Ukraine TB/HIV Concept Note Outcomes of TRP GAC and Grant M aking

1. Ukraine TB/HIV Concept NoteOutcomes of TRP GAC and Grant Making Day Month Year

2. Overview of Allocation Request • Technically sound and overall well balanced Concept Note. • Builds on achieved results and strong experience in a difficult programming environment. • The funding request aims to scale-up and ensure equitable access to prevention, care, treatment and support for key populations and vulnerable groups, and to strengthen health and community systems that enable integrated and sustainable interventions for key populations. • The CN builds on gains of previous investment in HIV and TB control, and is aligned with the National TB Program 2012-2016. • A number of strategic, technical and operational issues to be addressed. • CONGRATULATIONS • Hard work, tight deadlines, 3 consecutive proposals, limited funding!!! • Very difficult country circumstances! • In previous TRP window, 50% of proposals referred back to country.

3. Overview of Allocation Request • Recommendation on allocation amount: • Budget ceiling for NFM period (2015-2017): USD 130,489,741, incl. USD 128,828,095 (est. budget ceiling prior to TRP review) + USD 1,661,646 (additional savings in signed grant identified after TRP review). • Partially, “above-allocation” request can be covered from the allocated funds (based on savings identified), but no additional/above-allocation funding. • Since TRP/GAC, Country Team has approved reallocation of some savings (ca. USD 1.2 m) to cover unfunded activities for Red Cross and emergency gap in MDR medicines. *$5,135,033 of savings identified before submission to TRP + $1,661,646 identified after finalizing all Annual Funding Decisions, after submission to TRP.

4. Budget analysis – Confirmed savings 16 May 2014

5. Budget analysis – Potential savings and proposed allocation Day Month Year

6. Budget analysis – Proposed reallocation Day Month Year

7. Use of additional savings Day Month Year

8. Concept Note Review - Recommendations • Proposed strategic approaches remain unclear: • social contracting mechanism for the HIV prevention package, • scale-up of VCT in key populations to twice a year and ART in people who inject drugs, • regionalisation approach, • approach to integration of services, • sustainability plan. • Technical issues to resolve: • Optimize to ensure value for money for packages for MARPs, CD4 and treatment monitoring and different forms of methadone. • ARV treatment – 3FDC vs 2FDC +EFV – to follow the country decision • Strengthen rapid diagnosis of rifampicin resistance and quinolone-resistant MDR-TB by the Xpert and LPA. • Strengthen patient-centered approach to improve treatment outcomes for TB. • How to address low access to medical and social services in prison. 16 May 2014

9. Concept Note Review - Recommendations • Operational issues require negotiation: • Crimea – to invest and seek for the solutions. • How we work in conflict-affected regions and what can be done for IDPs. • Implementation arrangements, including central level functional unit, need to be clarified: efficiency, effectiveness, coordination, relevance/expertise, effect on quality of service for end users.

10. Next steps • In cooperation with technical partners agree on reinvestment of savings and address the remaining challenges. • Develop and agree on grant making work planand its implementation modalities. • One week before November 13, 2014 – ready-to-sign grant documents have to be submitted for GAC2. • GAC2 on November 13 followed by the board approval. • WE HAVE 7 WEEKS TO FINALISE GRANT MAKING! 16 May 2014

11. Grant Making • Process of translating the funding request based on the TRP and GAC1 recommendations into disbursement-ready grants for Board approval and signature. • Disbursement-ready grant: • all required grant making outputs are in final form and agreed with PR(s) • adequate risk mitigation measures are agreed and in place • all significant issues to be resolved prior to first disbursement are addressed 16 May 2014

12. Grant Making • We need to develop a work plan for the deliverables of these workstreams. 16 May 2014

13. Deadlines During review, please do not change the documents. • Grant documents: • 1st draft: 26 September (with turn around by 3 October) • 2nd draft: 10 October (with turn around by 17 October) • Final submission: 24 October • Implementation mapping: • Grant signing requirement • Half day macro-level planning tomorrow • Regional mapping – understanding of regionalisation approach, but regional mapping should be started and finished by end of year. • CAT: • CT will work with PRs and LFA. Final deadline is 31 October, but need support. • Grant agreement documents: • PRs to begin populating information. • Government framework agreement needs to be worked on right away. Day Month Year

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