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Regional Malaria and Other Communicable Disease Threats Trust FundFinal Report

This report details the key achievements of the Regional Malaria and Other Communicable Disease Threats Trust Fund from its creation in 2013 to the first half of 2018. It provides detailed analysis of the results by outcome, profiles specific projects that serve as exemplars of the fund’s impact, and offers insights into how similar trust funds can be managed for success in future.

About the Asian Development Bank

ADB is committed to achieving a prosperous, inclusive, resilient, and sustainable Asia and the Pacific, while sustaining its efforts to eradicate extreme poverty. Established in 1966, it is owned by 67 members—48 from the region. Its main instruments for helping its developing member countries are policy dialogue, loans, equity investments, guarantees, grants, and technical assistance.

REGIONAL MALARIA AND OTHER COMMUNICABLE DISEASE THREATS TRUST FUNDFINAL REPORT

NOVEMBER 2018



NOVEMBER 2018

REGIONAL MALARIA AND OTHER COMMUNICABLE DISEASE THREATS TRUST FUND

Migrant and mobile populations (MMPs)reached

through community outreach events in Lao PDR and Myanmar trained

Malaria workers, health workers,

and peer educators

in Cambodia, Lao PDR,Myanmar, and Viet Nam

malaria microscopy

IEC materials developed and distributed

Mosquito protection commodities (including LLINs) distributed

Proportion of reached MMPs aware of malaria transmission

Malaria incidence significantly declined in high burdened project sites P. falciparum incidence per 1000

Cambodia Lao PDR

in Asia and the Pacific commit to the malaria elimination road map

Leaders

First ADB health bond launched

developed with Curtin University-WHO Collaborating Center on HIAHealth Impact Assessment (HIA) curriculum

targeting 262 future practitioners

Universitiesin the GMS

government and

HIAtrainingin ADB

• Included in the standard poverty and social analysis training• Integrated into the Air Quality training

HIAdemonstration

in the GMS

Transport

Energy

Urban development

Water supplyand sanitation

special economic

zones

Malaria risk maps developed and used in Cambodia, Lao PDR and Myanmar

Capacity building on Health Information System geo-enabling

Public health facility readiness to provide malaria services mapped in Viet Nam

Unique patient ID assessment tool developed and applied in the GMS

Capacity building for HL7 FHIR in Viet Nam for information systems interoperability

GMS=Greater Mekong Subregion; HIA=health impact assessment; IEC=Information, education and communication; Lao PDR=Lao People's Democratic Republic; LLIN=long-lasting insecticidal nets; MMPs=migrant and mobile populations; NRAs=National regulatory agencies; SF=substandard and falsified.

KEY ACHIEVEMENTS

Malaria elimination dashboard developed

to track progress toward the commitments

Investment cases and tool kitsfinancing malaria elimination

for

• National and regional investment cases • Business cases for private sector

engagement• Malaria elimination transmission a

nd costing model •

analysis toolmalaria elimination and addressing communicable disease threats

ADB-Global Fund memorandum of understanding for blended financing

National Regulatory Agencies (NRAs) operational capacities strengethened in the GMS

New financing mechanisms for

Country and regional NRA capacity development

road maps created

Pharmacovigilance Medical device regulation

Chemistry, manufacturing

and controls

Bioequivalence Standardized approach to

medicine reviews

countries trained on SF incidents and WHO reporting tool

6 portable devices assessed

detect malaria SF medicines

Electronic drug registration information system

established in Myanmar

Landscape analysis of health management information systems in the GMS

Malaria data analytics based on mobile phone call

records in Thailand

Cross-border information

exchangeNumber of monthly disease information

exchanged within cluster provinces in

Cambodia, Lao PDR, and Viet Nam

in 2017

$100 million

Transformational digital interventions

Viet Nam

Creative Commons Attribution 3.0 IGO license (CC BY 3.0 IGO)

© 2018 Asian Development Bank6 ADB Avenue, Mandaluyong City, 1550 Metro Manila, PhilippinesTel +63 2 632 4444; Fax +63 2 636 2444www.adb.org

Some rights reserved. Published in 2018.

ISBN 978-92-9261-364-8 (print), 978-92-9261-365-5 (electronic)Publication Stock No. TCS189605-2DOI: http://dx.doi.org/10.22617/TCS189605-2

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CONTENTS

Tables and Figures vii

Acknowledgments viii

Abbreviations ix

Executive Summary xi

1. Introduction 1From Control to Elimination 1Asian Development Bank and Malaria Elimination 3Leadership, Collaboration, Innovation 3The Structure of the Regional Malaria and Other Communicable Disease Threats Trust Fund 4

2. Fund Utilization and Management 6

3. Results by Outcome 8Outcome 1: Leadership 9

Rationale 10Asia Pacific Leaders Malaria Alliance Support 11Investment Cases 11Enabling Factors 12Next Steps and Sustainability Pathway 12

Outcome 2: Financing 13Rationale 14Mobilizing Financing 14Landmark Collaboration 14Enabling Factors 15Next Steps and Sustainability Pathway 15

Outcome 3: Medicines 16Rationale 17Regulatory Systems Strengthening 17Medicines Safety 18Malaria Medicines Field Testing 18Myanmar Regulatory Reform 19Enabling Factors 19Next Steps and Sustainability Pathway 19

Contentsvi

Outcome 4: Information Systems 21Rationale 22Landscape Analysis 23Malaria Surveillance 23Geospatial Technology 23Policy and Strategy 24Investment Guidance 24Viet Nam 25Enabling Factors 25Next Steps and Sustainability Pathway 26

Outcome 5: Laboratory Diagnostics and Surveillance 27Rationale 28Communicable Disease Control 2 - Additional Financing 31Laboratory Quality Assurance and Malaria Surveillance in Myanmar 31Migrant and Mobile Populations 31Enabling Factors 32Next Steps and Sustainability Pathway 32

Outcome 6: Promotion and Prevention 34Rationale 35Malaria Prevention in Infrastructure Development 35Case Study in Urban Development Project 35Case Studies in Special Economic Zones and Border Development 35Curriculum Development and Training 37Regulations and Guidelines 37Enabling Factors 38Next Steps and Sustainability Pathway 38

4. Knowledge Products and Publications 39

5. Gender Dimensions 41

6. Annex 42Annex A. RMTF Results-Based Framework 42Annex B. Glossary of Results-Based Framework Terms 75Annex C. Gender Dimensions 76Annex D: Finance 82Annex E. RMTF Recommendations for Management of Future Trust Funds 83

TABLES AND FIGURES

TABLES

1 Results of Outcome 1.1 102 Results of Outcome 1.2 113 Results of Outcome 2 144 Results of Outcome 3.1 175 Results of Outcome 3.2 186 Results of Outcome 4 227 Results of Outcome 5.1 288 Results of Outcome 5.2 289 Results of Outcome 5.3 2910 Results of Outcome 5.4 3011 Results of Outcome 6.1 3612 Results of Outcome 6.2 37

FIGURES

1 The RMTF Ecosystem 22 Cambodia - Malaria Incidence per 1,000 population 23 Lao PDR - Malaria Incidence per 1,000 population 34 Viet Nam - Malaria Incidence per 1,000 population 35 Projects of the Regional Malaria and Other Communicable Disease Threats Trust Fund 5

ACkNOwLEDGMENTS

Report preparation led by Susann Roth and Jane Parry, supported by Rosebelle May Azcuna, Liza Tabora, Randolph Dacanay, and Editha Santos. Graphic design and layout led by keisuke Taketani.

Financing partners: The Government of Australia (Department of Foreign Affairs and Trade); the Government of Canada (Department of Foreign Affairs, Trade and Development); and the Government of the United kingdom (Department for International Development).

ABBREVIATIONS

ADB Asian Development BankADF Asian Development FundAeHIN Asia eHealth Information NetworkAPLMA Asia Pacific Leaders Malaria AllianceAOP annual operational plan APMEN Asia Pacific Malaria Elimination NetworkCDC communicable disease controlCoRE Centre of Regulatory ExcellenceCSO civil society organizationDFAT Department of Foreign Affairs and Trade, AustraliaDFID Department for International DevelopmentDFTAD The Department of Foreign Affairs, Trade and Development DMC developing member countryDMS Data management systemeCDS electronic communicable disease surveillance eHealth ICT in the health sector, also called “digital health”FDA Department of Food and Drug Administration GAP gender action planGIS geographic information systemGlobal Fund/GFATM The Global Fund to Fight AIDS, Tuberculosis and MalariaGMS Greater Mekong SubregionHIA health impact assessmentHIE health information exchangeHIGAF health ICT governance architecture framework HINARI HINARI Access to Research in Health Programme HIS health information systemHISP Health Information Systems ProgrammeHL7-FHIR HL7 Fast Healthcare Interoperability Resources ICT information and communication technologyIEC information, education and communicationIOM International Organization for MigrationIRIMS integrated regulatory information management systemLLIN long lasting insecticidal netsLOMwRU Lao-Oxford-Mahosot Hospital wellcome Trust Research UnitM&E monitoring and evaluationmDMS Mobile data management systemMETCAP Malaria Elimination Transmission and Costing in the Asia PacificMMP mobile and migrant populationsMOH Ministry of HealthMOHS Ministry of Health and Sports

Regional Malaria and Other Communicable Disease Threats Trust Fundx

MORU Mahidol Oxford Research UnitMOU memorandum of understandingMPEAT Malaria Program Efficiency Analysis Tool NMCP National Malaria Control ProgrammeNGO nongovernment organizationNHL National Health Laboratory NRA National Regulatory AgencyOCO Office of Cofinancing OperationsLao PDR Lao People’s Democratic RepublicPHMP Public Health Management Plan PMU project management unitPNG Papua New GuineaPPMU provincial project management unitPRC People’s Republic of ChinaRBF results-based frameworkR-CDTA regional capacity development technical assistanceRECAP Results for Malaria Elimination and Control of Communicable Disease Threats in

Asia and the PacificRMTF Regional Malaria and Other Communicable Disease Threats Trust FundRRP Asia Pacific Regional Regulatory Partnership for Malaria Elimination RRT Rapid response teamSDG Sustainable Development GoalSEARO Regional Office for South-East Asia SERD Southeast Asia DepartmentSEZ Special Economic Zone SF substandard and falsifiedSOP standard operating procedure TA technical assistanceTGA Therapeutic Goods Administration, AustraliaUCSF/MEI University of California, San Francisco Malaria Elimination InitiativeUHC universal health coverageURC University Research Co.US United StatesVMG volunteer malaria groupwHO world Health OrganizationwPRO Regional Office for the western Pacific

ExECUTIVE SUMMARY

The Regional Malaria and Other Communicable Disease Threats Trust Fund (RMTF) was set up in December 2013. Its remit was to support multicountry, cross-border and multisector responses to urgent malaria and other communicable disease issues, with a focus on the countries of the Greater Mekong Subregion (GMS).

In 2015 the fund moved from supporting the control of malaria to eliminating the disease as a public health threat. This shift was in response to growing resistance to artemisinin-based combination therapy, which was emerging in four GMS countries: Cambodia, Myanmar, Thailand and Viet Nam. The rationale was that achieving elimination in Asia and the Pacific would prevent resistance reaching the African continent.

Over the next 5 years, the project funded projects under six broad domains: leadership, financing, medicines, information systems, laboratory diagnostics and surveillance, and promotion and prevention.

Key achievements

• Galvanized malaria elimination leadership at the highest level and provided decision support for accountability;

• Introduced innovative mechanisms for malaria elimination financing and donor collaboration;• Supported regulatory and disease control bodies to work more effectively, strengthen post-market

surveillance of anti-malarials, and to collaborate with regional counterparts;• Convened partners within countries and across borders to work toward the common goal of eliminating

malaria;• Stimulated the appetite for transformational digital interventions and improved capacity, resulting in

increased surveillance and automated reporting of malaria and communicable diseases;• Strengthened the role of health impact assessment for malaria prevention in infrastructure projects and

special economic zones in border areas.

The Department of Foreign Affairs and Trade (Australia) and Department for International Development (United kingdom) contributions came to a close in June 2018, but in each of the six domains, a sustainability pathway was left in place to ensure that the results continue to resonate, that the governments of each country involved at different levels, together with donor agencies, nongovernment organizations and the private sector, can continue to build on what has been achieved.

HFPF Steering Committee Chair WooChong Um,

Director General, Sustainable Development and Climate Change Department (SDCC)

HFPF Steering Committee MembersMichael Barrow

Director General, Private Sector Operations Department

Hun KimDirector General, South Asia Department

Amy LeungDirector General, East Asia Department

Ramesh SubramaniamDirector General, Southeast Asia Department (SERD)

Werner E. LiepachDirector General, Central and West Asia Department

Ma. Carmela D. LocsinDirector General, Pacific Department

Ayako InagakiHealth Committee Chair, Director, Human and Social Development Division, SERD

Facility ManagerN.J. Ahmad

Deputy Director General, SDCC, concurrently Chief Compliance Officer

Robert GuildChief Sector Officer

Sustainable Development and Climate Change Department (SDCC)

Health Sector SecretariatPatrick Osewe, Chief of Health Sector, Health Sector Group, Sector Advisory Service Cluster (SDSC-HEA)

Eduardo Banzon, Principal Health Specialist, SDSC-HEASusann Roth, Senior Social Development Specialist, SDSC-HEA

Sonalini Khetrapal, Health Specialist, SDSC-HEAKirthi Ramesh, Social Development Specialist, SDSC-HEA

Pura Angela Wee-Co, Associate Health Officer, SDSC-HEAHoney May Manzano-Guerzon, Operations Analyst, SDSC-HEA

Wendy Nazal Montealto, Senior Operations Assistant, SDSC-HEA

Office of Cofinancing Operations (OCO)Kai Preugschat, Head, OCO

Ilaria Caetani, Principal Financing Partnerships Specialist, OCOGuenther Mate, Principal Financing Partnership Specialist, OCO

Marites Torres, Senior Financing Partnerships Officer, OCOKatherine Barrameda, Financing Partnerships Officer, OCO

Trina Mari M. Raymundo-Samia, Financing Partnerships Analyst, OCO

GOvERNANCE STRUCTURE Regional Malaria and Other Communicable Disease Threats Trust Fund

under the Health Financing Partnership Facility (HFPF)

1. INTRODUCTION

From Control to Elimination

when the Regional Malaria and Other Communicable Disease Threats Trust Fund (RMTF) was set up in December 2013, its remit was to support, for a five-year period, the Asian Development Bank’s (ADB) developing member countries (DMCs) to develop multicountry, cross-border, and multisector responses to urgent malaria and other communicable disease issues. In 2015 the fund moved from supporting the control of malaria to eliminating the disease through a process of strengthening health systems that would also have an impact on other communicable disease threats.

Two factors led to this decision: first, growing resistance to artemisinin-based combination therapy—the last line of simple-to-use and effective malaria drugs—had been detected in four countries of the Greater Mekong Subregion (GMS): Cambodia, Myanmar, Thailand, and Viet Nam.

Second, it became clear that with the right health systems’ building blocks in place, eliminating malaria was technically feasible in Asia and the Pacific. Elimination, as defined by the world Health Organization (wHO), is “the interruption of local transmission (i.e., reduction to zero incidence of indigenous cases) of a specified malaria parasite species in a defined geographical area.” Achieving this in Asia and the Pacific could prevent resistance reaching the African continent, where it would have devastating consequences and potentially reverse the gains in global malaria control made over the previous decade.

This shift in focus is aligned with the wHO Framework for Malaria Elimination, which calls on countries to put in place the tools and systems needed to reduce the disease burden of malaria and progress toward elimination as soon as possible.1 These interventions include enhancing and optimizing vector control and case management; increasing the sensitivity and specificity of surveillance; accelerating transmission reduction, and investigating and clearing individual cases. All of these were addressed under the RMTF.

In turn, the fund’s activities tied in with the health-related Sustainable Development Goals (SDGs) and targets, in particular SDG Target 3.3: “by 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases,” and SDG target 3.8: “achieving UHC, including access to quality essential health-care services and safe, effective, quality and affordable essential medicines.”2

The GMS countries overall have made great progress in controlling malaria. Data from the ministries of health in the recent years show that the Lao People’s Democratic Republic (Lao PDR) had an 85% decline in its malaria incidence from 7.2 in 2014 to 1.2 cases per 1,000 population in 2017. The malaria incidence in Viet Nam in 2014 was already low at 0.1 cases per 1,000 population but was further reduced by 40% in 2017. Cambodia had 3.1 malaria cases per 1,000 population in 2014 and was significantly reduced to 1.6 cases per 1,000 in 2016. The country however experienced a surge in the number of malaria cases in 2017, which raised the incidence level back to 3.0 cases per 1,000.

1 wHO. 2017. A framework for malaria elimination. Geneva: wHO.2 Sustainable Development Goal 3. https://sustainabledevelopment.un.org/sdg3

http://www.who.int/malaria/publications/atoz/9789241511988/en/

2 Regional Malaria and Other Communicable Disease Threats Trust Fund

Malaria transmission in the GMS is mostly concentrated in hilly, forested areas, in border areas, and where forest goers and temporary migrants and seasonal workers reside. Such areas were targeted in the RMTF through the CDC2-AF. In the project sites of Cambodia, the malaria incidence of 31.3 cases per 1,000 in 2014, more than halved to 13.1 per 1,000 in 2017. In the Lao PDR project sites, malaria incidence was reduced by 86%, from 31.1 in 2014 to 4.2 cases per 1,000 in 2017. The malaria incidence in the Viet Nam project sites was already low at 1.4 in 2015 but was further reduced to 1.0 cases per 1,000 in 2017.

Source: Ministy of Health, Cambodia, provided August 2018.

Outcome 1

Outcome 6

LOMWRU

Government/

Head of state

UN Agencies

Ministry of Foreign

A�airs Ministryof Health

GMS Health Security Loan

ADF Health Security

ADB Health Bond

Medicine outlet

AeHIN

HIS convergence, unique health ID,

standards and interoperability

Convergence of regulatory practices in ASEANfield malaria medicine

quality testing tools

CAN DFAT

DfID

AUS DFAT

UNICEF WHO

Laboratory quality

assurance and networksImproved service delivery

ADB RMTF

$28.7 millio

n

AeHIN Asia eHealth Information NetworkADB Asian Development BankADF Asian Development Fund APLMA Asia Pacific Leaders Malaria Alliance ASEAN Association of Southeast Asian NationsCD communicable diseases CoRE-NUS Center of Regulatory Excellence, Duke-National University of Singapore Graduate Medical SchoolDFAT Department of Foreign A�airs and TradeDfID Department of International DevelopmentDMC developing member countryFDA food and drug administrationGIS geographic information system

RRP Regional Regulatory PartnershipRMTF Regional Malaria and Other Communicable Disease Threats Trust FundSEZs Special Economic ZonesSSFFCs substandard, spurious, falsely labeled, falsified, and counterfeit commoditiesUCSF University of California, San FranciscoUN United NationsUNICEF United Nations Children’s FundUoO University of OsloUSP United States PharmacopeiaWHO World Health Organization

GIT Georgia Institute of TechnologyGMS Greater Mekong SubregionHIA health impact assessmentHIS health information systemsIOM International Organization for MigrationIRIMIS integrated regulatory information systemLOMWRU Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit MMPs migrant and mobile populationsMORU Mahidol Oxford Tropical Medicine Research UnitMSU Mahasarakham UniversityNRA National Regulatory AgencyPRCF fund People’s Republic of China (PRC) Regional Cooperation and Poverty Reduction Fund

IOM

Malaria

elimination

dashboard

APLMA

MMPs

Risk mapping, core registries,

and HIS geo-enabling

WHO

GIT

Mobile

phone

provider

Health

GeoLab

Collaborative

CoRE-NUS

$124 million

$52.5 millionreceived

$100 million

Curtin

Univ.

HIA Network

Asia Pacific

Clinics

Laboratory

RMTF Regional Malaria and Other Communicable Disease Threats Trust Fund

Outcome 3Outcome 4

Outcome 2

Outcome 5HIA in SEZs, energy, water,

urban development, tr

ansport

Reaching

MMPs

mHealth for

surveillance

Co-financing

MoU signed with the

Global Fund

Digital health

Centers of ExcellenceFDA Cambodia, Lao PDR,

and Viet Nam

LEADERSHIP

FINANCING

INFORMATION SYSTEMS

LABORATORY DIAGNOSTICS AND SURVEILLANCE

PREVENTION

Commitment for

domestic finance

for malaria and CDInvestment cases and

toolkits for financing

malaria elimination

Regionalcooperation

Infrastructure

CLINICCLINIC

USP Reporting of substandard

and falsified medicinesTesting portable

devices

for quality of

Malaria medicines

RRP

NRA capacity

assessment and

strengthening

work plans

Increased investment in Malaria and CD FDAMyanmar

Policies, IRIMIS, NRA

FDAPhilippines

Reliance policy

SIL-Asia

UCSF

PRCF funding

UoO

Digital Health

Investment Framework:

guidance and user manual

Private

Sector

ADB safeguard,

guidelines, policy,

capacity development,

demonstration projects

MEDICINES

MORU

Improved

malaria

diagnostic

capacity

Quality

assurance

Regional coordination unit

Malaria and CD data exchange,

joint outbreak investigations

AIH

Figure 1: The RMTF Ecosystem

Figure 2: Cambodia - Malaria Incidence per 1,000 population

3.1 1.8 2.4

31.3

17.3

24.9

3.5 2.1 1.7

22.2

12.2 11.5

1.6 0.9 0.8

7.33.0 4.83.0 1.8 1.4

13.1

4.4

8.9

05

101520253035

All malariacases

P.falciparum

cases

P. vivaxcases

All malariacases

P.falciparum

cases

P. vivaxcases

National

2014 2015 2016 2017

Mal

aria

cas

es p

er 1,

000

Project site

RMTF = Regional Malaria and Other Communicable Disease Threats Trust Fund.Source: Authors.

Introduction 3

Lao PDR = Lao People’s Democratic RepublicSource: Ministry of Health, Lao People’s Democratic Republic, provided August 2018.

Source: Ministry of Health, Viet Nam, provided August 2018.

Asian Development Bank and Malaria Elimination

Health is an integral part of ADB’s work, and under Strategy 2030, the bank’s new strategy agenda, it is recognized as a key building block to achieve a prosperous, inclusive, resilient, and sustainable Asia and the Pacific, while sustaining its efforts to eradicate extreme poverty.3 with its background in supporting regional health security, coupled with its commitment to investing in health, ADB is in a good position to

3 ADB. 2018. Strategy 2030: Achieving a Prosperous, Inclusive, Resilient, and Sustainable Asia and the Pacific. Manila. https://www.adb.org/documents/strategy-2030-prosperous-inclusive-resilient-sustainable-asia-pacific

support malaria elimination by strengthening health systems in the region. ADB’s established reputation and relationships with DMC governments, as well as its partnerships with other development agencies, the private sector, and civil society organizations (CSOs) have amplified the fund’s impact.

Through engagement with ADB, DMCs gain access to ADB’s technical assistance (TA) and grant funding, as well as to loans and innovative ways for countries to finance health systems strengthening. The RMTF was useful in catalyzing impact for malaria, but entrusting funds to ADB for malaria elimination also led to a return on investment beyond this goal. Many governments and donors are looking at integrative health programs, and are reaching for ways to strengthen health systems, both nationally and regionally. ADB had identified an emerging trend in government demand for health financing, to leverage past successes in vertical disease programs and begin to focus on integrated health sector and systems development.

In response to increasing demand for new types of financing to support integrated health goals, including malaria elimination, ADB engaged with the Global Fund to Fight AIDS, Tuberculosis and Malaria and other development partners. Through this consultative process with partners, donors, and governments, it became clear that funding for programs like malaria elimination required a new approach. This new approach built upon the successes of the RMTF to target blended financing for health. Partners such as the Global Fund recognize their investments are much more impactful over the long term when paired with ADB financing. This type of financing will also sustain results, such as strong health systems that prevent the reemergence of malaria.

Leadership, Collaboration, Innovation

The RMTF promoted political leadership on malaria elimination and related investments in health systems, including a higher level of sustainable domestic financing. It also mobilized more funds to tackle malaria and other communicable disease

Figure 3: Lao PDR - Malaria Incidence per 1,000 population

Figure 4: Viet Nam - Malaria Incidence per 1,000 population

05

101520253035

National Project sites

2014 2015 2016 2017

7.23.8 3.6

31.1

15.9 16.3

5.2 2.2 3.1

22.9

9.414.0

2.0 0.8 1.3

8.3

3.0 5.41.2 0.6 0.6

4.21.6 2.7

All malariacases

P.falciparum

cases

P. vivaxcases

All malariacases

P.falciparum

cases

P. vivaxcases

Mal

aria

cas

es p

er 1,

000

National Project sites

2015 2016 2017

Mal

aria

cas

es p

er 1,

000

0.1 0.1 0.1

1.4

0.8 0.7

0.1 0.0 0.0

0.9

0.6

0.3

0.1 0.0 0.0

1.0

0.7

0.3

0.00.20.40.60.81.01.21.41.6

All malariacases

P.falciparum

cases

P. vivaxcases

All malariacases

P.falciparum

cases

P. vivaxcases


threats. Its projects contributed to the process of fostering more reliable supplies of quality medicines, improved data for evidence-based decision-making, and strengthened national malaria and other communicable disease threats programs.

Through its projects, RMTF advocated for a collaborative approach to malaria elimination that goes beyond the health sector and national governments to draw in the private sector, nongovernment agencies, and the donor community across multiple domains, with a focus on health systems strengthening, rather than on a single disease.

The fund’s activities tackled malaria at multiple levels, from regional to national and subnational. For example, the fund boosted regional leadership on malaria elimination through its collaboration of the Asia Pacific Leaders Malaria Alliance (APLMA). RMTF projects also built regional learning networks for health impact assessment (HIA) of infrastructure projects, and in medicines regulation created a regional road map for regulatory systems strengthening. This in turn informed the work of a newly created Asia Pacific Regional Regulatory Partnership for Malaria Elimination (RRP). By providing additional financing to ADB’s already well-established regional communicable disease control project, the fund was able to build on preexisting successes, especially related to financing activities and building capacity at the subnational level rather than starting from scratch to develop a regional health project.

At the national level, projects under the RMTF entailed widespread engagement with government ministries for policy dialog, advocacy, and planning, strengthening both capacity building and evidence-informed decision-making. while national level action is key, many malaria elimination initiatives are most effective at the subnational level. The fund’s projects include subnational level malaria and communicable disease reporting, laboratory systems strengthening, access to innovative information and communication tools, post-market medicines surveillance, outreach to underserved and marginalized populations, and local-level training. The fund also supported malaria-specific operational research.

The Structure of the Regional Malaria and Other Communicable Disease Threats Trust Fund

The RMTF funded a range of projects under six distinct outcomes: leadership, financing, medicines, information technology, laboratory diagnostics and surveillance, and promotion and prevention. It took as its starting point the theory of change structure of the Department for International Development (DFID) of the United kingdom, which sought to address gaps in regional cooperation, sustainable financing for regional public goods in health, adequate incentives and institutions for the medicines supply chain, timely and reliable data, and effective program management.

Projects were then developed under each of the outcomes, deliberately tailored to the prevailing malaria and other communicable disease, and health system landscape in each country. This bespoke approach enabled the fund to best meet the needs of each country, rather than using an overly simplistic, one-size-fits-all approach. while development banks and donor agencies bring their own unique expertise to every project they fund, engaging implementing partners and coordinating within a crowded development partner landscape is crucial to the success of a project. ADB took a pragmatic approach to this, partnering with whatever agencies could best support each project, be they international nongovernment organizations (NGOs), CSOs, academic institutions, government agencies, or individual expert consultants. Taken together, these six pillars of the RMTF coalesced to form a health system strengthening approach, and the fund supported countries to reach for attainment of universal health coverage (UHC).

The RMTF financed regional capacity development technical assistance (R-CDTA), standalone projects, and grant components of investment to improve health outcomes and increase health security by reducing the risk of malaria and other communicable disease threats in Asia and the Pacific.

Introduction 5

The RMTF’s financing partners were the Government of Australia (Department of Foreign Affairs and Trade, $15.8 million), the Government of Canada (Department of Foreign Affairs, Trade and Development, $0.5 million), and the Government of the United kingdom (DFID $12.4m).

In total, the RMTF management has approved a total of $18.075 million for five technical assistance projects, and $9.5 million in additional financing for ADB’s Second GMS Regional Communicable Diseases Project (CDC2) (Figure 5).

Figure 5: Projects of the Regional Malaria and Other Communicable Disease Threats Trust Fund

Source: Authors.

2. FUND UTILIZATION AND MANAGEMENT

The donors’ total investment of $28.70 million and interest income of $316,764 were used to mobilize consultants, procure equipment, provide malaria-specific health services, conduct workshops and training, and cover costs directly related to trust fund administration and management. Total support by the RMTF to specific activities of five technical assistance and three grant projects in the GMS countries amounted to $28.33 million (Annex D). The bulk of the unspent balance of the RMTF, $685,703, were savings from the planned activities of CDC2-Additional Financing which were not pursued based on the advice of the governments of Cambodia, the Lao PDR, and Viet Nam. It was agreed with The Department of Foreign Affairs, Trade and Development (DFATD) Canada that its contribution, amounting to $531,916, can remain in the fund beyond 2018

and does not need to be returned. This leaves less than $150,000 from the income earned from investments from the RMTF under the Department for International Development (DFID) of the United kingdom and Department of Foreign Affairs and Trade, Australia (DFAT) contributions.

The ADB has reported quarterly to the donors on the status of RMTF utilization using a financial reporting system that is different from that used by the donors. Because the donors found ADB’s reporting system complicated, a financial dashboard was designed for donors’ easy understanding. The RMTF financial dashboard is an RMTF financial management tool that visually summarizes the quarterly comparative trends of RMTF disbursements from 2014 to 2018, and the results of Outcome 1 to Outcome 6 in the GMS countries.

Fund Utilization and Management 7

TRUS T FUND OUTCOME S

1 S treng thened leaders hip

2 Increas ed financing

3 Quality medicines

4 Improved informations ys tems

5S treng thened laboratorydiag nos tics ands urveillance

6Prevention ofcommunicable dis eas ethreats in infras tructureprojects

TRUS T FUND AMOUNT

Over-all in million US dollars

0 1 0 20 30

Total RMTF

DFAT

DFID

DFATD

Inves tment Income

1 5.76

29.02

1 2.41

0.53

0.32

Allocation per Outcome in million US dollars

0 1 0 20 30

Outcome 1

Outcome 2

Outcome 3

Outcome 4

Outcome 5

Outcome 6

Others / Inves tmentIncome

1 4.37

3.88

3.49

3.39

0.99

2.53

0.37

FINANCIAL S TATUS

Over-all Status as of Aug 201 8

91 %

9%

RMTF

S tatus per Outcome as of Aug 201 8

92%

24%

76%

8%

21

1 00%1 9%

81 %

43

1 00%

93%

7%

5 6

% disbursed from allocated amount

% undisbursed from allocated amount

ACCOUNTING FOR RESULTS The Regional Malaria and Other Communicable Disease Threats Trust Fund

3. RESULTS BY OUTCOME

The following section presents the results and achievements for each of the RMTF six outcomes. These are presented through a financial dashboard, results-based framework indicator table, list of TA projects contributing to the outcome, and

description of key achievements. Details of each RMTF output and activity are elaborated in the results-based framework (RBF) (Annex A) and project work plans.

Results by Outcome 9

1L E A D E R S H I P

1

Strengthened leadership, decis ion-making and accountabi l i ty for malar ia e l iminat ion and address ing communicable d isease threats .

RCDTA 8485: Strengthening Regional

Response to Malaria and Other Communicable

Diseases in Asia and the Pacific

R-CDTA 8763: Results for Malaria

Elimination and Control of Communicable

Diseases Threats in Asia and the Pacific (RECAP)

– Output 1

R-CDTA 8681 :Awareness Raising to

Adopt Action forMalaria Elimination in

Asia Pacific

OUTCOME 1 : S trengthened leadership, decision-making and accountability for malaria elimination and addressing communicable disease threats

KE Y OUTCOME S

Increased commitment and collaboration for malariaelimination and addressing communicable diseasethreats

Improved use of information for decision-making andaccountability to progress toward malaria eliminationand addressing communicable disease threats

OUTCOME RE S ULTS

Countries that have endorsed the malaria elimination roadmap(As of Aug 201 8)

Timor -Leste

Pakis tan

Nepal

Bhutan Bang lades h Afg hanis tan

Viet NamVanuatuUS

ThailandS olomonIs landsS ing apore

Rus s iaPNGPhilippines

New ZealandMyanmar

Malays iaLao PDRJ apanIndones ia

IndiaCambodia

Aus tralia

Countries Malaria-endemic country Donor country

E ndors ement s tatus E ndorsed Has not endorsed

Note: List of countries provided by Asia Pacific Leaders MalariaAlliance secretariat

Other key achievements

• Malaria E limination Dashboard• Investment cases for financing malaria elimination program and the Malaria Program E fficiency Analysis Tool developed

TRUS T FUND ALLOCATION

Totalallocationin million US $

2.53 S hare in RMTF 9%

DIS BURS E ME NT HIS TORY and PROJE CTION

Q2201 4

Q3201 4

Q4201 4

Q1201 5

Q2201 5

Q3201 5

Q4201 5

Q1201 6

Q2201 6

Q3201 6

Q4201 6

Q1201 7

Q2201 7

Q3201 7

Q4201 7

Q1201 8

81 ,021

279,1 73

59,51 4

41 5,1 81

66,998

226,499

59,828

27,991

323,606

253,541

1 58,875

1 31 ,023

30,224

1 1 5,465

93,523

22,641

2,345,1 03

Quarterly disbursements

Cumulative disbursement

Note: Moved UCS F financial data from Outcome 2 to Outcome 1 .UCS F outputs contribute better under Outcome 1 toward improveduse of information for decision-making and accountability.

Brunei Darussalam

People’s Republicof China

Democratic People’s Republic

of Korea

Republic ofKorea


Rationale

Globally, malaria infected 216 million people in 91 countries in 2016, leading to 445,000 deaths.4 Progress toward malaria elimination has stalled in many countries, and the world is failing to keep pace with wHO’s 2020 milestones that can bring about a 40% reduction in incidence and death rates by 2030. More than 2.1 billion people in Asia and

4 wHO. 2018. World Malaria Day 2018: Ready to beat malaria. Geneva: wHO. http://www.who.int/malaria/media/world-malaria-day-2018/en/

the Pacific are at risk of malaria, including 152.3 million in the GMS, making the disease a major regional public health concern. According to wHO estimates for Asia and the Pacific, there were 16.2 million malaria cases in 2016, and 30,300 deaths. with such a large-scale threat, eliminating malaria demands political and financial commitment at the highest level, for both national responses, and for regional partnerships and coordination of efforts.

Table 1: Results of Outcome 1.1Outcome 1.1 Increased commitment and collaboration for malaria elimination and addressing communicable disease threats

Outcome Indicator 2014Baseline

Status in Target Progress Output Indicator 2014Baseline

Status in Target Progress2016 2017 2016 20171. Number of malaria-

endemic countries that endorsed the malaria elimination road map

0 13 14* 21** 1. Malaria elimination road map developed

No Yes Yes Yes

2. Number of donor countries that endorsed the malaria elimination road map

0 7 7*** 7

Progress: Achieved or on track* Cambodia, India, Indonesia, Lao People’s Democratic Republic Malaysia, Myanmar, Papua New Guinea, People’s Republic of China, Philippines, Republic of korea, Solomon Islands, Thailand, Vanuatu, Viet Nam** APLMA’s 2020 target** Australia, Brunei Darussalam, Japan, New Zealand, Russian Federation, Singapore, United StatesSource: Authors.

Asia Pacific Leaders Malaria Alliance Support

Under the leadership component of the RMTF, APLMA—an affiliation of Asian and Pacific heads of government, housed within ADB from its establishment 2014 to 2016—was supported with technical input. APLMA is now a full fledged independent entity that works to accelerate progress against malaria and to eliminate it in the region by 2030. APLMA has also been financed directly by DFAT and the Bill & Melinda Gates Foundation in addition to the collaboration and specific technical support under the RMTF.

with support under the RMTF, APLMA has introduced the Leaders’ Dashboard, a decision and accountability tool that provides visibility to national and regional progress toward malaria elimination

targets, as well as fulfillment of priority actions and identification of areas requiring attention. Support was also provided to strengthen the investment case of malaria elimination.

Investment Cases

The RMTF competitively recruited the University of California San Francisco Malaria Elimination Initiative (UCSF/MEI) to develop a series of investment cases and a toolkit for financing malaria elimination programs. The investment cases aim to generate evidence around optimal ways to increase and expand the amount of sustainable financing in support of malaria elimination. National and regional policymakers can use this evidence to inform malaria program budgeting, strategic planning, and advocacy for domestic resource


Table 2: Results of Outcome 1.2Outcome 1.2 Improved use of information for decision-making and accountability for malaria elimination and addressing communicable disease threats



Status in Target Progress2016 2017 2016 20171. Malaria Elimination

Dashboard used to inform high-level regional policy dialog on malaria elimination

No No Yes Yes 1. Malaria Elimination Dashboard prototype

No Yes Yes Yes

2. Number of countries with data compiled from the world Health Organization (wHO) for the technical annex of the Malaria Elimination Dashboard

0 22 22 22

3. Number of countries with data compiled for Malaria Elimination Dashboard indicators

0 4 22 22

4. Malaria Elimination Dashboard finalized

No No No Yes

2. Investment cases and toolkit results used to inform high-level regional policy dialog on malaria financing

No No Yes Yes 1. Costing framework and tools developed*

No Yes Yes Yes

2. Number of countries/subregion with costing for malaria elimination* (BAN, IND, PNG, GMS)

0 2 2 4

3. Number of country/subregional investment cases developed* (BAN, IND, PNG, GMS)

0 0 4 4

4. Number of business cases for private sector investment in malaria control and elimination* (BAN/IND/PNG and GMS)

0 0 2 2

5. Malaria program efficiency analysis tool (MPEAT)*

0 0 1 1

6. Recommendations developed on financing options for the Asia and Pacific Region*

No No Yes Yes

Progress: Achieved at least 95% of targetBAN = Bangladesh, GMS = Greater Mekong Subregion, IND = India.* Upon review of the logical flow of outputs and outcomes, these outputs that were previously tracked under Outcome 2 (Financing) are moved here as these better contribute toward improved use of information for decision-making and accountability for malaria elimination and addressing communicable diseaseSource: Authors.


mobilization. The investment cases have since been used by both APLMA and ADB in policy dialog with countries and have also informed other parts of the RMTF’s work, including the financing component, to help malaria program managers collect, organize, and track data points related to the technical efficiency of a malaria program.

National investment cases were commissioned for Bangladesh, Indonesia, and Papua New Guinea (PNG); two regional investment cases, one for the Asia and Pacific region and another specifically for the GMS, with estimates on the cost and economic and financial returns of malaria elimination through 2030; and business cases for private sector engagement in malaria elimination and communicable disease control in Bangladesh, Indonesia, PNG, and the GMS.

The RMTF also supported the development of the Malaria Program Efficiency Analysis Tool (MPEAT), to help malaria program managers collect, organize, and track data points related to the technical efficiency of a malaria program. The MPEAT has been used in Bangladesh, Indonesia, and PNG. In Bangladesh and Indonesia MPEAT was used to identify areas that need strengthening, to maximize value, reduce waste, and ultimately save resources. In the Philippines, the costing tool was used to help navigate the country’s transition from Global Fund grant support to domestic financing for malaria elimination.

The tool is designed to be used in conjunction with the Malaria Elimination Transmission and Costing in the Asia Pacific (METCAP), a transmission

model that measures allocative efficiency, created by Mahidol Oxford Tropical Medicine Research Unit (MORU), in collaboration with the USCF and the University of Cape Town. The outputs of the METCAP have been transformed into an online interactive mobile application that generates reader-friendly graphs and charts showing changes in malaria morbidity and mortality and associated program costs under different intervention scenarios.

Enabling Factors

The Leaders’ Dashboard was an effective accountability tool, and the investment cases gave much-needed tangible evidence of the potential beneficial impact of malaria elimination ADB’s involvement brought each country’s ministry of finance to the table, which gave APLMA a level of reach that it could not have otherwise attained.

Next Steps and Sustainability Pathway

APLMA is now accepted as a legitimate policy platform, and DFAT also continues to support it. The Malaria Elimination Dashboard will hold leaders accountable, as well as supporting advocacy and communication to keep the malaria agenda active.

The partnership with APLMA under the RMTF also supported the collaboration with the Global Fund, which led to the signing of a memorandum of understanding (MOU), between ADB and the Global Fund to Fight AIDS, Tuberculosis and Malaria for a proposed regional financing facility (see p. 14).


2 F I N A N C I N GIncreased f inancing for malar ia e l iminat ion

and address ing communicable d isease threats

2

R-CDTA 8763: Results for Malaria

Elimination and Control of Communicable Diseases Threats in Asia and the

Pacific (RECAP) – Output 2

OUTCOME 2: Increased funds for malaria elimination and addressing communicable disease threats

KE Y OUTCOME S

Increased investments for malaria elimination andaddressing communicable disease threats

Increased domestic funds for malaria elimination

OUTCOME RE S ULTS

Amount of ADB g rants madeavailable for malaria eliminationand addres s ing communicable

dis eas e threats

Amount of country loans formalaria elimination and

addres s ing communicabledis eas e threats

201 4Baseline

May 201 7S tatus

201 7 Target 201 4Baseline

May 201 7S tatus

201 7 Target

22m$

83m$ 80m$

1 44m$

1 20m$

27m$


• New innovative mechanisms that mobilized financing such as ADB's first Health Bond of $1 00M and ADB-Global Fund MOU



0.37 S hare in RMTF 1 %


Q2 201 5 Q4 201 5 Q4 201 6 Q1 201 7 Q2 201 7 Q3 201 7 Q4 201 7 Q1 201 8 Q2 201 8

25,044

1 6,71 71 4,828

1 1 6,699

1 7,841

26,326

43,838

51 9

1 5,321

277,1 33


Cumulative disbursements

Note: Moved UCS F financial data from Outcome 2 to Outcome 1 .UCS F outputs contribute better under Outcome 1 toward improveduse of information for decision-making and accountability.


Rationale

Malaria elimination costs money, but the human and financial cost of underfunding is far higher. Securing funding entails both innovative approaches to sustainable health-care financing and ensuring that existing investments work smarter and are sustainable to achieve the most impact.

Mobilizing Financing

In 2015 the fund allocated $9.5 million to an existing project in Cambodia, the Lao PDR, and Viet Nam. However, it was the use of RMTF funding as a catalyst that enabled the fund to both focus on malaria, and to greatly amplify its impact, by raising additional ADB resources through the development of new financing mechanisms to support efforts for malaria elimination and addressing communicable disease threats.

A total of $52.5 million in grants was mobilized for health security measures from the Asian Development Fund (ADF), as well as an additional $125 million worth of loans and grants for health security in GMS countries and, most notably, the issuance of ADB’s first health bond. The private placement of $100 million issued in March 2017 was purchased by the Dai-ichi Life Insurance Company, Limited, making it the world’s first institutional investor to buy a bond that supports ADB’s health

program. The bond will support lending to countries on targeted health financing, including malaria and communicable disease programs, and ADB will continue to support the bond pipeline process for potential subsequent issues.

Landmark Collaboration

In late 2017, against a backdrop of Asia and the Pacific countries previously eligible for Global Fund grants transitioning to domestic responsibility for malaria and other communicable disease investments, the Global Fund and ADB signed a landmark MOU to find common ground and align malaria and other communicable disease funding opportunities. The MOU, signed in November 2017, was the first of its kind between the Global Fund and a development bank. The Global Fund/ADB MOU promotes ongoing coordination and future cofinancing between the two institutions, directly through projects and also through a new regional fund. There is already a project pipeline targeting health systems development and strengthening. Cofinancing opportunities for Bhutan, PNG, and Sri Lanka, as well as the GMS countries have already been mapped as a result of the MOU. The model is also proof of concept for ADB to collaborate with other donors on other health projects in future, beyond malaria, based on country needs and donor priorities.

Table 3: Results of Outcome 2Outcome Indicator 2014

BaselineStatus in Target Progress Output Indicator 2014

BaselineStatus in Target Progress2016 Q2 2018 2016 Q2 2018

1. Amount of ADB grants made available for malaria elimination and addressing communicable disease threats

$22.0m $82.5m* $82.5m* $80.0m 1. ADF health security grants for group A and B countries mobilized ($52.5m)

No Yes Yes Yes

2. Amount of country loans for malaria elimination and addressing communicable disease threats

$27.0m $144.0m* $144.0m* $120.0m 2. GMS health security funds approved ($117m as loan and $8m as grant)

No Yes Yes Yes

3. ADB Health Bond launched ($100m OCR)

No No Yes Yes

Progress: Achieved at least 95% of target * Cumulative amountADB = Asian Development Bank, ADF = Asian Development Fund, GMS = Greater Mekong Subregion, m = million, OCR = ordinary capital resources.Source: Authors.


Enabling Factors

Having a clear understanding of national government priorities and constraints, and establishing how public–private partnerships could appeal to both private and public sectors, paid off in terms of obtaining buy-in from both within ADB and with external partners. The success of the financing component is also a testament to the way in which the six outcomes worked together: the strong backdrop of projects that the RMTF had already developed, including the work done on what investments are needed to eliminate malaria, and the pipeline of upcoming projects gave much-needed traction to leverage the broader health sector.


A legal agreement between ADB and the Global Fund has been drafted for the design of the new Regional Health Fund. This fund will potentially finance priority strategic regional activities, provide support to countries in the region with

the highest malaria burden and least capacity to secure domestic funding, and scale up investments in national programs. It will meet demand for structured blended finance, allowing for integrated health sector development through concessional loans and innovative finance structures, including results-based grants, risk transfer mechanisms, and loan buy-downs. The vision is to provide a one-stop blended finance shop for governments to access finance that targets whole-system health programs. As a result, specific regional goals such as malaria elimination will also be expedited—with sustainable and long-term results—and health systems strengthened.

In addition, the health bond process was set up in a way that can be replicated, either for other health issuances or for related themes.

ADB has committed to health sector investment by increasing the health pipeline, providing substantial technical assistance, and integrating health in ADB country partnership strategies. The ADB Strategy 2030 also provides ample opportunity to leverage ADB’s strong infrastructure footprint for the health sector.


M E D I C I N E SImproved regulatory capacity to support increased avai labi l i ty and use of qual i ty assured medic ines for malar ia and other communicable d iseases

R-CDTA 8763: Results for Malaria Elimination and Control of Communicable

Diseases Threats in Asia and the Pacific (RECAP) Output 2 availability and use of quality assured commodities

3

OUTCOME 3: Improved quality assurance and post-market surveillance of medicines for malaria and other communicable diseases

KE Y OUTCOME S

Improved operational capacity of nationalregulatory agencies

Improved post-market surveillance of medicinesfor malaria and other communicable diseases

OUTPUT RE S ULTS

Status as of Aug 201 8

Completed nationalreg ulatory authority

capacity as s es s ment

Developed reg ulatorys ys tems s treng thening

plan

Cambodia

Lao PDR

Myanmar

Thailand

Viet Nam

Accomplished


• Country assesment reports and roadmaps through collaboration with Centre of Regulatory E xcellence• Cost-effectiveness analysis of portable detection tools for substandard and falsified medicines• E lectronic registration information system and tablet-based system and database for post-marketing surveillance of malaria medicines for Myanmar Food and Drug Administration



3.88 S hare in RMTF 1 3%


Q1201 5

Q2201 5

Q3201 5

Q4201 5

Q1201 6

Q2201 6

Q3201 6

Q4201 6

Q1201 7

Q2201 7

Q3201 7

Q4201 7

Q1201 8

Q2201 8

Q3201 8

339,527

201 ,461

431 ,1 26

477,303

33,470

1 08,281

1 66,91 9

21 2,734

41 8,598

1 06,855

375,695

207,628

20,243

2,41 11 3,901

3,1 1 6,1 52




Rationale

Eliminating malaria requires reliable supplies of safe and efficacious treatments delivered to where they are needed, but the market is plagued by substandard and falsified (SF) medicines. This undermines the work of the Global Fund to Fight AIDS, Tuberculosis and Malaria, and other development agencies bringing malaria medicines to where they are needed. Better regulation and post-marketing surveillance of malaria medicines is key to addressing this issue. This in turn requires strong national regulatory agencies (NRAs) with effective tools for testing and post-market surveillance of malaria medicines, as well as collaboration with the global community of practice tackling the international trade in SF medical products.

Regulatory Systems Strengthening

Many NRAs in Asia and the Pacific struggle to cope with marketing approvals of new health products, inspections of manufacturing and distribution facilities, and ensuring the continued quality of medicines and medical devices throughout the supply chain.5 The RMTF supported regulatory systems strengthening through collaboration with the Centre of Regulatory Excellence (CoRE), a regional capacity-building center and partner-coordinating platform for regulatory systems strengthening and convergence for Southeast Asian DMCs.

CoRE developed individual country assessment reports and road maps, which were further analyzed to develop a regional capacity development road

5 ADB. 2014. Better Regulation of Medicines Means Stronger Regional Health Security. ADB Briefs No. 54. April. Manila.

Table 4: Results of Outcome 3.1Outcome 3.1 Improved operational capacity of national regulatory agencies (NRAs)



Status in Target Progress2016 Q2 2018 2016 Q2 20181. Number of countries

with improved operational regulatory capacity

0 0 3* 3 1. Number of countries with NRA capacity profiles (CAM, LAO, MYA, THA, VIE)

0 3 5 5

2. Number of countries with NRA capacity strengthening road maps (CAM, LAO, MYA, THA, VIE)

0 0 5 5

3. Training modules developed

No No Yes Yes

4. Number of countries with NRA staff trained on priority regulatory issues and gaps

0 0 5 5

Progress: Achieved at least 95% of targetCAM = Cambodia, LAO = Lao People’s Democratic Republic, MYA = Myanmar, THA = Thailand, VIE = Viet Nam.* Cambodia, the Lao PDR, and Myanmar built capacity based on the Centre of Regulatory Excellence (CoRE) needs assessment, which helped identify areas of focus and improve partner coordination. The trainings conducted for country representatives and the road map developed all encapsulate capacity building. Additionally, the targeted technical support and work in Myanmar had a direct impact on the operational capacity of its Food and Drug Administration and ad-ditional activities addressing targeted monitoring of the quality of medicines on the market, linking the quality control laboratory into the electronic information system and developing the basis of a national drug safety strategy and pharmacovigilance system.Source: Authors.


Table 5: Results of Outcome 3.2Outcome 3.2 Improved post-market surveillance of medicines for malaria and other communicable diseases




piloting new field detection tools

0 0 1 1 SF field detection tools

1. Formal relationships with global and local research institutions established

No Yes Yes Yes

2. Library of active ingredients and finished product profiles developed

No No Yes Yes

3. Report on results of testing and cost-effectiveness evaluation of field detection tools

No No Yes Yes

4. Recommendations on cost-effective post-market surveillance field tools for detecting SF developed

No No Yes Yes

2. Number of wPRO and SEARO countries started to report to the global substandard and falsified (SF) medical products reporting mechanism*

0 6 10 5 SF reporting

1. Number of countries with staff trained on the wHO global SF reporting mechanism

0 22 22 22

Progress: Achieved at least 95% of target SEARO = Regional Office for South-East Asia, wPRO = Regional Office for the western Pacific, wHO = world Health Organization.* wHO does not divulge information on reporting by individual countries due to confidentiality rules. Source: Authors.

map, focusing on needs that are common among the five GMS countries. Further improvements in the operational capacity of NRAs in the GMS, while meeting their diverse needs, will require a coordinated effort by development partners, and with this in mind, the regional road map was shared with the RRP and the information was subsequently incorporated into the RRP workplan.

Medicines Safety

By sensitizing NRAs to the ways in which SF medical products contribute to artemisinin resistance and the danger this poses to malaria elimination efforts, the RMTF medicines component has supported countries to participate in the wHO monitoring mechanism for SF products. The training provided jointly with wHO led to improved reporting of SF

products into the wHO Global SF medical product reporting mechanism. In addition, six countries in the wHO western Pacific Region and South-East Region have since started to report SF products for the first time.

Malaria Medicines Field Testing

The RMTF also funded the Lao-Oxford-Mahosot Hospital-wellcome Trust Research Unit (LOMwRU) to test portable devices for detecting anti-malaria medicine quality in both controlled and field conditions. This research led to advice and strategic recommendations both for DMCs looking to invest in such devices, and to device developers to make them more fit for purpose. The devices were piloted with the Lao PDR NRA, which provided invaluable insight into their usability in the


field by resource-constrained NRA when testing antimalarial medications.

Myanmar Regulatory Reform

Myanmar’s regulatory agency, Food and Drug Administration (FDA), Myanmar, relied on a paper-based medicines registration, and the agency’s systems did not enable it to conduct effective post-marketing surveillance of malaria medicines, or efficiently bring new medicines to market. In late 2017, ADB worked with the regulatory agency, FDA, Myanmar, to move its paper-based registration system online to an integrated regulatory information management system (IRIMS), a digital platform that processes, stores, retrieves and shares information on regulatory activities. This is vital to ensuring the country can improve its supplies of safe, reliable, high-quality antimalarial medicines, a key facet of malaria elimination efforts.

By mid-2018, an online-only product registration application process was in place, including training of the private sector applicants, manufacturers, and agents. As part of establishing an IRIMS, the FDAs’ online databases were linked to those for the management of facility inspections and of quality control (QC) laboratories.

National QC lab and inspectors can now use a tablet-based system to connect to the central registration database to know which products are registered, and to directly upload images and videos of the facility they inspect, along with the inspection report and follow-up action. The FDA also reviewed its existing list of approved products, to compare them with those used by reference authorities. After this review, the online medicines registration system was set up to automatically trigger an alert on any products submitted for registration that contain banned or obsolete active ingredients. Product information documents, which describe a medicine’s indications, contraindications, dosages, and warnings, will also rely on reference texts obtained from the Therapeutic Goods Administration, Australia (TGA).

Enabling Factors

Recognizing NRAs as partners and key stakeholders in public health, and working with them together with technical agencies, especially wHO, was key to the success of this component. Coordinating efforts with other development partners ensured messaging to NRAs and training were aligned. CoRE was well placed to gain the trust and attention of NRAs, and to ensure that this newly established entity’s work was aligned with the needs of NRAs. Similarly, LOMwRU has key expert researchers in the field and is based in one of the GMS countries with close links to the regulatory agency there, which was helpful.

In Myanmar, one of the key enablers was the fact that there was little in place already, making it relatively easy to introduce a new system. There was also an alignment of interests in the new online product registration system, as registrants also find the online system and standardized terminology it easier and cheaper to use. Inspectors in the field are now able to check which antimalarial are registered, and what the packaging should look like, which makes it easier for them to identify SF products.


Implementation of recommendations for using portable testing devices still requires GMS countries to develop better policies on post-market surveillance and build the capacity of field inspectors who can act when suspected falsified and substandard medicines are identified. More understanding of the root causes of substandard medicines is needed to ascertain whether it is due to, for example, low-quality medicines entering the market, or subsequent incorrect storage along the supply chain.

while the portable devices that were assessed showed high sensitivity to falsified medicines, these devices were not optimal for detecting substandard medicines, yet in the Lao PDR, substandard malaria drugs are more prevalent than falsified ones in


registered drug outlets. Currently, there are no agreements on who will be responsible for building a reference library, and whether it is possible to have one at regional level.

Although there are regional bodies for capacity development, and plans are ongoing for development partner alignment and harmonization, more support is required for the Association of Southeast Asian Nations pharmaceutical working group and for building subregional (GMS) consensus on reliance policy and sharing of information on SF medicines.

In SF reporting, each country now has a designated, trained contact person on reporting SF medical products. Reporting from the region to wHO has increased as a direct result, and is expected to continue. Myanmar has had additional training of inspectors and developed a national task force and

action plan for addressing SF antimalarial medicines and other medical products. Also in Myanmar, DFAT is planning to continue funding the IRIMS work.

The capacity development plans that were developed for each NRA have been incorporated into the work of the RRP, which is helping to coordinate the actions of funding agencies and technical partners working to strengthen regulatory systems. At the national level, seven countries now have specific malaria elimination plans in place. wHO and TGA, the regulatory body for therapeutic goods in Australia, continue to be involved in supporting these efforts, and $20 million has been secured from DFAT to continue this work. The NRAs themselves have also taken up the task of regulatory system strengthening, and some have their own funding to commit to this task.


INFORMATION SYSTEMSIncreased use of qual i ty data , informat ion tools and technologies

to improve malar ia and other communicable d isease information systems

R-CDTA 8763: Results for Malaria Elimination and Control of Communicable Diseases

Threats in Asia and the Pacific (RECAP) Output 3

4

R-CDTA 8656: Malaria and Dengue Risk Mapping and

Response Planning in GMS in Cambodia, Myanmar and Thailand

OUTCOME 4: Increased use of quality data, information tools and technologies

KE Y OUTCOME S

Increased use of quality data, information toolsand technologies to improve malaria and othercommunicable disease information systems

eHE ALTH S OLUTIONS TE S TE D INGMS COUNTRIE S

Cambodia Myanmar Viet Nam

Unique Health IDs

GIS platform

Commong eo-reg is try

Dis eas es urveillances ys tem (eCDS v2)

HL7 and Fas tHealthcareInteroperabilityRes ources (FHIR)



3.49** Increased from 2.93

S hare in RMTF 1 2%


Q2201 4

Q3201 4

Q4201 4

Q2201 5

Q3201 5

Q4201 5

Q1201 6

Q2201 6

Q3201 6

Q4201 6

Q1201 7

Q2201 7

Q3201 7

Q4201 7

Q1201 8

Q2201 8

Q3201 8

701 ,225

408,959

296,793

592,272

98,1 43

422,649

21 3,381

272,033

35,27755,931

93,004

1 49,854

85,738

32,7464,307

24,909835

3,488,056




Rationale

A strong information and communication technology (ICT) backbone is crucial for countries to transition from malaria control surveillance to elimination. Strengthening health information systems through better use of ICT can help countries to unlock the data they already collect, and use it more effectively for eliminating malaria and controlling communicable diseases. In countries with numerous

disparate disease and patient-level systems and a complex ecosystem, tackling health information exchange, interoperability, and standardization directly improves the access to communicable disease data, both at the aggregate and patient levels. Interoperability efforts aimed at reducing the burden of health workers and providing seamless integration and transparency of information are needed to ensure use of the system.

Table 6: Results of Outcome 4Outcome Indicator 2014

BaselineStatus in Target Progress Output Indicator 2014

BaselineStatus in Target Progress2016 Q1 2018 2016 Q1 2018

1. Number of ICT solutions in use in malaria and other communicable disease information systems to improve and harmonize information management in GMS countries

0 0 3** 2 1. Surveillance mechanisms for malaria and communicable diseases mapped for GMS countries

No Yes Yes Yes

2. Recommendations on two ICT solutions to be used in the region

No Yes Yes Yes

3. Number of ICT solutions tested in GMS countries

0 0 5* 2

2. Number of countries utilizing harmonized geo-enabled malaria and dengue information systems

0 0 3 3 1. Number of countries with prevalence and incidence data for malaria and dengue analyzed

0 1 3 3

2. Number of countries with developed capacity of government public health experts for application of GIS-based visualization

0 1 3 3

3. Number of countries with GIS-based visualization system of malaria and dengue incidence and risk established and methodology evaluated

0 0 3 3

4. Number of countries with policy recommendations for targeting mobile populations in malaria and dengue surveillance and control programs communicated to Ministries of Health***

0 0 0 3

Progress: Achieved at least 95% of target Continued until Q4 2018 through additional funding for the workGMS = Greater Mekong Subregion, GIS = geographic information system, ICT = information and communication technology.* Unique Health ID in Cambodia; GIS platform in Cambodia, Myanmar, and Viet Nam; common geo-registry in Cambodia and Myanmar; Disease surveillance system (eCDS v2) in Viet Nam; HL7 and Fast Healthcare Interoperability Resources (FHIR) in Viet Nam.**GIS platform, common geo-registry and eCDS v2.***Policy recommendations are being developed currently and will be finalized as population movement results are shared and discussed with ministry of health (MOH) staff. Additional funding support has been secured by MORU to complete this work.Source: Authors.


6 Digital Health Infrastructure: The Backbone of Surveillance for Malaria Elimination - https://www.adb.org/sites/default/files/publication/210856/digital.

7 Funded under Outcome 5.8 ADB. 2016. The Geography of Universal Health Coverage. ADB Briefs No. 55. April. Manila.

Landscape Analysis

An RMTF-funded analysis of the landscape of health management information systems and malaria information systems in GMS countries found that most tools are used to manage malaria programs separately, without a common backbone or standards. A key finding was that support was needed so that a standards-based information system to benefit malaria and other communicable disease information system management could be built. To eliminate malaria, foundational components of surveillance are unique patient identification, the ability to track cases over the treatment course, and access to continuous timely surveillance data for both subnational and national stakeholders.

The analysis recommended several interventions, which informed subsequent projects under this outcome: implementation of good data management practices and digital health governance structure, agreement on digital health information standards and technical interoperability solutions, geo-enabling of the health information system, and implementation of unique health identifiers to link vertical disease information systems.6 The analysis showed that the gaps were not only technological, but also include the governance and enterprise architecture needed for the tools of ICT to be useful. Human resources for health information systems (HIS) were another key area for development under the project.

Malaria Surveillance

A low-cost software solution for hospital-based reporting of dengue cases in Myanmar was developed by MORU for piloting by the Myanmar Ministry of Health and Sports. MORU also trained local healthcare workers in high malaria risk areas in Cambodia and northeast Thailand to collect GPS data for village-level malaria risk mapping, a key step to local targeting of elimination activities. This uses a low-cost, high precision method developed by

MORU and the Asia eHealth Information Network (AeHIN) geographic information systems (GIS) Lab/Health GeoLab Collaborative with support from ADB. MORU mapped malaria and dengue surveillance data in Cambodia, Myanmar, and Thailand.

The project used data analytics based on call records, climate data, and travel surveys, to better understand the patterns of malaria infection and other communicable diseases (such as dengue) with regard to internal and cross-border migration. A consortium of research groups together with MORU analyzed mobile phone call records in Thailand to model the impact of population movement patterns on malaria and dengue distribution, and also analyzed travel survey data from patients with malaria in Cambodia, the Lao PDR, Myanmar, Thailand, and Viet Nam.

In Myanmar, data management systems for malaria surveillance were strengthened, including the use of mobile data management system (mDMS) for case reporting, and analytical tools for decision-making (see Outcome 5, pp.27).7 The project worked with grassroots volunteer malaria workers to improve routine, real-time case reporting through a mobile data management system piloted in the three townships. The mDMS, a smartphone-based app, was developed by Save the Children with the National Malaria Control Programme (NMCP), but RMTF funding enabled widespread piloting of the app for volunteer malaria workers and the initial results helped improve the app to make it more efficient and more user-friendly.

Geospatial Technology

The geographic dimension of malaria is key to enhancing disease surveillance and elimination through improved situational intelligence.8 In turn, ICT is key to geo-enabling a country HIS through geospatial technologies including GIS and the availability of a common registry of the geographic


objects core to public health (e.g., health facilities, administrative and reporting divisions, villages). RMTF funding supplied computer hardware and GIS software to Cambodia, Myanmar, Thailand, and Viet Nam, and also ran spatial data management and GIS training for national disease control program staff from the same countries, with the addition of Bangladesh and the Lao PDR.9 This initiative has now grown into the Health GeoLab Collaborative to bring more partners into the effort to geo-enable health systems in Asia and the Pacific and develop common geo-registries. RMTF funding also supported Cambodia, Myanmar, and Thailand to map and analyze national surveillance data for malaria and dengue.10

In Viet Nam, geospatial technology was applied to map the availability of malaria services in public health facilities and the readiness of these facilities to provide these services. This was done in nine districts with high malaria transmission rates. Results highlighted resource gaps in facilities to provide preventive, diagnostics, and treatment services. The same technology and assessment methodology have also been further applied by the malaria program.

Policy and Strategy

As governance was identified as a key gap in the malaria information systems landscape analysis, ADB developed a health ICT governance architecture framework (HIGAF), required for successful implementation and sustainability of digital health solutions. After consultation and close collaboration with health sector ICT experts in the region, the framework was further refined, leading to the creation of HIGAF 2.0, designed specifically to meet the evolving needs of DMCs in the region.11

key to continuity of care is the ability to track malaria-infected subjects wherever they connect with service delivery through a unique health identifier, and the RMTF supported the development of a tool for unique patient ID assessment, which was then applied in Cambodia, the Lao PDR, Myanmar, and Viet Nam.12 At the same time, policy recommendations from a brief on unique patient health IDs informed Cambodia’s strategy on national patient ID management, and the respective implementation plan. Mapping the country’s existing setup brought together different stakeholders at country level to decide on the country’s digital health vision and mission and develop potential next steps.

Investment Guidance

A working paper, Guidance for Investing in Digital Health, was published in May 2018, together with an accompanying website.13,14 The outcome of this work will inform decisions on developing digital health investments. This includes the strengthening of health systems as a whole, as well as the solutions required to address specific health challenges, such as malaria. The guidance demonstrates that investing simply in digitalizing the malaria surveillance and care system is not a value-for-money investment, and that there must first be a digital health foundation in place. Moreover, only a phased and well-planned investment in digital health can add significant value to malaria surveillance and at the same time remain sustainable. This is especially important to consider for development partners who tend to support the digitalization of vertical disease programs. The practicalities of delivering these outcomes while providing socioeconomic benefits have been addressed by developing an accompanying Digital

9 ADB. 2018. Building Capacity for Geo-Enabling Health Information Systems: Supporting Equitable Health Services and well-Being for All. ADB Briefs No. 88. February. Manila.

10 https://healthgeolab.net/.11 Transforming Health Systems Through Good Digital Health Governance. https://www.adb.org/sites/default/files/publication/401976/sdwp-

051-transforming-health-systems.pdf.12 ADB. 2018. Unique Health Identifier Assessment Tool Kit. Manila.13 ADB. 2018. Guidance for Investing in Digital Health. Manila. https://www.adb.org/sites/default/files/publication/424311/sdwp-052-guidance-

investing-digital-health.pdf.14 Digital Health: Strategy and investment. https://sites.google.com/view/digitalhealthasia/home.


Health Impact Framework (DHIF).15 The DHIF helps DMCs to understand how to invest in digital health for vertical disease programs while taking a health sector enterprise approach. Developed from over 60 digital health case studies from many countries, the framework helps decision makers make better informed decisions about planned socioeconomic and financial impacts. It can be applied to several projects simultaneously so decision makers can find an optimal fit of projects.

Viet Nam

Viet Nam was a focus country under the RMTF information systems component, and the projects there illustrate the importance of digital health improvements to support malaria elimination and communicable disease control. There were a number of interrelated RMTF-funded initiatives in digital health to improve the country’s generation and use of health data for malaria elimination. These initiatives helped the government establish a health ICT policy and develop an action plan to standardize national systems. The RMTF was also used to fund engagement for buy-in and training of health workers in the new policy and enhanced disease surveillance systems that are cased-based and include malaria and other communicable diseases.

with support under the RMTF, Viet Nam has adopted a digital health governance framework and decided to use the health-care standard HL7 FHIR as a practical solution to health data exchange and information systems interoperability. HL7 FHIR is a draft standard describing data formats and elements and an application programming interface for exchanging electronic health records especially in complex information systems so that patient data can be shared at all levels. Such data sharing is essential for countries to test, track, and treat and all malaria cases.

Before the involvement of the RMTF, in 2014 Viet Nam’s Ministry of Health (MOH), the US Center for Disease Control and Prevention, and

private sector international partners had already begun collaborating to build a data warehouse using the electronic health disease surveillance system (eCDS). The government recognized that an enhanced eCDS system could reduce the time needed to generate disease surveillance reports, improve access to data on vaccine coverage rates, enhance early outbreak detection on a case-level basis, and allow for real-time malaria surveillance.

One important goal was to implement digital health solutions to ensure timely reporting for all notifiable diseases, including malaria, as mandated by Viet Nam’s health policy. To bring all this work together, in February 2017, the MOH and the ADB met to identify a strategy and develop a workplan of activities and action for collaboration between the country’s health agencies. Further strengthening of disease surveillance at local health facility levels, including for malaria, was identified as a priority with system interoperability and provincial training as a next step.

Enabling Factors

For most of the ICT projects under the RMTF, once local champions were identified, either within government or in partner organizations with a strong local presence, projects gained traction. Countries also benefited from guidance in establishing or enhancing their vision for digital health in disease surveillance, and policy design, rather than implementation of small-scale technical pilots, which can lead to even more fragmentation, as seen in malaria programs. Making the most of ADB’s convening power, the RMTF projects brought together partners in ways they had not collaborated before, including separate ministries and departments within the same country, as well as uniting development partners to work more collaboratively toward a common goal. Another key enabler was deployment of both short-term international consultant experts and day-to-day engagement with local consultants.

15 Standards and Interoperability Lab for Asia. http://www.sil-asia.org/lab-assets/


The Viet Nam project succeeded because ADB brought key government decision makers together to get the foundations in place—standards, governance, and enterprise architecture—before launching in with new information systems. ADB was able to rally stakeholders and capitalize on the country leadership’s commitment to malaria and communicable disease surveillance as a health priority. The introduction of geo-enabling tools for surveillance, health information standardization, interoperability for vertical disease programs, community level information systems such as the Digital Health Frame were wholeheartedly embraced by the MOH. The decision to work with countries on their health-related ICT needs for malaria elimination existed at the start of the RMTF, but the project took off in Viet Nam in the latter part due to its right timing and commitment by all key stakeholders.


ADB helped establish both the Health GeoLab Collaborative, a collective of both institutions and individuals involved in geospatial technologies for health. Funding from the Bill & Melinda Gates Foundation is supporting continued geo-enabling work in Viet Nam, MORU’s risk mapping work in five GMS countries, and digital solutions to develop tools to support malaria elimination in Cambodia, the Lao PDR, and Viet Nam. Analysis of call data records to determine the impact of human mobility on malaria and dengue is ongoing.

ADB loans are in the pipeline for Viet Nam with an ICT component funded with an ADF grant to support the rollout of electronic health records with automated reporting of communicable diseases and malaria cases into vertical disease reporting systems. The Clinton Health Access Initiative and the National Institute of Malariology, Parasitology and Entomology, and Viettel Telecom and the Health Information Systems Programme Viet Nam continue to collaborate on developing the country’s malaria management system aligned to new standard operating procedures and reporting forms for malaria case and foci reporting and investigation. Viet Nam is making its own investments in patient portals and cloud-based health information systems to support national information systems.

To further ensure the timely subnational patient-level disease information, ADB supported the local health report automation by providing technical resources specific to District Health Information System (DHIS 2) that provides standardized health reporting from the 12,000 local health communes. This countrywide grassroots system will be connected with the district hospitals and national data center and is crucial in the timely access to patient-level communicable disease reporting and generation of the national health statistics. To help ensure standardization and disease reporting interoperability, ADB supported provincial-level MOH training of trainers and the drafting of standard operating procedures for reporting, which will also contribute to the sustainability of this project’s achievements.


LABORATORY DIAGNOSTICS AND

SURVEILLANCEImproved capacity of laboratory d iagnost ics and survei l lance systems

for malar ia and other communicable d iseases , inc luding cross-border coordinat ion5

G0448/G0449/G0450: CAM/LAO/VIE: Additional

financing for Second Greater Mekong Subregion

Communicable Diseases Control Project (CDC2)

RCDTA 8959: Malaria and

Communicable Diseases Control in the

GMS

OUTCOME 5: Improved capacity of laboratory diagnostics and surveillance system for malaria, including cross border coordination

KE Y OUTCOME S

Improved diagnostic and surveillance capacity formalaria

Improved cross-border coordination for malaria

S UPPORT TO COUNTRIE S

Cambodia Lao PDR Myanmar Viet Nam

S treng theningprovincialmalariadiag nos tic ands urveillancecapacity

S treng theningcros s -bordercoordinationfor malaria

Addres s ingmalaria amongmobile andmig rantpopulations



1 4.37 S hare in RMTF 50%


Q4 201 5 Q1 201 6 Q2 201 6 Q3 201 6 Q4 201 6 Q1 201 7 Q2 201 7 Q3 201 7 Q4 201 7 Q1 201 8 Q2 201 8 Q3 201 8

1 8,759

1 ,600,1 39

287,81 4

1 ,423,535

805,089

1 ,368,347

2,855,652

1 76,22921 8,44075,698

4,560,429

25,81 9

1 3,41 5,950




Rationale

Track, test, and treat is the mantra of malaria elimination, but this chain of events breaks down unless laboratory diagnostics and surveillance

systems are strong and well-functioning. The RMTF aimed to leverage ADB’s existing projects in communicable disease control that improved diagnostics and surveillance in the GMS, including to remote places and hard-to-reach populations, and strengthened cross-border cooperation.

Table 7: Results of Outcome 5.1Outcome 5.1 Increased diagnostic testing for malaria in project areas of Cambodia, Lao PDR, and Viet Nam



Status in Target Progress2016 2017 2016 20171. Annual blood

examination per 100 pop at risk for malaria in the project areas*

Diagnostic capacity for malaria

1. Proportion of health facilities in project areas equipped with malaria diagnostic equipment

CAM 0 0 83 80

LAO 0 100 100 70CambodiaPreah Vihear Province

11.2 6.7 8.4 10.0 VIE** 78 78 100 1002. Proportion of laboratory

staff in target provinces trained in malaria diagnosis

CAM 0 0 100 100

LAO 0 0 96 70

VIE 0 100 100 100Lao PDR Champassack Province

12.7 7.9 9.2 10.0

Attapeu Province 25.5 13.4 18.5 10.0

Saravane Province 14.2 8.3 8.4 10.0

Sekong Province 17.4 12.1 14.6 10.0

Viet Nam Binh Phuoc Province

12.5 15.6 10.5 10.0

Dak Nong Province 12.8 10.4 13.3 10.0

Progress: Achieved at least 95% of target Substantial progress achievedCAM = Cambodia, LAO = Lao People’s Democratic Republic, VIE = Viet Nam.* Data from the Ministry of Health** Of the 182 commune health stations in the project areas, only 40 required new microscopes for malaria testingSource: Authors.

Table 8: Results of Outcome 5.2Outcome 5.2 Improved surveillance and response for malaria and other communicable diseases in project areas of

Cambodia, Lao PDR, and Viet Nam including in cross-border areas



Status in Target Progress2016 2017 2016 20171. Proportion of disease

outbreaks (including malaria) in project areas reported within 24 hours

Surveillance capacity for malaria

1. Proportion of health facilities and laboratories in project areas equipped with electronic reporting instruments for malaria surveillance

CAM 0 0 100 100

LAO 0 0 100 50CambodiaPreah Vihear

100 100 100 80 VIE** 100 100 100 100

2. Proportion of health facilities in target provinces with staff trained in malaria surveillance with electronic reporting instrument

CAM 0 0 100 100

LAO 0 32 77 20

VIE 0 50 50* 80

continued on next page




Status in Target Progress2016 2017 2016 2017Lao PDR Champassack

100 100 100 80 Cross-border coordination and response for malaria

Attapeu 50 100 100 80 3. Number of coordinated cross-border action plans developed based on GMS malaria elimination strategy in targeted border provinces

CAM 0 0 1 1

Saravane 100 80 100 80 LAO 0 2 2 2

Sekong 100 60 83 80 VIE*** 0 - - 3

Viet Nam Binh Phuoc

100 100 100* 80 4. Number of village health workers at border provinces trained in malaria control and treatment

CAM 0 0 331 332

Dak Nong 100 100 100* 80 LAO 0 0 322 60

2. Proportion of border disease outbreaks (including malaria) in project areas reported across borders within 24 hours

VIE 0 236 236* 40

Cambodia Preah Vihear

NA NA NA 50

Lao PDR Champassack

100 100 100 50

Attapeu 50 100 100 50

Saravane 100 80 100 50

Sekong 100 60 83 50

Viet Nam Binh Phuoc

100 100 100* 50

Dak Nong 100 100 100* 50

Progress: Achieved at least 95% of target Substantial progress achievedCAM = Cambodia, LAO = Lao People’s Democratic Republic, NA – no outbreaks of regional or international relevance, VIE = Viet Nam.* As of Q1 2017** Facilities already have the needed equipment*** No specific cross-border action plans were developed by provinces but six cross-border activities were incorporated into the provincial annual operational plans that were all implementedSource: Authors.

Table 8: continued

Table 9: Results of Outcome 5.3Outcome 5.3 Increased diagnostic testing for malaria in project areas of Myanmara,b,c



Status in Target Progress2016 Q2 2018 2016 Q2 20181. National malaria

diagnostic quality assurance guidelines endorsed by the National Malaria Control Program

Diagnostic capacity for malaria

1. Proportion of health facilities in project areas equipped with malaria diagnostic equipment**

44 0 100 100

Mon State No No Yes Yes 2. Proportion of laboratory staff in target provinces trained in malaria diagnosis***

24 0 96 100

Sagaing Region No No Yes Yes 3. National malaria diagnostic quality assurance guidelines developed

No No Yes Yes

continued on next page


Table 9: continued


Status inTarget Progress Output Indicator 2014

BaselineStatus in

Target Progress2016 Q2 2018 2016 Q2 2018

2. Annual blood examination per 100 pop at risk for malaria in the project areas

Mon State (Project townships average)(Mawlamyaing, Belin, Paung, kyaikhto)

4.2 - 13.5* 8.0****

Sagaing Region (Project townships average)(Hkamti, Homalin, Paungbyin, Taze, Monywa, Pale)

3.1 - 24.1* 8.0****

Progress: Achieved at least 95% of targetQ = quarter* Data for 2017 ** Total number of 43 health facilities***Total number of 83 staff**** ABER target for 2020 in Myanmar, wHO-Malaria NSP 2016-30Note: 2016 data was not collected because the project interventions started only in 2017.a This outcome indicator is used only for Myanmar. RCDTA8959 supports the development of national guidelines on laboratory diagnostic and surveillance

and is consistent with the Monitoring and Result Framework of the ADB Technical Assistance Document for RCDTA8959 developed with concurrence from the Government of Myanmar. For Myanmar, the output indicator on cross border coordination is not included since the project has a limited scope on it while focusing on internal migrant and mobile populations. RCDTA8959 also supports MMP-related activities in Cambodia and the Lao PDR.

b Estimated total number of beneficiaries (1,984,915 under laboratory diagnostics: and 969,585 under surveillance).c RCDTA8959 supports the Government of Myanmar in developing of a model to strengthen its laboratory diagnostic and surveillance system at local

level in two project areas (Mon State and Sagaing Region), which is expected to roll out in the entire country, while simultaneously supporting the government capacity at the central level.

Source: Authors.

Table 10: Results of Outcome 5.4Outcome 5.4 Improved surveillance and response for malaria and other communicable diseases in project areas of

Myanmar



Status in Target Progress2016 Q2 2018 2016 Q2 20181. National malaria

surveillance guidelines endorsed by the National Malaria Control Program

1. Proportion of health staff in project areas equipped with electronic reporting instruments for malaria surveillance*

0 0 97 100

Mon State No No Yes Yes 2. Proportion of health staff in target provinces trained in malaria surveillance with electronic reporting instrument*

0 0 97 100

Sagaing Region No No Yes Yes 3. National malaria surveillance guidelines developed

No No Yes Yes2. Proportion of disease

outbreaks (including malaria) reported within 24 hours

Mon State NA NA ** 80Sagaing Region NA NA ** 80

Progress: Achieved at least 95% of target NA = NA – no outbreaks of regional or international relevance, Q = quarter.*Total number of health staff and village health volunteers** All malaria cases were reported real-time within 24 hours by mDMS (mobile database malaria surveillance)NA – no outbreaks of regional or international relevanceSource: Authors.


Communicable Disease Control 2– Additional Financing

The additional financing for malaria-related activities directed efforts toward controlling and eliminating malaria elimination through regional and country structures and processes already established under the ADB Communicable Disease Project 2 (CDC2). By allocating investments to the continuation of an existing ADB project, the RMTF was able to take previous gains, elevate them, and include malaria-specific interventions. Malaria activities funded under the RMTF complemented and augmented the national malaria programs in Cambodia, the Lao PDR, and Viet Nam and were synchronized with donor partners’ ongoing involvements in malaria and in addressing the spread of artemisinin resistance in the region.

In all three countries, the project’s activities strengthened and sustained vector control, promoted behavioral change, and strengthened malaria diagnosis, treatment, and surveillance capabilities. Through this project the RMTF was able to work at the grassroots level in cross-border areas, an otherwise extremely challenging environment in which to make an impact. The project brought about cooperation between the national malaria program and the communicable disease control (CDC) program at the central, provincial, and district levels. The two programs selected intervention sites together and jointly defined their priorities and resources needs for those sites.

In the areas identified for coverage by the RMTF project, support included provision of computer hardware, microscopes and other lab equipment; diagnostic supplies; and updating of lab standard operating procedures (SOPs) and quality assurance manuals and guidelines. The national malaria programs noted improvement in the quality of clinical diagnostic and case management through training conducted on malaria case management and treatment, surveillance for provincial and district health staff, and village health workers. Cross-border activities included disease information exchange, which included malaria and joint outbreak response simulation exercises.

Laboratory Quality Assurance and Malaria Surveillance in Myanmar

The RMTF-funded TA8959 project developed manuals, SOPs, and algorithms for malaria laboratory quality assurance for Myanmar. By bringing together the National Health Laboratory (NHL) and the NMCP, the project changed the way the two agencies worked together, which in turn also helped the NHL work with other disease agencies.

Data management systems for malaria surveillance in the project areas was strengthened, including the use of mobile data management system (mDMS) for case reporting, and analytical tools for decision-making. It worked with grassroots volunteer malaria workers to improve routine, and real-time case reporting through a mobile data management system piloted in the three townships. The mDMS, a smartphone-based app, was developed by Save the Children with the NMCP, but RMTF funding enabled widespread piloting of the app for volunteer malaria workers and the initial results helped improve the app to make it more efficient and more user-friendly. The NMCP and other development partners are reviewing the mDMS together with another mobile app developed by wHO for facility-based health workers.

Migrant and Mobile Populations

In Cambodia, the Lao PDR, and Myanmar, the RMTF extended the reach of the health system by training and equipping village health volunteers and migrant workers for malaria diagnosis and treatment, and mobile traders as volunteer peer educators to conduct health education and prevention. These volunteers formed the first line of defense against communicable diseases. The International Organization for Migration (IOM) worked with the national malaria programs in the three countries to develop innovative approaches to address malaria needs of migrant and mobile populations in work settings such as gold and jade mines, rubber plantations, and dam construction sites.


One of the key successes of the project is the engagement of the private sector by tapping and mobilizing camp site and construction managers as malaria volunteers. The managers were granted permission by the corporation heads to implement malaria control and prevention programs in their respective worksites. A final review mission in March 2018 found that mobile traders from the Lao PDR and Viet Nam, who ply around the district and who were trained as malaria peer educators, were found to effectively reach mobile and migrant populations (MMPs) with systematic malaria monitoring and have good coordination with the village volunteers.

Enabling Factors

Overall, building on existing project management units and the regional cooperation mechanisms established under the CDC2 project in Cambodia, the Lao PDR, and Viet Nam accelerated the achievements of the CDC2 AF in the provinces and districts and institutionalized malaria-specific SOPs.

In Myanmar, bringing together two different actors—the national health laboratories and the national malaria control program—under a common framework was transformational. with common SOPs and manuals on laboratory quality assurance, they were able for the first time to synchronize their reporting. Recruiting the right partners was also key: University Research Co. LLC (URC), and the IOM were chosen for their existing strong and deep presence in Myanmar and the Lao PDR. They brought with them an understanding of the local landscape, and existing relationships that could not be quickly achieved by a new player, smoothing the way for a good consultation process with country counterparts.


Case Detection and Laboratory TestingIn the Lao PDR, the reduction in malaria incidence can also be attributed to government efforts,

including discouraging illegal logging and people going into forests, and increased army patrols. Malaria cases may start to rise if these efforts are not sustained, through cooperation with the private sector and the military.

There is need to sustain and expand ICT infrastructure for better case reporting, as well as staff competencies on facility management, infection control, disease management through more health-care worker training. There is also a need to strengthen subnational financial management, so that funds reach the districts where they are required, to properly implement the 1–3–7 malaria elimination strategy.16

In Cambodia, as for the other GMS countries, mechanisms for microscopy skills retention and laboratory quality assurance should be in place, as fewer malaria cases will be seen during the elimination phase. while laboratory staff in Cambodia, for example, have stated a preference to use rapid diagnostic tests rather than microscopy, since this is easier, health-care workers should actually perform microscopy for malaria diagnosis. This is in line with the country’s malaria elimination strategy, which states that each case must be confirmed by microscopy before treatment can be provided, as recommended by wHO. The technical support under CDC2-AF was able to provide microscopes, training on microscopy, and updated guidelines. The microscopes provided can digitally capture and share digital image of the blood smears. This cuts down diagnosis time and should facilitate timely treatment.

The country’s medicine stocking and redistribution policy and processes should be adjusted. Cambodia experienced stockouts of malaria testing kits and medicines in 2018. The malaria program claims that this was due to the unexpected increase in the malaria cases, and there were difficulties restocking. Extra supplies from other provinces could not be directly channeled to the facilities where they were needed, as these commodities had to be first be channeled back to the central level.

16 The 1–3–7 malaria elimination strategy entails reporting of malaria cases within 1 day, confirmation and investigation within 3 days, and response to prevent further transmission within 7 days.


Malaria P. vivax cases are increasing and this requires glucose-6-phosphate dehydrogenase (G6PD) testing and close supervision during treatment, patient counseling and access to blood transfusion services for G6PD-deficient individuals. This will require health facilities and service providers in malaria endemic areas to have the right laboratory equipment and commodities, training, and mechanisms for medical supervision of G6PD-deficient cases.

Cross-Border Information ExchangeCambodia, the Lao PDR, and Viet Nam have started to exchange data on an agreed list of communicable diseases of public health significance. However, the frequency and timeliness of information exchange can still be improved, and data standards, such as for case definition, need to be aligned.

Migrant and Mobile PopulationsIn discussions with the members of the Cambodia malaria program, it is clear that MMPs are still one of the main sources of malaria transmission and drug resistance. It also appears that the government does not have the capacity to address MMP issues, which include a general lack of access to health services, especially for foreign MMPs and undocumented workers. Some tend to self-medicate and travel to home countries to access health services. The issue of malaria elimination among MMPs must be integrated into the national health strategy, and addressing the issue of how to reach MMPs will also require stronger collaboration with the private sector.

Another challenge is sustaining the motivation, skills, and work of malaria health volunteers and peer educators as malaria incidence goes down and when Global Fund grant support for GMS countries ends and financing switches to their governments instead. In Cambodia, the government cannot pay for activities that are conducted beyond 20 kilometers from the health facilities, and most MMPs are forest goers. The government therefore relies on NGOs, which also have flexible systems that allow them to pay for volunteer health workers people outside the public health system. Treatment compliance among MMPs is also challenging. The first dose of malaria treatment is usually administered at the health facility, but problems remain with ensuring completion of treatment doses.

In Myanmar, the project with URC started under the RMTF will continue through Defeat Malaria Activity funded by the United States Agency for International Development. The Global Fund is working on funding support for IOM–Myanmar to continue its work on malaria and migrant and mobile population in the RMTF project sites. Central and provincial health offices in Cambodia and the Lao PDR have committed to sustain mobilization of village volunteers, particularly training of mobile traders as outreach and peer educators. This model was piloted under CDC2-AF has been expanded to the other provinces using Global Fund grants.


P R O M OT I O N A N D P R E V E N T I O N

Increased capacity to apply heath impact assessment to consider determinants of health and communicable d iseases in infrastructure projects

6R-CDTA 8763:

Results for Malaria Elimination and Control of Communicable Diseases Threats in Asia and the Pacific (RECAP)

Output 6 communicable diseases addressed in infrastructure projects

OUTCOME 6: Increased capacity to address communicable diseases in infrastructure projects

KE Y OUTCOME S

Increased capacity to address communicablediseases in infrastructure projects

HE ALTH IMPACT AS S E S S ME NTDE MONS TRATION PROJE CT

Cambodia Lao PDR Myanmar Thailand Viet Nam

E nerg y

Trans port

Urbandevelopment

Water s upply

Water ands anitation

S pecialeconomiczones



3.39** Increased from 2.96

S hare in RMTF 1 2%


Q3201 5

Q4201 5

Q1201 6

Q2201 6

Q3201 6

Q4201 6

Q1201 7

Q2201 7

Q3201 7

Q4201 7

Q1201 8

Q2201 8

Q3201 8

307,61 0303,01 4

584,1 21

830,849

1 52,594

1 98,1 33

268,81 0241 ,670

68,740

1 93,328

1 20,1 5891 ,836

26,741

3,387,604




Rationale

Infrastructure projects have a health dimension that can be assessed, the impact ameliorated, and the benefits magnified to prevent malaria and other communicable diseases, and promote healthy development. The current public health challenges that stem from the interface of development and environmental and social change include the impacts of developing economic corridors and special economic zones (SEZs), issues of air quality, water and food security, and growing mobility. Antimicrobial resistance and poor coverage of informal often mobile and migrant population groups working in infrastructure development projects also justify the need for HIA.

Malaria Prevention in Infrastructure Development

The promotion and prevention component of the RMTF promoted HIA as a means to mitigate vector-borne diseases risks in large-scale infrastructure projects and improve community health outcomes. Large infrastructure projects attract mobile and migrant populations—those most at risk of malaria. The RMTF created an opportunity to advance HIA, particularly in the GMS, as a good practice to ensure project designs can safeguard and promote human health. The promotion of HIA was timely given the current public health challenges that stem from the interface of development and environmental and social change.

In the GMS countries, HIA policies and practice and efforts to include HIA as a formal part of infrastructure development planning and investment practice have been at different stages of development. Under the RMTF, HIA was promoted as an intersectoral approach to protecting and promoting community health and safety. Capacity for HIA practice expanded in the GMS in the past 2 years with RMTF support. The project became a catalyst for renewed interest for HIA as a development planning tool drawing attention to health risks and health co-benefits and facilitating healthy design and management of infrastructure projects.

An interrelated package of support was provided, to GMS countries and at regional level, for capacity development. To demonstrate HIA good practice, case studies were conducted in various sectors, i.e., energy, SEZs and border development, transport, urban development, and water and sanitation. These case studies, considering both community and occupational health and safety, offered recommendations to manage risks and benefits as part of the project planning, design and implementation.

Case Study in Urban Development Project

An HIA was developed for Mandalay Urban Services Improvement Project 1, which included a Public Health Management Plan (PHMP) with health indicators for monitoring of community health impacts. Stakeholder consultations promoted collaboration between project stakeholders and public health authorities for the implementation of the PHMP and discussion of institutional arrangements for the monitoring and management of vector-related diseases such as malaria and their environmental determinants. The meetings also enabled discussions on strengthening the capacity of local public health and environmental conservation teams to support public awareness and education campaigns. Project stakeholders, including government local health and environment staff, were trained on HIA.

Case Studies in Special Economic Zones and Border Development

HIAs were initiated in three SEZs—Savannakhet (Savan-SENO), the Lao PDR; Mukdahan, Thailand; Thilawa, Myanmar and in a border economic zone—Yunnan Lincang Border Economic Cooperation Zone Development, People’s Republic of China (PRC). In the PRC, HIA involved rapid scoping and an analysis of health risks such as vector-borne diseases and impacts and recommendations for mitigation. The recommendations, developed in partnership with local health officials, were required to protect both workers and community members, include malaria services and supplemental to the


Table 11: Results of Outcome 6.1Outcome 6.1 Increased capacity to apply health impact assessment (HIA) in infrastructure projects at country level




that started to apply HIA in infrastructure projects (LAO, THA)

0 0 2 2 Situational analysis and needs assessment

1. Number of HIA country profiles (CAM, LAO, MYA, THA, VIE)

0 0 5 5

2 Number of infrastructure projects that applied HIA (Savannakhet, Mukdahan, Hongsa)

0 0 3 3 Country HIA guidelines

2. Number of countries with country HIA guidelines developed

0 0 3 3

3. Regional HIA framework for special economic zones developed

0 0 1 1

Capacity development

4. HIA training modules developed

No No Yes Yes

5. Number of countries with staff trained in HIA

0 0 4 4

6. HIA curriculum developed for graduate public health and environmental programs

No No Yes Yes

7. Number of countries that integrated HIA curriculum into graduate public health and environmental programs

0 0 4 4

8. Number of countries that started to offer HIA in graduate public health and environmental programs

0 0 4 4

9. Regional network of HIA experts and universities established

0 0 1 1

Policy and governance

10. Number of countries with costed HIA proposal

0 0 5 5

11. Number of countries with HIA policies in place or developed

0 0 3 3

12. Number of countries with intersectoral coordination on HIA

0 0 3 3

13. Number of HIA policy briefs developed

0 0 2 2

Progress: Achieved at least 95% of target CAM = Cambodia, HIA = health impact assessment, Lao PDR = Lao People’s Democratic Republic, MYA = Myanmar, THA = Thailand, VIE = Viet Nam.Source: Authors.


existing environment impact assessment and management plan.

HIA in the three SEZs enabled the development of an HIA framework for SEZs in the GMS, which can serve as a management tool for the continued development of healthy economic zones in the subregion.17 Country-specific guidelines were also produced for the Lao PDR, Myanmar, and Thailand reflecting their local context and specific requirements. Cross-border cooperation has also been promoted, with the Lao PDR and Thailand bilateral cooperation agreement for joint health surveillance and reporting, particularly in the affected border areas between Savannakhet and Mukdahan SEZs.

Curriculum Development and Training

To increase HIA capacity in the region key government agencies and universities should cooperate to improve the skills and knowledge of those currently involved in HIA, and build a new generation of HIA experts. In partnership with the wHO Collaborating Center for Impact Assessment at Curtin University (wHO CC-Curtin University) three curricula were developed—a standalone HIA course; HIA in environmental impact assessment;

and HIA in planning, environment, or health courses. Using adapted curricula, certificate courses were subsequently offered by six GMS universities and parallel training workshops were led by health ministries. Over 600 HIA practitioners from key government agencies and staff from the private sector have been trained on basic principles and practice of HIA, application of tools, exploring decision-making criteria and options for institutional arrangements between the health and environment sectors to support a coordinated approach to HIA. within ADB, ADB staff have been trained on HIA as part of staff development training program, using the bank’s own funding.

Regulation and Guidelines

To ensure infrastructure projects do not inadvertently increase the risk of malaria and undermine efforts to eliminate the disease, national legislation for HIA implementation is essential. In the GMS, both the Lao PDR and Thailand have an HIA policy as part of their healthy public policy since 2006 and 2000, respectively. Technical assistance through RMTF made possible a review of HIA policy and implementation and the development of sector-specific guidelines for these countries. In Cambodia, Myanmar, and

17 ADB. 2018. A Health Impact Assessment Framework for Special Economic Zones in the Greater Mekong Subregion. Manila.

Table 12: Results of Outcome 6.2Outcome 6.2 Increased capacity to apply HIA at ADB



Status in Target Progress2016 Q2 2018 2016 Q2 20181. Number of

ADB-supported infrastructure projects in malaria-endemic areas that applied HIA* (CAM, MYA, VIE)

0 0 4 4 1. ADB HIA tools developed (sourcebook and checklists)

No Yes Yes Yes

2. ADB HIA training modules developed

No Yes Yes Yes

3. Number of ADB staff trained in HIA

0 30 30 30

4. ADB HIA tools integrated into ADB processes

No No Yes Yes

Progress: Achieved at least 95% of target *Desktop review ADB = Asian Development Bank, CAM = Cambodia, HIA = health impact assessment, MYA = Myanmar, VIE = Viet Nam.Source: Authors.


Viet Nam, the RMTF has enabled discussion between ministries of health and ministries of environment on the integration of health into the well-functioning environment impact assessment processes. Moreover, HIA guidelines have been prepared for these countries for further intergovernmental review led by each country’s ministry of health. Country and sector-specific guidelines allow for more explicit community health and workers’ health and safety components in infrastructure development, which can be used as part of the malaria elimination effort in these countries.

within ADB, an HIA sourcebook has been developed, providing clear procedures to ensure commitment for community and occupational health and safety are met in the development and implementation of projects. Following this new guideline, advocacy for HIA in large projects continues, including consultation with safeguards staff on stronger monitoring of health impacts from projects to mitigate risks of malaria. Further, an addendum on health has been proposed for inclusion in the ADB Handbook on Poverty and Social Analysis. This could support the assessment of community health attributes of a project.

Enabling Factors

At the country level, the key to success of every project was the presence of a local champion within the country counterpart agencies, and also engagement of local consultants who could carry the work of the international consultants forward in the local language. keeping HIA highly visible within ADB over a protracted period of time paid off, both in terms of creating demand for HIA training, and for advocacy for resources to continue the work started under the RMTF. The project came at a time when a tipping point could be reached within ADB, and the bank has become the only multilateral financing institutions with so much experience in

HIA to share with development partners. Engaging with the wHO CC-Curtin University on HIA to develop curricula and then disseminating them through local universities was a very successful strategy to mainstream HIA and make local training in it sustainable.


Countries still have unexploited opportunities to formally adopt national HIA guidelines and other HIA tools, particularly in the provinces. within the health sector, institutional arrangements must govern HIA with clear and functional links to other MOH departments and health programs. There is a need to further strengthen intersectoral cooperation to apply HIAs and implement PHMP to mitigate risks of malaria and other communicable disease threats as it relates to development projects. This requires clear institutional arrangements between public health, environment, and planning authorities, including at provincial level.

Governments still need to agree on the nature of HIA, not only in terms of health risk assessment with a view to mitigation, but also in identification of health opportunities to promote health co-benefits from development projects., such as through provision of health services to MMPs who often work in large development projects, integrated border development projects or SEZs. To encourage and sustain improvements in the practice of HIA, a network was established jointly with the wHO CC-Curtin University. It is envisaged that the HIA Network Asia Pacific will facilitate collaboration between countries and HIA practitioners, including research and sharing of good practices.18 The GMS Health Cooperation Strategy and Action Plan for 2018–2022 will guide forward programming and mobilizing resources for health cooperation, and includes HIA as one of the strategic and operational priorities. This provides additional opportunities to expand HIA work in the GMS.

18 About the HIA Network Asia Pacific. http://www.hianetworkasiapac.com/about/

4. kNOwLEDGE PRODUCTS AND PUBLICATIONS

Regional Malaria and Other Communicable Disease Threats Trust FundADB. 2015. Malaria Elimination: An entry point for strengthening heath systems and regional security, and a public health best buy. Manila. https://www.adb.org/sites/default/files/publication/178203/malaria-elimination.pdf

LeadershipM. Counahan et al. 2018. Investing in Regional Health Security for Sustainable Development in Asia and the Pacific. ADB Sustainable Development Working Paper Series No. 56. Manila: Asian Development Bank. https://www.adb.org/publications/regional-health-security-asia-pacific

MedicinesS. Roth et al. 2018. Strong Regulation of Medical Products: Cornerstone of Public Health and Regional Health Security. ADB Briefs. No. 99. Manila: Asian Development Bank. https://www.adb.org/sites/default/files/publication/456866/adb-brief-099-strong-regulation-medical-products.pdf

S. Roth et al. 2018. Portable Screening Devices for Medicines Quality: Putting Power into the Hands of Regulators in Low-Resource Settings. ADB Briefs. NO.101. Manila: Asian Development Bank. https://www.adb.org/sites/default/files/publication/461051/adb-brief-101-screening-devices-medicine-quality.pdf

S. Roth et al. 2016. Strong Supply Chains Transform Public Health. ADB Briefs. No. 72. Manila: Asian Development Bank. https://www.adb.org/sites/default/files/publication/214036/strong-supply-chains.pdf

S. Roth et al. 2016. Better Regulation of Medicines Means Stronger Regional Health Security. ADB Briefs. No. 54. ADB Briefs No. 54, Manila: Asian Development Bank. https://www.adb.org/sites/default/files/publication/184392/better-regulation-medicine.pdf

Information TechnologyADB. Forthcoming. Digital Health Convergence Meeting Toolkit.

P. Drurry et al. 2018. Guidance for Investing in Digital Health. ADB Sustainable Development Working Paper Series. No.52. Manila: Asian Development Bank. https://www.adb.org/sites/default/files/publication/424311/sdwp-052-guidance-investing-digital-health.pdf

ADB. 2018. Unique Health Identifier Assessment Tool Kit. Manila https://www.adb.org/documents/unique-health-identifier-assessment-toolkit

A. Marclo et al. 2018. Transforming Health Systems Through Good Digital Health Governance. ADB Sustainable Development Working Paper Series. No.


51. Manila: Asian Development Bank. https://www.adb.org/publications/transforming-health-systems-good-digital-health-governance.

S. Ebener et al. 2018. Building Capacity for Geo-Enabling Health Information Systems: Supporting Equitable Health Services and well-Being for All. ADB Briefs. No. 88. Manila: Asian Development Bank. https://www.adb.org/publications/building-capacity-geo-enabling-health-information-systems.

S. Mellor et al. 2016. Digital Health Infrastructure: The Backbone of Surveillance for Malaria Elimination. ADB Briefs. No. 69. Manila: Asian Development Bank. https://www.adb.org/sites/default/files/publication/210856/digital-health-infrastructure.pdf.

M. Stahl et al. 2018. On the Road to Universal Health Coverage Every Person Matters. ADB Briefs. No. 56. Manila: Asian Development Bank. https://www.adb.org/sites/default/files/publication/183512/uhc-every-person-matters.pdf

S. Roth et al. 2016. The Geography of Universal Health Coverage. ADB Briefs. No. 55. Manila: Asian Development Bank. https://www.adb.org/sites/default/files/publication/183422/geography-uhc.pdf

S. Roth et al. 2015. Universal Health Coverage By Design. ADB Briefs. No. 36. Manila: Asian Development Bank. https://www.adb.org/sites/default/files/publication/160117/universal-health-coverage-design-ict.pdf

Promotion and PreventionADB. 2018. A Health Impact Assessment Framework for Special Economic Zones in the Greater Mekong Subregion. Manila. https://www.adb.org/publications/health-impact-assessment-framework-economic-zones-gms.

ADB. 2016. Greater Mekong Subregion Health Impact Assessment Project: Project Brief. Manila. https://www.adb.org/publications/gms-health-impact-assessment-project-brief.

OthersADB and world Health Organization. 2016. Monitoring Universal Health Coverage in the Western Pacific. Framework, indicators and dashboard. Manila. https://www.adb.org/sites/default/files/publication/203926/uhc-western-pacific.pdf.

5. GENDER DIMENSIONS

ADB’s Strategy 2020 identifies gender equity as one of the five drivers of change that are emphasized in all of its operations. ADB’s commitment to gender equality is integral to the management of the RMTF. ADB loans and grants meeting specific requirements include a gender action plan (GAP), with a clear monitoring and evaluation framework.

There are several specific gender issues related to malaria and other communicable diseases, which are considered under the RMTF implementation. Men are more at risk to contract malaria through occupational exposure during night time in rubber plantations, forests and mines, for example. On the other hand, women shoulder the main burden of taking care of sick family members, and pregnant women are more vulnerable to develop severe malaria. However, typically there is a lack of sex-disaggregated data in national malaria information systems. In terms of malaria project staffing, although there are more female than male village-level malaria workers, at the management level in national malaria programs, there are more men than women. In some settings, such as plantations deep in forested areas where it was difficult or dangerous for women to work, it was more appropriate to work with male volunteers rather than females.

Gender activities were integrated into the implementation of the main activities of the project, notably the additional financing to Second GMS Regional Communicable Diseases Control Project,

which specifically included gender action plans for each country to address some of the issues raised above.

Some key achievements for Cambodia, the Lao PDR, and Viet Nam are detailed in the following tables, according to three dimensions: (i) enhancement of opportunities for female staff in Center for Disease Control systems and improved gender analysis in regional CDC systems; (ii) improved responsiveness of CDC to gender/ethnic issues in targeted districts and/or province and increased participation and awareness of women in CDC prevention in project location; and (iii) enhanced gender-awareness and responsiveness of CDC project management.

Highlights include the fact that 100% of surveillance and response data in the Lao PDR is sex-disaggregated. In Viet Nam, data collected since 2016 is disaggregated and in Cambodia, malaria and other key communicable disease data has been sex-disaggregated. This data is widely used in project plans across the three countries. All three have also shown marked increased in hiring of new female staff, increasing the overall proportion of female staff from 44% in 2012 to 54% in 2016 Cambodia, and from 45% in 2014 to 61.7% in 2016 in the Lao PDR. women are equally represented in the ranks of volunteer health workers (VHw) in the Lao PDR, account for 44% of VHws trained since 2012 in Cambodia, and accounted for the majority trained in Viet Nam.

6. A

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3. N

umbe

r of c

ount

ry/s

ubre

gion

al

inve

stm

ent c

ases

dev

elop

ed*

(BA

N, I

ND

, PN

G, G

MS)

00

44

4. N

umbe

r of b

usin

ess c

ases

for p

rivat

e se

ctor

inve

stm

ent i

n m

alar

ia c

ontro

l an

d el

imin

atio

n*

(BA

N/IN

D/P

NG

and

GM

S)

00

22

5. M

alar

ia p

rogr

am e

ffici

ency

ana

lysis

tool

(MPE

AT)*

00

11

6. R

ecom

men

datio

ns d

evel

oped

on

finan

cing

opt

ions

for t

he A

sia a

nd

Paci

fic R

egio

n*

No

No

Yes

Yes

Prog

ress

: A

chie

ved

at le

ast 9

5% o

f tar

get

BAN

= B

angl

ades

h, IN

D =

Indi

a, G

MS

= G

reat

er M

ekon

g Sub

regi

on.

* Upo

n re

view

of t

he lo

gica

l flow

of o

utpu

ts a

nd o

utco

mes

, the

se o

utpu

ts th

at w

ere

prev

ious

ly tr

acke

d un

der O

utco

me

2 (F

inan

cing

) are

mov

ed h

ere

as th

ese

bette

r con

tribu

te to

war

d im

prov

ed u

se o

f in

form

atio

n fo

r dec

ision

-mak

ing a

nd a

ccou

ntab

ility f

or m

alar

ia e

limin

atio

n an

d ad

dres

sing c

omm

unic

able

dise

ase

Stor

y be

hind

the

num

bers

Mal

aria

elim

inat

ion

dash

boar

d

•Th

e A

PLM

A M

alar

ia E

limin

atio

n D

ashb

oard

is a

dec

ision

and

acc

ount

abilit

y too

l tha

t pro

vide

s visi

bilit

y to

natio

nal a

nd re

gion

al p

rogr

ess t

owar

d m

alar

ia e

limin

atio

n ta

rget

s, as

wel

l as f

ulfil

lmen

t of

prio

rity a

ctio

ns a

nd id

entifi

catio

n of

are

as re

quiri

ng a

ttent

ion.

Tw

enty

mal

aria

-end

emic

cou

ntrie

s hav

e ag

reed

to u

se th

e da

shbo

ard

and

its a

ssoc

iate

d te

chni

cal a

nnex

to in

form

hig

h-le

vel r

egio

nal

polic

y dia

log o

n m

alar

ia e

limin

atio

n. T

he d

ashb

oard

dat

a was

gath

ered

from

the

APL

MA

coun

tries

usin

g a q

uest

ionn

aire

, and

the

tech

nica

l ann

ex u

ses t

he la

test

dat

a fro

m th

e w

orld

Mal

aria

Rep

ort

2017

pub

lishe

d in

Nov

embe

r 201

7. Th

e A

PLM

A M

alar

ia E

limin

atio

n D

ashb

oard

was

pre

sent

ed a

nd d

iscus

sed

as a

tool

to in

form

hig

h-le

vel r

egio

nal p

olic

y di

alog

on

mal

aria

elim

inat

ion

durin

g th

e A

PLM

A S

enio

r Offi

cial

’s M

eetin

g in

Dec

embe

r 201

7 an

d pu

blic

atio

n vi

a th

e A

PLM

A w

ebsit

e is

due

by th

e en

d of

201

8.

cont

inue

d on

nex

t pag

e

Annex 45

Stor

y be

hind

the

num

bers

Inve

stm

ent c

ases

and

tool

kit f

or fi

nanc

ing

mal

aria

elim

inat

ion

•To

asse

ss th

e ec

onom

ic ra

tiona

le fo

r mal

aria

elim

inat

ion,

thre

e na

tiona

l leve

l inve

stm

ent c

ases

in B

angl

ades

h, In

done

sia, a

nd P

apua

New

Gui

nea (

PNG

), as

wel

l as t

wo

regi

onal

inve

stm

ents

case

s in

the

Gre

ater

Mek

ong S

ubre

gion

(GM

S), a

nd th

e w

hole

Asia

and

Pac

ific

regi

on, w

ere

com

plet

ed in

June

201

7. Ea

ch c

ase

estim

ates

the

cost

and

eco

nom

ic a

nd fi

nanc

ial r

etur

ns o

f mal

aria

elim

inat

ion

thro

ugh

2030

. Nat

iona

l and

regi

onal

pol

icym

aker

s can

use

this

evid

ence

to in

form

mal

aria

pro

gram

bud

getin

g, st

rate

gic p

lann

ing,

and

advo

cacy

for d

omes

tic re

sour

ce m

obiliz

atio

n. T

hey a

lso ai

m to

ge

nera

te e

vide

nce

arou

nd o

ptim

al w

ays t

o in

crea

se a

nd e

xpan

d th

e am

ount

of s

usta

inab

le fi

nanc

ing i

n su

ppor

t of m

alar

ia e

limin

atio

n.•

Mod

elin

g and

ingr

edie

nt a

ppro

ache

s wer

e us

ed to

cos

t mal

aria

elim

inat

ion

by 2

030.

A c

ostin

g too

l for

the

mod

elin

g app

roac

h an

d m

athe

mat

ical

tran

smiss

ion

mod

els f

or p

roje

ctin

g mal

aria

bur

den

acro

ss 2

2 co

untri

es in

Asia

and

the

Paci

fic h

ave

been

com

plet

ed. T

he c

ostin

g too

l usin

g the

ingr

edie

nt a

ppro

ach

was

impl

emen

ted

in B

angl

ades

h an

d In

done

sia.

•Th

e ec

onom

ic a

nd s

ocia

l ben

efits

of e

limin

atio

n w

ere

estim

ated

thro

ugh

the

Mal

aria

Elim

inat

ion

Tran

smiss

ion

and

Cost

ing

in th

e A

sia P

acifi

c (M

ETCA

P), a

tran

smiss

ion

mod

el c

reat

ed b

y th

e M

ahid

ol-O

xfor

d Tr

opic

al M

edic

ine

Rese

arch

Uni

t (M

ORU

), in

col

labo

ratio

n w

ith th

e M

EI a

nd th

e U

nive

rsity

of C

ape

Tow

n. It

is th

e fir

st m

ulti-

spec

ies m

odel

to b

e ex

clus

ivel

y de

velo

ped

for t

he

Asia

and

Paci

fic re

gion

. It ca

n pr

ojec

t tra

nsm

issio

n re

duct

ions

and

pred

ict e

limin

atio

n ba

sed

on a

num

ber o

f sce

nario

s. Fo

ur co

unte

rfact

ual s

cena

rios w

ere m

odel

ed, in

clud

ing o

ne b

usin

ess-

as-u

sual

sc

enar

io an

d th

ree

reve

rse

scen

ario

s tha

t sim

ulat

ed th

e po

tent

ial im

pact

of s

calin

g dow

n th

e m

alar

ia p

rogr

am. T

he si

x elim

inat

ion

scen

ario

s wer

e m

odel

ed se

quen

tially

to in

crea

se in

com

plex

ity an

d in

the

num

ber o

f int

erve

ntio

ns in

clud

ed. A

cros

s all 1

0 sc

enar

ios,

thre

e as

sum

ptio

ns ar

ound

the

likel

ihoo

d of

arte

misi

nin

resis

tanc

e w

ere

appl

ied,

the

use

of m

ass d

rug a

dmin

istra

tion

(MD

A), a

nd th

e sc

ale u

p of

LLI

Ns t

o 80

%. F

or ea

ch co

untry

, the

min

imum

scen

ario

that

wou

ld ac

hiev

e mal

aria

elim

inat

ion

was

det

erm

ined

, defi

ned

as 1 y

ear w

ith le

ss th

an o

ne re

porte

d cl

inic

al ca

se. T

hese

addi

tiona

l sc

enar

ios p

rodu

ced

a tot

al o

f 80

scen

ario

s (w

ith an

d w

ithou

t res

istan

ce; w

ith an

d w

ithou

t MD

A; a

nd w

ith an

d w

ithou

t LLI

N sc

ale

up to

80%

). In

addi

tion,

the

effec

t of i

mpr

oved

targ

etin

g of m

alar

ia

inte

rven

tions

was

sim

ulat

ed o

n co

sts b

y red

ucin

g int

erve

ntio

n co

vera

ge b

y 30%

am

ong t

he P

AR

for a

ll sce

nario

s, w

ith a

nd w

ithou

t the

resis

tanc

e an

d M

DA

ass

umpt

ions

.•

The o

utpu

ts o

f the

MET

CAP

have

bee

n tra

nsfo

rmed

into

an o

nlin

e int

erac

tive m

obile

appl

icat

ion

that

gene

rate

s gra

phs a

nd ch

arts

show

ing c

hang

es in

mal

aria

mor

bidi

ty an

d m

orta

lity a

nd as

soci

ated

pr

ogra

m c

osts

und

er th

e di

ffere

nt in

terv

entio

n sc

enar

ios.

It is

curre

ntly

in B

eta

form

, and

can

be

acce

ssed

at:

http

://w

ww.

met

capm

odel

.net

•Bu

ildin

g on

the

Sept

embe

r 201

4 fo

rum

“Opp

ortu

nitie

s for

Cor

pora

te S

ecto

r Eng

agem

ent i

n M

alar

ia C

ontro

l in

Asia

-Pac

ific”

co-

host

ed b

y A

PLM

A a

nd th

e w

HO

in th

e A

sia a

nd P

acifi

c re

gion

, th

e M

EI g

ener

ated

four

bus

ines

s cas

es o

n pr

ivat

e se

ctor

eng

agem

ent i

n m

alar

ia e

limin

atio

n on

e fo

r the

cou

ntrie

s in

the

GM

S an

d on

e fo

r Ban

glad

esh,

Indo

nesia

, and

PN

G. T

hese

bus

ines

s cas

es

asse

ss th

e m

otiv

ator

s, en

able

rs a

nd in

cent

ives

rega

rdin

g pr

ivat

e se

ctor

inve

stm

ent i

n m

alar

ia e

limin

atio

n an

d th

eir p

artic

ipat

ing

in p

ublic

-priv

ate

partn

ersh

ips.

In th

e G

MS,

pro

duct

ivity

is th

e m

ost

frequ

ently

stat

ed m

otiv

ator

for c

ompa

nies

to in

vest

in h

ealth

and

the

abse

nce

of sk

illed

wor

kers

is se

en a

s hav

ing

a m

ajor

impa

ct o

n pr

oduc

tivity

. The

mos

t com

mon

ena

bler

was

the

gove

rnm

ent

(bot

h lo

cal a

nd n

atio

nal)

prov

idin

g cl

ear i

nstru

ctio

ns o

n w

here

the

priv

ate

sect

or c

an c

ontri

bute

. In

addi

tion,

rele

vant

info

rmat

ion

on th

e ch

alle

nges

at h

and

wou

ld e

nabl

e th

e pr

ivat

e se

ctor

to

iden

tify s

olut

ions

and

reso

urce

s nee

ded.

Res

pond

ents

iden

tified

tax i

ncen

tives

and

reco

gniti

on aw

ards

as v

iabl

e in

cent

ives

to p

rom

ote

priv

ate

sect

or in

volv

emen

t in

mal

aria

elim

inat

ion.

•Th

e M

PEAT

was

dev

elop

ed b

y th

e M

EI to

hel

p m

alar

ia p

rogr

am m

anag

ers c

olle

ct, o

rgan

ize, a

nd tr

ack

data

poi

nts r

elat

ed to

the

tech

nica

l effi

cien

cy o

f a m

alar

ia p

rogr

am. M

PEAT

ena

bles

use

rs to

co

mpa

re sp

ecifi

c epi

dem

iolo

gica

l, fina

ncia

l, and

ope

ratio

nal in

dica

tors

bet

wee

n tw

o ye

ars a

nd ag

ains

t per

form

ance

targ

ets s

et b

y the

pro

gram

. The

MPE

AT h

as b

een

used

in B

angl

ades

h, In

done

sia

and

PNG

, Ban

glad

esh,

and

Indo

nesia

to id

entif

y are

as th

at n

eed

stre

ngth

enin

g, w

ith th

e ob

ject

ive

of m

axim

izing

valu

e, re

duci

ng w

aste

, and

ulti

mat

ely s

avin

g res

ourc

es.

•A

mon

g th

e effi

cien

cy a

reas

incl

uded

is p

rocu

rem

ent o

f goo

ds a

nd s

ervi

ces;

targ

etin

g of

ser

vice

s an

d in

terv

entio

ns; c

hoic

e of

bes

t val

ue/h

ighe

st im

pact

stra

tegi

es a

nd v

ertic

al v

ersu

s in

tegr

ated

pr

ogra

mm

ing;

and

colla

bora

tion

with

oth

er p

rogr

ams a

nd p

artn

ers.

•Th

e po

ssib

ility

of e

stab

lishi

ng a

regi

onal

hea

lth fu

nd fo

r add

ress

ing

the

heal

th se

curit

y th

reat

from

infe

ctio

us d

iseas

es w

as e

xplo

red.

Mal

aria

is o

ne o

f the

seve

ral i

nfec

tious

dise

ases

of c

once

rn in

th

e A

sia an

d Pa

cific

regi

on an

d po

litic

al le

ader

s and

pub

lic h

ealth

exp

erts

are

awar

e of

the

thre

at to

hea

lth se

curit

y pos

ed b

y bot

h dr

ug re

sista

nce

and

emer

ging

dise

ase

thre

ats.

The

curre

nt fi

nanc

ial

land

scap

e fo

r mal

aria

and

mal

aria

elim

inat

ion

in th

e A

sia a

nd P

acifi

c re

gion

was

exa

min

ed a

nd o

ppor

tuni

ties f

or re

sour

ce m

obiliz

atio

n, in

clud

ing a

n in

nova

tive

regi

onal

hea

lth fu

nd, w

ere

disc

usse

d.

This

fund

wou

ld p

oten

tially

fina

nce

prio

rity s

trate

gic r

egio

nal a

ctiv

ities

, pro

vide

supp

ort t

o co

untri

es in

the

regi

on w

ith th

e hi

ghes

t mal

aria

bur

den

and

leas

t cap

acity

to se

cure

dom

estic

fund

ing,

and

scal

e up

inve

stm

ents

in n

atio

nal p

rogr

ams.

A re

gion

al re

sour

ce m

obiliz

atio

n st

rate

gy w

as d

evel

oped

, whi

ch p

rovi

des a

sum

mar

y of

the

curre

nt st

ate

of re

sour

ces a

vaila

ble

for m

alar

ia e

limin

atio

n an

d re

com

men

ds ke

y opp

ortu

nitie

s to

mob

ilize

addi

tiona

l res

ourc

es fo

r nat

iona

l mal

aria

elim

inat

ion

in th

e A

sia an

d Pa

cific

regi

on. T

he re

port,

bas

ed o

n a r

egio

nal r

esou

rce

mob

ilizat

ion

fram

ewor

k, pr

ovid

es a

n ov

ervi

ew o

f dem

and

for m

alar

ia e

limin

atio

n re

sour

ces,

curre

nt su

pply

of r

esou

rces

, and

reco

mm

ends

key

opp

ortu

nitie

s to

fill t

he re

sour

ce g

ap. T

he re

sour

ce m

obiliz

atio

n fra

mew

ork

and

repo

rt in

clud

e po

litic

al c

apita

l and

the

polit

ical

env

ironm

ent f

or p

olic

y re

form

s, in

clud

ing

reco

mm

ende

d fis

cal r

efor

ms t

o in

crea

se h

ealth

fina

ncin

g. It

assu

mes

that

the

dem

and

for a

dditi

onal

re

sour

ces h

as b

een

dete

rmin

ed a

nd th

at th

e un

derly

ing

evid

ence

and

inve

stm

ent c

ase

for e

limin

atio

n ha

s bee

n de

velo

ped.

The

stra

tegy

leve

rage

s on

the

findi

ngs o

f the

inve

stm

ent c

ases

, priv

ate

sect

or b

usin

ess c

ases

, and

the

Asia

and

Pac

ific

regi

on fi

nanc

ing a

sses

smen

t, an

d ai

ms f

or a

n in

crea

se in

reso

urce

s for

elim

inat

ion

thro

ugh

to 2

030.

It o

utlin

es th

e pr

oces

ses a

nd p

riorit

y act

ions

that

ne

ed to

be

unde

rtake

n to

mob

ilize

and

sust

ain

the

nece

ssar

y res

ourc

es to

ena

ble

the

regi

on to

ach

ieve

its g

oal o

f a m

alar

ia-f

ree

Asia

and

Pac

ific

regi

on b

y 203

0.

Box c

ontin

ued

cont

inue

d on

nex

t pag

e

46 Annex

Stor

y be

hind

the

num

bers

•D

issem

inat

ion

mee

tings

on

the

inve

stm

ent c

ases

wer

e co

nduc

ted

with

mal

aria

pro

gram

s, lo

cal p

artn

ers,

and

stak

ehol

ders

in B

angl

ades

h, In

done

sia, a

nd P

NG

. The

hig

h-le

vel fi

ndin

gs o

f the

in

vest

men

t cas

es an

d re

com

men

datio

ns fr

om p

rivat

e sec

tor b

usin

ess c

ases

and

MPE

AT w

ere d

iscus

sed

at th

e Sen

ior B

udge

t Offi

cial

s mee

ting i

n To

kyo

in M

ay 20

17. P

rodu

cts f

rom

this

body

of w

ork

wer

e sha

red

with

atte

ndee

s of t

he w

HO

Stra

tegi

c Adv

isory

Gro

up in

New

Del

hi in

Nov

embe

r 201

7, an

d th

e MPE

AT w

as fe

atur

ed in

the J

oint

Sen

ior B

udge

t Offi

cial

s Net

wor

k for

Fisc

al S

usta

inab

ility

of H

ealth

Sys

tem

s for

Asia

in D

ecem

ber 2

017.

Join

t Mal

aria

wee

k fro

m D

ecem

ber 4

–8 in

Nay

Pyi

Taw

, Mya

nmar

hig

hlig

hted

this

wor

k, co

-spo

nsor

ed b

y A

PLM

A a

nd th

e A

sia a

nd P

acifi

c M

alar

ia

Elim

inat

ion

Net

wor

k (A

PMEN

). Se

vera

l ses

sions

inco

rpor

ated

the

findi

ngs,

incl

udin

g: A

PMEN

wor

ksho

p on

the

MPE

AT (4

Dec

embe

r 201

7), A

DB

Regi

onal

Mal

aria

Tru

st F

und

(5 D

ecem

ber 2

017)

, A

PLM

A S

enio

r Offi

cial

s Mee

ting

(6 D

ecem

ber 2

017)

, RA

I DG

’s m

eetin

g (7

Dec

embe

r 201

7), a

nd th

e M

inist

eria

l Mee

ting

on M

alar

ia E

limin

atio

n–G

MS

and

Chin

a (8

Dec

embe

r 201

7). T

he th

ree

natio

nal in

vest

men

t cas

es an

d tw

o re

gion

al in

vest

men

t cas

es, t

he M

ETCA

P, p

rivat

e se

ctor

bus

ines

s cas

es, a

nd th

e M

PEAT

are

all a

vaila

ble

onlin

e at

ww

w.sh

rinki

ngth

emal

aria

map

.org

and

are

bein

g sh

ared

with

key

par

tner

s. A

Q&

A w

ith B

en R

olfe

(chi

ef e

xecu

tive

office

r, A

PLM

A), S

usan

n Ro

th (

seni

or d

evel

opm

ent s

peci

alist

, AD

B), a

nd R

ima

Shre

tta (

asso

ciat

e di

rect

or o

f eco

nom

ics

and

finan

cing

, UCS

F M

EI) w

as p

rodu

ced.

Thi

s wor

k has

also

bee

n fe

atur

ed in

the

New

Yor

k Tim

es a

nd N

atur

e.

Box c

ontin

ued

Annex 47

OU

TCO

ME

2: F

INA

NCI

NG

Incr

ease

d fin

anci

ng fo

r mal

aria

elim

inat

ion

and

addr

essin

g com

mun

icab

le d

iseas

e th

reat

s

Out

com

e In

dica

tor

2014

Base

line

Stat

us in

Targ

et

Prog

ress

O

utpu

t Ind

icat

or20

14Ba

selin

eSt

atus

inTa

rget

Pr

ogre

ss20

16Q

2 20

1820

16Q

2 20

181.

Am

ount

of A

DB

gran

ts m

ade

avai

labl

e fo

r mal

aria

elim

inat

ion

and

addr

essin

g co

mm

unic

able

dise

ase

thre

ats

$22.

0m$8

2.5m

*$8

2.5m

*$8

0.0m

1. A

DF

heal

th se

curit

y gra

nts f

or gr

oup

A

and

B co

untri

es m

obiliz

ed ($

52.5

m)

No

Yes

Yes

Yes

2. A

mou

nt o

f cou

ntry

loan

s for

m

alar

ia e

limin

atio

n an

d ad

dres

sing

com

mun

icab

le

dise

ase

thre

ats

$27.0

m$1

44.0

m*

$144

.0m

*$1

20.0

m2.

GM

S he

alth

secu

rity f

unds

ap

prov

ed (

$117

m a

s loa

n an

d $8

m

as gr

ant)

No

Yes

Yes

Yes

3. A

DB

Hea

lth B

ond

laun

ched

($

100m

OCR

)N

oN

oYe

sYe

s

Prog

ress

: A

chie

ved

at le

ast 9

5% o

f tar

get

* Cu

mul

ativ

e am

ount

AD

B =

Asia

n D

evel

opm

ent B

ank,

AD

F =

Asia

n D

evel

opm

ent F

und,

GM

S =

Gre

ater

Mek

ong S

ubre

gion

, m =

milli

on, O

CR =

ord

inar

y cap

ital r

esou

rces

.

Stor

y be

hind

the

num

bers

•Be

fore

the

deve

lopm

ent o

f the

RM

TF, A

DB

had

inve

sted

$49

milli

on in

com

mun

icab

le d

iseas

e co

ntro

l ($2

2 m

illion

as g

rant

for C

ambo

dia

and

the

Lao

PDR,

and

$27

milli

on lo

an fo

r Vie

t Nam

). U

sing

the

RMTF

fund

s, an

add

ition

al gr

ant o

f $9.

5 milli

on w

as re

leas

ed in

201

5 for

Cam

bodi

a, th

e La

o PD

R, a

nd V

iet N

am.

•Th

e RM

TF w

as c

atal

ytic

in ra

ising

add

ition

al A

DB

fund

s to

sup

port

effor

ts fo

r mal

aria

elim

inat

ion

and

addr

essin

g co

mm

unic

able

dise

ase

thre

ats.

A to

tal o

f $52

.5 m

illion

has

bee

n m

obiliz

ed fo

r hea

lth

secu

rity

mea

sure

s for

all

coun

tries

elig

ible

for t

he A

sian

Dev

elop

men

t Fun

d (A

DF)

as p

er A

DB’

s con

cess

iona

l ass

istan

ce p

olic

y. A

n ad

ditio

nal $

125

milli

on w

orth

of l

oans

and

gra

nts f

or h

ealth

secu

rity

in

GM

S co

untri

es w

as a

lso a

ppro

ved

in N

ovem

ber o

f 201

6.•

whi

le th

e ta

rget

has

bee

n m

et fo

r inc

reas

ed fi

nanc

ing,

AD

B co

ntin

ues t

o su

ppor

t fina

ncin

g m

echa

nism

s for

hea

lth, m

ost n

otab

ly th

roug

h th

e iss

uanc

e of

AD

B’s fi

rst h

ealth

bon

d. T

he b

ond

was

a p

rivat

e pl

acem

ent o

f $10

0 m

illion

issu

ed in

Mar

ch 20

17 a

nd w

ill su

ppor

t len

ding

to co

untri

es o

n ta

rget

ed h

ealth

fina

ncin

g, in

clud

ing m

alar

ia a

nd co

mm

unic

able

dise

ase

prog

ram

s. A

DB

will

cont

inue

to su

ppor

t the

bo

nd p

ipel

ine

proc

ess f

or p

oten

tial s

ubse

quen

t iss

ues.

The

AD

B he

alth

bon

d pr

ivat

e pl

acem

ent i

s a fi

rst o

f its

kind

, bot

h re

gion

ally

and

glob

ally.

AD

B is

asse

ssin

g the

pot

entia

l for

a fu

rther

AD

B he

alth

bon

d iss

uanc

e in

201

8, p

endi

ng a

suita

ble

heal

th p

roje

ct p

ipel

ine.

•A

DB

also

dev

elop

ed a

publ

ic–p

rivat

e pa

rtner

ship

s (PP

Ps) i

nves

tmen

t brie

f for

the

heal

th se

ctor

to p

rom

ote

incr

ease

d su

ppor

t for

hea

lth P

PPs i

nclu

ding

thos

e se

rvic

es th

at co

uld

bene

fit m

alar

ia e

limin

atio

n an

d co

mm

unic

able

dise

ases

. The

hea

lth P

PP b

rief i

nclu

ded

a de

taile

d re

view

of t

he b

road

er h

ealth

sys

tem

s st

reng

then

ing

ecos

yste

m re

quire

d to

sup

port

succ

essf

ul P

PPs,

incl

udin

g le

sson

s fro

m o

ther

se

ctor

s and

pro

gram

s on

build

ing s

ucce

ssfu

l PPP

pro

gram

s.•

In D

ecem

ber 2

017,

AD

B sig

ned

a m

emor

andu

m o

f und

erst

andi

ng (M

OU

) with

the

Glo

bal F

und

(GF)

, the

firs

t of i

ts k

ind

betw

een

the

GF

and

a de

velo

pmen

t ban

k. Th

e M

OU

is d

esig

ned

to (i

) pro

mot

e in

stitu

tiona

l coo

rdin

atio

n, (i

i) de

velo

p a

proj

ect p

ipel

ine

targ

etin

g hea

lth sy

stem

s dev

elop

men

t and

stre

ngth

enin

g for

mal

aria

, TB

and

HIV

and

AID

S el

imin

atio

n an

d co

ntro

l, and

(iii)

supp

ort g

over

nmen

ts’

trans

ition

al fi

nanc

e. T

he M

OU

was

dev

elop

ed in

coor

dina

tion

with

AD

B’s O

ffice

of C

ofina

ncin

g Ope

ratio

ns (O

CO),

the

Hea

lth S

ecto

r Gro

up, r

egio

nal d

epar

tmen

ts, a

nd th

e G

F re

gion

al te

ams.

The

MO

U

proc

ess a

llow

ed A

DB

and

the

GF

to d

iscus

s det

aile

d fin

anci

ng a

nd co

llabo

ratio

n m

odal

ities

, incl

udin

g res

ults

and

inpu

ts-b

ased

gran

t fina

ncin

g, an

d bl

ende

d fin

anci

ng m

odal

ities

bas

ed o

n pa

ralle

l and

join

t co

finan

cing

. Sin

ce th

e M

OU

sign

ing,

the

focu

s has

bee

n on

iden

tifyi

ng a

nd a

sses

sing

cofin

anci

ng o

ppor

tuni

ties.

The

inno

vativ

e fin

ance

con

sulta

nt h

as b

een

wor

king

with

AD

B re

gion

al d

epar

tmen

ts a

nd

the

GF

to fa

cilit

ate

proj

ect m

appi

ng a

nd c

ofina

ncin

g—a

proj

ect t

hat e

ncom

pass

es m

alar

ia a

nd o

ther

com

mun

icab

le d

iseas

es fo

r Bhu

tan,

PN

G, a

nd S

ri La

nka,

as w

ell a

s the

GM

S co

untri

es. P

relim

inar

y di

scus

sions

wer

e al

so h

eld

to su

ppor

t the

GF

and

Paci

fic Is

land

nat

ions

disc

uss a

pro

cure

men

t sys

tem

to su

ppor

t nat

iona

l pur

chas

ing a

nd p

rice

effec

tiven

ess.

cont

inue

d on

nex

t pag

e

48 Annex

Stor

y be

hind

the

num

bers

•Fr

om Ja

nuar

y 20

18 to

June

201

8 ke

y pa

rtner

wor

ksho

p an

d co

llabo

ratio

n m

eetin

gs (n

ot fi

nanc

ed u

nder

the

RMTF

) wer

e he

ld in

Gen

eva

(OCO

, GF

Mar

ch 2

018)

, Sin

gapo

re (A

DB

SDCC

, OCO

, reg

iona

l de

partm

ents

, and

GF

coun

terp

arts

and

APL

MA

dur

ing A

pril 2

018)

, and

Mel

bour

ne (w

orld

Mal

aria

Con

gres

s, Ju

ly 2

018)

. Dur

ing t

hese

mee

tings

the

follo

win

g wer

e ac

hiev

ed:

»D

evel

opm

ent o

f a d

etai

led

conc

ept n

ote

high

light

ing c

olla

bora

tion

fram

ewor

ks, o

utlin

es o

f inn

ovat

ive

finan

cing

pilo

ts fo

r five

coun

tries

bet

wee

n G

F an

d A

DB,

dra

ft fra

mew

ork a

gree

men

ts, t

he “R

egio

nal

Fina

ncin

g Fa

cilit

y” p

relim

inar

y de

sign

pitc

h bo

ok, a

dra

ft m

onito

ring

and

eval

uatio

n (M

&E)

fram

ewor

k, an

d de

taile

d m

eetin

g, w

orks

hop

and

pane

l pre

sent

atio

ns a

nd m

ater

ials

to s

uppo

rt pa

rtner

di

scus

sions

;»

Go-

ahea

d by

par

tner

s (A

PLM

A, G

F to

dat

e, p

endi

ng c

onfir

mat

ion

of in

volv

emen

t bet

wee

n th

ree

mor

e pa

rtner

s) to

faci

litat

e de

taile

d fu

nd d

esig

n in

clud

ing a

con

cret

e pr

ojec

t pip

elin

e of

col

labo

ratio

n/co

finan

cing

that

supp

orts

hea

lth se

ctor

dev

elop

men

t inc

ludi

ng m

alar

ia a

nd o

ther

com

mun

icab

le d

iseas

es;

»So

cial

izatio

n of

the

prop

osed

regi

onal

fina

ncin

g fac

ility t

o br

oade

r sta

keho

lder

s inc

ludi

ng w

orld

Ban

k, w

HO

, aca

dem

ia, a

nd b

ilate

ral;

»Fo

rmal

izing

a kn

owle

dge

shar

ing n

etw

ork b

etw

een

AD

B O

CO, S

DCC

, APL

MA

and

the

Inte

r-A

mer

ican

Dev

elop

men

t Ban

k on

expe

rienc

es w

ith m

ultid

onor

faci

litie

s to

supp

ort m

alar

ia an

d ot

her h

ealth

in

nova

tive

finan

cing

mec

hani

sms;

and

»Fa

cilit

atin

g di

scus

sions

bet

wee

n G

F an

d pa

rtner

s, an

d A

DB

regi

onal

dep

artm

ent s

taff

to d

iscus

s in

tegr

atio

n of

cofi

nanc

ing

or p

aral

lel fi

nanc

ing

on p

roje

cts

in B

angl

ades

h, B

huta

n, S

ri La

nka,

PN

G,

Solo

mon

Isla

nds a

nd th

e La

o PD

R.

Box c

ontin

ued

Annex 49

OU

TCO

ME

3: M

EDIC

INES

Impr

oved

regu

lato

ry c

apac

ity to

supp

ort i

ncre

ased

avai

labi

lity a

nd u

se o

f qua

lity-

assu

red

heal

th p

rodu

cts f

or m

alar

ia a

nd o

ther

com

mun

icab

le d

iseas

es

Out

com

e 3.

1 Im

prov

ed o

pera

tiona

l cap

acity

of n

atio

nal r

egul

ator

y age

ncie

s (N

RAs)

Out

com

e In

dica

tor

2014

Base

line

Stat

us in

Targ

et

Prog

ress

O

utpu

t Ind

icat

or20

14Ba

selin

eSt

atus

inTa

rget

Pr

ogre

ss20

16Q

2 20

1820

16Q

2 20

18

1. N

umbe

r of c

ount

ries w

ith im

prov

ed

oper

atio

nal r

egul

ator

y cap

acity

00

3*3

1. N

umbe

r of c

ount

ries w

ith N

RA

capa

city

pro

files

(CA

M, L

AO, M

YA,

THA

, VIE

)

03

55

2. N

umbe

r of c

ount

ries w

ith N

RA

capa

city

stre

ngth

enin

g roa

d m

aps

(CA

M, L

AO, M

YA, T

HA

, VIE

)

00

55

3. T

rain

ing m

odul

es d

evel

oped

No

No

Yes

Yes

4. N

umbe

r of c

ount

ries w

ith N

RA st

aff

train

ed o

n pr

iorit

y reg

ulat

ory i

ssue

s an

d ga

ps

00

55

Prog

ress

: A

chie

ved

at le

ast 9

5% o

f tar

get

CAM

= C

ambo

dia,

LAO

= L

ao P

eopl

e’s D

emoc

ratic

Rep

ublic

, MYA

= M

yanm

ar, T

HA

= T

haila

nd, V

IE =

Vie

t Nam

.* C

ambo

dia,

the

Lao

PDR,

and

Mya

nmar

bui

lt ca

paci

ty b

ased

on

the

Cent

re o

f Reg

ulat

ory E

xcel

lenc

e (C

oRE)

nee

ds a

sses

smen

t, w

hich

hel

ped

iden

tify a

reas

of f

ocus

and

impr

ove

partn

er c

oord

inat

ion.

The

tra

inin

gs c

ondu

cted

for c

ount

ry re

pres

enta

tives

and

the

road

map

dev

elop

ed a

ll enc

apsu

late

cap

acity

bui

ldin

g. A

dditi

onal

ly, th

e ta

rget

ed te

chni

cal s

uppo

rt an

d w

ork i

n M

yanm

ar h

ad a

dire

ct im

pact

on

the

oper

atio

nal c

apac

ity o

f its

Foo

d an

d D

rug A

dmin

istra

tion

and

addi

tiona

l act

iviti

es a

ddre

ssin

g tar

gete

d m

onito

r-in

g of t

he q

ualit

y of m

edic

ines

on

the

mar

ket,

linki

ng th

e qu

ality

con

trol la

bora

tory

into

the

elec

troni

c in

form

atio

n sy

stem

and

dev

elop

ing t

he b

asis

of a

nat

iona

l dru

g saf

ety s

trate

gy a

nd p

harm

acov

igila

nce

syst

em.

Stor

y be

hind

the

num

bers

•w

ith A

DB

supp

ort,

the

CoRE

, a re

gion

al c

apac

ity b

uild

ing

cent

er a

nd p

artn

er-c

oord

inat

ing

plat

form

for r

egul

ator

y sy

stem

s st

reng

then

ing

and

conv

erge

nce

for S

outh

east

Asia

n de

velo

ping

mem

ber

coun

tries

, was

est

ablis

hed

in c

olla

bora

tion

with

the

Gov

ernm

ent o

f Sin

gapo

re (w

hich

pro

vide

d $1

0 m

illion

in c

ofina

ncin

g), D

uke-

NU

S, w

HO

, Uni

ted

Stat

es P

harm

acop

eia

(USP

) and

oth

er p

artn

ers.

•Bu

ildin

g on

the

wH

O p

rofil

ing t

ool, a

mor

e pr

actic

al re

gula

tory

syst

em p

rofil

ing i

nstru

men

t (RS

PI) t

o as

sess

NRA

capa

bilit

y, es

peci

ally

rela

ted

to re

gula

ting a

nti-m

alar

ias a

nd o

ther

com

mun

icab

le d

iseas

es

med

icin

e, h

as b

een

deve

lope

d an

d ca

paci

ty ga

p an

alys

is ha

s bee

n co

nduc

ted

by C

oRE

for t

he N

RAs i

n Ca

mbo

dia,

the

Lao

PDR,

Mya

nmar

, Tha

iland

, and

Vie

t Nam

.•

Base

d on

the

capa

city

pro

files

, prio

rity t

rain

ing n

eeds

wer

e id

entifi

ed in

the

area

s of f

ound

atio

ns a

nd p

roce

sses

of r

egul

ator

y pra

ctic

e, p

ost-

mar

ket s

urve

illanc

e an

d m

edic

al d

evic

e re

gula

tion.

•Co

urse

curri

cula

and

train

ing m

ater

ials

wer

e dev

elop

ed fo

r pha

rmac

ovig

ilanc

e, m

edic

al d

evic

e reg

ulat

ion,

and

good

regu

lato

ry p

ract

ice.

Tra

inin

gs in

the L

ao P

DR

and

Cam

bodi

a on

phar

mac

ovig

ilanc

e wer

e co

nduc

ted

in A

ugus

t 201

7 an

d tra

inin

g on

med

ical

dev

ices

was

con

duct

ed in

Cam

bodi

a in

Nov

embe

r 201

7.•

Coun

try c

apac

ity b

uild

ing

road

map

s wer

e de

velo

ped,

disc

usse

d w

ith th

e N

RAs a

nd fi

naliz

ed. I

n ad

ditio

n, a

regi

onal

dev

elop

men

t roa

d m

ap, w

hich

info

rms t

he A

ssoc

iatio

n of

Sou

thea

st A

sian

Nat

ions

(A

SEA

N) p

roce

ss o

f con

verg

ing r

egul

ator

y pra

ctic

es, w

as p

repa

red.

•Co

RE h

as b

een

parti

cipa

ting

in th

e Re

gion

al R

egul

ator

y Pa

rtner

ship

(w

hich

focu

ses

on re

gula

tion

of a

ntim

alar

ials)

, whi

ch h

as s

een

its c

apac

ity g

ap a

nalys

es in

tegr

ated

into

the

natio

nal w

ork

plan

s de

velo

ped

by th

e pa

rtner

ship

.•

CoRE

has

con

duct

ed a

dditi

onal

trai

ning

ses

sions

in S

inga

pore

on

regu

lato

ry p

ract

ices

as

part

of it

s re

gula

r act

iviti

es. R

egul

ator

s fro

m V

iet N

am a

nd T

haila

nd h

ave

atte

nded

som

e of

thes

e se

ssio

ns to

ad

dres

s ide

ntifi

ed c

apac

ity is

sues

usin

g the

ir ow

n fu

ndin

g.•

The

key a

chie

vem

ent h

as b

een

the

deve

lopm

ent o

f cap

acity

dev

elop

men

t pla

ns th

at w

ill su

ppor

t the

har

mon

izatio

n of

regu

lato

ry st

reng

then

ing e

fforts

by p

artn

ers a

nd a

coh

eren

t app

roac

h fa

cilit

ated

by

CoRE

.

cont

inue

d on

nex

t pag

e

50 Annex

Stor

y be

hind

the

num

bers

•Th

e su

cces

s for

impl

emen

ting p

lans

for r

egul

ator

y cap

acity

bui

ldin

g lar

gely

dep

ends

on

the

conv

ictio

n of

the

NRA

on

the

need

for s

yste

ms s

treng

then

ing,

coup

led

with

a cl

arity

on

how

this

prog

ress

can

be

achi

eved

. The

RSP

I was

dev

elop

ed to

iden

tify g

aps i

n th

e reg

ulat

ory s

yste

ms,

so th

at w

ith th

e res

olut

ion

of th

ese g

aps,

the r

egul

ator

y cap

acity

of t

he N

RA ca

n be

bro

ught

to th

e nex

t lev

el to

mee

t the

nee

ds

of th

e he

alth

care

syst

em. T

he fi

ndin

gs fr

om R

SPI a

re in

corp

orat

ed w

ith in

puts

from

ext

erna

l reg

ulat

ory s

take

hold

ers e

.g., in

dust

ry a

ssoc

iatio

n, p

harm

acy a

ssoc

iatio

ns, t

o ac

hiev

e a

degr

ee o

f val

idat

ion

and

trian

gula

tion,

and

cove

rs fr

om o

rgan

izatio

nal s

truct

ure,

gove

rnan

ce, a

nd h

uman

reso

urce

s to

the

key r

egul

ator

y fun

ctio

ns. T

he N

RAs w

ere

prov

ided

with

thei

r ind

ivid

ual c

ount

ry as

sess

men

t rep

orts

on

the

gaps

in th

eir r

egul

ator

y sys

tem

s, as

wel

l as a

road

map

on

the

reco

mm

ende

d ac

tions

to h

elp

stre

ngth

en th

eir s

yste

ms.

Thes

e do

cum

ents

pro

vide

the

nece

ssar

y inf

orm

atio

n an

d pr

actic

al re

com

men

datio

ns

to h

elp

the N

RAs p

riorit

ize th

eir s

teps

in b

uild

ing r

egul

ator

y cap

acity

and

faci

litat

e tim

ely a

cces

s to

qual

ity h

ealth

pro

duct

s. Re

gula

tory

grow

th an

d pr

ogre

ss, a

s of a

ny ch

ange

s in

a lar

ge an

d co

mpl

ex sy

stem

, is

chal

leng

ing t

o m

easu

re. A

long

itudi

nal s

tudy

is re

quire

d ov

er a

few

year

s to

capt

ure

the

impa

ct o

f int

erve

ntio

ns fo

r reg

ulat

ory s

yste

ms s

treng

then

ing.

It sh

ould

also

be

note

d th

at su

ch gr

owth

dep

ends

on

the

polit

ical

, soc

ial, a

nd c

ultu

ral in

fluen

ces,

and

ther

efor

e a

mul

tipro

nged

app

roac

h w

ould

be

requ

ired.

Effo

rts to

pur

sue

such

an

appr

oach

wou

ld re

quire

subs

tant

ial in

vest

men

t and

com

mitm

ent.

•In

vie

w o

f the

mul

tiple

org

aniza

tions

that

are

cur

rent

ly a

ssist

ing

the

NRA

s in

regu

lato

ry c

apac

ity b

uild

ing,

ther

e is

a ne

ed to

coo

rdin

ate

thes

e tra

inin

g ac

tiviti

es w

ith th

e pr

imar

y go

al to

incr

ease

the

effici

ent a

nd e

ffect

ive

use

of re

sour

ces.

Aga

in, s

uch

coor

dina

tion

wou

ld re

quire

cla

rity

on th

e ne

eds o

f the

var

ious

NRA

s. Th

e as

sess

men

t rep

orts

from

the

AD

B-Co

RE p

roje

ct w

ere

shar

ed (u

nder

term

s of

confi

dent

ialit

y with

the

resp

ectiv

e N

RAs)

with

vario

us p

artn

ers a

t the

regi

onal

pla

tform

, incl

udin

g wH

O, A

PLM

A, a

nd T

hera

peut

ic G

oods

Adm

inist

ratio

n. In

addi

tion,

the

info

rmat

ion

from

the

coun

try

road

map

s fo

r reg

ulat

ory

syst

ems

stre

ngth

enin

g of

the

NRA

s in

the

GM

S w

ere

utiliz

ed a

nd c

ontri

bute

d to

the

deve

lopm

ent o

f a re

gion

al w

ork

plan

for r

egul

ator

y sy

stem

s st

reng

then

ing.

Thro

ugh

this

wor

k pl

an, t

echn

ical

par

tner

s can

indi

cate

the

area

s of c

omm

itmen

t in

regu

lato

ry tr

aini

ng, w

hich

has

to m

ove

way

from

a si

lo-e

d, d

iseas

e-sp

ecifi

c ap

proa

ch. T

his i

nitia

tive

forti

fies t

he e

ffort

for p

artn

er

enga

gem

ent a

nd su

ppor

ts m

easu

res f

or su

stai

nabi

lity o

f effo

rts in

the

GM

S.

Box c

ontin

ued

Annex 51

Out

com

e 3.

2 Im

prov

ed p

ost-

mar

ket s

urve

illan

ce o

f med

icin

es fo

r mal

aria

and

oth

er c

omm

unic

able

dise

ases

Out

com

e In

dica

tor

2014

Base

line

Stat

us in

Targ

et

Prog

ress

O

utpu

t Ind

icat

or20

14Ba

selin

eSt

atus

inTa

rget

Pr

ogre

ss20

16Q

2 20

1820

16Q

2 20

181.

Num

ber o

f cou

ntrie

s pilo

ting n

ew fi

eld

dete

ctio

n to

ols

00

11

SF fi

eld

dete

ctio

n to

ols

1. Fo

rmal

rela

tions

hips

with

glob

al a

nd

loca

l res

earc

h in

stitu

tions

est

ablis

hed

No

Yes

Yes

Yes

2. L

ibra

ry o

f act

ive

ingr

edie

nts a

nd

finish

ed p

rodu

ct p

rofil

es d

evel

oped

N

oN

oYe

sYe

s

3. R

epor

t on

resu

lts o

f tes

ting a

nd

cost

-effe

ctiv

enes

s eva

luat

ion

of fi

eld

dete

ctio

n to

ols

No

No

Yes

Yes

4. R

ecom

men

datio

ns o

n co

st-e

ffect

ive

post

-mar

ket s

urve

illanc

e fie

ld to

ols f

or

dete

ctin

g SF

deve

lope

d

No

No

Yes

Yes

2. N

umbe

r of w

PRO

and

SEA

RO

coun

tries

star

ted

to re

port

to th

e gl

obal

su

bsta

ndar

d an

d fa

lsifie

d (S

F) m

edic

al

prod

ucts

repo

rting

mec

hani

sm*

06

105

SF re

porti

ng

1. N

umbe

r of c

ount

ries w

ith st

aff tr

aine

d on

the

wH

O gl

obal

SF

repo

rting

m

echa

nism

022

2222

Prog

ress

: A

chie

ved

at le

ast 9

5% o

f tar

get

* wH

O d

oes n

ot d

ivul

ge in

form

atio

n on

repo

rting

by i

ndiv

idua

l cou

ntrie

s due

to c

onfid

entia

lity r

ules

.

Stor

y be

hind

the

num

bers

•A

DB

esta

blish

ed fo

rmal

rela

tions

hips

with

glob

al an

d lo

cal r

esea

rch

inst

itutio

ns w

ith e

xper

tise

in m

alar

ia re

sista

nce

and

qual

ity m

edic

ines

for i

mpr

ovin

g evi

denc

e on

use

of p

ost-

mar

ket s

urve

illanc

e to

ols f

or q

ualit

y te

stin

g of

ant

i-mal

aria

ls. A

lite

ratu

re su

rvey

of c

urre

nt te

chno

logi

es w

as c

ompl

eted

and

11 m

edic

ine-

qual

ity fi

eld

dete

ctio

n de

vice

s wer

e id

entifi

ed fo

r ass

essm

ent.

Thei

r lib

rarie

s w

ere

deve

lope

d w

here

nec

essa

ry a

nd p

aram

eter

s ass

esse

d in

pre

para

tion

for t

he fi

eld

eval

uatio

n in

a m

ock p

harm

acy.

•Th

e m

ock p

harm

acy h

as b

een

esta

blish

ed an

d th

e de

vice

s shi

pped

to th

e La

o PD

R fo

r fiel

d te

stin

g. Th

e La

o PD

R N

RA in

spec

tors

wer

e tra

ined

on

the

oper

atio

n of

the

devi

ces,

and

field

test

ing w

ith

the

Lao

NRA

was

com

plet

ed b

y the

end

of D

ecem

ber 2

017.

An

asse

ssm

ent o

f the

cost

-effe

ctiv

enes

s of t

he d

evic

es an

d an

anal

ysis

of th

eir p

erfo

rman

ce h

as b

een

com

plet

ed an

d a m

ultis

take

hold

er

mee

ting,

incl

udin

g re

gula

tors

and

insp

ecto

rs fr

om G

MS

NRA

s, to

disc

uss t

he re

sults

and

the

impl

icat

ions

for t

he u

se o

f sel

ecte

d de

vice

s in

prac

tice,

was

hel

d in

Apr

il 20

18. T

he v

iew

s fro

m th

e w

orks

hop

wer

e in

corp

orat

ed in

to th

e fin

al re

port.

•Tr

aini

ng o

n SF

med

icin

es re

porti

ng in

to th

e wH

O gl

obal

surv

eilla

nce m

echa

nism

was

cond

ucte

d jo

intly

by w

HO

and

USP

with

AD

B su

ppor

t. SF

repo

rting

is la

ggin

g in

the A

sia an

d Pa

cific

coun

tries

. Th

eref

ore,

all w

HO

/Reg

iona

l Offi

ce fo

r the

wes

tern

Pac

ific

(wPR

O) a

nd w

HO

/Sou

thea

st A

sia D

epar

tmen

t (SE

ARO

) cou

ntrie

s wer

e ta

rget

ed b

eyon

d th

ose

in th

e G

MS.

•To

supp

ort G

MS

coun

tries

dire

ctly

and

fost

er cr

oss-

bord

er co

llabo

ratio

n, a

high

-leve

l mee

ting w

ith h

eads

of N

RAs f

ollo

wed

by a

han

ds-o

n tra

inin

g wor

ksho

p w

as ar

rang

ed in

conj

unct

ion

with

wH

O

(Apr

il 201

7). A

nat

iona

l wor

ksho

p on

Stra

tegi

es to

Com

bat S

ubst

anda

rd an

d Fa

lsifie

d M

edic

al P

rodu

cts w

as th

en h

eld

in M

yanm

ar (N

ovem

ber 2

017)

in w

hich

a na

tiona

l coo

rdin

atio

n m

echa

nism

to

com

bat S

F m

edic

al p

rodu

cts w

as d

iscus

sed

and

adop

ted.

Thi

s was

follo

wed

by a

nat

iona

l tra

inin

g wor

ksho

p fo

r Mya

nmar

Food

and

Dru

g Adm

inist

ratio

n (F

DA)

insp

ecto

rs o

n ho

w to

pre

vent

, det

ect

and

resp

ond

to S

F m

edic

al p

rodu

cts.

wH

O w

ill pr

ovid

e fu

rther

follo

w-u

p in

201

8 as

wel

l as l

ook t

o fu

rther

nat

iona

l wor

ksho

ps.

•A

cons

ulta

nt w

as e

ngag

ed to

assis

t the

Mya

nmar

FD

A d

evel

op an

SF

actio

n pl

an (a

nd im

plem

ent a

nti-m

alar

ial s

peci

fic re

com

men

datio

ns) a

nd im

plem

enta

tion

of ca

paci

ty-s

treng

then

ing a

ctiv

ities

. ke

y in

form

atio

n re

sour

ces w

ere

prov

ided

to th

e FD

A, a

com

pute

rized

inte

grat

ed re

gist

ratio

n an

d in

form

atio

n sy

stem

wer

e im

plem

ente

d w

hich

, fol

low

ing

train

ing

of re

gula

tors

and

app

lican

ts in

N

ovem

ber 2

017,

was

fully

ope

ratio

nal b

y Fe

brua

ry 2

018.

Tec

hnic

al su

ppor

t was

also

pro

vide

d to

the

Mya

nmar

FD

A in

dev

elop

ing

a dr

aft m

echa

nism

for r

espo

ndin

g to

SF

med

ical

pro

duct

s and

or

gani

zing a

nat

iona

l wor

ksho

p to

disc

uss t

his,

follo

wed

by a

trai

ning

wor

ksho

p fo

r NRA

insp

ecto

rs o

n SF

med

ical

pro

duct

s with

inpu

t fro

m w

HO

and

USP

(Nov

201

7).

cont

inue

d on

nex

t pag

e

52 Annex

Stor

y be

hind

the

num

bers

•A

dditi

onal

ly, th

e qu

ality

con

trol l

abor

ator

y w

as li

nked

into

the

elec

troni

c in

form

atio

n sy

stem

and

a m

odul

e fo

r com

pany

regi

stra

tions

to b

e m

anag

ed th

roug

h th

e el

ectro

nic

info

rmat

ion

syst

em

deve

lope

d. P

rovi

ncia

l ins

pect

ors w

ere

prov

ided

with

tabl

ets b

y w

hich

they

cou

ld a

cces

s the

cen

tral d

atab

ase

in re

al-t

ime

to c

heck

regi

stra

tion

stat

us a

nd p

rodu

ct c

hara

cter

istic

s as w

ell a

s sub

mit

thei

r rep

orts

. Cur

rent

ly re

gist

ered

med

icin

es w

ere

asse

ssed

for p

atie

nt sa

fety

risk

s and

a n

atio

nal d

rug s

afet

y stra

tegy

and

pha

rmac

ovig

ilanc

e sy

stem

pro

pose

d fo

r im

plem

enta

tion.

•Th

e M

yanm

ar F

DA

has

bee

n su

ppor

ted

in m

oves

that

pro

mot

e gr

eate

r reg

ulat

ory

harm

oniza

tion

and

conv

erge

nce

havi

ng jo

ined

the

wH

O C

olla

bora

tive

Regi

stra

tion

Sche

me,

par

ticip

ated

in th

e A

SEA

N Jo

int A

sses

smen

t Pro

cedu

re fo

r reg

istra

tion

of m

edic

al p

rodu

cts a

nd jo

ined

the

Upp

sala

Mon

itorin

g Ce

ntre

(a w

HO

col

labo

ratin

g ce

nter

on

phar

mac

ovig

ilanc

e) a

s an

asso

ciat

e m

embe

r. Th

e M

yanm

ar F

DA

has

also

par

ticip

ated

in th

e A

sia–P

acifi

c Re

gion

al R

egul

ator

y Par

tner

ship

.

Box c

ontin

ued

Annex 53

OU

TCO

ME

4: IN

FORM

ATIO

N S

YSTE

MS

Incr

ease

d us

e of

qua

lity d

ata,

info

rmat

ion

tool

s, an

d te

chno

logi

es to

impr

ove

mal

aria

and

oth

er c

omm

unic

able

dise

ase

in

form

atio

n sy

stem

s

Out

com

e In

dica

tor

2014

Base

line

Stat

us in

Targ

et

Prog

ress

O

utpu

t Ind

icat

or20

14Ba

selin

eSt

atus

inTa

rget

Pr

ogre

ss20

16Q

1 201

820

16Q

1 201

81.

Num

ber o

f ICT

solu

tions

in u

se in

m

alar

ia a

nd o

ther

com

mun

icab

le

dise

ase

info

rmat

ion

syst

ems t

o im

prov

e an

d ha

rmon

ize in

form

atio

n m

anag

emen

t in

GM

S co

untri

es

00

3**

21.

Surv

eilla

nce

mec

hani

sms f

or m

alar

ia

and

com

mun

icab

le d

iseas

es m

appe

d fo

r G

MS

coun

tries

No

Yes

Yes

Yes

2. R

ecom

men

datio

ns o

n tw

o IC

T so

lutio

ns to

be

used

in th

e re

gion

No

Yes

Yes

Yes

3. N

umbe

r of I

CT so

lutio

ns te

sted

in G

MS

coun

tries

0

05*

2

2. N

umbe

r of c

ount

ries u

tilizi

ng

harm

onize

d ge

o-en

able

d m

alar

ia a

nd

deng

ue in

form

atio

n sy

stem

s

00

33

1. N

umbe

r of c

ount

ries w

ith p

reva

lenc

e an

d in

cide

nce

data

for m

alar

ia a

nd

deng

ue a

naly

zed

01

33

2. N

umbe

r of c

ount

ries w

ith d

evel

oped

ca

paci

ty o

f gov

ernm

ent p

ublic

hea

lth

expe

rts fo

r app

licat

ion

of G

IS-b

ased

vi

sual

izatio

n

01

33

3. N

umbe

r of c

ount

ries w

ith G

IS-b

ased

vi

sual

izatio

n sy

stem

of m

alar

ia a

nd

deng

ue in

cide

nce

and

risk e

stab

lishe

d an

d m

etho

dolo

gy e

valu

ated

00

33

4. N

umbe

r of c

ount

ries w

ith p

olic

y re

com

men

datio

ns fo

r tar

getin

g mob

ile

popu

latio

ns in

mal

aria

and

den

gue

surv

eilla

nce

and

cont

rol p

rogr

ams

com

mun

icat

ed to

Min

istrie

s of

Hea

lth**

*

00

03

Prog

ress

: A

chie

ved

at le

ast 9

5% o

f tar

get

C

ontin

ued

until

Q4

2018

thro

ugh

addi

tiona

l fun

ding

for t

he w

ork

GM

S =

Gre

ater

Mek

ong S

ubre

gion

, GIS

= ge

ogra

phic

info

rmat

ion

syst

em, I

CT =

info

rmat

ion

and

com

mun

icat

ion

tech

nolo

gy.

* Uni

que

Hea

lth ID

in C

ambo

dia;

GIS

pla

tform

in C

ambo

dia,

Mya

nmar

, and

Vie

t Nam

; com

mon

geo-

regi

stry

in C

ambo

dia

and

Mya

nmar

; Dise

ase

surv

eilla

nce

syst

em (e

CDS

v2) i

n Vi

et N

am; H

L7 a

nd

Fast

Hea

lthca

re In

tero

pera

bilit

y Res

ourc

es (F

HIR

) in

Viet

Nam

.**

GIS

pla

tform

, com

mon

geo-

regi

stry

and

eCD

S v2

.**

*Pol

icy r

ecom

men

datio

ns a

re b

eing

dev

elop

ed c

urre

ntly

and

will

be fi

naliz

ed a

s pop

ulat

ion

mov

emen

t res

ults

are

shar

ed a

nd d

iscus

sed

with

min

istry

of h

ealth

(MO

H) s

taff.

Add

ition

al fu

ndin

g sup

-po

rt ha

s bee

n se

cure

d by

MO

RU to

com

plet

e th

is w

ork.

54 Annex

Stor

y be

hind

the

num

bers

•A

nalys

is of

exis

ting s

urve

illanc

e sy

stem

s in

Cam

bodi

a, th

e La

o PD

R, M

yanm

ar, a

nd V

iet N

am h

ighl

ight

ed th

e ne

ed to

mai

nstre

am a

nd h

arm

onize

exis

ting m

alar

ia a

nd o

ther

com

mun

icab

le d

iseas

e in

form

atio

n sy

stem

into

the

rout

ine

heal

th m

anag

emen

t inf

orm

atio

n sy

stem

(HM

IS) t

o ov

erco

me

fragm

enta

tion

of su

rvei

llanc

e sy

stem

s and

to a

llow

surv

eilla

nce

for m

alar

ia e

limin

atio

n (is

sue

brie

f pub

lishe

d). T

he an

alys

is re

com

men

ds th

e us

e of

uni

que

patie

nt h

ealth

iden

tifier

s to

help

conn

ect t

he va

rious

verti

cal d

iseas

e m

anag

emen

t pro

gram

s, su

ch as

mal

aria

, to

enab

le b

ette

r del

iver

y of

car

e an

d en

sure

trea

tmen

t cou

rses

for m

alar

ia a

re b

eing

com

plet

ed. A

tool

for u

niqu

e pa

tient

ID a

sses

smen

t was

dev

elop

ed a

nd a

pplie

d in

Cam

bodi

a, th

e La

o PD

R, M

yanm

ar, a

nd V

iet N

am.

Polic

y re

com

men

datio

ns fr

om a

brie

f on

uniq

ue p

atie

nt h

ealth

IDs i

nfor

med

Cam

bodi

a’s n

atio

nal p

atie

nt id

entifi

catio

n (I

D) m

anag

emen

t stra

tegy

and

the

resp

ectiv

e im

plem

enta

tion

plan

. The

se

polic

y re

com

men

datio

ns a

re a

lso d

issem

inat

ed th

roug

h th

e A

sia e

Hea

lth In

form

atio

n N

etw

ork,

a pe

er-t

o-pe

er le

arni

ng p

latfo

rm fo

r gov

ernm

ent e

xper

ts. A

s som

e co

untri

es m

ove

to e

lect

roni

c he

alth

reco

rds (

EHR)

, and

aut

omat

ed re

porti

ng in

to v

ertic

al d

iseas

es in

form

atio

n sy

stem

s thr

ough

EH

Rs, g

over

nmen

t-m

anda

ted

natio

nal I

Ds w

ill be

util

ized

with

linka

ges t

o ot

her s

yste

ms (

such

as

soci

al se

curit

y). F

or V

iet N

am, a

sing

le E

HR

syst

em is

cur

rent

ly b

eing

dev

elop

ed a

nd w

ill be

pilo

ted

in 2

019.

The

find

ings

from

Vie

t Nam

’s ID

and

man

agem

ent i

nfor

mat

ion

syst

ems s

tock

-tak

ing

wer

e di

ssem

inat

ed d

urin

g an

EHR

wor

ksho

p in

Feb

ruar

y 201

8. P

oten

tial u

sage

of a

uni

que

heal

th ID

was

inco

rpor

ated

into

the

exec

utiv

e su

mm

ary f

or M

OH

. The

Vie

t Nam

gove

rnm

ent d

ecid

ed to

us

e its

Soc

ial S

ecur

ity (V

SS) n

umbe

r as t

he u

niqu

e nu

mbe

r for

linki

ng va

rious

pat

ient

regi

stra

tion

syst

ems.

Pote

ntia

l nex

t ste

ps o

n ho

w to

use

the

VSS

num

ber a

s an

enab

ler f

or in

tero

pera

bilit

y wer

e in

trodu

ced

in a

n el

ectro

nic

med

ical

reco

rds w

orks

hop

and

in te

chni

cal m

eetin

gs w

ith M

OH

. In

June

201

8, a

wor

ksho

p w

as h

eld

for M

OH

EH

A a

nd p

rivat

e se

ctor

hea

lth in

form

atio

n sy

stem

s (H

IS)

solu

tion

prov

ider

s on

best

pra

ctic

e in

iden

tity m

anag

emen

t and

mas

ter p

atie

nt in

dex.

•A

s co

untri

es b

ecom

e m

ore

awar

e of

the

impo

rtanc

e of

link

ing

thei

r exis

ting

data

silo

s w

ithin

the

heal

th s

ecto

r, an

d as

they

hav

e to

rely

on

rout

ine

info

rmat

ion

syst

ems

whe

n m

alar

ia c

ases

are

de

crea

sing,

the

deve

lopm

ent o

f stra

tegi

c mas

ter p

lans

on

HIS

is an

impo

rtant

step

to gu

ide

coun

tries

in th

e rig

ht d

irect

ion.

Cam

bodi

a alre

ady fi

naliz

ed it

s dra

ft H

MIS

mas

ter p

lan,

with

AD

B su

ppor

t. M

yanm

ar re

leas

ed it

s st

rate

gic

actio

n pl

an fo

r stre

ngth

enin

g he

alth

info

rmat

ion

2017

–202

1.Vie

t Nam

’s In

form

atio

n Te

chno

logy

(IT)

Dev

elop

men

t Pla

n 20

16–2

020

was

use

d to

est

ablis

h se

vera

l ne

w in

tero

pera

bilit

y po

licie

s with

the

MO

H in

201

8. A

dditi

onal

ly, A

DB

supp

orte

d th

e re

view

of t

he d

raft

vers

ion

1 of t

he E

nter

prise

Arc

hite

ctur

e w

ith fo

cus o

n th

e es

tabl

ishm

ent o

f a st

rate

gy fo

r in

tegr

atio

n an

d in

tero

pera

bilit

y of

exis

ting

info

rmat

ion

syst

ems a

cros

s the

dire

ctor

ates

(pre

vent

ive

and

cura

tive)

that

incl

udes

a st

anda

rds-

base

d ap

proa

ch a

nd a

mor

e co

mpr

ehen

sive

vers

ion

2 ar

chite

ctur

e. G

iven

the

MO

H p

lans

for a

nat

iona

l dat

a ce

nter

, AD

B pr

ovid

ed te

chni

cal e

xper

t res

ourc

e fo

r gui

danc

e in

bes

t pra

ctic

es in

nat

iona

l dat

a ce

nter

s.•

In m

any

GM

S co

untri

es, t

he w

ork

on in

tero

pera

bilit

y of

clie

nt a

nd fa

cilit

y re

gist

ries i

s ong

oing

, as i

s con

verg

ence

of c

omm

unic

able

dise

ases

info

rmat

ion

syst

ems a

nd h

ealth

IT g

over

nanc

e. It

is

beco

min

g in

crea

singl

y cl

ear t

hat s

igni

fican

t inv

estm

ents

in b

ackb

one

info

rmat

ion

and

com

mun

icat

ion

tech

nolo

gy (

ICT)

infra

stru

ctur

e, p

roce

ss im

prov

emen

ts, a

nd c

apac

ity d

evel

opm

ent a

re

requ

ired

and

that

thos

e ca

n al

so b

e le

vera

ged

by u

sers

out

side

the

heal

th se

ctor

. AD

B w

orke

d w

ith V

iet N

am e

stab

lish

a Hea

lth IC

T ac

tion

plan

. As o

ne o

f the

com

pone

nts a

nd to

faci

litat

e on

goin

g in

tero

pera

bilit

y tes

ting a

nd kn

owle

dge

base

d on

exis

ting n

atio

nal p

olic

ies,

the

Stan

dard

s and

Inte

rope

rabi

lity L

ab fo

r Asia

is a

ssist

ing V

iet N

am e

stab

lish

its in

tero

pera

bilit

y lab

at t

he M

OH

EH

A.

•To

achi

eve i

nter

oper

abilit

y, ca

paci

ty b

uild

ing a

nd go

vern

ance

in h

ealth

care

, sta

ndar

ds b

ased

on

natio

nal p

olic

ies i

s crit

ical

. In V

iet N

am, A

DB

faci

litat

ed a

natio

nal in

tero

pera

bilit

y wor

ksho

p in

Mar

ch

2018

and

hel

d fo

llow

-up

mee

tings

with

pub

lic a

nd p

rivat

e so

lutio

n pr

ovid

ers t

o ad

vanc

e kn

owle

dge

and

use

of H

ealth

Lev

el S

even

(HL7

) FH

IR fo

r int

erop

erab

ility i

n di

seas

e su

rvei

llanc

e an

d EH

R.

AD

B m

ade r

ecom

men

datio

ns re

gard

ing i

nter

oper

abilit

y for

the l

ocal

hea

lth co

mm

une l

evel

info

rmat

ion

syst

ems (

12,0

00 st

atio

ns) a

nd as

siste

d th

e MO

H to

esta

blish

a Vi

et N

am In

tero

pera

bilit

y lab

.•

Trai

ning

hea

lth w

orke

rs in

new

ly e

nhan

ced

dise

ase

surv

eilla

nce

syst

ems i

s key

to e

nsur

ing

use,

impr

ovin

g da

ta q

ualit

y an

d pr

omot

ing

com

preh

ensiv

e re

porti

ng o

f com

mun

icab

le d

iseas

es. I

n Vi

et

Nam

, AD

B su

ppor

ted

eigh

t lar

ge p

rovi

ncia

l lev

el e

lect

roni

c co

mm

unic

able

dise

ase

surv

eilla

nce

(eCD

S) tr

aini

ngs,

and

supp

orte

d tra

inin

g in

clin

ical

term

inol

ogy

(cod

ing)

for t

he M

OH

Vie

t Nam

A

dmin

istra

tion

of M

edic

al S

ervi

ces.

AD

B al

so e

valu

ated

dig

ital h

ealth

trai

ning

pro

gram

s and

cou

rses

and

form

ulat

ed a

set o

f rec

omm

enda

tions

on

how

to im

prov

e an

d su

stai

n eH

ealth

cap

acity

at

univ

ersit

ies.

•w

orki

ng c

lose

ly w

ith V

iet N

am’s

Gen

eral

Dep

artm

ent o

f Pre

vent

ive

Med

icin

e, A

DB

impl

emen

ted

the

initi

al s

yste

ms

deve

lopm

ent o

f the

Dig

ital H

ealth

Fra

me

aim

ed a

t diss

emin

atin

g ou

tbre

ak

info

rmat

ion

to c

omm

unity

leve

l. In

supp

ort o

f thi

s new

syst

em, s

erve

r equ

ipm

ent w

as p

rocu

red.

•N

umer

ous c

ount

ries c

ontin

ue to

inve

st in

DH

IS2 i

mpl

emen

tatio

n as

an in

form

atio

n sy

stem

to ai

d na

tiona

l hea

lth st

atist

ics r

epor

ting.

In la

te 20

17, V

iet N

am in

stitu

ted

polic

y to

utiliz

e D

HIS

2 at g

rass

ro

ots l

evel

to a

id in

the

annu

al h

ealth

stat

istic

s rep

ortin

g, w

hich

is n

ow a

mul

tiyea

r man

ual c

ompi

latio

n pr

oces

s. A

DB

is su

ppor

ting

the

repo

rt au

tom

atio

n by

pro

vidi

ng te

chni

cal r

esou

rces

(HIS

P Vi

et N

am).

Supp

orte

d ac

tiviti

es in

clud

e M

OH

trai

ning

of t

he tr

aine

rs an

d dr

aftin

g of s

tand

ard

oper

atin

g pro

cedu

res (

SOPs

) for

nat

iona

l sca

le. w

ith V

iet N

am’s

plan

to im

plem

ent a

rem

odel

ed lo

cal

heal

th c

omm

une

stru

ctur

e na

tionw

ide,

AD

B w

orke

d w

ith th

e M

OH

EH

A a

nd th

e D

epar

tmen

t of P

lann

ing

and

Fina

nce

deve

lop

term

s of r

efer

ence

for l

ocal

to n

atio

nal l

evel

info

rmat

ion

flow

and

in

tero

pera

bilit

y. Th

e sy

stem

will

utiliz

e D

HIS

2 for

hea

lth st

atist

ics r

epor

ting,

esta

blish

the

EHR

and

enab

le H

IS in

tero

pera

bilit

y. Th

e lo

cal h

ealth

com

mun

e w

ill en

com

pass

pre

vent

ativ

e an

d cu

rativ

e se

ctor

s, in

clus

ive

of d

iseas

e su

rvei

llanc

e.•

In V

iet N

am, A

DB

team

ed u

p w

ith th

e Cl

into

n H

ealth

Acc

ess

Initi

ativ

e an

d th

e N

atio

nal I

nstit

ute

of M

alar

iolo

gy, P

aras

itolo

gy a

nd E

ntom

olog

y (N

IMPE

) to

eva

luat

e th

e co

untry

’s eC

DS

and

deve

lope

d a s

et o

f rec

omm

enda

tions

for d

evel

opin

g the

mal

aria

man

agem

ent s

yste

m. T

he G

ener

al D

epar

tmen

t of P

reve

ntiv

e Med

icin

e and

NIM

PE ar

e to

esta

blish

step

s for

an in

tegr

ated

not

ifiab

le

dise

ase

surv

eilla

nce

syst

em (u

sing e

CDS)

and

mal

aria

man

agem

ent s

yste

ms.

AD

B al

so su

ppor

ted

the

cond

uct o

f fac

ility a

sses

smen

t to

info

rm o

n m

alar

ia se

rvic

e re

adin

ess a

nd av

aila

bilit

y in

publ

ic

heal

th fa

cilit

ies i

n ni

ne d

istric

ts o

f Vie

t Nam

with

hig

h m

alar

ia tr

ansm

issio

n ra

tes.

A c

ostin

g to

ol b

ased

on

the

resu

lts o

f the

faci

lity

asse

ssm

ent w

as d

evel

oped

to p

rovi

de e

stim

ates

of t

he c

ost o

f ad

dres

sing c

urre

nt a

nd e

mer

ging

reso

urce

gaps

ove

r five

-yea

r tim

e sc

ale.

Res

ults

wer

e di

scus

sed

in a

foru

m th

at b

roug

ht to

geth

er N

IMPE

offi

cial

s and

mal

aria

staff

at p

rovi

ncia

l and

dist

rict l

evel

.•

To in

stitu

tiona

lize

mal

aria

elim

inat

ion

surv

eilla

nce,

a s

tand

ards

-bas

ed, g

eo-e

nabl

ed in

form

atio

n sy

stem

has

to b

e in

pla

ce w

ith ro

utin

e pr

oces

ses

linke

d to

an

inte

rope

rabl

e he

alth

info

rmat

ion

exch

ange

. The

pro

ject

sign

ifica

ntly

adv

ance

d th

e po

licy

dial

og o

n an

ent

erpr

ise a

rchi

tect

ure

appr

oach

to H

IS a

s cou

ntrie

s go

thro

ugh

thei

r dig

ital t

rans

form

atio

n. T

his w

ill en

sure

that

futu

re IC

T he

alth

inve

stm

ents

are

sust

aina

ble,

effi

cien

t, eff

ectiv

e an

d di

rect

ly c

ontri

butin

g to

cou

ntry

’s da

ta a

nd in

form

atio

n ne

eds.

The

scop

e of

the

activ

ities

also

incl

uded

wor

k on

a h

ealth

IT g

over

nanc

e fra

mew

ork,

whi

ch w

ill he

lp to

addr

ess d

ata s

harin

g, pr

ivac

y and

secu

rity i

ssue

s. U

ntil t

hose

are

addr

esse

d, d

ata s

harin

g am

ong a

genc

ies a

nd co

untri

es w

ill no

t be

poss

ible

. Mor

eove

r, the

pro

ject

bui

lt th

e cap

acity

of M

OH

s to

man

age h

ealth

ICT

proj

ects

and

ensu

re th

at d

evel

opm

ent p

artn

ers s

uppo

rt eH

ealth

solu

tions

for c

omm

unic

able

dise

ase a

nd m

alar

ia p

rogr

ams a

re sc

alab

le an

d su

stai

nabl

e.

cont

inue

d on

nex

t pag

e

Annex 55

Stor

y be

hind

the

num

bers

•Th

e ge

ogra

phic

dim

ensio

n of

mal

aria

and

deng

ue is

key t

o en

hanc

ing d

iseas

e su

rvei

llanc

e an

d m

alar

ia e

limin

atio

n th

roug

h im

prov

ed si

tuat

iona

l inte

lligen

ce. I

t also

pro

vide

s a u

niqu

e co

ntex

t to

link

verti

cal d

iseas

e pro

gram

s tog

ethe

r thr

ough

the g

eo-e

nabl

emen

t of t

he H

IS. A

mon

g the

nin

e ele

men

ts d

efini

ng th

e HIS

geo-

enab

ling f

ram

ewor

k, tw

o ar

e dire

ctly

rela

ted

to IC

T so

lutio

ns: (

i) Th

e use

of

geo

spat

ial t

echn

olog

ies i

nclu

ding

GIS

; (ii)

the

avai

labi

lity o

f a c

omm

on g

eo-r

egist

ry to

ena

ble

the

para

llel h

ostin

g, m

aint

aini

ng a

nd u

pdat

ing

of th

e m

aste

r list

s for

the

geog

raph

ic o

bjec

ts c

ore

to

publ

ic h

ealth

(hea

lth fa

cilit

ies,

adm

inist

rativ

e an

d re

porti

ng d

ivisi

ons,

villa

ges.

•M

ORU

and

the

Hea

lth G

eoLa

b Co

llabo

rativ

e (H

GLC

, for

mer

ly A

eHIN

GIS

lab)

wor

ked

toge

ther

to st

reng

then

the

tech

nica

l cap

acity

of t

he N

atio

nal M

alar

ia C

ontro

l Pro

gram

s (N

MCP

s) a

s wel

l as

oth

er ke

y MO

H e

ntiti

es in

Ban

glad

esh,

Cam

bodi

a, M

yanm

ar, T

haila

nd, a

nd V

iet N

am th

roug

h: (i

) The

dev

elop

men

t of r

efer

ence

mat

eria

l to

ensu

re th

e us

e te

chno

logy

to b

e em

bedd

ed in

good

ge

ospa

tial d

ata m

anag

emen

t pra

ctic

es (d

ocum

enta

tion

and

prom

otio

n of

the

conc

ept o

f com

mon

geo-

regi

stry

for e

xam

ple)

; (ii)

The

pro

visio

n of

appr

opria

te e

quip

men

t (ha

rdw

are

and

softw

are)

; (ii

i) Th

e co

nduc

t of N

atio

nal a

nd R

egio

nal t

rain

ings

(also

atte

nded

by

the

Lao

PDR)

; (iv

) Ons

ite a

nd re

mot

e te

chni

cal s

uppo

rt in

map

ping

and

ana

lysis

of su

rvei

llanc

e da

ta fo

r the

who

le c

ount

ry

for m

alar

ia a

nd d

engu

e; (v

) The

col

lect

ion

of g

eogr

aphi

c co

ordi

nate

s in

the

field

to im

prov

e so

me

of th

e ke

y la

yers

of i

nfor

mat

ion

need

ed fo

r mal

aria

elim

inat

ion;

(vi)

The

anal

ysis,

map

ping

, and

pr

esen

tatio

n in

diff

eren

t for

ums o

f cou

ntry

wid

e m

alar

ia a

nd d

engu

e su

rvei

llanc

e da

ta (C

ambo

dia,

Mya

nmar

, and

Tha

iland

).•

In ad

ditio

n to

the

abov

e, in

itial

wor

k on

asse

ssin

g the

rela

tions

hip

betw

een

clim

ate,

fore

st, a

nd m

alar

ia u

sing w

eath

er st

atio

n an

d re

mot

e se

nsin

g sat

ellit

e da

ta h

as b

een

com

plet

ed w

ith fu

rther

wor

k on

goin

g. A

nalys

is of

cal

l det

ail r

ecor

ds in

Tha

iland

has

bee

n co

mpl

eted

to m

odel

the

impa

ct o

f pop

ulat

ion

mov

emen

t pat

tern

s on

mal

aria

and

den

gue

dist

ribut

ion.

Fin

al a

ppro

val f

or th

is is

pend

ing

from

the

natio

nal r

egul

ator

in M

yanm

ar. T

rave

l sur

vey d

ata

from

pat

ient

s with

mal

aria

in C

ambo

dia,

the

Lao

PDR,

Mya

nmar

, Tha

iland

, and

Vie

t Nam

has

bee

n an

alyz

ed a

nd sh

ared

.•

The

AeH

IN G

IS L

ab h

as c

onve

rted

into

the

HG

LC in

Dec

embe

r 201

7 to

brin

g m

ore

partn

ers,

and

ther

efor

e re

sour

ces,

to c

ount

ries i

n A

sia a

nd th

e Pa

cific

to c

ontin

ue th

e w

ork

star

ted

unde

r the

um

brel

la o

f the

RM

TF. A

t the

tim

e of

clo

sing t

he R

ECA

P te

chni

cal a

ssist

ance

(TA)

, the

HG

LC co

unts

16-m

embe

r ins

titut

ions

incl

udin

g the

MO

H e

ntiti

es in

volv

ed in

the

HIS

geo-

enab

ling p

roce

ss

and

his p

rovi

ding

reso

urce

s acc

essib

le p

rinci

pally

to th

e 30

low

and

mid

dle-

inco

me

coun

tries

in A

sia a

nd th

e Pa

cific

.•

Polic

y re

com

men

datio

ns fo

r ta

rget

ing

mob

ile p

opul

atio

ns in

mal

aria

and

den

gue

surv

eilla

nce

and

cont

rol p

rogr

ams

have

bee

n de

velo

ped

for

Cam

bodi

a, M

yanm

ar, a

nd T

haila

nd. T

he fi

nal

reco

mm

enda

tions

will

be p

rovi

ded

once

the

resu

lts o

f the

pop

ulat

ion

mov

emen

t ana

lysis

usin

g ca

ll da

ta re

cord

s hav

e be

en sh

ared

and

disc

usse

d w

ith M

OH

staff

. Add

ition

al fu

ndin

g su

ppor

t has

be

en se

cure

d by

MO

RU to

com

plet

e th

is w

ork.

•In

crea

sed

inve

stm

ent i

n di

gita

l hea

lth c

an s

uppo

rt im

prov

ed m

alar

ia s

urve

illanc

e an

d re

spon

se. P

art o

f AD

B’s

digi

tal h

ealth

stra

tegy

gui

danc

e an

d di

gita

l hea

lth im

pact

fram

ewor

k in

clud

es a

n ex

ampl

e of

an

inve

stm

ent c

ase

stra

tegy

for m

alar

ia se

rvic

es a

nd a

n im

plem

enta

tion

guid

e. It

was

diss

emin

ated

to G

MS

coun

tries

in a

regi

onal

wor

ksho

p du

ring

the

2018

Prin

ce M

ahid

ol A

war

ds

Conf

eren

ce.

Box c

ontin

ued

56 Annex

OU

TCO

ME

5: L

ABO

RATO

RY D

IAG

NO

STIC

S A

ND

SU

RVEI

LLA

NCE

Impr

oved

cap

acity

of l

abor

ator

y dia

gnos

tics a

nd su

rvei

llanc

e sy

stem

for m

alar

ia a

nd o

ther

com

mun

icab

le d

iseas

es, in

clud

ing c

ross

-bor

der c

oord

inat

ion

Out

com

e 5.

1 Inc

reas

ed d

iagn

ostic

test

ing

for m

alar

ia in

pro

ject

are

as o

f Cam

bodi

a, L

ao P

DR,

and

Vie

t Nam

Out

com

e In

dica

tor

2014

Base

line

Stat

us in

Targ

et

Prog

ress

O

utpu

t Ind

icat

or20

14Ba

selin

eSt

atus

inTa

rget

Pr

ogre

ss20

1620

1720

1620

171.

Ann

ual b

lood

exa

min

atio

n pe

r 100

pop

at

risk

for m

alar

ia in

the

proj

ect a

reas

*D

iagn

ostic

cap

acity

for m

alar

ia

1. Pr

opor

tion

of h

ealth

fa

cilit

ies i

n pr

ojec

t are

as

equi

pped

with

mal

aria

di

agno

stic

equ

ipm

ent

CAM

0 0

83

80

LAO

010

010

0 7

0Ca

mbo

dia

Prea

h Vi

hear

Pro

vinc

e11

.2 6

.7 8

.410

.0VI

E**

7878

100

100

2. Pr

opor

tion

of la

bora

tory

st

aff in

targ

et p

rovi

nces

tra

ined

in m

alar

ia

diag

nosis

CAM

0 0

100

100

LAO

0 0

96

70

VIE

010

010

010

0La

o PD

R Ch

ampa

ssac

k Pr

ovin

ce12

.7 7

.9 9

.210

.0

Atta

peu

Prov

ince

25.5

13.4

18.5

10.0

Sara

vane

Pro

vinc

e14

.2 8

.3 8

.410

.0

Seko

ng P

rovi

nce

17.4

12.1

14.6

10.0

Viet

Nam

Bi

nh P

huoc

Pro

vinc

e12

.515

.610

.510

.0

Dak

Non

g Pro

vinc

e12

.810

.413

.310

.0

Prog

ress

: A

chie

ved

at le

ast 9

5% o

f tar

get

S

ubst

antia

l pro

gres

s ach

ieve

dCA

M =

Cam

bodi

a, L

AO =

Lao

Peo

ple’s

Dem

ocra

tic R

epub

lic, V

IE =

Vie

t Nam

.* D

ata

from

the

Min

istry

of H

ealth

** O

f the

182

com

mun

e he

alth

stat

ions

in th

e pr

ojec

t are

as, o

nly 4

0 re

quire

d ne

w m

icro

scop

es fo

r mal

aria

test

ing

Annex 57

Out

com

e 5.

2 Im

prov

ed su

rvei

llanc

e an

d re

spon

se fo

r mal

aria

and

oth

er c

omm

unic

able

dise

ases

in p

roje

ct a

reas

of

Cam

bodi

a, L

ao P

DR,

and

Vie

t Nam

incl

udin

g in

cro

ss-b

orde

r are

as

Out

com

e In

dica

tor

2014

Base

line

Stat

us in

Targ

et

Prog

ress

O

utpu

t Ind

icat

or20

14Ba

selin

eSt

atus

inTa

rget

Pr

ogre

ss20

1620

1720

1620

171.

Prop

ortio

n of

dise

ase

outb

reak

s (in

clud

ing m

alar

ia) i

n pr

ojec

t are

as

repo

rted

with

in 2

4 ho

urs

Surv

eilla

nce

capa

city

for m

alar

ia

1. Pr

opor

tion

of h

ealth

faci

litie

s and

la

bora

torie

s in

proj

ect a

reas

equ

ippe

d w

ith e

lect

roni

c re

porti

ng in

stru

men

ts fo

r m

alar

ia su

rvei

llanc

e

CAM

00

100

100

LAO

00

100

50Ca

mbo

dia

Prea

h Vi

hear

100

100

100

80VI

E**

100

100

100

100

2. P

ropo

rtion

of h

ealth

faci

litie

s in

targ

et

prov

ince

s with

staff

trai

ned

in m

alar

ia

surv

eilla

nce

with

ele

ctro

nic

repo

rting

in

stru

men

t

CAM

00

100

100

LAO

032

7720

VIE

050

50*

80La

o PD

R Ch

ampa

ssac

k 10

010

010

080

Cros

s-bo

rder

coo

rdin

atio

n an

d re

spon

se fo

r mal

aria

Atta

peu

50

100

100

803.

Num

ber o

f coo

rdin

ated

cro

ss-

bord

er a

ctio

n pl

ans d

evel

oped

ba

sed

on G

MS

mal

aria

elim

inat

ion

stra

tegy

in ta

rget

ed b

orde

r pr

ovin

ces

CAM

00

11

Sara

vane

100

80

100

80LA

O

02

22

Seko

ng10

0 6

0 8

380

VIE*

**0

--

3

Viet

Nam

Bi

nh P

huoc

100

100

100*

804.

Num

ber o

f villa

ge h

ealth

wor

kers

at

bord

er p

rovi

nces

trai

ned

in m

alar

ia

cont

rol a

nd tr

eatm

ent

CAM

00

331

332

Dak

Non

g10

010

010

0*80

LAO

0

032

260

2. P

ropo

rtion

of b

orde

r dise

ase

outb

reak

s (in

clud

ing m

alar

ia) i

n pr

ojec

t are

as

repo

rted

acro

ss b

orde

rs w

ithin

24

hour

s

VIE

023

623

6*40

Cam

bodi

a Pr

eah

Vihe

arN

AN

AN

A50

Lao

PDR

Cham

pass

ack

100

100

100

50

Atta

peu

50

100

100

50

Sara

vane

100

80

100

50

Seko

ng10

0 6

0 8

350

Viet

Nam

Bi

nh P

huoc

100

100

100*

50

Dak

Non

g10

010

010

0*50

Prog

ress

: A

chie

ved

at le

ast 9

5% o

f tar

get

S

ubst

antia

l pro

gres

s ach

ieve

dCA

M =

Cam

bodi

a, L

AO =

Lao

Peo

ple’s

Dem

ocra

tic R

epub

lic, N

A –

no

outb

reak

s of r

egio

nal o

r int

erna

tiona

l rel

evan

ce, V

IE =

Vie

t Nam

.* A

s of Q

1 201

7**

Faci

litie

s alre

ady h

ave

the

need

ed e

quip

men

t**

* No

spec

ific

cros

s-bo

rder

act

ion

plan

s wer

e de

velo

ped

by p

rovi

nces

but

six c

ross

-bor

der a

ctiv

ities

wer

e in

corp

orat

ed in

to th

e pr

ovin

cial

ann

ual o

pera

tiona

l pla

ns th

at w

ere

all im

plem

ente

d

58 Annex

Stor

y be

hind

the

num

bers

•Th

e ad

ditio

nal fi

nanc

ing

for m

alar

ia-r

elat

ed a

ctiv

ities

aim

ed to

dire

ct e

fforts

tow

ard

mal

aria

con

trol a

nd e

limin

atio

n th

roug

h re

gion

al a

nd c

ount

ry s

truct

ures

and

pro

cess

es a

lread

y es

tabl

ished

und

er th

e A

DB

Com

mun

icab

le D

iseas

e Pro

ject

2 (C

DC2

). M

alar

ia ac

tiviti

es fu

nded

und

er th

e RM

TF co

mpl

emen

ted

and

augm

ente

d th

e nat

iona

l mal

aria

pro

gram

s in

Cam

bodi

a, th

e Lao

PD

R, an

d Vi

et N

am an

d w

ere s

ynch

roni

zed

with

don

or p

artn

ers’

ongo

ing i

nvol

vem

ents

in m

alar

ia a

nd in

add

ress

ing t

he sp

read

of a

rtem

isini

n re

sista

nce

in th

e re

gion

.•

The

RMTF

con

tribu

ted

to th

e sig

nific

ant d

ecre

ase

in th

e in

cide

nce

of P

. fal

cipar

um m

alar

ia in

the

proj

ect s

ites (

from

17.3

case

s per

1000

pop

ulat

ion

in 2

014

to 1.

8 in

201

7 in

the

proj

ect s

ites o

f Cam

bodi

a, a

nd fr

om

15.9

in 2

014

to 1.

6 in

201

7 in

the

proj

ect s

ites o

f the

Lao

PD

R).

Lao

PDR

•Th

e st

rate

gies

and

activ

ities

fund

ed u

nder

the

RMTF

in th

e La

o PD

R w

ere

iden

tified

in co

nsul

tatio

n w

ith d

evel

opm

ent p

artn

ers a

nd st

akeh

olde

rs w

orki

ng in

mal

aria

to e

nsur

e th

at th

e RM

TF in

vest

men

ts w

ould

lead

to

valu

e fo

r mon

ey a

nd re

ap m

axim

um re

sults

with

out d

uplic

atin

g effo

rts.

•In

the

proj

ect s

ites,

vect

or su

rvei

llanc

e an

d co

ntro

l gui

delin

es a

nd tr

aini

ng m

anua

ls w

ere

upda

ted,

vect

or c

ontro

l equ

ipm

ent w

ere

prov

ided

, and

staff

and

villa

ge h

ealth

wor

kers

wer

e tra

ined

.•

Beha

vior

al c

hang

e co

mm

unic

atio

n/IE

C m

ater

ials

wer

e de

velo

ped

targ

etin

g spe

cific

aud

ienc

es vi

a TV

and

radi

o ca

mpa

igns

. Reg

ular

mob

ile h

ealth

edu

catio

n se

ssio

ns w

ere

cond

ucte

d in

scho

ols a

nd vi

llage

s in

high

pr

eval

ence

are

as.

•Pr

ovin

cial

and

dist

rict h

ealth

staff

wer

e tra

ined

on

mal

aria

cas

e m

anag

emen

t and

trea

tmen

t whi

le vi

llage

hea

lth w

orke

rs w

ere

also

trai

ned

on m

alar

ia c

ontro

l and

surv

eilla

nce.

•SO

Ps a

nd g

uide

lines

wer

e up

date

d an

d tra

inin

gs c

ondu

cted

on

mal

aria

dia

gnos

is an

d m

icro

scop

y an

d la

bora

tory

qua

lity

assu

ranc

e. A

ll di

stric

t-le

vel f

acilit

ies

in th

e pr

ojec

t site

s w

ere

alre

ady

equi

pped

with

m

icro

scop

es. H

emog

lobi

nom

eter

s w

ere

requ

este

d in

stea

d to

add

ress

the

high

inci

denc

e of

P. v

ivax

case

s in

the

Lao

PDR.

Rel

evan

t sta

ff w

ere

train

ed o

n th

e us

e of

the

mac

hine

and

on

the

adm

inist

ratio

n of

pr

imaq

uine

for P

. viva

x tre

atm

ent.

•Th

e pr

ojec

t sup

porte

d m

alar

ia c

ase

surv

eilla

nce

and

repo

rting

at c

entra

l, pr

ovin

cial

and

dist

rict l

evel

s, in

clud

ing

pass

ive

and

activ

e ca

se d

etec

tion

and

dire

ctly

obs

erve

d tre

atm

ent.

Staff

from

cen

tral,

prov

inci

al

dist

rict a

nd c

heck

poin

ts w

ere

prov

ided

with

tele

phon

e ca

rds f

or d

iseas

e su

rvei

llanc

e an

d re

porti

ng. T

hey w

ere

also

trai

ned

on th

e D

HIS

2 re

porti

ng sy

stem

for m

alar

ia.

•Cr

oss-

bord

er d

iseas

e in

form

atio

n ex

chan

ge in

clud

ed m

alar

ia. A

ll pro

vinc

ial a

nnua

l ope

ratio

ns p

lan

incl

uded

mal

aria

targ

ets a

nd a

ctiv

ities

.

Cam

bodi

a•

The

RMTF

supp

ort i

n th

e pr

ojec

t site

in C

ambo

dia

(Pre

ah V

ihea

r) w

as to

pilo

t P. fa

lcipa

rum

elim

inat

ion

stra

tegi

es a

nd in

terv

entio

ns.

•Th

roug

h th

e RM

TF, t

he q

ualit

y of

pro

vinc

ial l

abor

ator

y se

rvic

es w

as im

prov

ed th

roug

h tra

inin

g an

d su

ppor

tive

supe

rvisi

on o

f lab

orat

ory

staff

, pur

chas

e of

labo

rato

ry e

quip

men

t (Lo

op-m

edia

ted

isoth

erm

al

ampl

ifica

tion

[LA

MP]

, mic

rosc

opes

), m

ater

ials,

reag

ents

, and

oth

er la

bora

tory

con

sum

able

s. LA

MP

devi

ces w

ere

prov

ided

for t

he d

etec

tion

of m

alar

ia c

ases

with

low

par

asite

den

sity.

The

mic

rosc

opes

pro

vide

d ha

d m

ount

ed c

amer

as to

cap

ture

and

shar

e di

gita

l im

ages

of t

he b

lood

smea

rs, s

horte

ning

dia

gnos

is tim

e an

d su

bseq

uent

ly re

sulti

ng to

tim

ely

treat

men

t. Th

e pr

ovisi

on o

f suc

h m

icro

scop

es c

ompl

emen

ted

the

inno

vativ

e m

icro

scop

y qua

lity a

ssur

ance

and

con

trol p

roce

dure

s tha

t wer

e im

plem

ente

d in

the

targ

et h

ealth

faci

litie

s.•

The

qual

ity o

f clin

ical

dia

gnos

tic a

nd c

ase

man

agem

ent w

as im

prov

ed th

roug

h th

e tra

inin

g of

hea

lth st

aff o

n m

alar

ia c

linic

al m

anag

emen

t, m

anag

emen

t of s

tock

s and

supp

lies,

and

the

re-e

stab

lishm

ent o

f the

fu

nctio

ns o

f villa

ge m

alar

ia w

orke

rs a

nd tr

aini

ng th

em to

impr

ove

thei

r ski

lls o

n cl

inic

al d

iagn

osis

and

case

man

agem

ent.

•Th

e su

rvei

llanc

e an

d re

spon

se sy

stem

was

exp

ande

d to

incl

ude

the

prov

ision

of t

rain

ing

to h

ealth

staff

and

villa

ge m

alar

ia w

orke

rs o

n pr

oper

dat

a m

anag

emen

t and

repo

rting

, rea

l-tim

e ca

se n

otifi

catio

n, v

illage

st

ratifi

catio

n an

d in

dex

case

inve

stig

atio

n. S

hifti

ng fr

om a

pre

viou

sly p

assiv

e ca

se d

etec

tion

syst

em a

t pub

lic h

ealth

faci

litie

s to

a ne

w m

odel

that

com

bine

s exis

ting

pass

ive

syst

em a

nd a

ctiv

e sy

stem

of s

cree

ning

m

alar

ia c

ases

at c

omm

uniti

es a

nd h

ouse

hold

s res

ulte

d in

Incr

ease

d ca

se d

etec

tion

rate

in th

e pr

ojec

t site

s. Fo

ci in

vest

igat

ions

wer

e al

so c

ondu

cted

alo

ng w

ith a

ctiv

e ca

se d

etec

tion

and

inve

stig

atio

n.•

A d

igita

l dat

a de

vice

(DD

D) w

as in

trodu

ced

and

used

by

heal

th c

ente

r sta

ff an

d vi

llage

mal

aria

wor

kers

for r

eal-t

ime

mal

aria

pos

itive

cas

es re

porti

ng a

nd n

otifi

catio

n us

ing

a st

anda

rdize

d te

mpl

ate

with

com

plet

e se

t of i

nfor

mat

ion

for c

ase

inve

stig

atio

n. M

OH

repo

rted

that

the

use

of th

e D

DD

has

impr

oved

mal

aria

surv

eilla

nce

and

resp

onse

.•

The

proj

ect a

lso e

ngag

ed re

gist

ered

priv

ate

prov

ider

s in

case

det

ectio

n, q

ualit

y tre

atm

ent,

follo

w-u

p, d

ata

man

agem

ent,

and

case

repo

rting

. wor

ksho

ps o

n ph

arm

acov

igila

nce

(mal

aria

dru

g us

e) w

ere

prov

ided

to

heal

th p

rofe

ssio

nal in

bot

h pu

blic

and

priv

ate

sect

ors.

Ratio

nal u

se o

f ant

i-mal

aria

l dru

gs w

as e

ncou

rage

d w

ith su

ppor

tive

supe

rvisi

on, a

nd p

artn

ersh

ip w

ith p

rivat

e pr

ovid

ers w

as e

stab

lishe

d.•

The

proj

ect s

uppo

rted

the

form

atio

n of

mal

aria

elim

inat

ion

task

forc

e co

mpr

ised

of p

rovi

ncia

l hea

lth o

ffice

s, lo

cal a

utho

ritie

s, no

n-he

alth

age

ncie

s, an

d de

velo

pmen

t par

tner

s ope

ratin

g in

the

proj

ect s

ites.

•IE

C m

ater

ials

wer

e de

velo

ped

and

diss

emin

ated

thou

gh m

ulti-

med

ia c

hann

els,

incl

udin

g billb

oard

s tar

getin

g mig

rant

and

mob

ile p

opul

atio

ns (M

MPs

) on

mal

aria

pre

vent

ion.

•D

iseas

e in

form

atio

n ex

chan

ge a

mon

g bor

der p

rovi

nces

incl

uded

mal

aria

. All p

rovi

ncia

l ann

ual o

pera

tions

pla

n al

so in

clud

ed m

alar

ia ta

rget

s and

act

iviti

es.

•Th

e st

rate

gy a

nd in

itiat

ives

dev

elop

ed b

y RM

TF in

Pre

ah V

ihea

r for

mal

aria

elim

inat

ion

was

repo

rted

by M

OH

to h

ave

been

exp

ande

d to

oth

er a

reas

in th

e co

untry

.

cont

inue

d on

nex

t pag

e

Annex 59

Stor

y be

hind

the

num

bers

Viet

Nam

•Th

e m

alar

ia s

ituat

ion

in th

e pr

ojec

t site

s in

Vie

t Nam

rem

aine

d re

lativ

ely

stab

le s

ince

201

6 w

ith v

ecto

r con

trol c

over

age

mai

ntai

ned

as p

lann

ed, a

nd th

e di

agno

sis a

nd tr

eatm

ent o

f mal

aria

follo

wed

the

MO

H

prot

ocol

.•

Trai

ning

s on

mal

aria

surv

eilla

nce

was

pro

vide

d to

88

prov

inci

al an

d di

stric

t sta

ff, an

d 19

4 co

mm

une

staff

. Tra

inin

gs o

n la

bora

tory

tech

niqu

es an

d on

the

use

of m

icro

scop

es w

ere

prov

ided

to 30

pro

vinc

ial a

nd d

istric

t st

aff.

•Su

perv

ision

s wer

e fie

lded

to th

e pr

ovin

cial

mal

aria

cen

ters

, dist

rict h

ealth

cen

ters

, and

com

mun

e he

alth

stat

ions

.•

Four

roun

ds o

f mal

aria

surv

eilla

nce,

act

ive

case

det

ectio

n an

d tre

atm

ent w

ere

cond

ucte

d in

four

dist

ricts

of B

inh

Phuo

c.•

Four

roun

ds o

f mon

itorin

g the

pro

hibi

ted

circ

ulat

ion

and

use

of m

onot

hera

py, c

ount

erfe

it an

d po

or q

ualit

y dru

gs at

the

med

ical

stat

ions

and

phar

mac

ies w

ere

cond

ucte

d in

the

dist

ricts

and

tow

ns o

f the

two

proj

ect

prov

ince

s. N

o vi

olat

ions

to th

e re

gula

tions

wer

e de

tect

ed.

•Th

e pr

ojec

t sup

porte

d or

ient

atio

n w

orks

hops

on

mal

aria

con

trol f

or C

ambo

dia–

Lao

PDR–

Viet

Nam

bor

der p

rovi

nces

(Oct

ober

–Dec

embe

r 201

6 an

d Fe

brua

ry–M

arch

201

7).

•M

onth

ly in

form

atio

n sh

arin

g inc

ludi

ng m

alar

ia w

as c

ondu

cted

in 13

of 1

4 bo

rder

pro

vinc

es in

Vie

t Nam

. All p

rovi

ncia

l ann

ual o

pera

tions

pla

n al

so in

clud

ed m

alar

ia ta

rget

s and

act

iviti

es.

Box c

ontin

ued

60 Annex

Out

com

e 5.

3 In

crea

sed

diag

nost

ic te

stin

g fo

r mal

aria

in p

roje

ct a

reas

of M

yanm

ara,

b,c

Out

com

e In

dica

tor

2014

Base

line

Stat

us in

Targ

et

Prog

ress

O

utpu

t Ind

icat

or20

14Ba

selin

eSt

atus

inTa

rget

Pr

ogre

ss20

16Q

2 20

1820

16Q

2 20

181.

Nat

iona

l mal

aria

dia

gnos

tic q

ualit

y as

sura

nce

guid

elin

es e

ndor

sed

by th

e N

atio

nal M

alar

ia C

ontro

l Pro

gram

Dia

gnos

tic c

apac

ity fo

r mal

aria

1. Pr

opor

tion

of h

ealth

faci

litie

s in

proj

ect

area

s equ

ippe

d w

ith m

alar

ia d

iagn

ostic

eq

uipm

ent*

*

440

100

100

Mon

Sta

te

No

No

Yes

Yes

2. P

ropo

rtion

of l

abor

ator

y sta

ff in

targ

et

prov

ince

s tra

ined

in m

alar

ia d

iagn

osis*

**24

096

100

Saga

ing R

egio

nN

oN

oYe

sYe

s3.

Nat

iona

l mal

aria

dia

gnos

tic q

ualit

y as

sura

nce

guid

elin

es d

evel

oped

No

No

Yes

Yes

2. A

nnua

l blo

od e

xam

inat

ion

per 1

00 p

op

at ri

sk fo

r mal

aria

in th

e pr

ojec

t are

asM

on S

tate

(Pro

ject

tow

nshi

ps av

erag

e)(M

awla

mya

ing,

Belin

, Pau

ng, k

yaik

hto)

4.2

-13

.5*

8.0*

***

Saga

ing R

egio

n (P

roje

ct to

wns

hips

av

erag

e)(H

kam

ti, H

omal

in, P

aung

byin

, Taz

e,

Mon

ywa,

Pal

e)

3.1

-24

.1*8.

0***

*

Prog

ress

: A

chie

ved

at le

ast 9

5% o

f tar

get

Q =

qua

rter

* Dat

a fo

r 201

7 **

Tot

al n

umbe

r of 4

3 he

alth

faci

litie

s**

*Tot

al n

umbe

r of 8

3 st

aff**

** A

BER

targ

et fo

r 202

0 in

Mya

nmar

, wH

O-M

alar

ia N

SP 2

016-

30N

ote:

201

6 da

ta w

as n

ot c

olle

cted

bec

ause

the

proj

ect i

nter

vent

ions

star

ted

only

in 2

017.

a Thi

s out

com

e ind

icato

r is u

sed

only

for M

yanm

ar. R

CDTA

8959

supp

orts

the d

evel

opm

ent o

f nat

iona

l gui

delin

es o

n lab

orat

ory d

iagno

stic

and

surv

eilla

nce a

nd is

cons

isten

t with

the M

onito

ring a

nd R

esul

t Fra

mew

ork

of th

e AD

B Te

chni

cal A

ssist

ance

Doc

umen

t for

RCD

TA89

59 d

evel

oped

with

conc

urre

nce f

rom

the G

over

nmen

t of M

yanm

ar. F

or M

yanm

ar, t

he o

utpu

t ind

icato

r on

cros

s bor

der c

oord

inat

ion

is no

t inc

lude

d sin

ce th

e pr

ojec

t has

a lim

ited

scop

e on

it wh

ile fo

cusin

g on

inte

rnal

migr

ant a

nd m

obile

pop

ulat

ions

. RCD

TA89

59 al

so su

ppor

ts M

MP-

relat

ed ac

tiviti

es in

Cam

bodi

a and

the L

ao P

DR.

b E

stim

ated

tota

l num

ber o

f ben

efici

arie

s (1,9

84,9

15 u

nder

labo

rato

ry d

iagn

ostic

s: an

d 96

9,58

5 un

der s

urve

illanc

e).

c RCD

TA89

59 su

ppor

ts th

e G

over

nmen

t of M

yanm

ar in

dev

elop

ing o

f a m

odel

to st

reng

then

its l

abor

ator

y dia

gnos

tic a

nd su

rvei

llanc

e sy

stem

at l

ocal

leve

l in tw

o pr

ojec

t are

as (M

on S

tate

and

Sag

aing

Re-

gion

), w

hich

is e

xpec

ted

to ro

ll out

in th

e en

tire

coun

try, w

hile

sim

ulta

neou

sly su

ppor

ting t

he go

vern

men

t cap

acity

at t

he c

entra

l leve

l.

Annex 61

Out

com

e 5.

4 Im

prov

ed su

rvei

llanc

e an

d re

spon

se fo

r mal

aria

and

oth

er c

omm

unic

able

dise

ases

in p

roje

ct a

reas

of M

yanm

ar

Out

com

e In

dica

tor

2014

Base

line

Stat

us in

Targ

et

Prog

ress

O

utpu

t Ind

icat

or20

14Ba

selin

eSt

atus

inTa

rget

Pr

ogre

ss20

16Q

2 20

1820

16Q

2 20

181.

Nat

iona

l mal

aria

surv

eilla

nce

guid

elin

es

endo

rsed

by t

he N

atio

nal M

alar

ia

Cont

rol P

rogr

am

1. Pr

opor

tion

of h

ealth

staff

in p

roje

ct

area

s equ

ippe

d w

ith e

lect

roni

c re

porti

ng

inst

rum

ents

for m

alar

ia su

rvei

llanc

e*

00

9710

0

Mon

Sta

te

No

No

Yes

Yes

2. P

ropo

rtion

of h

ealth

staff

in ta

rget

pr

ovin

ces t

rain

ed in

mal

aria

surv

eilla

nce

with

ele

ctro

nic

repo

rting

inst

rum

ent*

00

9710

0

Saga

ing R

egio

nN

oN

oYe

sYe

s3.

Nat

iona

l mal

aria

surv

eilla

nce

guid

elin

es

deve

lope

dN

oN

oYe

sYe

s

2. P

ropo

rtion

of d

iseas

e ou

tbre

aks

(incl

udin

g mal

aria

) rep

orte

d w

ithin

24

hour

sM

on S

tate

N

AN

A**

80

Saga

ing R

egio

nN

AN

A**

80

Prog

ress

: A

chie

ved

at le

ast 9

5% o

f tar

get

N

A =

NA

– n

o ou

tbre

aks o

f reg

iona

l or i

nter

natio

nal r

elev

ance

, Q =

qua

rter.

*Tot

al n

umbe

r of h

ealth

staff

and

villa

ge h

ealth

volu

ntee

rs**

All m

alar

ia c

ases

wer

e re

porte

d re

al-t

ime

with

in 2

4 ho

urs b

y mD

MS

(mob

ile d

atab

ase

mal

aria

surv

eilla

nce)

NA

– n

o ou

tbre

aks o

f reg

iona

l or i

nter

natio

nal r

elev

ance

Stor

y be

hind

the

num

bers

•Th

e RM

TF T

A in

Mya

nmar

was

des

igne

d to

dev

elop

(i) a

mod

el to

stre

ngth

en c

apac

ities

for l

abor

ator

y dia

gnos

tics a

nd su

rvei

llanc

e fo

r mal

aria

and

com

mun

icab

le d

iseas

e at

loca

l and

nat

iona

l leve

ls, a

nd

(ii) a

mod

el to

stre

ngth

en h

ealth

serv

ice

deliv

ery s

yste

m fo

r MM

P, fo

cusin

g on

inte

rnal

MM

P w

ith in

volv

emen

t of t

he p

rivat

e se

ctor

.

On

mal

aria

labo

rato

ry q

ualit

y as

sura

nce

and

mal

aria

surv

eilla

nce

in M

yanm

ar•

The T

A fo

cuse

d on

stre

ngth

enin

g dat

a man

agem

ent s

yste

ms f

or m

alar

ia su

rvei

llanc

e inc

ludi

ng th

e upg

radi

ng o

f ana

lytic

al to

ols f

or d

ecisi

on-m

akin

g, sc

ale u

p an

d m

aint

enan

ce o

f dat

a man

agem

ent s

yste

ms,

coop

erat

ion

with

vol

unte

er m

alar

ia w

orke

rs (

VMw

) on

rout

ine

repo

rting

, and

real

-tim

e re

porti

ng. T

he a

ssist

ance

also

focu

sed

on u

pgra

ding

labo

rato

ry d

iagn

ostic

qua

lity

assu

ranc

e by

impl

emen

ting

a pr

ofici

ency

test

ing a

nd c

ross

chec

king

syst

em in

pro

ject

tow

nshi

ps b

ased

on

the

revi

sed

mal

aria

qua

lity a

ssur

ance

(QA)

man

uals

and

SOPs

and

thro

ugh

train

ing o

n ex

pand

ed m

alar

ia m

icro

scop

y.

•Th

e N

MCP

with

supp

ort f

rom

par

tner

s dev

elop

ed a

mob

ile D

ata

Man

agem

ent S

yste

m (m

DM

S) p

ilote

d in

the

Maw

lam

yine

, Bel

in a

nd H

kam

ti to

wns

hips

to st

reng

then

the

qual

ity o

f mon

thly

mal

aria

dat

a re

porti

ng an

d to

est

ablis

h re

al-t

ime

notifi

catio

n of

mal

aria

pos

itive

case

s fro

m V

Mw

s, ba

sic h

ealth

staff

(BH

S), h

ospi

tals

and

the

priv

ate

sect

or. T

he n

otifi

catio

n is

done

via S

MS/

Vibe

r or m

obile

appl

icat

ion

to th

e St

ate/

Regi

on a

nd T

owns

hip

Vect

or-B

orne

Dise

ase

Cont

rol o

ffice

s (VB

DC

) dat

a fo

cal p

erso

n. C

ase

inve

stig

atio

n is

expe

cted

to b

e co

nduc

ted

by B

HS

with

in 72

hou

rs a

nd p

ublic

hea

lth re

spon

se b

y th

e To

wns

hip

VBD

C w

ithin

7 d

ays.

Surv

eilla

nce

equi

pmen

t for

the

mD

MS

wer

e pr

ocur

ed a

nd d

istrib

uted

to vi

llage

volu

ntee

rs. T

rain

ings

on

mD

MS

wer

e pr

ovid

ed to

BH

S an

d vo

lunt

eers

at t

owns

hip

leve

l.

•Co

mm

oditi

es fo

r sur

veilla

nce

wer

e pr

ocur

ed an

d di

strib

uted

to th

e ce

ntra

l hea

lth o

ffice

s, re

gion

al an

d st

ate

and

tow

nshi

p m

edic

al o

ffice

s: ce

ntra

l ser

ver a

t NM

CP, 3

1 lap

tops

, 200

mob

ile p

hone

s for

villa

ge

heal

th w

orke

rs, 2

1 ext

erna

l har

d di

sk d

rives

, 11 p

rinte

rs a

nd 4

4 ca

rtrid

ges,

8 pr

ojec

tors

and

scre

ens,

and

12 S

IM c

ard

rout

ers.

Labo

rato

ry e

quip

men

t wer

e al

so p

rocu

red

and

dist

ribut

ed: 3

1 mic

rosc

opes

with

4

for t

he N

atio

nal H

ealth

Lab

orat

ory (

NH

L), 1

0 fo

r Sag

aing

and

17 fo

r Mon

, mic

rosc

ope

with

dig

ital c

amer

a fo

r NH

L, 5-

head

ed m

ultiv

iew

ing

teac

hing

mic

rosc

ope

for N

HL,

lab

equi

pmen

t and

reag

ent f

or

mal

aria

mic

rosc

opy,

cabi

nets

and

ben

ches

for t

he la

bs, 1

3 des

ktop

com

pute

rs a

nd fo

ur p

rinte

rs, a

nd 10

gene

rato

rs fo

r Sag

aing

regi

on.

•D

iffer

ent t

rain

ings

wer

e co

nduc

ted

afte

r the

dist

ribut

ion

of la

b eq

uipm

ent,

nam

ely:

on la

b Q

A an

d m

icro

scop

y for

lab

tech

nici

ans,

on la

b qu

ality

cont

rol c

ross

chec

king

by N

MCP

, pan

el te

stin

g by N

HL,

and

on-t

he-jo

b/re

fresh

er c

ours

es.

cont

inue

d on

nex

t pag

e

62 Annex

Stor

y be

hind

the

num

bers

•A

join

t mon

itorin

g an

d qu

ality

ass

uran

ce s

yste

m w

as e

stab

lishe

d, a

nd m

onito

ring

and

supe

rvisi

on w

ere

cond

ucte

d in

col

labo

ratio

n w

ith N

MCP

and

NH

L. T

he S

OPs

and

man

ual o

n M

icro

scop

y an

d La

bora

tory

QA

wer

e ap

prov

ed b

y th

e U

nion

Min

ister

of t

he m

inist

ries o

f hea

lth (M

OH

s) in

Apr

il 20

17, a

nd th

e m

anua

l was

app

rove

d by

the

MO

HS-

NM

CP in

Sep

tem

ber 2

017

for n

atio

nwid

e us

e. T

hese

m

ater

ials

have

bee

n di

strib

uted

nat

ionw

ide

and

used

for t

rain

ing M

OH

staff

in th

e pr

ojec

t are

as. L

ikew

ise, a

mal

aria

mic

rosc

opy a

lgor

ithm

and

mal

aria

refe

renc

e sli

de p

oste

rs w

ere

deve

lope

d fo

r use

by l

ab

tech

nici

ans n

atio

nwid

e.

•La

b an

d su

rvei

llanc

e ini

tiativ

es u

nder

the p

roje

ct w

ill be

repl

icat

ed b

y NM

CP in

oth

er p

arts

of t

he co

untry

supp

orte

d by

the D

EFEA

T M

alar

ia p

roje

ct o

f Uni

ted

Stat

es A

genc

y for

Inte

rnat

iona

l Dev

elop

men

t.

On

reac

hing

mob

ile a

nd m

igra

nt p

opul

atio

ns in

Cam

bodi

a, th

e La

o PD

R an

d M

yanm

ar•

A m

alar

ia vu

lner

abilit

y and

risk

asse

ssm

ent t

ool (

heal

th fa

cilit

y and

mal

aria

serv

ices

map

ping

, mig

ratio

n an

d m

obilit

y pro

file a

nd m

ovem

ent,

beha

vior

and

awar

enes

s ass

essm

ent)

was

dev

elop

ed an

d us

ed in

pr

ojec

t site

s in

Cam

bodi

a, th

e La

o PD

R, a

nd M

yanm

ar. R

esul

ts w

ere

shar

ed d

urin

g the

Glo

bal M

alar

ia w

eek i

n N

ay P

yi T

aw in

Dec

embe

r 201

7. In

the

Lao

PDR,

trac

king

of M

MP

mov

emen

t was

cond

ucte

d in

targ

et vi

llage

s to

mon

itor t

he tr

end

in m

ovem

ent o

f MM

Ps in

clud

ing f

ores

t and

hos

t com

mun

ities

, and

to id

entif

y the

loca

tions

in w

hich

they

stay

.

•Tr

aini

ng o

n ba

selin

e as

sess

men

t res

earc

h an

d da

ta co

llect

ion

tech

niqu

es w

as co

nduc

ted

in C

ambo

dia,

the

Lao

PDR,

and

Mya

nmar

. Villa

ge h

ealth

volu

ntee

r and

pee

r edu

cato

r tra

inin

g was

also

cond

ucte

d in

the

proj

ect s

ites i

n th

e La

o PD

R an

d M

yanm

ar w

ith 11

0 vo

lunt

eers

par

ticip

atin

g.

•M

obiliz

atio

n of

mig

rant

wor

kers

and

/or t

heir

fam

ily m

embe

rs tr

aine

d as

mal

aria

vol

unte

ers

as a

com

mon

app

roac

h w

as a

dopt

ed a

s ag

reed

with

the

MO

H o

f Cam

bodi

a, th

e La

o PD

R an

d M

yanm

ar.

Volu

ntee

r tra

inin

g and

out

reac

h ac

tiviti

es fo

r MM

Ps h

ave

been

con

duct

ed. T

he tr

aini

ng in

form

ed o

n m

alar

ia ve

ctor

s, sy

mpt

oms,

diag

nosis

, tre

atm

ent,

and

prev

entio

n.

•Th

ere w

ere 1

,956

out

reac

h pa

rtici

pant

s in

the L

ao P

DR

(1,0

82 in

kho

ng d

istric

t and

874

in P

houv

ong d

istric

t) w

hile

in M

yanm

ar th

ere w

ere 1

3,760

par

ticip

ants

in th

e thr

ee p

roje

ct to

wns

hips

. Vol

unte

ers h

ave

carri

ed o

ut IE

C se

ssio

ns in

wor

ksite

s as w

ell a

s pro

ject

site

s in

proj

ect a

reas

. Mal

aria

eve

nts,

cam

paig

ns, a

nd w

orld

Mal

aria

Day

cele

brat

ions

wer

e he

ld to

attra

ct p

ublic

’s at

tent

ion

on th

e w

ork o

f vol

unte

ers

and

avai

labi

lity o

f rap

id d

iagn

ostic

test

serv

ices

and

trea

tmen

t.

•To

pro

mot

e su

stai

nabi

lity a

nd h

arm

oniza

tion

with

nat

iona

l sys

tem

s, sp

ecifi

c effo

rts h

ave

been

mad

e to

ens

ure

that

activ

ities

and

case

dat

a wer

e in

corp

orat

ed in

to th

e re

porti

ng sy

stem

s of N

atio

nal M

alar

ia

Cent

ers.

The v

olun

teer

s pro

vide

d te

stin

g and

trea

tmen

t ons

ite ac

cord

ing t

o na

tiona

l gui

delin

es, w

ith al

l cas

e dat

a for

pat

ient

s tes

ted

and

outc

omes

reco

rded

and

com

mun

icat

ed fo

r inc

lusio

n in

the n

atio

nal

syst

ems f

ollo

win

g exis

ting m

alar

ia p

atie

nt re

gist

er fo

rmat

s and

guid

elin

es fo

r eas

e of i

nteg

ratio

n in

to n

atio

nal r

epor

ting.

Mal

aria

volu

ntee

rs fi

ll in

mon

thly

repo

rt fo

rms a

nd su

bmit

to to

wns

hip

and/

or d

istric

t le

vel h

ealth

team

s, w

ho su

bseq

uent

ly su

bmit

mon

thly

dat

a to

pro

vinc

ial, s

tate

and

subs

eque

ntly

cen

tral le

vel.

•Th

e wor

ksite

pro

ject

in M

yanm

ar d

istrib

uted

long

-last

ing i

nsec

ticid

al n

ets p

rovi

ded

by th

e Nat

iona

l Mal

aria

Con

trol P

rogr

am. T

he p

roje

ct in

the L

ao P

DR

on th

e oth

er h

and,

guid

ed b

y the

reco

mm

enda

tions

of

the

situa

tiona

l ass

essm

ent,

dist

ribut

ed h

amm

ock n

ets,

mos

quito

coi

ls, sp

rays

, and

pat

ches

targ

etin

g for

est-

goer

s and

MM

Ps.

•Te

chni

cal i

nput

to C

ambo

dia’s

MO

H O

pera

tiona

l Gui

delin

es fo

r Mob

ile, M

igra

nt a

nd o

ther

Und

erse

rved

Pop

ulat

ions

in th

e Co

ntex

t of M

alar

ia E

limin

atio

n w

as p

rovi

ded

thro

ugh

the

proj

ect.

Agr

eem

ent

was

also

reac

hed

by th

e M

OH

of t

he th

ree

coun

tries

on

the

defin

ition

of M

MPs

.

•Th

e La

o PD

R’s c

entra

l and

pro

vinc

ial h

ealth

offi

ces c

omm

itted

to su

stai

n (i)

the

train

ing

and

mob

ilizat

ion

of m

obile

trad

ers f

rom

the

Lao

PDR

and

Viet

Nam

who

ply

aro

und

the

dist

rict,

as m

alar

ia p

eer

educ

ator

s and

can

effe

ctiv

ely

reac

h M

MPs

; (ii)

the

iden

tifica

tion

and

train

ing

of th

e ca

m o

r wor

ksite

man

ager

s and

/or d

irect

ors a

s vol

unte

ers,

effec

tive

appr

oach

to e

ngag

e th

e pr

ivat

e se

ctor

in m

alar

ia

prev

entio

n an

d tre

atm

ent;

(iii)

deve

lopm

ent o

f inn

ovat

ive

info

rmat

ion

and

educ

atio

n/be

havi

oral

cha

nge

com

mun

icat

ion

mat

eria

ls fo

r spe

cific

MM

P ta

rget

s, (iv

) sys

tem

atic

iden

tifica

tion

and

mon

itorin

g of

MM

Ps th

roug

h ou

treac

h ac

tiviti

es o

f the

trai

ned

volu

ntee

r hea

lth w

orke

rs; a

nd (v

) dev

elop

men

t and

use

of r

epor

ting f

orm

s for

MM

Ps th

at ca

n in

form

the

natio

nal m

alar

ia re

porti

ng sy

stem

. In

Mya

nmar

, sim

ilar a

ppro

ache

s wer

e co

nduc

ted

whe

re 55

wor

ksite

man

ager

s wer

e en

gage

d as

volu

ntee

rs a

nd vi

llage

hea

lth vo

lunt

eers

in p

lant

atio

ns, g

old

and

jade

min

es tr

aine

d an

d m

obiliz

ed.

•In

Mya

nmar

, the

pro

ject

inte

rven

tion

for M

MPs

in th

e pr

ojec

t site

s will

be su

stai

ned

by th

e G

F.

Box c

ontin

ued

Annex 63

OU

TCO

ME

6: P

ROM

OTI

ON

AN

D P

REVE

NTI

ON

Incr

ease

d ca

paci

ty to

app

ly h

eath

impa

ct a

sses

smen

t to

cons

ider

det

erm

inan

ts o

f hea

lth a

nd c

omm

unic

able

dise

ases

in in

frast

ruct

ure

proj

ects

Out

com

e 6.

1 Inc

reas

ed c

apac

ity to

app

ly h

ealth

impa

ct a

sses

smen

t (H

IA) i

n in

frast

ruct

ure

proj

ects

at c

ount

ry le

vel

Out

com

e In

dica

tor

2014

Base

line

Stat

us in

Targ

et

Prog

ress

O

utpu

t Ind

icat

or20

14Ba

selin

eSt

atus

inTa

rget

Pr

ogre

ss20

16Q

2 20

1820

16Q

2 20

181.

Num

ber o

f cou

ntrie

s tha

t sta

rted

to

appl

y HIA

in in

frast

ruct

ure

proj

ects

(L

AO, T

HA)

00

22

Situ

atio

nal a

nalys

is an

d ne

eds a

sses

smen

t

1. N

umbe

r of H

IA c

ount

ry p

rofil

es (C

AM

, LA

O, M

YA, T

HA

, VIE

)0

05

5

2 N

umbe

r of i

nfra

stru

ctur

e pr

ojec

ts th

at

appl

ied

HIA

(Sav

anna

khet

, Muk

daha

n,

Hon

gsa)

00

33

Coun

try H

IA gu

idel

ines

2. N

umbe

r of c

ount

ries w

ith c

ount

ry H

IA

guid

elin

es d

evel

oped

00

33

3. R

egio

nal H

IA fr

amew

ork f

or sp

ecia

l ec

onom

ic zo

nes d

evel

oped

00

11

Capa

city

dev

elop

men

t

4. H

IA tr

aini

ng m

odul

es d

evel

oped

N

oN

oYe

sYe

s

5. N

umbe

r of c

ount

ries w

ith st

aff tr

aine

d in

HIA

00

44

6. H

IA c

urric

ulum

dev

elop

ed fo

r gra

duat

e pu

blic

hea

lth a

nd e

nviro

nmen

tal

prog

ram

s

No

No

Yes

Yes

7. N

umbe

r of c

ount

ries t

hat i

nteg

rate

d H

IA c

urric

ulum

into

grad

uate

pub

lic

heal

th a

nd e

nviro

nmen

tal p

rogr

ams

00

44

8. N

umbe

r of c

ount

ries t

hat s

tarte

d to

off

er H

IA in

grad

uate

pub

lic h

ealth

and

en

viro

nmen

tal p

rogr

ams

00

44

9. R

egio

nal n

etw

ork o

f HIA

exp

erts

and

un

iver

sitie

s est

ablis

hed

00

11

Polic

y and

gove

rnan

ce

10. N

umbe

r of c

ount

ries w

ith c

oste

d H

IA

prop

osal

0

05

5

11. N

umbe

r of c

ount

ries w

ith H

IA p

olic

ies

in p

lace

or d

evel

oped

00

33

12. N

umbe

r of c

ount

ries w

ith in

ters

ecto

ral

coor

dina

tion

on H

IA

00

33

13. N

umbe

r of H

IA p

olic

y brie

fs d

evel

oped

00

22

Prog

ress

: A

chie

ved

at le

ast 9

5% o

f tar

get

CA

M =

Cam

bodi

a, H

IA =

hea

lth im

pact

ass

essm

ent,

Lao

PDR

= La

o Pe

ople

’s D

emoc

ratic

Rep

ublic

, MYA

= M

yanm

ar, T

HA

= T

haila

nd, V

IE =

Vie

t Nam

.

64 Annex

Stor

y be

hind

the

num

bers

•A

DB

wor

ked

at th

ree

leve

ls (c

ount

ry, r

egio

nal,

with

in A

DB)

to im

prov

e H

IA in

the

regi

on. T

he a

im w

as th

at im

prov

ed H

IA w

ill co

ntrib

ute

to b

ette

r com

mun

ity h

ealth

out

com

es a

s wel

l as h

elp

miti

gate

ve

ctor

-bor

ne d

iseas

es ri

sks i

n la

rge-

scal

e in

frast

ruct

ure

proj

ects

sinc

e m

any m

obile

and

mig

rant

peo

ple

are

invo

lved

in co

nstru

ctio

n sit

es. C

ount

ry-le

vel a

ctiv

ities

conc

entra

ted

in th

e fiv

e G

MS

coun

tries

i.e.

Cam

bodi

a, th

e La

o PD

R, M

yanm

ar, T

haila

nd, a

nd V

iet N

am.

•Si

tuat

iona

l ana

lysis

and

need

s ass

essm

ent o

n H

IA w

ere

cond

ucte

d in

the

five

GM

S co

untri

es. T

hese

coun

tries

are

at va

rious

stag

es o

f HIA

dev

elop

men

t and

pra

ctic

e. A

ll five

coun

tries

hav

e th

e po

tent

ial t

o ha

rnes

s HIA

as p

art o

f the

ir m

alar

ia p

reve

ntio

n an

d co

ntro

l mea

sure

s and

AD

B bu

ilt o

n th

is op

portu

nity

to a

ccel

erat

e H

IA in

the

GM

S.•

Coun

try p

ropo

sals

with

wor

k pl

ans a

nd b

udge

t est

imat

es h

ad b

een

prep

ared

in N

ovem

ber 2

016,

whi

ch d

efine

d ke

y ac

tiviti

es to

ach

ieve

stro

nger

nat

iona

l HIA

pra

ctic

e. B

ased

on

thes

e co

untry

pro

posa

ls,

natio

nal H

IA c

oord

inat

ors,

who

had

wor

ked

clos

ely w

ith c

ount

ry c

ount

erpa

rts, w

ere

recr

uite

d to

ens

ure

timel

y im

plem

enta

tion

of a

ctiv

ities

and

to h

ave

inst

itutio

nal a

rrang

emen

ts in

pla

ce.

•D

evel

opm

ent o

f HIA

cap

acity

at t

he c

ount

ry le

vel r

equi

red

inte

rsec

tora

l coo

rdin

atio

n an

d co

llabo

ratio

n be

twee

n th

e M

OH

, the

Min

istry

of E

nviro

nmen

t (M

oE)

and

othe

r rel

ated

gov

ernm

ent o

ffice

s. A

lthou

gh th

ere w

ere n

o fo

rmal

inst

itutio

nal a

rrang

emen

ts b

etw

een

thes

e con

cern

ed m

inist

ries A

DB

was

able

to fa

cilit

ate c

olla

bora

tion

betw

een

them

. Thi

s ena

bled

bet

ter u

nder

stan

ding

amon

g gov

ernm

ent

stak

ehol

ders

on

the

need

to e

xplic

itly i

nteg

rate

hea

lth in

to e

xistin

g im

pact

ass

essm

ents

(i.e

., env

ironm

ent a

nd so

cial

) and

con

sequ

ently

dro

ve th

e m

omen

tum

for H

IA.

•D

evel

opm

ent o

f HIA

capa

city

also

requ

ired

build

ing t

he sk

ills o

f exis

ting s

taff

both

from

the

publ

ic a

nd p

rivat

e se

ctor

s to

have

HIA

pra

ctiti

oner

s tha

t can

mee

t the

nee

ds fo

r effe

ctiv

e H

IA in

the

long

-ter

m.

Trai

ning

in H

IA fo

cuse

d on

aw

aren

ess c

reat

ion,

know

ledg

e ex

pans

ion

and

skills

dev

elop

men

t with

the

basic

prin

cipl

es a

nd p

ract

ice

of H

IA, t

he a

pplic

atio

n of

tool

s in

a re

alist

ic m

anne

r, ex

plor

ing

deci

sion-

mak

ing

crite

ria a

nd o

ptio

ns fo

r ins

titut

iona

l arra

ngem

ents

bet

wee

n th

e he

alth

and

env

ironm

ent s

ecto

rs in

supp

ort o

f coo

rdin

ated

app

roac

h to

HIA

. Tra

inin

g in

HIA

targ

eted

gov

ernm

ent s

taff

from

MO

H

and

MoE

.•

To g

ener

ate

exam

ples

of g

ood

prac

tices

, cas

e st

udie

s to

dem

onst

rate

HIA

wer

e un

derta

ken

in n

omin

ated

pro

ject

s of v

ario

us se

ctor

s (i.e

., ene

rgy,

road

dev

elop

men

t, sp

ecia

l eco

nom

ic zo

nes [

SEZs

], w

ater

an

d sa

nita

tion,

and

urb

an d

evel

opm

ent)

. HIA

dem

onst

ratio

n id

entifi

ed th

e ne

ed fo

r stro

nger

com

pone

nts o

n co

mm

unity

hea

lth a

nd sa

fety

and

yie

lded

reco

mm

enda

tions

for P

ublic

Hea

lth M

anag

emen

t Pl

an th

at in

clud

e cl

ear s

peci

fic in

dica

tors

to e

nabl

e m

onito

ring a

nd re

porti

ng o

n he

alth

out

com

es a

nd p

ossib

le ri

sks t

o co

mm

unity

hea

lth.

•So

und

polic

y an

d re

gula

tory

fram

ewor

ks w

ere

impo

rtant

con

sider

atio

ns in

stre

ngth

enin

g H

IA p

ract

ice

in th

e G

MS.

Sup

port

was

pro

vide

d fo

r the

dev

elop

men

t of n

atio

nal H

IA g

uide

lines

. Gov

ernm

ent

coun

terp

arts

from

Cam

bodi

a, M

yanm

ar, a

nd V

iet N

am h

ave

com

plet

ed th

eir r

espe

ctiv

e dr

aft H

IA g

uide

lines

, inc

ludi

ng th

e in

tegr

atio

n of

hea

lth in

to th

e en

viro

nmen

t im

pact

ass

essm

ent.

The

Lao

PDR

revi

ewed

10 ye

ars o

f HIA

exp

erie

nce

and

disc

usse

d th

e up

datin

g of e

xistin

g nat

iona

l HIA

guid

elin

e as

wel

l as t

he d

evel

opm

ent o

f sec

tora

l gui

delin

es. T

he L

ao P

DR

com

plet

ed a

dra

ft H

IA gu

idel

ine

spec

ific

for e

nerg

y sec

tor,

spec

ifica

lly fo

r the

rmal

pow

er p

lant

s.•

A G

MS

HIA

fram

ewor

k for

SEZ

s was

pro

duce

d pr

ovid

ing e

nhan

ced

guid

ance

for i

dent

ifyin

g, m

itiga

ting,

and

man

agin

g hea

lth ri

sks a

nd im

pact

s rel

ated

to th

e inc

reas

ed in

dust

rial a

nd ec

onom

ic d

evel

opm

ent

in S

EZs a

nd e

cono

mic

cor

ridor

s. Th

e fra

mew

ork

prom

otes

in-c

ount

ry H

IA p

roce

sses

and

resp

onse

to re

late

d tra

nsbo

unda

ry is

sues

incl

udin

g th

ose

asso

ciat

ed w

ith m

obile

and

mig

rant

wor

ker p

opul

atio

ns

in S

EZs a

nd e

cono

mic

cor

ridor

s. Th

e H

IA fr

amew

ork

posit

ione

d pe

ople

dire

ctly

affe

cted

by

SEZ

deve

lopm

ent a

t the

cen

ter a

s the

y di

rect

ly in

terfa

ce w

ith th

e SE

Z an

d its

ass

ocia

ted

activ

ities

. The

HIA

Fr

amew

ork f

or S

EZs f

or th

e G

MS

can

be a

cces

sed

at h

ttps

://w

ww.

adb.

org/

publ

icat

ions

/hea

lth-i

mpa

ct-a

sses

smen

t-fra

mew

ork-

econ

omic

-zon

es-g

ms

•Co

untry

-spe

cific

HIA

guid

elin

es fo

r SEZ

s for

the L

ao P

DR

and

Thai

land

hav

e bee

n de

velo

ped

base

d on

coun

try re

ques

ts. H

IA fo

cal f

rom

MO

H o

f the

se co

untri

es ar

e now

elev

atin

g the

se gu

idel

ines

at p

olic

y le

vel. M

yanm

ar g

over

nmen

t also

reac

hed

out f

or T

A o

n th

e de

velo

pmen

t of m

anag

emen

t pla

ns fo

r Thi

law

a SE

Z, sp

ecifi

cally

on

the

man

agem

ent o

f haz

ardo

us m

ater

ials,

was

te, v

ecto

r-bo

rne

dise

ases

and

em

erge

ncy p

repa

redn

ess a

nd re

spon

se. T

oget

her w

ith th

e Th

ilaw

a SEZ

Man

agem

ent C

omm

ittee

and

repr

esen

tativ

es fr

om b

usin

ess s

ecto

r, the

man

agem

ent p

lans

wer

e re

view

ed an

d in

the

proc

ess o

f bei

ng

put i

nto

effec

t in

Thila

wa S

EZ. T

he fr

amew

ork w

as al

so ap

plie

d in

an in

tegr

ated

bor

der d

evel

opm

ent p

roje

ct at

one

of t

he b

orde

rs b

etw

een

Mya

nmar

and

the P

eopl

e’s R

epub

lic o

f Chi

na (P

RC),

at th

e Lin

cang

bo

rder

are

a. In

crea

sed

risks

form

impo

rted

mal

aria

from

Mya

nmar

and

the

need

to p

rovi

de h

ealth

serv

ices

to m

igra

nt a

nd m

obile

pop

ulat

ion

grou

ps h

ave

been

iden

tified

.•

Bila

tera

l coo

pera

tion

betw

een

the

Lao

PDR

and

Thai

land

on

trans

boun

dary

hea

lth is

sues

was

ano

ther

impo

rtant

initi

ativ

e. M

OH

and

MoE

from

bot

h co

untri

es in

clud

ing

at p

rovi

ncia

l and

dist

rict l

evel

s ag

reed

to a

join

t hea

lth su

rvei

llanc

e in

rela

tion

to p

roje

cts i

n en

ergy

sect

or i.e

., Hon

gsa

ther

mal

pow

er p

lant

loca

ted

at x

ayab

oury

, Lao

-Nan

, Tha

i bor

der;

and

in S

EZs i

.e. t

he L

ao P

DR

Sava

n-SE

NO

SEZ

and

Th

aila

nd M

ukda

han

SEZ

both

loca

ted

in th

e bo

rder

of t

hese

two

coun

tries

.•

Colla

bora

tion

with

aca

dem

ic in

stitu

tions

has

bee

n in

itiat

ed to

hel

p su

stai

n H

IA c

apac

ity d

evel

opm

ent i

nclu

ding

in e

xpan

ding

HIA

teac

hing

and

rese

arch

in th

e re

gion

. HIA

cur

ricul

a (s

tand

alon

e H

IA, H

IA

in e

nviro

nmen

t im

pact

ass

essm

ent,

HIA

shor

t cou

rse

for h

ealth

, pla

nnin

g or

env

ironm

ent)

wer

e de

velo

ped

with

Cur

tin U

nive

rsity

-wH

O C

olla

bora

ting

Cent

er in

HIA

, whi

ch w

as u

sed

for H

IA c

ertifi

cate

co

urse

offe

ring

in fi

ve G

MS

univ

ersit

ies (

i.e., U

nive

rsity

of H

ealth

Sci

ence

s, U

nive

rsity

of P

ublic

Hea

lth Y

ango

n, M

ahid

ol U

nive

rsity

, Han

oi M

edic

al U

nive

rsity

, Ho

Chi M

inh

City

Uni

vers

ity o

f Med

icin

e an

d Ph

arm

acy)

. The

sam

e ha

s bee

n ad

opte

d to

upd

ate

curre

nt c

urric

ulum

of p

ublic

hea

lth a

nd e

nviro

nmen

t fac

ultie

s of fi

ve G

MS

univ

ersit

ies.

•In

col

labo

ratio

n w

ith C

urtin

Uni

vers

ity-w

HO

Col

labo

ratin

g Ce

nter

in H

IA, a

n H

IA n

etw

ork

was

est

ablis

hed

as a

key

reso

urce

to c

ount

ries o

n gu

idel

ines

and

tool

s, re

sear

ch a

nd p

olic

y de

velo

pmen

t. Th

e ne

twor

k al

so se

rves

as c

olla

bora

tion

and

know

ledg

e sh

arin

g pl

atfo

rm fo

r HIA

pra

ctiti

oner

s. M

ore

info

rmat

ion

abou

t the

HIA

Net

wor

k A

sia P

acifi

c ca

n be

acc

esse

d at

htt

p://w

ww.

hian

etw

orka

siapa

c.co

m/

abou

t/

Annex 65

Out

com

e 6.

2 In

crea

sed

capa

city

to a

pply

HIA

at A

DB

Out

com

e In

dica

tor

2014

Base

line

Stat

us in

Targ

et

Prog

ress

O

utpu

t Ind

icat

or20

14Ba

selin

eSt

atus

inTa

rget

Pr

ogre

ss20

16Q

2 20

1820

16Q

2 20

181.

Num

ber o

f AD

B-su

ppor

ted

infra

stru

ctur

e pr

ojec

ts in

mal

aria

-en

dem

ic a

reas

that

app

lied

HIA

* (C

AM

, MYA

, VIE

)

00

44

1. A

DB

HIA

tool

s dev

elop

ed (

sour

cebo

ok

and

chec

klist

s)N

oYe

sYe

sYe

s

2. A

DB

HIA

trai

ning

mod

ules

dev

elop

edN

oYe

sYe

sYe

s

3. N

umbe

r of A

DB

staff

trai

ned

in H

IA0

3030

30

4. A

DB

HIA

tool

s int

egra

ted

into

AD

B pr

oces

ses

No

No

Yes

Yes

Prog

ress

: A

chie

ved

at le

ast 9

5% o

f tar

get

*Des

ktop

revi

ew

AD

B =

Asia

n D

evel

opm

ent B

ank,

CAM

= C

ambo

dia,

HIA

= h

ealth

impa

ct a

sses

smen

t, M

YA =

Mya

nmar

, VIE

= V

iet N

am.

Stor

y be

hind

the

num

bers

•D

emon

stra

tion

of H

IA w

as o

rigin

ally

con

duct

ed in

four

AD

B-fin

ance

d pr

ojec

ts, n

amel

y Ca

mbo

dia

Rura

l wat

er S

uppl

y an

d Sa

nita

tion

Sect

or, M

anda

lay

Urb

an S

ervi

ces

Impr

ovem

ent P

roje

ct 1,

Ein

du-

kaw

kare

ik R

oad

Impr

ovem

ent,

and

Ho

Chi M

inh

City

was

tew

ater

and

Dra

inag

e Sys

tem

Impr

ovem

ent.

Thes

e pro

ject

s ser

ved

as H

IA ca

se st

udie

s und

erta

ken

in co

ordi

natio

n w

ith go

vern

men

t cou

nter

parts

an

d pr

ojec

t tea

ms.

The

HIA

incl

uded

a s

trong

focu

s on

mal

aria

and

oth

er c

omm

unic

able

dise

ases

. Sco

ping

and

val

idat

ion

of fi

ndin

gs th

roug

h de

sk re

view

(i.e

., lit

erat

ure

and

seco

ndar

y da

ta)

and

site

insp

ectio

ns a

nd in

terv

iew

s, an

d re

port

writ

ing

has b

een

com

plet

ed. T

here

has

incr

ease

d de

man

d am

ong

AD

B pr

ojec

t offi

cers

to c

ondu

ct H

IA fo

r new

pro

ject

s, an

d in

itial

HIA

scop

ing

was

con

duct

ed fo

r Yu

nnan

-Lin

cang

Bor

der E

cono

mic

Coo

pera

tion

Zone

Dev

elop

men

t Pro

ject

, and

Vie

t Nam

Hea

lth H

uman

Res

ourc

e D

evel

opm

ent P

roje

ct 2

. Clo

se c

olla

bora

tion

with

pro

ject

team

s enc

oura

ged

bette

r un

ders

tand

ing a

nd p

ract

ice

of H

IA.

•A

n H

IA s

ourc

eboo

k w

as d

evel

oped

to p

rovi

de te

chni

cal g

uida

nce

and

good

pra

ctic

e ex

ampl

es to

AD

B st

aff o

n ho

w to

opt

imize

com

mun

ity h

ealth

and

saf

ety

in A

DB

proj

ects

. Exp

erie

nces

from

the

dem

onst

ratio

n pr

ojec

ts p

rovi

ded

valu

able

inpu

ts to

the

sour

cebo

ok. T

he so

urce

book

was

pre

sent

ed a

t the

201

8 sp

ring

mee

ting

of th

e M

ultil

ater

al F

inan

cial

Inst

itutio

ns w

orki

ng G

roup

on

Envi

ronm

enta

l So

cial

Sta

ndar

ds. I

t inc

lude

s rec

omm

enda

tions

to in

clud

e m

alar

ia a

nd o

ther

vect

or-b

orne

dise

ase

spec

ific

ques

tions

in ra

pid

envi

ronm

enta

l ass

essm

ent t

ools.

•Fi

nanc

ed fr

om o

ther

sour

ces,

seve

ral H

IA in

trodu

ctor

y cou

rses

wer

e or

gani

zed

for A

DB

staff

and

facu

lty st

aff fr

om C

urtin

Uni

vers

ity an

d ot

her H

IA e

xper

ts se

rved

as re

sour

ce p

erso

ns. L

esso

ns fr

om R

MTF

re

late

d H

IA a

ctiv

ities

wer

e sh

ared

. with

AD

B bu

dget

, an

inte

nsiv

e H

IA c

ours

e Sa

fegu

ards

Dee

p D

ive, L

abor

Stan

dard

s and

Hea

lth Im

pact

Ass

essm

ent h

as b

een

deve

lope

d.

66 Annex

KEY

ACT

IVIT

IES

AN

D M

ILES

TON

ESPR

OG

RESS

ING

TO

WA

RD R

ESU

LTS

OU

TCO

ME

1: LE

AD

ERSH

IPSt

reng

then

ed le

ader

ship

, dec

ision

-mak

ing,

and

acco

unta

bilit

y for

elim

inat

ing m

alar

ia a

nd a

ddre

ssin

g com

mun

icab

le d

iseas

e th

reat

s

2015

2016

2017

Out

com

e 1.1

Incr

ease

d co

mm

itmen

t and

co

llabo

ratio

n fo

r m

alar

ia e

limin

atio

n an

d ad

dres

sing

com

mun

icab

le d

iseas

e th

reat

s

Dev

elop

men

t of m

alar

ia e

limin

atio

n ro

ad m

apPr

esen

tatio

n of

the

mal

aria

elim

inat

ion

road

map

in th

e A

PLM

A S

enio

r O

ffici

als M

eetin

gsM

ilest

one:

Mal

aria

elim

inat

ion

road

map

end

orse

d by

19 h

eads

of

gove

rnm

ent

Mile

ston

e: O

ne a

dditi

onal

mal

aria

elim

inat

ion

road

m

ap e

ndor

sed

by h

ead

of go

vern

men

tA

PLM

A b

ecom

es in

depe

nden

t

Out

com

e 1.2

Impr

oved

us

e of

info

rmat

ion

for d

ecisi

on-m

akin

g an

d ac

coun

tabi

lity f

or

mal

aria

elim

inat

ion

and

addr

essin

g co

mm

unic

able

dise

ase

thre

ats

Dev

elop

men

t of c

once

pt n

ote

and

desig

n of

the

Mal

aria

Elim

inat

ion

Das

hboa

rdM

ilest

one:

Das

hboa

rd c

once

pt

pres

ente

d at

regi

onal

wor

ld H

ealth

O

rgan

izatio

n (w

HO

) mee

tings

Dat

a co

mpi

latio

n fo

r the

Mal

aria

Elim

inat

ion

Das

hboa

rd te

chni

cal a

nnex

Dat

a co

mpi

latio

n fo

r the

Mal

aria

Elim

inat

ion

Das

hboa

rd in

dica

tors

Mile

ston

e: P

artia

l dat

abas

e fo

r the

Mal

aria

El

imin

atio

n D

ashb

oard

dev

elop

edM

ilest

one:

Lea

ders

das

hboa

rd p

roto

type

app

rove

d by

Asia

Pac

ific

Lead

ers M

alar

ia A

llianc

e (A

PLM

A)

Seni

or O

ffici

als M

eetin

g

Cont

inue

dat

a co

mpi

latio

n fo

r the

Mal

aria

Elim

inat

ion

Das

hboa

rd

indi

cato

rsFi

naliz

atio

n of

the

Mal

aria

Elim

inat

ion

Das

hboa

rdPr

esen

tatio

n of

the

Mal

aria

Elim

inat

ion

Das

hboa

rd in

the

2017

APL

MA

Se

nior

Offi

cial

s Mee

ting

Mile

ston

e: A

rrang

emen

ts fo

r das

hboa

rd p

ublic

atio

n m

ade

Revi

ew o

f reg

iona

l fun

ding

mod

els

Dev

elop

men

t of m

alar

ia e

limin

atio

n fra

mew

ork a

nd

cost

ing t

ools

Colle

ctio

n of

dat

a in

cou

ntrie

sM

ilest

one:

Dra

ft fra

mew

ork c

ostin

g too

ls fo

r m

alar

ia e

limin

atio

n de

velo

ped

Cont

inue

col

lect

ion

of d

ata

in c

ount

ries

Dev

elop

men

t of c

ount

ry a

nd su

breg

iona

l inve

stm

ent c

ases

Mile

ston

e: C

ount

ry a

nd su

breg

iona

l inve

stm

ent c

ases

at fi

nal s

tage

s of

deve

lopm

ent p

rodu

ced

Dev

elop

men

t of f

ram

ewor

k, to

ols a

nd c

olle

ctio

n of

dat

a fo

r priv

ate

sect

or b

usin

ess c

ase

stud

ies

Mile

ston

e: D

raft

busin

ess c

ases

for t

he p

rivat

e se

ctor

dev

elop

edD

evel

opm

ent a

nd a

pplic

atio

n of

tool

kit f

or a

sses

sing e

ffici

ency

gain

sM

ilest

one:

Too

lkit

appl

ied

in a

t lea

st o

ne c

ount

ryD

evel

opm

ent o

f fra

mew

ork a

nd c

olle

ctio

n of

dat

a fo

r dev

elop

men

t of

reco

mm

enda

tions

for fi

nanc

ing o

ptio

nsM

ilest

one:

Dra

ft re

port

on re

com

men

datio

ns fo

r fina

ncin

g opt

ions

av

aila

ble

Pres

enta

tion

of in

vest

men

t cas

es, t

oolk

it fo

r ass

essin

g effi

cien

cy ga

ins,

and

reco

mm

enda

tions

for fi

nanc

ing o

ptio

ns in

the

APL

MA

Sen

ior

Offi

cial

s Mee

ting

Mile

ston

e: P

rese

ntat

ion

of th

e fin

anci

ng to

ols a

gree

d w

ith A

PLM

A in

th

e ne

xt A

PLM

A S

enio

r Offi

cial

s Mee

ting

Lege

nd: A

ctiv

ity c

ompl

eted

; mile

ston

e re

ache

d

Annex 67

OU

TCO

ME

2: F

INA

NCI

NG

Incr

ease

d fin

anci

ng fo

r mal

aria

elim

inat

ion

and

addr

essin

g com

mun

icab

le d

iseas

e th

reat

s

2015

and

201

620

17Q

1 and

Q2

2018

Out

com

e 2.

1 In

crea

sed

finan

cing

fo

r mal

aria

elim

inat

ion

and

addr

essin

g co

mm

unic

able

dise

ase

thre

ats

Cond

uct o

f con

sulta

tions

on

finan

cing

mal

aria

el

imin

atio

nM

ilest

one:

New

fina

ncin

g mec

hani

sms f

or m

alar

ia

elim

inat

ion

iden

tified

Revi

ew o

f inn

ovat

ive

finan

ce, p

ublic

-priv

ate

partn

ersh

ip m

odel

s, an

d fin

anci

al m

arke

ts p

rodu

cts t

o id

entif

y pot

entia

l mod

els

Dev

elop

men

t of c

once

pt p

aper

for A

DF

regi

onal

he

alth

secu

rity

Mile

ston

e: C

once

pt a

nd e

ligib

ility c

riter

ia fo

r AD

F gr

ant o

n re

gion

al h

ealth

secu

rity s

et a

side

appr

oved

; A

DF

gran

t pro

posa

ls ap

prov

edD

evel

opm

ent o

f pro

ject

for G

MS

heal

th se

curit

y loa

nM

ilest

one:

GM

S he

alth

secu

rity l

oan

appr

oved

Dev

elop

men

t of c

once

pt p

aper

for A

DB

heal

th b

ond

Mile

ston

e: D

raft

conc

ept p

aper

for A

DB

heal

th b

ond

prod

uced

Cont

inue

d di

alog

s on

inno

vativ

e fin

anci

ng fo

r mal

aria

el

imin

atio

n an

d re

spon

se to

com

mun

icab

le d

iseas

e th

reat

sM

ilest

one:

AD

B he

alth

bon

d la

unch

ed

wor

k with

AD

B re

gion

al d

epar

tmen

ts, id

entif

y and

m

ap c

ofina

ncin

g opp

ortu

nitie

s with

GFA

TM a

nd/o

r ot

her d

onor

sO

rgan

ize th

e fir

st c

olla

bora

tion

mee

ting b

etw

een

partn

ers t

o su

ppor

t the

AD

B-G

FATM

mem

oran

dum

of

und

erst

andi

ng, in

clud

ing d

iscus

sion

on c

ofina

ncin

g op

portu

nitie

s, an

d a

deta

iled

desig

n of

ble

nded

fin

anci

ng m

odal

ities

(loa

n bu

ydow

ns, g

rant

s, ris

k tra

nsfe

rs, g

uara

ntee

s)M

ilest

one:

Cofi

nanc

ing o

ppor

tuni

ties a

re id

entifi

ed

and

furth

er d

evel

oped

into

“pro

ject

map

ping

” for

di

scus

sion

with

GFA

TM-A

DB

Mile

ston

e: A

DB-

GFA

TM m

eetin

gs h

eld

with

con

cret

e co

llabo

ratio

n an

d in

vest

men

t prio

ritie

s agr

eed

upon

Lege

nd: A

ctiv

ity c

ompl

eted

; mile

ston

e re

ache

d

68 Annex

OU

TCO

ME

3: M

EDIC

INES

Impr

oved

regu

lato

ry c

apac

ity to

supp

ort i

ncre

ased

avai

labi

lity a

nd u

se o

f qua

lity-

assu

red

heal

th p

rodu

cts f

or m

alar

ia a

nd o

ther

com

mun

icab

le d

iseas

es

2015

and

201

620

17Q

1 and

Q2

2018

Out

com

e 3.

1 Im

prov

ed

oper

atio

nal c

apac

ity

of n

atio

nal r

egul

ator

y ag

enci

es (N

RAs)

Regi

onal

pla

tform

for r

egul

ator

y sys

tem

s stre

ngth

enin

g an

d co

nver

genc

e fo

r dev

elop

ing m

embe

r cou

ntrie

s es

tabl

ished

Dev

elop

men

t of r

egul

ator

y sys

tem

s pro

filin

g in

stru

men

tM

ilest

one:

Reg

ulat

ory s

yste

ms p

rofil

ing i

nstru

men

t de

velo

ped

Ass

essm

ent o

f NRA

sD

evel

opm

ent o

f NRA

stre

ngth

enin

g roa

d m

aps

Mile

ston

e: N

RA c

apac

ity p

rofil

es d

evel

oped

Dev

elop

men

t of t

rain

ing m

odul

esCo

nduc

t of t

rain

ings

for N

RAs

Mile

ston

e: D

raft

train

ing m

odul

es d

evel

oped

Out

com

e 3.

2 Im

prov

ed

post

-mar

ket s

urve

illanc

e of

med

icin

es fo

r m

alar

ia a

nd o

ther

co

mm

unic

able

dise

ases

Inte

rnat

iona

l par

tner

s ide

ntifi

ed to

ass

ess n

ew q

ualit

y te

stin

g too

ls fo

r pos

t-m

arke

t sur

veilla

nce

Lite

ratu

re re

view

of c

urre

nt e

vide

nce

rega

rdin

g util

ity

of ra

pid

diag

nost

ic d

evic

es fo

r ass

ayin

g med

icin

e qu

ality

Mile

ston

e: S

uita

ble

field

det

ectio

n to

ols f

or e

valu

atio

n id

entifi

edO

ne c

ount

ry a

gree

s to

pilo

t new

qua

lity t

estin

g too

ls fo

r pos

t-m

arke

t sur

veilla

nce

Dev

elop

men

t of l

ibra

ry o

f act

ive

ingr

edie

nts a

nd

finish

ed p

rodu

ct p

rofil

esLa

bora

tory

- and

fiel

d-ba

sed

test

ing o

f fiel

d de

tect

ion

tool

s

Cost

-effe

ctiv

enes

s ana

lyses

of t

he fi

eld

dete

ctio

n to

ols

Dev

elop

men

t of r

ecom

men

datio

ns o

n co

st-e

ffect

ive

post

fiel

d de

tect

ion

tool

s for

det

ectin

g SFs

Coun

try d

ialo

gs to

disc

uss a

ppro

pria

te im

plem

enta

tion

of n

ew fi

eld

dete

ctio

n to

ols

Mile

ston

e: D

raft

set o

f rec

omm

enda

tions

dev

elop

ed

WH

O tr

aini

ng o

n Su

bsta

ndar

d an

d Fa

lsifie

d **

med

icin

es**

?Tw

o tra

inin

g wor

ksho

ps o

n su

bsta

ndar

d an

d fa

lsifie

d (S

F) **

med

icin

es**

? for

NRA

s con

vene

d, c

ount

ry fo

cal

poin

ts e

stab

lishe

d.M

ilest

one:

NRA

SF

foca

l poi

nts i

dent

ified

and

trai

ned.

Hig

h-le

vel G

reat

er M

ekon

g Sub

regi

on S

F m

eetin

g an

d fo

llow

-up

train

ing w

orks

hop

to p

rom

ote

regi

onal

co

llabo

ratio

n

Lege

nd: A

ctiv

ity c

ompl

eted

; mile

ston

e re

ache

d

Annex 69

2015

and

201

620

17Q

1 and

Q2

2018

Out

com

e 3.

2 Im

prov

ed

post

-mar

ket s

urve

illanc

e of

med

icin

es fo

r m

alar

ia a

nd o

ther

co

mm

unic

able

dise

ases

Mya

nmar

NRA

stre

ngth

enin

gCo

ordi

natio

n m

eetin

gs h

eld

with

Mya

nmar

NRA

Mile

ston

e: D

raft

5-ye

ar d

evel

opm

ent p

lan

for

phar

mac

eutic

als-

rela

ted

com

pone

nts o

f NRA

agr

eed

Com

pute

rized

med

icin

es re

gist

ratio

n an

d in

form

atio

n sy

stem

inst

alle

d an

d tra

inin

g con

duct

edM

ilest

one:

Tra

inin

g mod

ules

dev

elop

ed a

nd sc

hedu

les

agre

ed w

ith N

RAM

ilest

one:

Reg

istra

tion

and

info

rmat

ion

softw

are

used

in

one

uni

t in

the

NRA

Cond

ucte

d re

view

of p

atie

nt sa

fety

of r

egist

ered

m

edic

ines

, dev

elop

ed im

plem

enta

tion

plan

for

phar

mac

ovig

ilanc

e ce

nter

. Mya

nmar

NRA

join

s wH

O

Colla

bora

tive

Regi

stra

tion

Sche

me,

par

ticip

ates

in

ASE

AN

Join

t Ass

essm

ent P

rogr

amm

e an

d jo

ins w

HO

ph

arm

covi

gila

nce

netw

ork.

Agr

eem

ent w

ith A

ustra

lian

NRA

to u

se p

atie

nt in

form

atio

n le

aflet

s.M

ilest

ones

: (i)

Oth

er A

SEA

N N

RA a

gree

to a

form

al

exch

ange

of i

nfor

mat

ion;

(ii)

Mya

nmar

NRA

join

s the

w

HO

HIN

ARI

syst

em; (

iii) N

ew w

ritte

n SO

Ps a

nd

deci

sion

trees

impl

emen

ted;

(iv)

Sta

ndar

d pa

tient

in

form

atio

n le

aflet

s ado

pted

Mya

nmar

nat

iona

l wor

ksho

p on

SF

med

ical

pro

duct

s he

ld, n

atio

nal S

F co

ordi

natio

n m

echa

nism

ado

pted

an

d M

yanm

ar N

RA in

spec

tors

trai

ned

on S

F re

spon

se.

Mile

ston

e: N

atio

nal c

oord

inat

ion

mec

hani

sm to

co

mba

t SF

med

icin

es a

dopt

ed

Com

pute

rized

info

rmat

ion

syst

em e

xten

ded

and

linke

d to

qua

lity c

ontro

l labo

rato

ry a

nd p

ost-

mar

ketin

g in

spec

tion

mod

ule

NRA

insp

ecto

rs e

quip

ped

and

train

ed to

hav

e el

ectro

nic

acce

ss a

nd re

porti

ng w

ith c

entra

l re

gist

ratio

n da

taba

se.

Lege

nd: A

ctiv

ity c

ompl

eted

; mile

ston

e re

ache

d

70 Annex

OU

TCO

ME

4: IN

FORM

ATIO

N S

YSTE

MS

Incr

ease

d us

e of

qua

lity d

ata,

info

rmat

ion

tool

s and

tech

nolo

gies

to im

prov

e m

alar

ia a

nd o

ther

com

mun

icab

le d

iseas

e in

form

atio

n sy

stem

s

2015

and

201

620

17Q

1 and

Q2

2018

Incr

ease

d us

e of

qua

lity

data

, info

rmat

ion

tool

s an

d te

chno

logi

es to

im

prov

e m

alar

ia a

nd

othe

r com

mun

icab

le

dise

ase

info

rmat

ion

syst

ems

Inve

ntor

y of s

urve

illanc

e m

echa

nism

s for

mal

aria

and

co

mm

unic

able

dise

ases

in G

MS

coun

tries

Stak

ehol

der a

nd ID

syst

em m

appi

ng in

MYA

, CA

M,

and

LAO

Set u

p in

tero

pera

bilit

y lab

orat

ory i

n Ca

mbo

dia

Mile

ston

e: R

epor

t on

avai

labl

e ID

s

Stak

ehol

der a

nd ID

syst

em in

vent

ory i

n Vi

et N

amID

tool

kit d

evel

opm

ent

Dev

elop

bus

ines

s cas

e fo

r uni

que

heat

h ID

Mile

ston

e: D

raft

ID to

olki

t ava

ilabl

eM

ilest

one:

Rec

ruitm

ent o

f loc

al a

nd in

tern

atio

nal

cons

ulta

nts t

o su

ppor

t VIE

Dev

elop

guid

elin

es fo

r set

up

of c

ore

heal

th

info

rmat

ion

exch

ange

(HIE

) ele

men

tsPr

ovid

e te

chni

cal r

esou

rces

for t

estin

g exis

ting s

yste

ms

for s

tand

ards

-bas

ed in

tero

pera

bilit

yPr

ovid

e tra

inin

g at p

rovi

ncia

l leve

l for

not

ifiab

le d

iseas

e su

rvei

llanc

e sy

stem

Prov

ide

Ente

rpris

e A

rchi

tect

ure

revi

ew a

nd te

chni

cal

assis

tanc

e in

dat

a st

anda

rds i

nclu

ding

term

inol

ogy

serv

ices

Supp

ort V

IE se

t up

func

tioni

ng h

ealth

stee

ring

com

mitt

eeSu

ppor

t VIE

dev

elop

dat

a sh

arin

g and

secu

rity r

elat

ed

polic

ies

Supp

ort V

IE in

test

ing e

xistin

g sys

tem

s for

in

tero

pera

bilit

y via

HL7

FH

IR C

onne

ctat

hon

Supp

ort V

IE in

iden

tifyi

ng a

nd d

evel

opin

g loc

al/g

rass

ro

ot le

vel I

CT so

lutio

ns vi

a Ep

iHac

k eve

ntSu

ppor

t VIE

in b

uild

ing c

apac

ity in

HL7

stan

dard

s in

clud

ing F

HIR

. Con

duct

a C

onne

ctat

hon

with

na

tiona

l dise

ase

repo

rting

syst

ems t

o es

tabl

ish

prog

ram

min

g int

erfa

ces f

or d

ata

exch

ange

.Su

ppor

t VIE

con

duct

ass

essm

ent o

f fac

ility s

ervi

ce

read

ines

s for

mal

aria

Mile

ston

e: D

raft

data

col

lect

ion

tool

dev

elop

edSu

ppor

t des

ign

of th

e VI

E M

alar

ia M

anag

emen

t Sy

stem

Supp

ort V

IE te

st n

ew m

alar

ia re

porti

ng/in

vest

igat

ion

form

thro

ugh

usin

g a m

obile

app

licat

ion

Mile

ston

e: D

esig

n of

mob

ile a

pp d

evel

oped

Dev

elop

dig

ital h

ealth

stra

tegy

guid

ance

and

dig

ital

heal

th im

pact

fram

ewor

kM

ilest

one:

Dra

ft di

gita

l hea

lth st

rate

gy gu

idan

ce a

nd

digi

tal h

ealth

impa

ct fr

amew

ork i

nclu

des a

n ex

ampl

e of

an

inve

stm

ent c

ase

stra

tegy

for m

alar

ia se

rvic

es a

nd

an im

plem

enta

tion

guid

e.

Lege

nd: A

ctiv

ity c

ompl

eted

; mile

ston

e re

ache

d; C

ance

lled

due

to c

hang

e in

par

tner

s’ pr

ojec

t tim

elin

e m

akin

g the

act

ivity

/mile

ston

e un

feas

ible

Annex 71

2015

and

201

620

17Q

1 and

Q2

2018

Incr

ease

d us

e of

qua

lity

data

, info

rmat

ion

tool

s an

d te

chno

logi

es to

im

prov

e m

alar

ia a

nd

othe

r com

mun

icab

le

dise

ase

info

rmat

ion

syst

ems

Brai

nsto

rmin

g mee

ting w

ith E

sri in

Red

land

s, Ca

lifor

nia

Rele

ase

of th

e jo

int w

HO

-AD

B po

licy b

rief o

n th

e ge

ogra

phy o

f Uni

vers

al H

ealth

Cov

erag

e (U

HC

)O

ffici

al L

aunc

h of

the

AeH

IN G

IS L

ab a

nd fi

rst

miss

ion

to M

yanm

arRe

leas

e of

the

high

ly d

iscou

nted

Esr

i GIS

softw

are

bund

les

Rele

ase

of th

e H

IS ge

o-en

ablin

g fra

mew

ork

Firs

t miss

ion

to C

ambo

dia

Firs

t miss

ion

to V

iet N

amFi

naliz

atio

n of

the

HIS

geo-

enab

ling p

ilot p

roje

ct in

M

yanm

arIn

clus

ion

of H

IS ge

o-en

ablin

g int

o th

e H

MIS

m

aste

r pla

n (C

ambo

dia)

and

stra

tegi

c ac

tion

plan

fo

r stre

ngth

enin

g hea

lth in

form

atio

n 20

17–2

021

(Mya

nmar

)Co

mm

on ge

o-re

gist

ry w

orks

hop

in P

hnom

Pen

hM

eetin

g with

Esr

i to

ensu

re th

e su

stai

nabi

lity o

f the

so

ftwar

e bu

ndle

s for

Min

istrie

s of H

ealth

in c

ount

ries

and

rele

ase

of A

cces

sMod

5.0

Rele

ase

of th

e co

mm

on ge

-reg

istry

guid

ance

Conv

ersio

n of

the

AeH

IN G

IS L

ab in

to th

e H

GLC

Fina

lizat

ion

of th

e pi

lot p

roje

ct in

Cam

bodi

aFi

naliz

atio

n of

the

inst

itutio

naliz

atio

n pr

oces

s in

Mya

nmar

Laun

ch o

f the

HG

LC k

now

ledg

e Re

posit

ory

Subn

atio

nal le

vel t

rain

ing o

n ge

ospa

tial d

ata

and

tech

nolo

gies

in C

ambo

dia

and

Mya

nmar

Fina

lizat

ion

of th

e pi

lot p

roje

ct in

Vie

t Nam

Proo

f of c

once

pt d

emon

stra

ting t

hat t

he H

MIS

/HCP

pl

atfo

rm in

Cam

bodi

a ca

n se

rve

as c

omm

on ge

o-re

gist

ryRe

leas

e of

the

new

gene

ratio

n of

Esr

i sof

twar

e bu

ndle

sD

HIS

2 a

s com

mon

geo-

regi

stry

wor

ksho

p co

-or

gani

zed

with

the

Uni

vers

ity o

f Oslo

Lege

nd: A

ctiv

ity c

ompl

eted

; mile

ston

e re

ache

d

2015

and

201

620

17Q

1 201

8

Incr

ease

d us

e of

qua

lity

data

, info

rmat

ion

tool

s an

d te

chno

logi

es to

im

prov

e m

alar

ia a

nd

othe

r com

mun

icab

le

dise

ase

info

rmat

ion

syst

ems

Com

pila

tion

and

anal

ysis

of p

reva

lenc

e an

d in

cide

nce

data

for m

alar

ia a

nd d

engu

e an

alyz

edM

ilest

one:

At l

east

one

cou

ntry

with

pre

vale

nce

and

inci

denc

e da

ta fo

r mal

aria

and

den

gue

anal

yzed

Cond

uct o

f tra

inin

gs o

f app

licat

ion

of G

IS-b

ased

vi

sual

izatio

nM

ilest

one:

At l

east

one

cou

ntry

trai

ned

on a

pplic

atio

n of

GIS

-bas

ed vi

sual

izatio

n

Cond

uct o

f tra

inin

gs o

f app

licat

ion

of G

IS-b

ased

vi

sual

izatio

nM

ilest

one:

Six

coun

tries

trai

ned

on a

pplic

atio

n of

GIS

-ba

sed

visu

aliza

tion

Mile

ston

e: A

nalys

is an

d m

appi

ng o

f mal

aria

inci

denc

e da

ta c

ompl

eted

for t

hree

cou

ntrie

s and

den

gue

inci

denc

e da

ta fo

r tw

o co

untri

esD

evel

opm

ent o

f GIS

-bas

ed vi

sual

izatio

n sy

stem

. Sy

stem

has

bee

n de

liver

ed to

nat

iona

l pro

gram

s in

Cam

bodi

a an

d M

yanm

ar w

ith fu

rther

dev

elop

men

t an

d tra

inin

g ong

oing

. Tha

iland

alre

ady h

ave

thei

r ow

n sy

stem

and

disc

ussio

ns a

re o

ngoi

ng a

bout

how

this

can

best

be

com

plem

ente

d w

ith su

ppor

t fro

m A

DB.

Mile

ston

e: A

t lea

st o

ne c

ount

ry w

ith d

raft

plan

for

GIS

-bas

ed vi

sual

izatio

n sy

stem

Dev

elop

men

t of p

olic

y rec

omm

enda

tions

for n

atio

nal

prog

ram

s on

targ

etin

g mal

aria

and

den

gue

surv

eilla

nce

and

cont

rol*

Mile

ston

e: P

olic

y rec

omm

enda

tions

for n

atio

nal

prog

ram

s on

targ

etin

g mal

aria

and

den

gue

surv

eilla

nce

and

cont

rol a

re d

rafte

d*

Lege

nd: A

ctiv

ity c

ompl

eted

; mile

ston

e re

ache

d

*Pol

icy r

ecom

men

datio

ns a

re b

eing

dev

elop

ed c

urre

ntly

and

will

be fi

naliz

ed a

s pop

ulat

ion

mov

emen

t res

ults

are

shar

ed a

nd d

iscus

sed

with

MO

H st

aff. A

dditi

onal

fund

ing s

uppo

rt ha

s bee

n se

cure

d by

M

ORU

to c

ompl

ete

this

wor

k.

72 Annex

OU

TCO

ME

5: L

ABO

RATO

RY D

IAG

NO

STIC

AN

D S

URV

EILL

AN

CEIm

prov

ed c

apac

ity o

f lab

orat

ory d

iagn

ostic

s and

surv

eilla

nce

syst

em fo

r mal

aria

and

oth

er c

omm

unic

able

dise

ases

, incl

udin

g cro

ss-b

orde

r coo

rdin

atio

n

2015

and

201

620

17Q

1 and

Q2

2018

Impr

oved

cap

acity

of

labo

rato

ry

diag

nost

ics a

nd

surv

eilla

nce

syst

em

for m

alar

ia a

nd

othe

r com

mun

icab

le

dise

ases

, incl

udin

g cr

oss-

bord

er

coor

dina

tion

Proj

ect d

ocum

ents

of A

dditi

onal

Fin

anci

ng

and

Regi

onal

Cap

acity

Dev

elop

men

t Tec

hnic

al

Ass

istan

ce (R

CDTA

) 895

9 co

mpl

eted

thro

ugh

cons

ulta

tion

betw

een

AD

B an

d th

e go

vern

men

tsA

dditi

onal

Fin

anci

ng a

ppro

ved

by A

DB

and

signe

d by

the

gove

rnm

ents

.RC

DTA

8959

app

rove

d by

AD

BA

dditi

onal

fina

ncin

g mad

e eff

ectiv

e by

AD

BSe

lect

ion

and

cont

ract

ing o

f Int

erna

tiona

l no

ngov

ernm

ent o

rgan

izatio

ns (N

GO

s)

com

plet

ed (R

CDTA

8959

).A

DB

ince

ptio

n m

issio

ns fi

elde

d to

Mya

nmar

, Ca

mbo

dia,

the

Lao

PDR,

and

Vie

t Nam

(R

CDTA

8959

and

Add

ition

al F

inan

cing

).Pr

ojec

t im

plem

enta

tion

initi

ated

, incl

udin

g co

ntra

ctin

g for

pro

cure

men

t and

con

sulta

nts i

n ea

ch c

ount

ry (a

dditi

onal

fina

ncin

g)

Roll o

ut o

f the

test

ed m

odel

of l

abor

ator

y di

agno

stic

s and

surv

eilla

nce

initi

ated

, and

MM

P (R

CDTA

8959

)Ev

alua

tion

of th

e m

odel

s dev

elop

ed

(RCD

TA89

59)

Proc

urem

ent o

f goo

ds c

ompl

eted

. Dist

ribut

ion

of go

ods a

nd tr

aini

ng a

ctiv

ities

in p

roje

ct si

tes

initi

ated

(RCD

TA89

59)

Proj

ect i

mpl

emen

tatio

n co

mpl

eted

, incl

udin

g pr

ocur

emen

t and

dist

ribut

ion

of go

ods a

nd

train

ing a

ctiv

ities

(add

ition

al fi

nanc

ing)

Mile

ston

e: N

atio

nal g

uide

lines

(mal

aria

su

rvei

llanc

e an

d di

agno

stic

QA)

and

re

com

men

datio

ns o

n M

MP

deve

lope

d an

d en

dors

ed (R

CDTA

8959

)M

ilest

one:

Pub

licat

ion

of th

e 10

0 SO

P an

d m

anua

l for

lab

QA

, 100

SO

P on

mal

aria

m

icro

scop

y, 10

0 al

gorit

hm o

n m

alar

ia

mic

rosc

opy a

nd A

cces

s DM

S an

d SO

P on

m

obile

use

d in

mal

aria

surv

eilla

nce

by S

MS

and

Vibe

rM

ilest

one:

Inte

grat

ion

of th

e sy

stem

s dev

elop

ed

and

less

ons i

nto

the

upco

min

g GM

S H

ealth

Se

curit

y Pro

ject

(RCD

TA 8

959

and

addi

tiona

l fin

anci

ng).

Mile

ston

e: C

ompl

etio

n of

good

s dist

ribut

ion

in

proj

ect s

ite in

qua

rter (

Q) 1

.Co

mpl

etio

n of

trai

ning

for a

dditi

onal

hea

lth

wor

kers

and

refre

sher

cou

rses

for b

asic

hea

lth

stat

ion

wor

kers

and

villa

ge h

ealth

volu

ntee

rs in

Q

2.Re

gion

al la

b Q

A w

orks

hop

cond

ucte

d in

M

yanm

ar a

nd p

artic

ipat

ed b

y GM

S co

untri

es

and

vario

us d

evel

opm

ent p

artn

ers

Mile

ston

e: D

evel

opm

ent o

f Nat

iona

l Mal

aria

Co

ntro

l Pro

gram

s (N

CMP)

scal

e-up

pla

nH

ando

ver t

o N

MCP

and

con

duct

of

diss

emin

atio

n w

orks

hop

Mile

ston

e: D

evel

opm

ent o

f sca

le-u

p pl

an fo

r M

MP

com

plet

ed w

ith th

e m

inist

ry o

f hea

lthM

ilest

one:

Reg

iona

l Mal

aria

and

MM

P co

nfer

ence

con

duct

ed in

Apr

il 201

8Su

bmiss

ion

of M

MP

and

Mal

aria

know

ledg

e pr

oduc

tCo

nduc

t of d

issem

inat

ion

wor

ksho

p on

MM

P in

terv

entio

n

Lege

nd: A

ctiv

ity c

ompl

eted

; mile

ston

e re

ache

d

Annex 73

OU

TCO

ME

6: P

REVE

NTI

ON

Incr

ease

d ca

paci

ty to

add

ress

com

mun

icab

le d

iseas

es in

infra

stru

ctur

e pr

ojec

ts

2015

and

201

620

17Q

1 and

Q2

2018

6.1 I

ncre

ased

cap

acity

to

app

ly h

ealth

impa

ct

asse

ssm

ent (

HIA

) in

infra

stru

ctur

e pr

ojec

ts a

t co

untry

leve

l

Esta

blish

men

t of H

IA a

dviso

ry te

amCo

untry

situ

atio

nal a

nalys

is an

d ne

eds a

sses

smen

tCo

untry

con

sulta

tions

and

nat

iona

l and

pro

vinc

ial

wor

ksho

ps fo

r HIA

guid

elin

e de

velo

pmen

tM

ilest

one:

Dra

ft co

untry

guid

elin

es o

utlin

e de

velo

ped

Coun

try p

lans

with

bud

get o

n th

e de

velo

pmen

t HIA

in

the

Gre

ater

Mek

ong S

ubre

gion

(GM

S) c

ount

ries

Nat

iona

l HIA

coo

rdin

ator

s rec

ruitm

ent t

o su

ppor

t co

untry

HIA

dev

elop

men

tM

ilest

one:

Cou

ntry

con

sulta

tions

com

plet

ed

HIA

trai

ning

for g

over

nmen

t, ac

adem

e, a

nd p

rivat

e se

ctor

staff

HIA

trai

ning

inte

grat

ed in

min

istry

of h

ealth

trai

ning

pr

ogra

ms

Mile

ston

e: H

IA tr

aini

ng m

odul

es d

evel

oped

Sele

cted

GM

S un

iver

sitie

s offe

r HIA

cou

rse

in

grad

uate

pub

lic h

ealth

and

env

ironm

enta

l hea

lth

prog

ram

sH

IA c

ertifi

cate

cou

rse

offer

ings

in fi

ve G

MS

univ

ersit

ies

Mile

ston

e: H

IA c

urric

ulum

dev

elop

edD

evel

opm

ent o

f HIA

net

wor

k to

supp

ort c

ontin

ued

deve

lopm

ent o

f HIA

in th

e G

MS

Mile

ston

e: T

erm

s of r

efer

ence

of t

he H

IA n

etw

ork

final

ized

Dev

elop

men

t of p

olic

y brie

fs a

nd c

ondu

ct o

f pol

icy

dial

ogs

Mile

ston

e: P

olic

y brie

f out

line

avai

labl

eH

IA d

emon

stra

tion

in fi

ve ke

y sec

tors

to ga

in go

od

exam

ples

in H

IA p

ract

ice

Mile

ston

e: D

raft

HIA

repo

rt de

velo

ped

Dev

elop

men

t of n

atio

nal H

IA gu

idel

ines

Dev

elop

men

t of H

IA fr

amew

ork f

or sp

ecia

l eco

nom

ic

zone

s (SE

Zs) i

n th

e G

MS

and

spec

ific

guid

elin

es fo

r th

e La

o PD

R an

d Th

aila

ndM

ilest

one:

Cou

ntry

con

sulta

tions

to fi

naliz

e gu

idel

ines

co

nduc

ted

Disc

usse

d ac

tion

plan

with

tim

elin

e fo

r im

plem

enta

tion

of ke

y asp

ects

of H

IA n

etw

ork

Prep

arat

ion

of a

ctio

n pl

ans f

or H

IA te

achi

ng a

nd

rese

arch

at r

egio

nal a

nd u

nive

rsity

leve

lM

ilest

one:

Mee

ting w

ith H

IA n

etw

ork s

take

hold

ers

cond

ucte

dCo

untry

stat

us o

verv

iew

on

HIA

for fi

ve G

MS

coun

tries

hav

e be

en p

repa

red

Mile

ston

e: D

raft

repo

rt on

cou

ntry

HIA

ove

rvie

w

revi

ewed

Fina

lize

editi

ng o

f HIA

fram

ewor

k for

SEZ

s in

the

GM

SFi

naliz

e pu

blic

atio

n an

d up

load

HIA

fram

ewor

k in

the

AD

B an

d G

MS

web

sites

Mile

ston

e: D

raft

publ

icat

ion

revi

ewed

Prep

are

sect

oral

HIA

guid

elin

e fo

r the

rmal

pow

erpl

ant

in L

ao P

eopl

e’s D

emoc

ratic

Rep

ublic

(Lao

PD

R)Tr

ansla

tion

of se

ctor

al gu

idel

ine

to b

oth

natio

nal

lang

uage

and

Eng

lish

Mile

ston

e: D

raft

sect

oral

guid

elin

e re

view

edPr

epar

e re

ports

on

HIA

dem

onst

ratio

n or

pro

ject

cas

e st

udie

s on

HIA

Mile

ston

e: D

raft

case

stud

ies d

iscus

sed

with

go

vern

men

t cou

nter

parts

Bila

tera

l con

sulta

tion

betw

een

the

Lao

PDR

and

Thai

land

on

trans

boun

dary

issu

es re

latin

g to

SEZs

de

velo

pmen

tM

ilest

one:

Bila

tera

l coo

pera

tion

fram

ewor

k disc

usse

d w

ith go

vern

men

t cou

nter

parts

Lege

nd: A

ctiv

ity c

ompl

eted

; mile

ston

e re

ache

d

74 Annex

2015

and

201

620

17Q

1 and

Q2

2018

6.2

Incr

ease

d ca

paci

ty to

ap

ply H

IA a

t AD

BPr

elim

inar

y disc

ussio

ns w

ith A

DB

man

agem

ent t

o ad

opt H

IA in

AD

B-su

ppor

ted

infra

stru

ctur

e pr

ojec

tsD

raft

prop

osed

cha

nges

to A

DB’

s env

ironm

enta

l and

so

cial

impa

ct a

sses

smen

t too

l to

inco

rpor

ate

mal

aria

an

d ot

her c

omm

unic

able

dise

ase

thre

ats

Mile

ston

e: In

tern

al c

onsu

ltatio

ns sc

hedu

led

Incl

usio

n of

hea

lth in

the

exist

ing r

apid

env

ironm

ent

asse

ssm

ent

Mile

ston

e: U

pdat

ed c

heck

list d

iscus

sed

with

sect

or

grou

pD

evel

opm

ent o

f HIA

trai

ning

mod

ules

for t

rain

ing o

f A

DB

staff

HIA

trai

ning

for A

DB

staff

thro

ugh

exist

ing t

rain

ing

prog

ram

s suc

h as

the

stan

dard

pov

erty

and

soci

al

anal

ysis

train

ing

Mile

ston

e: O

utlin

e of

HIA

trai

ning

mod

ules

disc

usse

d

Org

anize

HIA

dem

onst

ratio

n in

key s

ecto

rs to

pro

vide

ev

iden

ce in

HIA

pra

ctic

eD

evel

opm

ent o

f HIA

repo

rt w

ith p

ublic

hea

lth

man

agem

ent p

lan

Mile

ston

e: D

raft

HIA

repo

rt di

scus

sed

Dev

elop

men

t of H

IA so

urce

book

to se

rve

as gu

idan

ce

in H

IA p

ract

ice

for A

DB

staff

Inco

rpor

ate

to d

raft

sour

cebo

ok go

od p

ract

ice

and

othe

r exp

erie

nces

from

the

HIA

dem

onst

ratio

nM

ilest

one:

Dra

ft H

IA so

urce

book

disc

usse

dPl

an fo

r add

ition

al H

IA tr

aini

ng fo

r AD

B st

aff in

clud

ing

for r

esid

ent m

issio

n st

aff in

201

8M

ilest

one:

AD

B fu

nds f

or a

dditi

onal

HIA

trai

ning

ap

prov

ed

Fina

lize

editi

ng o

f HIA

sour

cebo

okFi

naliz

e pu

blic

atio

n an

d up

load

HIA

Sou

rceb

ook i

n th

e A

DB

and

GM

S w

ebsit

esM

ilest

one:

Dra

ft pu

blic

atio

n re

view

ed b

y AD

B m

anag

emen

tFi

naliz

e H

IA E

-lear

ning

mat

eria

ls fo

r AD

B k-

Lear

n sit

e in

clud

ing v

ideo

and

aud

io o

ptio

nsM

ilest

one:

E-le

arni

ng m

ater

ials

disc

usse

d w

ith

k-Le

arn

team

Cond

uct H

IA in

trodu

ctor

y cou

rse

for A

DB

staff

Dev

elop

HIA

trai

ning

pro

gram

for f

urth

er A

DB

staff

tra

inin

gM

ilest

one:

AD

B bu

dget

disc

usse

dPr

esen

tatio

n of

HIA

initi

ativ

es a

t the

sprin

g mee

ting o

f M

ultil

ater

al F

inan

cial

Inst

itutio

ns w

orki

ng G

roup

on

Envi

ronm

enta

l and

Soc

ial S

afeg

uard

sM

ilest

one:

AD

B sa

fegu

ards

staff

agr

ee o

n th

e pr

esen

tatio

n m

ater

ial

Lege

nd: A

ctiv

ity c

ompl

eted

; mile

ston

e re

ache

d

Annex 75

Annex B: Glossary of Results-Based Framework Terms

Impact Changes in conditionsMillennium Development Goals (MDGs), health, social, economic, cultural, civil society, environmental, political.

Positive and negative long-term effects on identifiable population groups produced by a development intervention, directly or indirectly, intended or unintended.

Outcome Changes in capacity and performance of the primary duty-bearersChanges in behaviors and attitudes, social action, viability, institutional, policy formulation, decision-making, norms, knowledge, efficiency, competencies, opinions, standards. Achieved though the combination of RMTF investments.

The changes in institutional performance or behavior among individuals or groups that occur between the completion of outputs and the achievement of goals.

Output What implementers produceGoods and services, change in skills and capabilities, systems, evaluations, new products, reports, publications produced. Outputs are linked to project outputs.

The changes in skills or abilities, or the availability of new products and services that result from the completion of activities within a development intervention.

Activities What implementers doDevelop curriculum, train, evaluate, recruit, procure, facilitate, develop action plans, work with media, etc.

Actions taken or work performed through which inputs, such as funds, technical assistance and other types of resources are mobilized to produce specific outputs.

Inputs What stakeholders invest inHuman or financial resources, personnel, equipment, technology, time.

Milestone Sets out how much of a target or what specific steps toward that target will be complete by specific dates.

References:

International Labour Office. 2011. Applying Results-Based Management in the International Labour Organization, A Guidebook, Version 2. Geneva.

United Nations Development Group. 2011. Results-based Management Handbook. New York.

76 Annex

Ann

ex C

: Gen

der D

imen

sions

CAM

BOD

IA (r

eflec

ts w

ork

unde

r the

Com

mun

icab

le D

iseas

e Co

ntro

l (CD

C) 2

and

CD

C2-A

dditi

onal

Fin

anci

ng)

1. To

enh

ance

the

oppo

rtun

ities

and

cont

ribut

ion

of fe

mal

e st

aff in

CD

C sy

stem

s and

to im

prov

e ge

nder

ana

lysis

in re

gion

al C

DC

syst

ems

Prom

ote

the

incr

ease

d tra

inin

g of w

omen

in

CDC

surv

eilla

nce

and

resp

onse

Year

Tota

l num

ber o

f RRT

/CD

C st

affN

umbe

r of f

emal

e RR

T/CD

C st

affN

umbe

r of t

rain

ed

staff

Num

ber o

f tra

ined

fem

ale

staff

Perc

enta

ge o

f tr

aine

d fe

mal

e st

aff

2015

1,328

383

978

318

83

2016

1,486

423

1,242

381

90

Q3

2017

1,569

448

1,373

412

92RR

T=ra

pid

resp

onse

team

, CD

C =

com

mun

icab

le d

iseas

e co

ntro

lSo

urce

: Pro

ject

Dat

a Co

llect

ion

Form

of e

ach

proj

ect p

rovi

nce

Proa

ctiv

ely t

arge

t fem

ale

labo

rato

ry st

aff fo

r tra

inin

gA

ll (75

/75)

fem

ale

labo

rato

ry st

aff fr

om 12

pro

vinc

es in

clud

ing P

reah

Vih

ear w

ere

train

ed o

n th

e us

e of

new

equ

ipm

ent a

nd n

ew ra

pid

test

s.In

Pre

ah V

ihea

r pro

vinc

e, o

ne re

fresh

er tr

aini

ng o

n m

icro

scop

y and

clin

ical

man

agem

ent w

as p

rovi

ded

to 3

8 la

bora

tory

staff

(nin

e ar

e fe

mal

e).

Enco

urag

e an

d m

onito

r the

hiri

ng o

f new

fe

mal

e st

affTh

ere

was

an

incr

ease

in th

e pe

rcen

tage

of n

ew fe

mal

e CD

C/m

alar

ia st

aff, f

rom

44%

in 2

012

to 5

4% in

201

6.So

urce

: Pro

ject

Dat

a Co

llect

ion

Form

of e

ach

proj

ect p

rovi

nce

2011

–201

7

Colle

ct sp

ecifi

c se

x-di

sagg

rega

ted

data

in a

ll su

rvei

llanc

e fo

rms a

nd re

porti

ng d

ocum

enta

tion

Dat

a fo

r the

com

mun

icab

le d

iseas

e su

rvei

llanc

e sy

stem

, incl

udin

g for

Sev

ere

Acu

te R

espi

rato

ry In

fect

ion,

Influ

enza

-like

Illn

ess a

nd m

alar

ia, a

re a

ll se

x-di

sagg

rega

ted.

Out

brea

k dat

a, m

alar

ia su

perv

ision

che

cklis

t, tra

inin

g and

/or w

orks

hop,

hou

seho

ld su

rvey

and

villa

ge d

emog

raph

ic a

sses

smen

t re

sults

are

sex-

disa

ggre

gate

d, a

s app

ropr

iate

.

Reac

h m

ore

wom

en, in

clud

ing i

n th

e G

reat

er

Mek

ong S

ubre

gion

(GM

S) a

nnua

l join

t rev

iew

of

nat

iona

l mal

aria

pol

icie

s and

stra

tegi

es

Nat

iona

l mal

aria

stra

tegi

c pl

an h

as b

een

deve

lope

d fo

r 201

6–20

20. I

nter

vent

ions

for w

omen

and

chi

ldre

n in

the

plan

incl

udes

the

prov

ision

of b

ed

nets

to w

omen

with

chi

ldre

n un

der 5

year

s of a

ge, t

he p

rovi

sion

of a

nten

atal

mal

aria

scre

enin

g for

wom

en a

t hea

lth c

ente

r and

villa

ge le

vel, a

nd

train

ings

on

the

usag

e of

long

-last

ing i

nsec

ticid

al n

ets f

or w

omen

.

Inco

rpor

ate

gend

er-r

elat

ed c

onte

nt in

to c

ur-

ricul

um tr

aini

ng m

odul

es, h

uman

reso

urce

de

velo

pmen

t pla

ns a

nd c

ross

-bor

der a

ctiv

ities

The

Gen

der M

ains

tream

ing S

trate

gy a

nd A

ctio

n Pl

an 2

014–

2018

of M

inist

ry o

f Hea

lth (M

OH

), Ca

mbo

dia

was

dev

elop

ed fo

r stre

ngth

enin

g com

-m

unic

able

and

non

-com

mun

icab

le se

rvic

es, a

nd a

dvoc

ates

for t

he in

clus

ion

of ge

nder

dim

ensio

n in

add

ress

ing t

hese

dise

ases

.A

ll sev

en C

DC/

mal

aria

trai

ning

cur

ricul

a an

d IE

C m

ater

ials

incl

uded

gend

er c

onte

nts.

Hea

lth w

orkf

orce

Dev

elop

men

t Pla

n 20

16–2

020

endo

rsed

by M

OH

on

1 Mar

ch 2

016

incl

uded

gend

er-r

elat

ed c

onte

nt.

2. T

o im

prov

e re

spon

siven

ess o

f CD

C to

gen

der a

nd e

thni

c iss

ues i

n ta

rget

ed d

istric

ts o

r pro

vinc

es a

nd to

incr

ease

the

part

icip

atio

n an

d aw

aren

ess o

f wom

en in

CD

C pr

even

tion

in p

roje

ct

loca

tions

Colle

ct, u

se, a

nd a

naly

ze se

x-di

sagg

rega

ted

data

in

com

mun

ity-b

ased

CD

C as

sess

men

ts a

nd

plan

s

Dem

ogra

phic

ass

essm

ents

bet

wee

n 20

13 a

nd 2

014

for 1

80 m

odel

hea

lthy v

illage

s use

d an

d an

alyz

ed se

x-di

sagg

rega

ted

data

. In

2014

, the

bas

elin

e su

rvey

col

lect

ed se

x-di

sagg

rega

ted

data

.D

ata

colle

ctio

n fo

rms w

ith c

ompo

nent

s for

gend

er a

nd in

dige

nous

peo

ple

wer

e de

velo

ped

and

intro

duce

d to

all p

rovi

ncia

l impl

emen

tatio

n ag

en-

cies

for c

ompl

etio

n.In

stitu

tiona

l and

trai

ning

dat

a fro

m 2

011 t

o 20

17 a

re d

isagg

rega

ted

by se

x and

eth

nici

ty.

Proa

ctiv

ely t

rain

wom

en a

s villa

ge h

ealth

volu

n-te

ers a

nd/o

r wor

kers

A to

tal o

f 2,9

25 o

ut o

f 6,3

83 (4

6%) f

emal

e he

alth

volu

ntee

rs w

ere

train

ed si

nce

2012

.

Ensu

re th

at a

t lea

st h

alf o

f new

ly se

lect

ed vi

llage

he

alth

volu

ntee

rs a

nd/o

r wor

kers

in d

istric

ts a

re

fem

ale

Ove

r the

CD

C2 a

nd C

DC2

-Add

ition

al F

inan

cing

(AF)

pro

ject

per

iod,

11 p

roje

ct p

rovi

nces

hav

e re

crui

ted

616

(47%

) new

fem

ale

villa

ge h

ealth

wor

k-er

s out

of t

he 1,

298

new

ly re

crui

ted

villa

ge h

ealth

wor

kers

.

Annex 77

Syst

emat

ical

ly in

clud

e ge

nder

-spe

cific

issu

es

into

the

train

ing a

ctiv

ities

impl

emen

ted

by th

e pr

ojec

t

Ther

e w

ere

two

train

ings

on

gend

er in

Qua

rter (

Q) 2

201

7, on

e in

Rat

anak

iri p

rovi

nce

with

47

parti

cipa

nts (

22 fe

mal

e), a

nd o

ne in

Stu

ng T

reng

pr

ovin

ce w

ith 4

4 pa

rtici

pant

s (23

fem

ale)

.In

Q3

2017

, tw

o tra

inin

gs o

n ge

nder

and

/or i

ndig

enou

s peo

ple

and

on C

DC

wer

e co

nduc

ted,

one

in P

reah

Vih

ear p

rovi

nce

and

the

othe

r in

Mon

-du

lkiri

pro

vinc

e.

Inte

grat

e ge

nder

issu

es a

nd ta

rget

ed a

ctio

ns fo

r w

omen

in jo

int a

ctio

n pl

ans f

or m

alar

ia p

reve

n-tio

n an

d re

spon

se in

the

bord

er p

rovi

nces

Join

t act

ion

plan

was

dev

elop

ed in

Q2

2017

. Cro

ss-b

orde

r mee

ting w

ith n

eigh

borin

g cou

ntry

of P

reah

Vih

ear w

as o

rgan

ized

on 19

–20

June

201

7. G

ende

r iss

ues p

erta

inin

g to

join

t act

ion

plan

hav

e no

t bee

n id

entifi

ed.

3. T

o en

hanc

e th

e ge

nder

aw

aren

ess a

nd re

spon

siven

ess o

f CD

C pr

ojec

t man

agem

ent

Tailo

r the

gend

er a

ctio

n pl

an to

nat

iona

l and

pr

ovin

cial

con

text

sG

ende

r Act

ion

Plan

201

2–20

15 w

as d

evel

oped

and

app

rove

d by

MO

H o

n 4

Janu

ary 2

013.

Thi

s has

bee

n im

plem

ente

d at

bot

h ce

ntra

l and

pro

vin-

cial

leve

ls sin

ce 2

012,

and

in P

reah

Vih

ear P

rovi

nce

in Q

4 20

15.

Inte

grat

e ge

nder

-rel

ated

act

iviti

es a

nd b

udge

t al

loca

tion

in a

nnua

l ope

ratio

nal p

lans

In th

e 20

17 a

nnua

l ope

ratio

nal p

lan,

five

targ

eted

pro

vinc

es a

lloca

ted

budg

et fo

r gen

der a

ctiv

ities

.

App

oint

gend

er re

pres

enta

tives

in p

rogr

am

man

agem

ent u

nit o

r pro

ject

impl

emen

ting u

nit/

SC

Prov

inci

al a

nd n

atio

nal g

ende

r/ind

igen

ous p

eopl

e fo

cal p

oint

s hav

e be

en va

lidat

ed, u

pdat

ed a

nd tr

aine

d in

all 1

2 pr

ojec

t pro

vinc

es. T

here

are

cur

-re

ntly

17 ge

nder

and

indi

geno

us p

eopl

e fo

cal p

oint

s and

7 o

f the

m a

re w

omen

.

Recr

uit a

soci

al d

evel

opm

ent s

peci

alist

to c

over

ge

nder

issu

es/g

ende

r act

ion

plan

impl

emen

ta-

tion

One

soci

al d

evel

opm

ent e

xper

t and

one

nat

iona

l soc

ial d

evel

opm

ent s

peci

alist

wer

e en

gage

d in

201

7.

Cond

uct g

ende

r sen

sitiv

e an

d/or

gend

er a

ctio

n pl

an tr

aini

ng fo

r pro

ject

staff

All 1

39 (3

2 ar

e fe

mal

e) p

roje

ct st

aff w

ere

train

ed o

n ge

nder

sens

itivi

ty a

nd o

n th

e ge

nder

act

ion

plan

. Tra

inin

g-of

-tra

iner

s was

con

duct

ed in

201

3 by

the

MO

H G

ende

r Mai

nstre

amin

g Act

ion

Gro

up, a

nd c

asca

de tr

aini

ngs w

ere

cond

ucte

d by

pro

vinc

ial t

eam

for a

ll RRT

staff

and

oth

er h

ealth

st

aff w

ith a

tota

l of 6

10 (2

35 fe

mal

es) p

artic

ipan

ts b

etw

een

2013

and

201

5.

Incl

ude

gend

er is

sues

in p

roje

ct p

lann

ing a

nd

man

agem

ent w

orks

hops

A c

heck

list t

o en

sure

gend

er is

sues

are

inco

rpor

ated

in w

orks

hops

and

tech

nica

l tra

inin

gs h

as b

een

deve

lope

d an

d pr

esen

ted

in th

e pr

ogra

m m

an-

agem

ent u

nit a

nd p

roje

ct im

plem

entin

g uni

t tra

inin

g in

May

201

7.

Prom

ote

wom

en’s

parti

cipa

tion

in p

roje

ct

man

agem

ent

A to

tal o

f 32

out o

f 139

(23%

) pro

gram

man

agem

ent u

nit a

nd p

roje

ct im

plem

entin

g uni

t sta

ff w

ere

fem

ales

in th

e 11

pro

ject

pro

vinc

es.

Sour

ce o

f dat

a: L

ist o

f gov

ernm

ent c

ount

erpa

rt st

aff.

78 Annex

LAO

PEO

PLE’

S D

EMO

CRAT

IC R

EPU

BLIC

(LA

O P

DR)

(refl

ects

wor

k un

der t

he C

DC2

and

CD

C2-A

F)1:

To e

nhan

ce th

e op

port

uniti

es a

nd co

ntrib

utio

n of

fem

ale

staff

in C

DC

syst

ems a

nd to

impr

ove

gend

er a

naly

sis in

regi

onal

CD

C sy

stem

s

Prom

ote

the

incr

ease

d tra

inin

g of w

omen

in

CDC

surv

eilla

nce

and

resp

onse

110

out o

f the

134

(82%

) fem

ale

surv

eilla

nce

and

resp

onse

staff

wer

e tra

ined

. The

201

7 Co

mpe

tenc

y Rep

ort e

stim

ates

that

87%

of s

urve

illanc

e an

d re

spon

se st

aff a

re h

ighl

y com

pete

nt.

Am

ong t

he C

DC

staff

, 1,3

95 o

f the

1,74

1 (>8

0%) f

emal

es h

ave

been

trai

ned.

Sour

ce: P

rovi

ncia

l Tra

inin

g and

Gen

der S

urve

y 201

7

Proa

ctiv

ely t

arge

t fem

ale

labo

rato

ry st

aff fo

r tra

inin

g14

7 ou

t of t

he 16

2 (9

1%) f

emal

e la

bora

tory

staff

wer

e tra

ined

.So

urce

: Pro

vinc

ial T

rain

ing a

nd G

ende

r Sur

vey 2

017

Colle

ct sp

ecifi

c se

x-di

sagg

rega

ted

data

in a

ll su

rvei

llanc

e fo

rms a

nd re

porti

ng d

ocum

enta

-tio

n

100%

of s

urve

illanc

e an

d re

spon

se d

ata

are

sex-

disa

ggre

gate

d.So

urce

: Mon

thly

repo

rts o

n ou

tbre

aks a

nd n

otifi

able

dise

ase

case

s

Reac

h m

ore

wom

en, in

clud

ing i

n th

e G

MS

annu

al jo

int r

evie

w o

f nat

iona

l mal

aria

pol

icie

s an

d st

rate

gies

The

proj

ect t

arge

ted

actio

ns to

reac

h w

omen

and

is in

clud

ed in

the

GM

S an

nual

join

t rev

iew

of n

atio

nal m

alar

ia p

olic

ies a

nd st

rate

gies

. The

Na-

tiona

l Stra

tegy

for M

alar

ia C

ontro

l and

Elim

inat

ion

asse

sses

risk

and

iden

tifies

targ

ets a

nd st

rate

gies

. You

ng m

ale

fore

st w

orke

rs a

re o

verw

helm

ingl

y th

e m

ost a

t-ris

k gro

up, a

lthou

gh th

e re

port

iden

tifies

MM

Ps (i

nclu

ding

wom

en) a

nd e

thni

c gr

oups

con

duct

ing s

lash

-and

-bur

n fa

rmin

g also

to b

e po

tent

ially

at-

risk.

wom

en a

re re

cogn

ized

to b

e im

porta

nt in

fam

ily w

elfa

re a

nd fo

r ens

urin

g the

use

of l

ong-

last

ing i

nsec

ticid

al n

ets.

The

stra

tegy

is

ther

efor

e to

con

tinue

to e

mph

asize

and

mar

ket b

ed n

ets t

o ho

useh

olds

, par

ticul

arly

thro

ugh

wom

en a

nd w

ives

Inco

rpor

ate

gend

er-r

elat

ed c

onte

nt in

to c

ur-

ricul

um tr

aini

ng m

odul

es, h

uman

reso

urce

de

velo

pmen

t pla

ns a

nd c

ross

-bor

der a

ctiv

ities

Gen

der c

onte

nts a

re re

flect

ed in

CD

C tra

inin

g cur

ricul

a at

inst

itutio

n, m

odel

hea

lth vi

llage

s, an

d co

mm

unity

leve

ls.H

uman

reso

urce

dev

elop

men

t pla

ns a

re ge

nder

resp

onsiv

e. (e

.g. u

ses s

ex-d

isagg

rega

ted

data

, has

quo

ta fo

r fem

ale

staff

to p

artic

ipat

e in

trai

ning

s)So

urce

: Pro

vinc

ial r

epor

ts, w

orks

hop

repo

rts a

nd p

lans

Enco

urag

e an

d m

onito

r the

hiri

ng o

f new

fe

mal

e st

aff20

14 –

261

of t

he 5

78 (4

5%) C

DC

staff

are

fem

ale

2016

– 3

84 o

f the

622

(62%

) CD

C st

aff a

re fe

mal

e20

16-2

017

– 16

of t

he 2

3 (7

0%) n

ew p

roje

ct m

anag

emen

t uni

t sta

ff ar

e fe

mal

eSo

urce

: Pro

vinc

ial T

rain

ing a

nd G

ende

r Sur

veys

201

4 an

d 20

17

2. T

o im

prov

e re

spon

siven

ess o

f CD

C to

gen

der i

ssue

s in

targ

eted

dist

ricts

/pro

vinc

es a

nd to

incr

ease

the

part

icip

atio

n an

d aw

aren

ess o

f wom

en in

CD

C pr

even

tion

in p

roje

ct lo

catio

ns

Colle

ct, u

se, a

nd a

naly

ze se

x-di

sagg

rega

ted

data

in

com

mun

ity-b

ased

CD

C as

sess

men

ts a

nd

plan

s

All p

roje

ct p

lans

and

ass

essm

ents

use

sex-

disa

ggre

gate

d da

ta: e

.g., p

roje

ct c

ondu

cts f

ocus

grou

ps fo

r ind

igen

ous p

eopl

e re

sear

ch, h

ouse

hold

su

rvey

s, tra

inin

g rep

orts

, and

out

brea

k and

surv

eilla

nce

data

Sour

ce: T

rain

ing a

nd G

ende

r Sur

veys

, Hou

seho

ld S

urve

ys, r

egul

ar re

porti

ng o

n tra

inin

g and

wor

ksho

ps a

nd su

rvei

llanc

e

Proa

ctiv

ely t

rain

wom

en a

s villa

ge h

ealth

volu

n-te

ers a

nd w

orke

rs

2,49

3 ou

t of t

he 2

,977

(84%

) tra

ined

villa

ge h

ealth

wor

kers

wer

e fe

mal

e.So

urce

: Pro

vinc

ial T

rain

ing a

nd G

ende

r Sur

vey 2

017

Ensu

re th

at a

t lea

st h

alf o

f new

ly se

lect

ed vi

llage

he

alth

volu

ntee

rs a

nd w

orke

rs in

dist

ricts

are

fe

mal

e

453

out o

f 916

(50%

) new

villa

ge h

ealth

wor

kers

wer

e fe

mal

e (T

he p

roje

ct se

t up

crite

ria th

at e

ach

villa

ge m

ust h

ave

one

mal

e an

d on

e fe

mal

e vi

llage

hea

lth w

orke

r).

Sour

ce: C

ompe

tenc

y Sur

vey 2

017

Proa

ctiv

ely o

utre

ach

and

targ

et w

omen

in

com

mun

ity-b

ased

CD

C or

mal

aria

act

iviti

es a

nd

cam

paig

ns u

sing g

ende

r-se

nsiti

ve IE

C m

etho

ds

and

mat

eria

ls

2014

Com

mun

ity E

vent

s - 2

57 o

ut o

f the

646

(40%

) par

ticip

ants

wer

e fe

mal

e.20

14 V

illage

Man

agem

ent G

roup

Eve

nts -

157

out o

f the

342

(46%

) par

ticip

ants

wer

e fe

mal

e.20

17 C

omm

unity

Eve

nts 2

,883

out

of t

he 4

,550

(63%

) par

ticip

ants

wer

e fe

mal

e.20

17 V

MG

Eve

nts –

1,98

6 of

the

3,34

1 (59

%) p

artic

ipan

ts w

ere

fem

ale.

Sour

ce: P

rovi

ncia

l Tra

inin

g and

Gen

der S

urve

ys 2

014

and

2017

Syst

emat

ical

ly in

clud

e ge

nder

-spe

cific

issu

es

into

the

train

ing a

ctiv

ities

impl

emen

ted

by th

e pr

ojec

t

All t

rain

ing a

ctiv

ities

are

gend

er m

ains

tream

ed. T

rain

ings

and

mod

el h

ealth

villa

ge tr

aini

ng c

urric

ula

incl

ude

gend

er is

sues

.So

urce

: Rep

orts

from

trai

ning

und

erta

ken

3. T

o en

hanc

e th

e ge

nder

aw

aren

ess a

nd re

spon

siven

ess o

f CD

C pr

ojec

t man

agem

ent

Tailo

r the

Gen

der A

ctio

n Pl

an to

nat

iona

l and

pr

ovin

cial

con

text

s N

atio

nal g

ende

r act

ion

plan

is u

nder

impl

emen

tatio

n an

d w

as re

vise

d in

Apr

il 201

3.G

ende

r act

ion

plan

, and

des

ign

and

mon

itorin

g fra

mew

ork p

rogr

ess a

re u

pdat

ed q

uarte

rly.

Sour

ce: G

ende

r act

ions

and

act

iviti

es re

porte

d in

pro

vinc

ial A

OPs

, Qua

rterly

Rep

orts

Annex 79

Inte

grat

e ge

nder

-rel

ated

act

iviti

es a

nd b

udge

t al

loca

tion

in a

nnua

l ope

ratio

nal p

lans

Ann

ual o

pera

tiona

l pla

ns in

clud

e ge

nder

act

iviti

es a

nd b

udge

t allo

catio

n.G

ende

r tra

inin

gs w

ere

cond

ucte

d at

pro

vinc

ial, d

istric

t, he

alth

cen

ter,

and

mod

el h

ealth

villa

ge le

vels.

Sour

ce: A

OP

subm

itted

to th

e pr

ojec

t

App

oint

gend

er re

pres

enta

tives

in p

rogr

am

man

agem

ent u

nit a

nd p

roje

ct im

plem

entin

g uni

t or

SC

Qua

rterly

repo

rts in

clud

e ge

nder

act

ion

plan

and

Indi

geno

us P

eopl

e up

date

s. A

ll dat

a (e

.g. o

utbr

eaks

and

trai

ning

s) a

re se

x-di

sagg

rega

ted

Sour

ce: Q

uarte

rly R

epor

ts h

ave

a st

anda

rd ge

nder

and

indi

geno

us p

eopl

e se

ctio

n

Recr

uit a

soci

al d

evel

opm

ent s

peci

alist

to c

over

ge

nder

issu

es a

nd ge

nder

act

ion

plan

impl

emen

-ta

tion

Inte

rnat

iona

l gen

der s

peci

alist

was

recr

uite

d an

d m

obiliz

ed in

Janu

ary 2

012.

Loca

l spe

cial

ist re

crui

ted

and

mob

ilized

in N

ovem

ber 2

012

Sour

ce: R

esea

rch

and

field

stud

ies u

nder

take

n an

d re

ports

com

plet

ed

Gen

der s

ensit

iveo

r Gen

der A

ctio

n Pl

an tr

aini

ng

for p

roje

ct st

affSe

rvic

e tra

inin

g - 2

,451

staff

trai

ned

(59%

are

fem

ale)

Trai

ning

man

agem

ent –

701

staff

trai

ned

(41%

are

fem

ale)

Gen

der a

ctio

n pl

an tr

aini

ng –

690

staff

trai

ned

(72%

are

fem

ale)

Incl

ude

gend

er is

sues

in p

roje

ct p

lann

ing a

nd

man

agem

ent w

orks

hops

Gen

der i

s mai

nstre

amed

into

all w

orks

hops

. Gen

der i

s em

phas

ized

in p

rovi

ncia

l tra

inin

g act

iviti

es.

Sour

ce: w

orks

hop

repo

rts

Prom

ote

wom

en’s

parti

cipa

tion

in p

roje

ct m

an-

agem

ent

2014

- 51

out

of 9

8 (5

2%) p

roje

ct im

plem

entin

g uni

t sta

ff w

ere

fem

ale

2017

- 41

out

of 8

5 (4

8%) p

roje

ct im

plem

entin

g uni

t sta

ff w

ere

fem

ale

Sour

ce: P

rovi

ncia

l Tra

inin

g and

Gen

der S

urve

y 201

7

80 Annex

VIET

NA

M (r

eflec

ts w

ork

unde

r the

CD

C2 a

nd C

DC2

-AF)

1. To

enh

ance

the

oppo

rtun

ities

and

cont

ribut

ion

of fe

mal

e st

aff in

CD

C sy

stem

s and

to im

prov

e ge

nder

ana

lysis

in re

gion

al C

DC

syst

ems

Prom

ote

the

incr

ease

d tra

inin

g of w

omen

in C

DC

surv

eilla

nce

and

resp

onse

In Q

2 20

17, 9

5 ou

t of 2

21 (4

3 %

) fem

ale

staff

of p

rovi

ncia

l pro

ject

man

agem

ent u

nit (

PPM

U)s

in D

ak N

ong a

nd B

inh

Phuo

c w

ere

train

ed.

In 2

016,

186

out o

f 222

(84

%) f

emal

e st

aff o

f Dak

Non

g and

Bin

h Ph

uoc

PPM

Us w

ere

train

ed.

In 2

015,

2,2

33 o

ut o

f 4,3

32 (5

6 %

) fem

ale

staff

of 2

0 PP

MU

s wer

e tra

ined

.Tr

aini

ng to

pics

: Stre

ngth

en st

aff c

apac

ity fo

r sur

veilla

nce,

ana

lysis

and

repo

rting

of i

nfec

tious

dise

ases

(Den

gue

feve

r, H

FMD

, etc

.) at

all

leve

lsD

ata

sour

ce: P

rovi

ncia

l rep

ort

Proa

ctiv

ely t

arge

t fem

ale

labo

rato

ry st

aff fo

r tra

inin

gIn

Q2

2017

, 5 o

ut o

f 8 (6

3 %

) fem

ale

staff

of D

ak N

ong a

nd B

inh

Phuo

c PP

MU

s wer

e tra

ined

.In

201

6, 7

out

of 1

3 (5

4 %

) fem

ale

staff

of D

ak N

ong a

nd B

inh

Phuo

c PP

MU

s wer

e tra

ined

.In

201

5, 14

1 out

of 5

65 (2

5 %

) fem

ale

staff

of 2

0 PP

MU

s wer

e tra

ined

.Tr

aini

ng to

pics

: labo

rato

ry b

iosa

fety

; man

ual o

pera

tion

of la

b eq

uipm

ent;

sam

plin

g, pr

eser

vatio

n, te

stin

g, an

d sa

mpl

e tra

nspo

rting

te

chni

ques

; use

of e

nzym

e-lin

ked

imm

unos

orbe

nt a

ssay

equ

ipm

ent f

or d

engu

e te

stin

g; m

etal

test

ing t

echn

ique

s for

Ars

enic

, mer

cury

, ca

dmiu

m in

food

.D

ata

sour

ce: P

rovi

ncia

l rep

ort

Colle

ct sp

ecifi

c se

x-di

sagg

rega

ted

data

in a

ll sur

veil-

lanc

e fo

rms a

nd re

porti

ng d

ocum

enta

tion

Dat

a on

cas

es/d

eath

are

sex-

disa

ggre

gate

d ac

cord

ing t

o Ci

rcul

ar N

o. 4

8/20

10/T

T-BY

T th

at gu

ides

the

decl

arat

ion,

info

rmat

ion

and

repo

rting

of c

omm

unic

able

dise

ases

. Thi

s circ

ular

was

repl

aced

by C

ircul

ar 5

4/TT

-BYT

dat

e 28

Dec

201

5 th

at re

quire

s sex

-disa

ggre

gate

d da

ta. T

he e

CDS

(ele

ctro

nic

repo

rting

syst

em fo

r com

mun

icab

le d

iseas

es) a

lso re

quire

s sex

-disa

ggre

gate

d in

form

atio

n an

d pr

ojec

t pro

v-in

ces a

re c

ompl

ying

.D

ata

sour

ce: P

rovi

ncia

l rep

ort

Inco

rpor

ate

gend

er-r

elat

ed c

onte

nt in

to c

urric

ulum

tra

inin

g mod

ules

, hum

an re

sour

ce d

evel

opm

ent p

lans

an

d cr

oss-

bord

er a

ctiv

ities

100%

PPM

Us d

evel

oped

gend

er p

lan

and

is in

tegr

ated

in m

ajor

act

iviti

es su

ch a

s tra

inin

gs, w

orks

hops

, and

com

mun

icat

ions

.D

ata

sour

ce: P

rovi

ncia

l rep

ort

Enco

urag

e an

d m

onito

r the

hiri

ng o

f new

fem

ale

staff

In 2

015,

113

of th

e 21

6 (5

2.3%

) new

ly h

ired

staff

wer

e fe

mal

e.In

201

6, n

o ne

w st

aff w

ere

recr

uite

d fo

r Dak

Non

g and

Bin

h Ph

uoc

PPM

Us.

In Q

2, 2

017:

1 of

the

3 (3

3.3%

) new

ly h

ired

staff

was

fem

ale

for D

ak N

ong P

PMU

. No

new

staff

recr

uitm

ent f

or B

inh

Phuo

c PP

MU

.D

ata

sour

ce: P

roje

ct M

anag

emen

t Uni

t/Pro

vinc

ial R

epor

t

2. T

o im

prov

e re

spon

siven

ess o

f CD

C to

gen

der/e

thni

c iss

ues i

n ta

rget

ed d

istric

ts/p

rovi

nce

and

to in

crea

se th

e pa

rtic

ipat

ion

and

awar

enes

s of w

omen

in C

DC

prev

entio

n in

pro

ject

loca

tion

Colle

ct, u

se a

nd a

naly

ze se

x-di

sagg

rega

ted

data

in c

omm

unity

-bas

ed C

DC

asse

ssm

ents

an

d pl

ans

Som

e of

the

mai

n co

mm

unity

-bas

ed a

sses

smen

ts h

ave

used

and

ana

lyze

d se

x-di

sagg

rega

ted

data

incl

udin

g pro

ject

surv

eys o

n w

orm

s and

re-

sear

ches

on

CDC.

Dat

a so

urce

: Pro

vinc

ial r

epor

t

Proa

ctiv

ely t

rain

wom

en a

s villa

ge h

ealth

volu

n-te

ers/

wor

kers

Year

Tota

l tra

ined

VH

Ws

Num

ber o

f tra

ined

fem

ale

VHW

s %

of t

rain

ed fe

mal

e VH

Ws

Not

e

2015

4,75

92,

707

56.9

20 P

PMU

s

2016

236

191

80.9

Dak

Non

g and

PPM

U B

inh

Phuo

c PP

MU

s

Q2

2017

228

192

84.2

Dak

Non

g and

PPM

U B

inh

Phuo

c PP

MU

s

VHw

= vi

llage

hea

lth w

orke

rSo

urce

: Pro

vinc

ial r

epor

t/Res

ults

of r

esea

rche

s

Annex 81

Ensu

re th

at a

t lea

st h

alf o

f new

ly se

lect

ed vi

l-la

ge h

ealth

volu

ntee

rs/w

orke

rs in

dist

ricts

are

fe

mal

e

In 2

011,

48 o

ut o

f 86

(55.

8%) n

ew vi

llage

hea

lth w

orke

rs w

ere

fem

ale.

In 2

012,

68

out o

f 123

(55.

3%) n

ew vi

llage

hea

lth w

orke

rs w

ere

fem

ale.

In 2

013,

87

out o

f 149

(58.

4%) n

ew vi

llage

hea

lth w

orke

rs w

ere

fem

ale.

In 2

014,

89

out o

f 146

(61%

) new

villa

ge h

ealth

wor

kers

wer

e fe

mal

e.In

201

5, 6

5 ou

t of 9

5 (6

8.4%

) new

villa

ge h

ealth

wor

kers

wer

e fe

mal

e.A

ccum

ulat

ed fi

gure

= 3

57 o

ut o

f 599

(59.

6%) n

ew vi

llage

hea

lth w

ere

fem

ale.

Dat

a so

urce

: Pro

vinc

ial r

epor

t

Syst

emat

ical

ly in

clud

e ge

nder

-spe

cific

issu

es

into

the

train

ing a

ctiv

ities

impl

emen

ted

by th

e pr

ojec

t

Und

er th

e pr

ojec

t man

agem

ent u

nit’s

inst

ruct

ions

, PPM

Us i

nteg

rate

d ge

nder

issu

es in

to tr

aini

ngs a

nd w

orks

hops

.Th

e pr

ojec

t con

duct

ed ge

nder

-spe

cific

trai

ning

cou

rses

(pro

cess

and

impl

emen

tatio

n of

loca

l hum

an re

sour

ce d

evel

opm

ent p

lans

, gen

der a

war

e-ne

ss a

nd im

plem

enta

tion

of ge

nder

- in

tegr

ated

act

iviti

es.).

Gen

der i

ssue

s are

inte

grat

ed in

som

e as

pect

s of C

DC

train

ings

with

prio

rity g

iven

to w

omen

of r

epro

duct

ive

age

in th

e ta

rget

pop

ulat

ion.

For

ex-

ampl

e: va

ccin

atio

n (m

easle

s, ru

bella

, tet

anus

, etc

.), p

rom

otio

n of

pub

lic c

omm

unic

atio

n on

wor

m in

fect

ion

in th

e co

mm

unity

, per

iodi

c de

wor

min

g, et

c.D

ata

sour

ce: P

rovi

ncia

l rep

ort

3. T

o en

hanc

e th

e ge

nder

awar

enes

s and

resp

onsiv

enes

s of C

DC

proj

ect m

anag

emen

t

Tailo

r the

Gen

der A

ctio

n Pl

an to

nat

iona

l/pro

-vi

ncia

l con

text

s Ce

ntra

l Gen

der A

ctio

n Pl

an w

as d

evel

oped

, intro

duce

d an

d pa

rtly i

mpl

emen

ted

by P

PMU

s.D

ata

sour

ce: P

MU

repo

rt

All a

nnua

l ope

ratio

nal p

lans

incl

ude

gend

er-

rela

ted

activ

ities

and

bud

get a

lloca

tions

Ann

ual o

pera

tiona

l pla

ns in

clud

e ge

nder

and

eth

nic

min

ority

targ

ets f

or 2

0 PP

MU

s.D

ata

sour

ce: P

roje

ct A

OP

App

oint

gend

er re

pres

enta

tives

in p

rogr

am

man

agem

ent u

nit a

nd p

roje

ct im

plem

entin

g un

it/SC

Staff

hav

e be

en a

ssig

ned

to m

onito

r and

sum

mar

ize p

roje

ct p

rogr

ess o

f pro

ject

man

agem

ent u

nit a

nd P

PMU

.D

ata

sour

ce: P

MU

/PPM

U re

ports

Recr

uit a

soci

al d

evel

opm

ent s

peci

alist

to c

over

ge

nder

issu

es/G

ende

r Act

ion

Plan

impl

emen

-ta

tion

Two

gend

er c

onsu

ltant

s wer

e re

crui

ted

and

deve

lope

d ge

nder

and

eth

nic

min

ority

pla

n.D

ata

sour

ce: P

MU

repo

rt

Cond

uct g

ende

r sen

sitiv

e or

Gen

der A

ctio

n Pl

an tr

aini

ng fo

r pro

ject

staff

Cond

ucte

d tra

inin

g-of

-tra

iner

s on

gend

er se

nsiti

vity

and

Gen

der A

ctio

n Pl

an in

June

201

2 fo

r 16

peop

le. T

hese

trai

ners

and

a n

atio

nal s

peci

alist

th

en c

asca

ded

train

ings

to 13

0 of

320

staff

from

pro

ject

man

agem

ent u

nit,

20 P

PMU

s, 4

IHEs

, 3 IM

PEs (

Inst

itute

of M

alar

iolo

gy, P

aras

itolo

gy a

nd

Ento

mol

ogy)

.In

201

5, th

e pr

ojec

t man

agem

ent u

nit c

ondu

cted

a tr

aini

ng o

n ge

nder

, min

ority

/gen

der a

ctio

n pl

an fo

r 30

out o

f 277

pro

ject

staff

from

pro

ject

m

anag

emen

t uni

t and

20

PPM

Us (

incl

udin

g foc

al p

oint

s for

gend

er is

sues

in 2

0 PP

MU

s). T

he fo

cal p

oint

then

org

anize

d tra

inin

g ses

sions

for 2

10

staff

at t

he lo

cal le

vel.

Dat

a so

urce

: PM

U/P

PMU

repo

rts

Cond

uct g

ende

r sen

sitiv

e or

Gen

der A

ctio

n Pl

an tr

aini

ng fo

r pro

ject

staff

In 2

011–

2015

, 29

out o

f the

47

(62%

) pro

ject

man

agem

ent u

nit s

taff

wer

e fe

mal

e, a

nd 6

3 ou

t of t

he 2

66 (2

4%) P

PMU

staff

wer

e fe

mal

e.In

201

6–20

17, 1

7 ou

t of t

he 3

3 (2

6%) P

PMU

staff

of D

ak N

ong a

nd B

inh

Phuo

c w

ere

fem

ale.

Dat

a so

urce

: PM

U/P

PMU

s rep

ort

Prom

ote

wom

en’s

parti

cipa

tion

in p

roje

ct

man

agem

ent

In 2

011–

2015

, 29

out o

f the

47

(62%

) pro

ject

man

agem

ent u

nit s

taff

wer

e fe

mal

e, a

nd 6

3 ou

t of t

he 2

66 (2

4%) P

PMU

staff

wer

e fe

mal

e.In

201

6–20

17, 1

7 ou

t of t

he 3

3 (5

2%) p

roje

ct m

anag

emen

t uni

t sta

ff w

ere

fem

ale,

5 o

ut o

f the

19 (2

6%) P

PMU

staff

of D

ak N

ong a

nd B

inh

Phuo

c w

ere

fem

ale.

Dat

a so

urce

: PM

U/P

PMU

s rep

ort

82 Annex

Annex D: Finance

ASIAN DEVELOPMENT BANKADMINISTRATOR FOR

REGIONAL MALARIA AND OTHER COMMUNICABLE DISEASE THREATS TRUST FUND

STATUS OF GRANT AS OF 31 AUGUST 2018

(ExPRESSED IN US DOLLARS)

CONTRIBUTION RECEIVED:Government of Australia (DFAT) 15,756,300 Government of UkNI (DFID) 12,414,880 Government of Canada (DFATD) 531,916

NET CONTRIBUTION AVAILABLE 28,703,096 Investment Income 316,764 TOTAL AMOUNT AVAILABLE 29,019,860

AMOUNT UTILIZED FOR:Outcome 1: Leadership (2,345,103)Outcome 2: Financing (277,133)Outcome 3: Medicines (3,116,152)Outcome 4: Information Systems (3,488,056)Outcome 5: Laboratory Dianostic and Surveillance (13,415,950)Outcome 6: Promotion and Prevention (3,387,604)Direct Charges (858,464)Administrative Costs, Audit, Financial Costs (1,445,695) (28,334,157)

UNUTILIZED BALANCE 685,7031/

1/ Unutilized Balance 685,703

Less: DFATD/Canada Contribution (531,916)

DFATD/Canada Investment Income (5,870)

DFID/DFAT Unutilized Balance 147,917

Annex 83

Annex E: RMTF Recommendations for Management of Future Trust Funds

• Background research is essential to ensure efforts are aligned with government needs and that they take into account the prevailing environment in terms of private sector and other agency involvement.

• Meeting donor reporting requirements is a key part of successful fund management, and it is useful to have donor involvement at the beginning, preferably at the country fact-finding mission stage, so that data collection can be organized in a way that meets donor requirements. For the same reason, it is also important to involve an evaluation and monitoring expert from the outset.

• Delays due to constraints on counterparts should be anticipated and built into project design so that projects can evolve as circumstances change.

• Local counterpart and government champions can expedite projects and greatly increase their chance of success.

• International and locally based consultants have complementary skills and both are needed to achieve sustainable results.

• when working at the grassroots level, people and civil society organizations can be trusted to know the needs of local community, and are often the best placed to get results from interventions if they are genuinely involved from the planning stage onwards and empowered to take charge of projects.

• Innovation entails risk, and it should be expected that a proportion of projects will fail. Lessons should be shared.

• Close collaboration with development partners is important to avoid duplication, silos, and unsustainable results.

• It is common for some of the funds to be returned when a project ends, and this does not necessarily signal project failure. Sometimes activities are less expensive than anticipated.


ASIAN DEVELOPMENT BANK6 ADB Avenue, Mandaluyong City1550 Metro Manila, Philippineswww.adb.org

Regional Malaria and Other Communicable Disease Threats Trust FundFinal Report

This report details the key achievements of the Regional Malaria and Other Communicable Disease Threats Trust Fund from its creation in 2013 to the first half of 2018. It provides detailed analysis of the results by outcome, profiles specific projects that serve as exemplars of the fund’s impact, and offers insights into how similar trust funds can be managed for success in future.

About the Asian Development Bank

ADB is committed to achieving a prosperous, inclusive, resilient, and sustainable Asia and the Pacific, while sustaining its efforts to eradicate extreme poverty. Established in 1966, it is owned by 67 members—48 from the region. Its main instruments for helping its developing member countries are policy dialogue, loans, equity investments, guarantees, grants, and technical assistance.


NOVEMBER 2018

regional malaria and other communicable disease threats ... · regional malaria and other...

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