Information on the program implementation progress during July 2008 on both HIV and TB Round 6 components

1)The Grant Progress:

Both components (including VAT – update for July 2008,financial progress and procurement activities)

  • HIV component

Prevention activities in prisons /
  • This month, the implementers of the prevention activities in prisons (Romanian Harm Reduction Network, ARAS, ALIAT, INTEGRATION, Close to you Foundation): started negotiations with individual prisons in order to signcollaboration protocols (to agree days/hours/approaches for the implementation of prevention activities); initiated a pre-assessment, to collect data about prisoner’s interest in prevention activities and materials, and their HIV risk behaviors; drafted all the informative materials planned to be produced by the end of Q5.

Prevention activities among MSM /
  • ACCEPTand PSI started the implementation of the capture – recapture procedure that helps countingMSM as unique beneficiaries of the prevention program. The method (using branded badges for distribution among MSM) will be applied during the summer prevention activities, (every week-end for 8 weeks), starting 11th of July. It is expected that the summer activities will gather at the sea side most of the MSM reached during the year in the 10 program cities. In the mean while, especially during week-days activities, capture-recapture will be going on also in the 10 cities.

Implementation of BSS among SWs /
  • Last revision by the M&E team of the formative research methodology (qualitative) and of the quantitative data collection methodology. The methodology was initiated by PR M&E team and then developed by ARAS and its research consultant.
  • ARAS field interviewers were trained (end of July) to conduct the formative research, as well as the quantitative data collection.

Implementation of BSS among IDUs /
  • The M&E team contributed tothe revision of the formative research report issued by UNODC in mid July. The purpose of this report was to pre-test and inform the BSS methodology developed in joint collaboration by UNODC, the PR and some sub-recipients.
  • As agreed with UNODC and the other partners in the study (sub-recipients), besides the technical assistance (revision of BSS methodology and instruments – the RDS method), the PR will also provide the HIV rapid tests and the medical consumables (gloves, disinfectants, needles) needed for the HIV surveillance of the sample of IDUs. The PR already procured 500 HIV rapid tests for the study; the other consumables will be procured by the beginning of September, when the data collection is planned to start.

Implementation of BSS among PLWHAs /
  • The PR selected the two consultants that will coordinate the implementation of the BSS among PLWHAs (one principal investigator and one data analysis specialist). The contracts will be signed during the first week of August and their assignments will span from August 2008 until December 2008 (expected month for the finalization of the research report).

Revision of quarterly progress reports /
  • 10th of July was the deadline for receiving the Q4 progress reports from the sub-recipients. Therefore, the whole month the M&E team was involved in:
Revising the reports and the support documents provided (presentation, reporting accuracy, provision of all relevant support documents)
Formulating recommendations and proposing revised implementation plans for SRs who experience delays in implementation or whose quality of activities was evaluated as not satisfactory by the M&E team.
Financial Progress /
  • Direct payment was made for MID Consulting – the audit company.
  • 34 financial reports of implementers verified and 34 disbursements was made for 16 Implementers
  • Direct payments was made for the procurement conducted by PR: Antiseptica (for heparin)
  • Technical assistance (meetings, phone calls, mails) provided for all Implementers in order to be able to finalized the financial report for fourth quarter

Procurement /
  1. During July 2008 it was finalized the delivery of medical consumables procured with UNDP’s help, that is the remaining 262,690 pieces of syringes were delivered on 1st July 2008. At the same time RAA has begun the process of launching the procurement of medical consumables for the 2nd year of the programme. The documents have been prepared and sent for verification to UNDP on 24.07.2008. RAA has asked for UNDP’s helpdue to the same reasons applicable in the 1st year of implementation (UNDP can apply for VAT recovery and is exempted of custom taxes).
  2. On 24.06.2008 RAA has launched the procurement of 10,785 pieces of HIV rapid tests (10,285 pieces for National Antidrug Agency and 500 pieces for the studies which are supervised by RAA), 480 pieces of HVC rapid tests (for National Antidrug Agency) and 480 pieces of HVB rapid tests (for National Antidrug Agency). The procurement was finalized on 04.07.2008 and the suppliers are SC REAL GRUP SRL for HVC and HVB rapid tests and SC ASCENSIS GRUP SRL for HIV rapid tests. 4900 HIV rapid tests have already been delivered to NAA on 17.07.2008 and the remaining will be delivered by mid August. The HVC and HVB rapid tests will be delivered by mid August.
  3. On 07.07.2008 RAA has begun the procedure for procuring 30 liters of hand disinfectant for NAA; the procurement was finalized on 18.07.2008, the supplier is SC ANTISEPTICA SRL and the goods delivery will be done by end of July.
  4. On 07.07.2008 RAA has started the procurement for examination gloves for NAA, this being finalized on 22.07.2008, and the goods delivery being scheduled by end of July.
  5. On 07.07.2008 RAA initiated the procurement of anti-HVB vaccine. 11 suppliers were invited, however by 18.07.2008 – the set up deadline – only one supplier applied. Therefore the deadline has been extended until 01.08.2008 and all the short list suppliers have been informed.
  6. The agreement with UNFPA for condoms’ procurement has been signed and the payment has been done on 25.07.2008. We are expecting confirmation of payment receiving from UNFPA and the shipment of goods.
  7. On 25.07.2008 the procurement of 3,500 HIV rapid tests has been launched (3,000 pieces for ARAS and 500 pieces for RAA supervised studies). The deadline for submission of tenders is 07.08.2008.
  8. During July the PR has continued to provide assistance to the Sub-Recipients on procurement issues (such as: NAA, RHRN, Salvati Copiii, Baylor, MIRA).
  9. During the next period RAA will continue the procurement of medical consumables through UNDP and not only and will provide assistance to the Sub-Recipients.
  10. All documents concerning the call for tenders initiated during the month of July 2008 are available on the Round 6 web-site at the following link:

  • TB component
  • The Methodological Guide for implementation of the National Programme for TB Control 2007- 2011 is still on the public website of the Ministry of Public Health for public consultation ( till 6th of August 2008. Afterwards it will be approved through a Ministry of Public Health order and become effective. Beside the general comments and recommendation provided before, on the 15th of July another set of recommendation were submitted to the main stakeholders in order to include then into the implementation norms of NTP; these recommendation were related mainly to the MDR-TB case management as provided by the GLC (Green Light Committee) Mission performed during March 2008.
  • The Sub-grant agreement with the National Administration of Penitentiaries (NAP) was finally signed on the 9th of July. On the 17th of July a working meeting was held with NAP representatives in order to revise the annexes of both projects implemented by NAP. The revision was considered needed view the fact that the 3rd quarter of the grant implementation was already left behind, and a new plan for implementation on realistic basis was done. The new annexes of the sub- grant agreement were signed on the 23rd of July and replaced the old ones. The first disbursement request was received on the 1st of August 2008.
  • During July the PR continued its efforts in preparing the application for drugs procurement.
  • At the same time meetings (CPSS) and discussions took place for the procurement of various goods and services with the Sub-Recipients. In respect to the pick flow meters and IT equipment procurement for CNSMF, the Sub-Recipient is in the process of gathering the information from the field in line with the local needs.
  • On 25.07.2008 RAA has launched the call for application for DRS expert. The applications are expected until 08.08.2008.
  • No disbursement was made to the SRs during the month of July.
  • VAT (both HIV/AIDS and TB grants)

Following the meeting on 8th July between RAA representatives, Minister of Health (E. Nicolaescu) and Director of budgets Department of the MoH (Mrs. Barbuta), the Ministry of Health has submitted to the Ministry of Finance the documentation concerning the request for issuing the new legislation concerning VAT refund for GFATM R6 Grants.

The Minister of Health must now wait for Ministry of Finance’s decision, in order to be able to propose the new legislation to the Parliament.

On 4th August, RAA representatives have also had a meeting with the Director of budgets department of the Ministry of Finance, in order to offer clarifications regarding the GFATM R6 grants in order to accelerate the decision.

2) The Recent Successes:

Both components

  • HIV component
  • No significant successes to report.
  • TB component
  • The MDR- TB patient’s Guide became available. During July started its distribution in the MDR- TB Center from Bucharest and in the 6 TB Dispensaries from Bucharest. This tool was developed by the Project Implementation Unit from “Marius Nasta” Institute with technical assistance from RAA, in very good design conditions. We hope to be appreciated as well by the beneficiaries, the MDR- TB patients.

3) The Challenges Being Faced:

  • Both components

Although some important steps have been achieved as a result of RAA intervention at the Ministry of Health, the VAT co-funding for GFATM Grants is not yet solved.

  • HIV component
  • Conducting HIV rapid tests among SWs and IDUs in locations where the outreach teams have no vans. The teams have to establish partnerships with public & private medical practices that are willing to offer them the space for conducting HIV testing.
  • There are organizations (especially among PLWHAs’ organizations) that proved to be less experienced in planning ahead their activities and expenditures. For these cases, at the end of Q4, the M&E team had to provide and propose revised implementation plans (including new activities, timeline, targets). The role of these plans is to help the organizations catch up with their initial work plans and targets. To monitor closely these cases, starting July 2008, the M&E teamrequested from these organizations monthly progress reports. This practice will go on as long as it will be necessary.
  • TB component
  • The DOTS- Plus project extension request was finally submitted to the GLC on the 1st of August 2008. We had to submit this request because the delay was already very important (enrollment of MDR- TB patients should start on October 2008 when the 2nd line anti- TB drugs should be available) even the NTP implementation norms were not yet released by the Ministry of Public Health and also the commitment for the funds from the National Health Insurance House (NHIH) for the MDR- TB patients that are not included under the GFATM project was not insured by the Ministry of Public Health, even approaches were made on this issue on main stakeholders: Ministry of Public Health, Public Health Authority and National Agency for Public Health Programmes. The reason was that there is no legal framework to make the payments to IDA (International Dispensary Association), the provider agreed by GFATM and GLC. During the next period we shall continue approaches in order to propose/ find solutions for solving this issue. Also we shall be available to ask any questions to clarify certain issues raised by GLC.
  • Another important challenge is the Second Line anti TB Drugs- Drug Resistance Survey (SLD-DRS) Protocol. The draft submitted by the Sub- Recipient, The Project Implementation Unit from “Marius Nasta” Institute need improvement, important work on it before the revision from the WHO consultants could be considered. During the next period RAA will work together with the SR in order to provide a good document by end of August 2008. For this activity an expert in TB laboratory will be hire by RAA.

Also, WHO is considering providing technical assistance for solving this “bottle-neck” in implementation of this GFATM project.

This will have impact on the key- indicator related to the SLD-DRS that should be performed by 30th of September 2008.

4) The Key Outcomes:

  • Both components
  • HIV component

Disbursement to SR’s was made as follows:

Sub Recipient / Amount transferred (RON) / Payment order: no / date / Equivalent EURO / Exchange rate / Project Code
Mid Consulting / 215,890.00 / OP 831/03.07.2008 / 59,622.00 / 3.621
TOTAL 03.07.2008 / 215,890.00 / 59,622.00
Inima de copil / 105,060.28 / OP 877/15.07.2008 / 29,244.00 / 3.595 / O2 S6 A7 I19
TOTAL 15.07.2008 / 105,060.28 / 29,244.00
DGASPC / 4,506.42 / OP 885/17.07.2008 / 1,273.00 / 3.54 / O1 S1 A12 I10
TOTAL 17.07.2008 / 4,506.42 / 1,273.00
ANA / 14,490.00 / OP 906/22.07.2008 / 4,140.00 / 3.5 / O1 S1 A3 I4
TOTAL 22.07.2008 / 14,490.00 / 4,140.00
SCOP / 4,244.67 / OP 919/25.07.2008 / 1,194.00 / 3,555 / O2 S6 A1 I22
Asociatia Speranta / 13,036.19 / OP 920/25.07.2008 / 3,667.00 / 3,555 / O2 S6 A5 I25
ANA / 55,379.79 / OP 92/25.07.2008 / 15,578.00 / 3,555 / O1 S2 A15 I4
Salvati Copiii / 27,885.42 / OP 922/25.07.2008 / 7,844.00 / 3,555 / O1S1 A12 I11
UNFPA / 24,271.78
TOTAL 25.07.2008 / 100,546.07 / 52,554.78
Noua Speranta Petrila / 859.95 / OP 923/28.07.2008 / 245.00 / 3.51 / O2 S6 A5 I14
Noua Speranta Petrila / 13,878.54 / OP 924/28.07.2008 / 3,954.00 / 3.51 / O2 S6 A11 I14
Noua Speranta Petrila / 2,569.32 / OP 925/28.07.2008 / 732.00 / 3.51 / O2 S6 A1 I14
Baylor-Marea Neagra / 3,559.14 / OP 926/28.07.2008 / 1,014.00 / 3.51 / O2 S6 A3 I17
TOTAL 28.07.2008 / 20,866.95 / 5,945.00
Asociatia Lizuca Bacau / 3,879.59 / OP 933/31.07.2008 / 1,102.00 / 3.5205 / O2 S6 A11 I15
Asociatia Lizuca Bacau / 3,502.90 / OP 934/31.07.2008 / 995.00 / 3.5205 / O2 S6 A6 I15
Asociatia Lizuca Bacau / 5,949.65 / OP 935/31.07.2008 / 1,690.00 / 3.5205 / O2 S6 A1 I15
Inima de copil / 1,756.73 / OP 936/31.07.2008 / 499.00 / 3.5205 / O2 S6 A3 I19
Inima de copil / 7,238.15 / OP 937/31.07.2008 / 2,056.00 / 3.5205 / O2 S6 A6 I19
Inima de copil / 5,006.15 / OP 938/31.07.2008 / 1,422.00 / 3.5205 / O2 S6 A1 I19
RHRN / 91,765.35 / OP 939/31.07.2008 / 26,066.00 / 3.5205 / O1 S1 A9 I32
HAR / 1,760.25 / OP 940/31.07.2008 / 500.00 / 3.5205 / O2 S6 A6 I26
HAR / 39,007.14 / OP 941/31.07.2008 / 11,080.00 / 3.5205 / O2 S6 A7 I26
HAR / 15,659.18 / OP 942/31.07.2008 / 4,448.00 / 3.5205 / O2 S6 A5 I26
AIDROM / 10,565.02 / OP 943/31.07.2008 / 3,001.00 / 3.5205 / O2 S6 A8 I29
Baylor-Marea Neagra / 3,509.94 / OP 944/31.07.2008 / 997.00 / 3.5205 / O2 S6 A1 I17
FDP / 22,513.60 / OP 945/31.07.2008 / 6,395.00 / 3.5205 / O2 S6 A1 I20
FDP / 3,798.62 / OP 946/31.07.2008 / 1,079.00 / 3.5205 / O2 S6 A3 I20
FDP / 6,460.12 / OP 947/31.07.2008 / 1,835.00 / 3.5205 / O2 S6 A5 I20
FDP / 17,377.19 / OP 948/31.07.2008 / 4,936.00 / 3.5205 / O2 S6 A6 I20
FDP / 33,444.75 / OP 949/31.07.2008 / 9,500.00 / 3.5205 / O2 S6 A7 I20
UNOPA / 134,532.39 / OP 950/31.07.2008 / 38,214.00 / 3.5205 / O2 S6 A1 I23
UNOPA / 14,722.73 / OP 951/31.07.2008 / 4,182.00 / 3.5205 / O2 S6 A3 I23
UNOPA / 176.03 / OP 952/31.07.2008 / 50.00 / 3.5205 / O2 S7 A9 I23
UNOPA / 44,217.48 / OP 953/31.07.2008 / 12,560.00 / 3.5205 / O2 S6 A9 I23
UNOPA / 92,747.57 / OP 954/31.07.2008 / 26,345.00 / 3.5205 / O2 S6 A10 I23
UNOPA / 17,514.49 / OP 955/31.07.2008 / 4,975.00 / 3.5205 / O2 S6 A11 I23
ANTISEPTICA / 892.50 / OP 956/31.07.2008 / 253.52 / 3.5205
TOTAL 31.07.2008 / 577,997.52 / 164,180.52

Romanian Angel Appeal, GFATM Implementation Department (FK, DM, AD, IH, SA), 09/08/2008Page 1