between SAARC and the Government of Canada represented by CIDA.  Health Canada has been contracted by CIDA to be responsible for implementing the project with the STAC. STAC and HC are doing the day-to-day management. HC is accountable for the use of all Canadian project resources.  Phased project implementation ensures that specific agreed milestones are met before proceeding with the next set of activities.  The STAC and HC co-direct and co-manage the project.  Three professionals at the STAC are involved in the project: an Epidemiologist, a Microbiologist and a Research Officer.  Canadian Public Health Epidemiologists were based in Kathmandu from time to time and shared technical knowledge with the STAC professionals.  The Canadian Cooperation Office (CCO) is providing assistance to the project on administrative, financial and procurement activities.
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SAARC Tuberculosis and HIV/AIDS Centre, Thimi, Bhaktapur,
GPO Box: 9517, Kathmandu, Nepal
Tel: 00977-1-6631048, 6632601, 6632477, Fax: 00977-1-6634379
E-mail: saarctb@mos.com.np, Website: saarctb.com.np