EMBASSY CAIRO RESPONSE TO HIV/AIDS AND THE GLOBAL

UNCLAS E F T O CAIRO 006192

SIPDIS

NOFORN
SENSITIVE
SIPDIS

STATE FOR S/GAC-MJEFFERS, PMAMACOS AND JMAZZONE
USAID/GH FOR MMILLER AND JWRIGHT
HHS FOR WSTEIGER

E.O. 12958: N/A
TAGS: KHIV EAID SOCI TBIO EG
SUBJECT: EMBASSY CAIRO RESPONSE TO HIV/AIDS AND THE GLOBAL
FUND: PARALLEL REVIEW PROCESS FOR ROUND SIX PROJECTS

REF: STATE 158244

Sensitive but unclassified. Please protect accordingly.


1. (SBU) Per reftel, Embassy Cairo comments on the the Global
Fund for AIDS, TB and Malaria Parallel Review Process follow.
Responses are keyed to format in reftel.


2. Country: Egypt
Region: Middle East
Title: Support for the National Plan for the Control of TB
Plus


A. Proposing Group: National CCM
Year 1: $2,898,934
Year 2: $2,276,614
Year 3: $1,469,614
Year 4: $1,409,614
Year 5: $1,410,614
Total Request: $ 9,465,390


B. Overall comments and recommendation for U.S. delegation
position: With impressive gains in the provision of quality
maternal and child health services, including tuberculosis,
Egypt is making noteworthy progress to meet the Millennium
Development Goals. GOE disease surveillance and response
capabilities are well-positioned to operate in a sustainable
manner as demonstrated by the success of the directly
observed, short-course (DOTS) strategy against tuberculosis.
The Ministry of Health and Population (MOHP) faces major
challenges including system-wide financial inefficiency,
regional disparities in health services and limited access
for the poor and vulnerable. Tuberculosis activities
contained in this proposal will improve TB case detection and
control for populations of significance, most notably the
rural poor, urban slum dwellers, prisoners and refuges.


C. Comments on the TRP review: Post concurs with TRP review;
the comments are relevant and appropriate. In particular, the
TRP identified issues of insufficient clarity regarding the
participation of private sector providers and the financial
gap calculation. Should the proposal receive funding,
beneficiary tracking, effectiveness of the referral system
and its impact on raising case detection rates will require
monitoring.


D. Other public health and scientific considerations: N/A


E. Coordination with other partners: TB program
implementation has been strong historically, principally
funded by the Netherlands, USAID and, in 2004, the GFATM
Round 2 Grant. No formal coordination mechanism exists. The
MOHP acts in a transparent manner with bilateral and UN
agencies for TB and HIV/AIDS. In addition to the GFATM
Grant, the GOE TB program currently receives assistance from
WHO and JICA. USAID supports a communication effort for
private sector pharmacists to detect chronic cough and refer
clients.

The CCM is minimally functional.


F. Political Considerations: Health is one of the GOE's
high-priority sectors, with a dynamic and visionary minister
appointed nine months ago. Under his leadership, the Ministry
of Health and Population is undergoing a significant and
broad reaching reform process to improve the health care
system. The long-range MOHP restructuring plan will require
short-term gains in high-quality primary care services with
seven priority areas identified to achieve fast and felt
changes. Outreach activities for underserved populations to
be funded in this proposal will assist the MOHP in its
efforts to enhance community confidence in GOE health
services.


G. Additional Comments: N/A


H. Embassy POC:
Holly Fluty-Dempsey
USAID/Egypt
e-mail hdempsey@usaid.gov
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