Minutes, DPG Health meeting 7th October 2015, Embassy of Ireland

Present

  1. Dr. Sudha SharmaUNICEFDPG H Outgoing Chair
  2. Leticia RweyemamuWHODPG H Secretariat
  3. Dr. Rufaro ChatoraWHOMember
  4. Karen ZamboniIrish EmbassyMember
  5. Dr. Richard BandaWHOMember
  6. Gradeline MinjaDANIDAMember
  7. Gayle MartinWBMember
  8. Dr. Alphoncina NanaiWHOMember
  9. Misa TamuraJICAMember
  10. Joshua LevensPEPFARMember
  11. Susanne GrimmGIZMember
  12. Angela MakotaCDCMember
  13. Miriam LutzUSAIDMember
  14. Dr. Grace SagutiWHOMember
  15. Suma MbatianiKOICAMember
  16. Dr. Theopista JohnWHOMember
  17. MadaniThiamDFATDMember
  18. Felister BwanaUNFPAMember
  19. Dr. Yahya IpugeWBMember
  20. Xiomara BrownDOD/WRAIRMember
  21. Eimear McDermottIrish EmbassyMember
  22. Catherine ShirimaJICAMember
  23. Emmanuel BainganaUNAIDSMember
  24. Harry OpataWHO Guest

AGENDA

  1. Welcome and Introduction of members
  2. Adoption of the Minutes + Agenda + Matters Arising
  3. Updates on SWAp events
  4. Update on Cholera Outbreak Control
  5. Critical issues from TWGs/ Thematic Areas
  6. Update on key events/ missions
  7. AOB:
  8. Next DPG-Health Meeting, proposed 22nd or 28thOctober 2015

Matters Arising:

Agenda / Action point / Responsible person/Agency / Status
Updates on SWAp events:
PAF Health Indicator / Volunteers to work on PAF Health indicator should inform Karen Zamboni / DPs
Update on Cholera Outbreak Control / WHO to provide talking points on what the government and partners can do,to be shared with Ambassadors and Heads of Agency. / DPG H Secretariat / Done

Main DPG-H meeting:

  1. Welcome and Introduction of members

The Outgoing Chair chaired the meeting on behalf of the Chair whom mebers were informed is out of the country. Members were warmly welcomed to the meeting followed by a round of introductions. New World Bank Program Lead, Gayle Martin was introduced and welcomed to the group.

  1. Adoption of the Minutes, Agenda and Matters Arising

Minutes of the September meeting were approved and Agenda of the October meeting was adopted.

  1. Updates on SWAp events:

HSSP IV Progress: The final copy was shared and has been uploaded on the DPG Health website.

JAHSR:

  • ToR for JAHSR has been shared with the DPG H members.
  • The Policy meeting has been postponed to19thNovember 2015 to allow a new Minister to participate.
  • USAID will support consultancy fee for the Moderator, MOHSW will approach WHO to support Rapporteur.
  • Technical meeting will be in November 4th and 5thas planned.

Code of Conduct and Common Management Arrangements: Comments from DPs on Code of Conduct were received. The Common Management Arrangements is still on draft, will be shared with DPG H.

Feedback on the Joint Field Visit:It was a very good learning experience with excellent participation from MOHSW. PMORALG and SIKIKA also participated. There were three teams: Kigoma, Tabora and Geita. The teams will meet next Tuesday 13th October 2015 to compile the field report which will be shared during the JAHSR. BRN regions were not fully aware of BRN initiative whereas Tabora was, and there are very useful innovative ways of staff retention in Tabora.

PAF Health Indicator:Need to reconfirm the value for 2014 achievement and the target for 2014/15. The last PAF indicator was done by DANIDA, partners support is required to work together on this. Any volunteers should inform Karen Zamboni (Irish Embassy). Angela Makota (CDC) volunteered. Though the target for nurses ratio3:10,000 population is below the national target, it is expected that the MOHSW will achieve and raise it accordingly.

  1. Update on Cholera Outbreak Control

WHO gave updates on the Cholera outbreak control, the outbreak started in Dar es Salaam on 15th August 2015. 11 other regions are affected including Dodoma, Geita, Iringa, Kigoma, Kilimanjaro, Mara, Morogoro, Mwanza, Pwani, Shinyanga and Singida. The outbreak in Dar has an epidemiological linkage with other regions except Kigoma. There are currently 3559 suspected and confirmed cases including 54 deaths. Dar es Salaam is the most affected Region with 2668 cases and 33 deaths. Singida rural is still reporting many cases. Laboratory tests have confirmed presence of Vibrio Cholera, Type 1, Ogawa strain. Deep wells have been contaminated due to sandy soil and high pit latrine. There are also illegal connections to DAWASCO water where sewage can go in due to broken pipes. The national Task Force has been triggered from the National to Municipal level and is informed of the daily meetings happening from regions to municipals levels. The Water sector was informed of the actions to be taken but the implementation is still low.

Partners who support cholera outbreak control include: UNICEF, WHO, USAID, CDC, PSI and Tanzania Red Cross Society. The Red Cross works as the main volunteers on the ground in collaboration with UNICEF. Partners’ support has been provided on the following areas: lab reagents, commodities, water treatment, capacity building for case management, water testing and funding for supervision and social mobilization.

The cholera cases started to decline in the Mid-September due to the efforts that were put to enforce by-laws. But they increased again after the Municipals have been told not to interfere with food vendors and water sellers. There are a number of proposed actions for cholera outbreak control and the budget summary will be reviewed after other gaps have been identified.

Discussion:

There is a need to push harder in terms of the broken pipes getting repaired. There is also a need to address the root causes. Short and long terms measures need to be in place. The control issues should be escalated to higher level. Partners need to see what they can do and how much they can contribute for outbreak response. Public health by-laws are very important in outbreak control. There is a need to ensure safe general elections without outbreak but the issue of food vendors and water sellers is a problem as both the regional and municipal teams were told not to interfere. The solution is the political decision to put control measures in place. The Ambassadors should talk to the government because this would be a better way to go and we could see some change. On the commodities, the initial plan was TZS 700m for Dar es Salaam only. At the DPG Main meeting it was suggested that we should be more ambitious to include CERF proposal for epidemic control. Involvement of CSOs in the control is crucial, they might be very helpful in terms of taking the key messages to communities. APHFTA is trying to see how they can help the government in the control, they will involve private hospitals.

Action: the meeting requested WHO to provide talking points on what the government and partners can do so that each DP could take to his/her Ambassador or Head of Agency. Attention should be put on behavioural change, coordination at highest level, to allow public health interventions especially to the most affected areas, need for money for volunteers to do house to house and street to street social mobilization, commodities for WASH and case management. DPs were also recommended to take preventive measures in their household.

  1. Critical issues from TWG/Thematic Areas

Detailed TWG/Thematic Areas Updates including, PPP, Pharmaceutical, Global Fund, DPG Nutrition and DPG AIDSare available at the DPG H website:

Highlights:

(i)Health Basket Fund

Basket partners met two weeks ago to see how the implementation of the new MoU and Side Agreement will be. ToR for Audit Sub-Committee is currently developed, Canada will take a lead in representing DPs in the Committee. A pilot region for direct disbursement of HBF to health facilities will be identified and the implementation will start next year. A guideline for disbursement is being prepared. DPs with comments on what to consider for direct disbursement should communicate with HBF Coordinator, WB by Friday 9th October 2015. The HBF Coordinator will send a reminder to basket partners about this.

(ii)DPG AIDS

WHO has released a new Guideline for prevention and treatment of HIV whereby ARVs should be initiated in everyone living with HIV regardless of CD4 count, and that daily use of oral pre-exposure prophylaxis (PrEP) be offered as an additional prevention choice for people at “substantial” risk of HIV infection as part of a combination prevention approach. The treatment recommendation will increase the global number of people becoming eligible for ART from currently 28 million to all 36.9 million people living with the virus. WHO realizes the cost implications but priority should be to the most affected people. The full cost implication will come out in December 2015 during the launching of the Guideline.

Global Standards for Quality Care for Adolescents has been developed by WHO and UNAIDS and it is now in place for countries to adopt, the government has not yet been engaged.

AIDS WorldDay will be in Singida and the new President is expected to be the Guest of Honour.

Draft HIV Investment case has been shared with partners working on HIV/AIDS for their comments, will have a roundtable meeting in November.

(iii)Global Fund

DPG Sub-committee on MSD:Weekly update on MSD assessment findings will be circulated to DPG H. TNCM debrief by the GF mission on MSD assessment will be on 12th October while for DPG H/ AIDS will be on 13th October 2015. The MSD report will also be shared during the JAHSR.

(iv)PPP TWG

Service Agreement has been revised, the Guideline on how to use it will be produced in Swahili language. APHFTA is looking on the ways to work with City Council on Cholera Outbreak Control. DANIDA is looking for a possibility of doing a tailor made PPP in the country instead of sending people to Denmark so as to train as many people as possible. Consultancy report on PPP forum will be finalised at the end of November for preparation of the Strategic Plan.

(v)RMNCH

RMNCH Plan is still in draft, the policy guideline that was reviewed has been completed. The Annual RMNCH Conference has been conducted in Dodoma where it provided updates from zonal and regional teams on the implementation of the Sharpened Plan, Draft Roadmap II, BRN, HSSP IV, SDGs and reviewed implementation of last year EMOC Assessment. The currentEMOC Assessment consolidated report will be shared with the technical committee by next week. Update on HMIS was also provided to encourage reporting and data gaps were identified, including maternal deaths reporting. CRVS is missing in One Plan II as GFF Investment Plan looks at health component and beyond i.e. CRVS. The final CRVS Strategy will be shared with stakeholders. There is a new funding for RMNCH which is going to run up to June 2016, this can be presented at the next DPG H meeting.

(vi)DPG Nutrition

The government is developing a national roadmap for the multi-sectoral nutrition response, including a costed implementation plan. DP’s are being asked to provide support to fund the preparation activities as well as provide technical assistance in a number of task forces in key technical areas. When the Prime Ministers’ Office shares the key areas, DPGN would like to ask all partners (not just those already funding nutrition) to consider whether they have technical expertise to share. DPGN are keen to ensure that nutrition is well covered in the new 5 year development plan (the new MKUKUTA), so if DPGH is invited to participate in consultations please include DPGN. DPGN would like to be informed of the process and ensure TFNC is actively involved.

(vii)RMO/DMOs Conference

Health Basket Fund (HBF) presentation was made by a person who was not involved in HBF so the presentation did not come out clearly. RMOs/DMOs will need another orientation session for HBF. Dr. Sudha Sharma will visit Mbeya next Thursday 15th October 2015 where DMOs from 10 districts will meet, she will present on HBF. If any DP organises RMOs/DMOs can inform WB to come and present on HBF, or any DP going to the field can update the RMO/DMO.

  1. Updates on key events
  • APHFTA Annual Scientific Conference will be held in December 2015.
  • Private Sector Health Summit in November 2015
  • Health Basket Financing discussion in Zanzibar on 8th October 2015.
  1. Next meeting:

The next meeting will be held on Wednesday, October28th, 2015 at Embassy of Ireland at 12:00pm to prepare for the November 4th-5thJAHSR.

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