Korea (Democratic Peoples Republic)

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General Grant Information

Country Korea (Democratic Peoples Republic)

Grant Number PRK-810-G02-T Component Tuberculosis Round 08

Grant Title Strengthening Tuberculosis Control in DPR Korea Principal Recipient United Nations Children's Fund

Grant Status Financially Closed -

Grant Start Date 15 Jun 2010 Grant End Date 30 Sep 2015

Current* Phase Start Date 15 Jun 2012 Current* Phase End

Date 30 Sep 2015 Latest Rating A1

Current* Phase Signed

Amount $ 23,987,898 Current* Phase

Committed Amount $ 23,987,898 Current* Phase

Disbursed Amount $ 23,987,898

Cumulative Signed Amount $ 45,454,650 Cumulative

Committed Amount $ 45,454,650 Cumulative

Disbursed Amount $ 45,454,650

% Disbursed 100%

Time Elapsed (at the end of the latest reporting period)

64 months Proposal Lifetime Not Available % of Grant Duration 100%

* Latest Phase if grant is closed

PRK-810-G02-T Last Updated on: 26 January 2016

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New GPR Report - Table of Contents (For ExternalVersion)

1. Program Description and Contextual Information

2. Key Grant Performance Information

2.1. Program Impact and Outcome Indicators 2.2. Programmatic Performance

2.3. Financial Performance

2.4. Progress Update and Disbursement Information

2.6. Phase 2 Grant Renewal 2.5. Contextual Information

2.2.1. Reporting Periods

2.2.2. Program Objectives, Service Delivery Areas and Indicators 2.2.3. Cumulative Progress To Date

2.3.1. Grant Financial Key Performance Indicators (KPIs) 2.3.2. Program Budget

2.3.3. Program Expenditures 1.1. Grant Summary - Web 1.2. Country Latest Statistics

1.3. Comments on Key Discrepancies between Approved Proposal and Grant Agreement

1.4. Conditions Precedent

2.3.4. Graph - Cumulative Program Budget, Expenditures and Disbursement to Date

Last Updated on: 26 January 2016

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1. Program Description and Contextual Information

1.1. Grant Summary - Web

Korea (DPR) had successfully controlled the TB epidemic until the 1990s. However, for a number of reasons, the incidence of TB in Korea (DPR) then increased rapidly and became one of the highest in the region, reaching 344 per 100,000 people in 2008. The National TB Control Program in Korea (DPR) implemented DOTS following the standard World Health Organization guidelines in 1998 and achieved nationwide coverage by the end of 2003. The program supported by this grant will expand DOTS and implement newer interventions in support of the country's strategic plan.

Tuberculosis Estimate Year Source

Estimated mortality of TB cases (all forms, excluding HIV) per 100 000 population

6 2012 Global tuberculosis report 2012

Estimated number of deaths from TB (all forms, excluding HIV) 1,557 2012 Global tuberculosis report 2012 Estimated number of incident TB cases (all forms) 84,280 2012 Global tuberculosis report 2012 Estimated prevalence of TB (all forms) 103,197 2012 Global tuberculosis report 2012 Estimated prevalence of TB (all forms) per 100 000 population 422 2012 Global tuberculosis report 2012 Estimated TB incidence (all forms) per 100 000 population 345 2012 Global tuberculosis report 2012 New smear-positive TB cases detected and treated 90,813 2014 Mid-2014 Global Fund Results

Background and Health Spending Estimate Year Source

Population, total 24,763,188 2012 The World Bank Group (Data latest 2013 update: 2012 Birth rate, crude (per 1,000 people) 14 2011 The World Bank Group (Data latest 2013 update: 2011 Death rate, crude (per 1,000 people) 10 2011 The World Bank Group (Data latest 2013 update: 2011 Life expectancy at birth, total (years) 69 2011 The World Bank Group (Data latest 2013 update: 2011 1.2. Country Latest Statistics

Last Updated on: 26 January 2016

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1.5. Conditions Precedent CP

#

CP Type Condition Precedent Functional Area

Tied To Terminal Date

Is curr ently met?

Comments

Condition Precedent

B. Conditions Precedent to disbursement 1. The delivery by the Principal Recipient to the Global Fund of a copy of the Green Light Committee (GLC) of the World Health Organization’s written approval for the

procurement of second-line TB drugs and the treatment of multi-drug resistant TB patients under the Program.

Procureme nt

Disbursem ent

Met PHASE 1

Condition Precedent

Special terms and Conditions: PHASE 2 1. Condition Precedent to Disbursement of Grant Funds to Procure Second- Line Anti-Tuberculosis Drugs:

A current detailed multi-drug resistant tuberculosis (“MDR-TB”) expansion plan (including the number of MDR-TB patients to be treated and the list and quantifications of the medicines to be procured for the MDR-TB program reflecting the Principal Recipient’s finalized forecast for the grant implementation period covered by the Grant Agreement) and the national guidelines for programmatic management of MDR-TB, both of which have been developed in collaboration with a technical partner acceptable to the Global Fund; and

This condition precedent is amended as follows:“Prior to the disbursement by the Global Fund to the Principal Recipient of Grant funds to finance the procurement of second-line anti-tuberculosis drugs, the Principal Recipient shall make available to the Global Fund, in form and substance satisfactory to the Global Fund, the following:

Procureme nt

Other Met PHASE 2

Condition Precedent

b. For each disbursement request that includes funds for the procurement of MDR-TB medicines, a pro forma invoice issued by the designated Procurement Agent of the Global Drug Facility, as delegated by the Green Light Committee Initiative.”

Procureme nt

Disbursem ent

Met PHASE 2

Condition Precedent

2. The delivery by the Principal Recipient to the Global Fund of a copy of the letter sent by the GLC to its procurement agent, and copied to the Principal Recipient,

listing the drugs approved for use and the maximum quantities for the cohort of patients approved by the GLC. This letter shall reflect the finalized forecast and quantification for second-line TB drugs included in the PSM Plan and consistent with the Grant workplan and budget

Procureme nt

Disbursem ent

Met PHASE 1

1.3. Comments on Key Discrepancies between Approved Proposal and Grant

Last Updated on: 26 January 2016

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CP

#

Comments

Condition Precedent

C.Special terms and Conditions;

1. The Global Fund confirms to UNICEF that, as of the date of this Agreement, The

Global Fund has received the

commitment of the Host Government to the following: (i) the

number of international staff working in UNICEF, WHO and UNDP Pyongyang offices for the

implementation of the Malaria and Tuberculosis grants will be eight to nine, of which one will

be a UNOPS staff member who will work as LFA in UNDP Pyongyang; and (ii) the Host

Government will give entry visa for the UNOPS staff member no later three (3) months after

the start of the grant agreement between UNICEF and the Global Fund relating to a grant for

anti-malaria programs in DPR Korea, dated 5 February 2010.

Other Met PHASE 1

Condition Precedent

C.Special terms and Condition:

1. is amended as follows: “The Global Fund confirms to UNICEF that: (a) the number of international staff working in UNICEF, WHO and UNDP Pyongyang offices for the implementation of Malaria and Tuberculosis grants will be ten, and (b) the Host Government will allow international staff working in UNICEF, WHO, UNOPS and the Global Fund to visit sites across the country provided that travel requests are submitted to the Host Government no later than noon of Thursday of a given week, for visits starting as early as the following Monday.”

Others Met PHASE 2

Condition Precedent

Special terms and Conditions;

2. With reference to Article 10(b) of this Agreement, it is acknowledged and understood

that the World Health Organization (WHO) is the only Sub- recipient. In the event that during

the Program term the Principal Recipient determines that it would be appropriate to engage

additional Sub-recipients, the selection of such additional Sub-recipients shall be subject to the

approval of the Global Fund and the GF may, at its election, conduct its own assessment of such Sub-recipients.

Other Met

Last Updated on: 26 January 2016

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CP

#

Comments

Condition Precedent

3. In case that an additional Sub-recipient is selected during grant implementation, prior to

the disbursement of Grant funds by the Principal Recipient to that additional Sub- recipient, the

Principal Recipient shall furnish to the Global Fund, in form and substance satisfactory to the

Global Fund, the following:

i. evidence demonstrating that the Principal Recipient has conducted a comprehensive

assessment of the Sub-recipient;

ii. evidence demonstrating that the Principal recipient has signed an agreement with the

Sub-recipient, which shall include, at a minimum, a budget, workplan, implementation

and financial and programmatic reporting responsibilities of the Sub-recipient;

iii. details identifying the financial institution or institutions into which Grant funds will be

disbursed for the benefit of the Sub- Recipient; and

4

iv. documentation demonstrating that the Sub-recipient has received training on monitoring

and evaluation responsibilities sufficient to meet its requirements under the Program.

Other Met

Condition Precedent

4. The Principal Recipient and the Global Fund agree that, in accordance with agreements

reached with the Host Government, the Principal Recipient will not advance Grant funds to any

implementing entities that are not UN agencies. The Principal Recipient will provide funding to

non-UN agencies only on a reimbursable basis, based on actual expenditures made in

accordance with budgets and workplans approved in advance by the Principal Recipient. The

Principal Recipient shall ensure that such non-UN implementing entities receive training on

monitoring and evaluation and reporting responsibilities sufficient to meet its requirements under the Program

Other Met

Condition Precedent

5. In accordance with the requirements under Article 10(b) of the Standard Terms and

Conditions of this Agreement that all Sub- recipient Agreements are consistent with this

Agreement and for the avoidance of doubt, the provisions regarding implementing entities in

this Annex A shall apply to the use and disbursement of Grant funds by any Sub- recipient.

Other Met

Last Updated on: 26 January 2016

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CP

#

Comments

Condition Precedent

6. Disbursement of funds to national counterparts to reimburse the costs of travel, daily

subsistence allowances, food, stationeries, room rentals and facilitator fees will not exceed the

rates established between the United Nations agencies and the Host Government (expressed in

Euros) and outlined in the document titled

“Payment Scale for Local Activities”, attached to

this Annex A.

Other Met PHASE 1

Condition Precedent

Special terms and Conditions

6. is amended as follows: “Disbursement of funds to national counterparts to reimburse the costs of in-country travel, DSA, food, stationeries, room rental and facilitator fees will not exceed the rates established between the UNICEF, WHO and the Host Government (expressed in United States dollars but paid in local currency) and

outlined in the document titled “Payment Scale for Local Activities.”

Met PHASE 2

Condition Precedent

Special Terms and Conditions:

7. Recognizing that the circumstances in the Host Country render it difficult to conduct

quality control testing along the supply chain as required under Article 18(n) of the Standard

Terms and Conditions of this Agreement, the Principal Recipient and the Global Fund will

explore options for quality control testing and monitoring with the aim of reaching resolution

satisfactory to UNICEF, the Global Fund, WHO and the Host Government within nine (9)

months after the Program Starting Date.

Other 30.Sep.11 Met

Last Updated on: 26 January 2016

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CP

#

Comments

Condition Precedent

8. The Global Fund and the Principal Recipient agree that the procurement of supplies and

equipment using Grant funds (including to support the activities of the

implementing entities)

will be conducted exclusively by the Principal Recipient; provided, however, that (i) WHO will

undertake the procurement of the goods that are listed in the workplan/budget as assets that will

be assigned to WHO; and (ii) a minimum amount of expenditure might be undertaken by

Government counterparts responsible for implementing activities. Procurement undertaken by

UNICEF will be done in accordance with UNICEF applicable regulations, rules and procedures

(including Supply Directives issued by UNICEF's Supply Division Copenhagen).

Without

limiting the generality of the foregoing, (i) Pharmaceuticals and Health products, and vehicles

(including those to be used by WHO), motorcycles, and computers will be procured through

UNICEF's Supply Division Copenhagen (which may decide to do so using the Supply function

in the UNICEF China Country Office or any other offices); (ii) other supplies and equipment

will be procured by the UNICEF DPR Korea Country Office, through a competitive bidding

process or, as appropriate, a

documented sole source procedure, on the principle of "best price,

best value" and so as to achieve the efficient and effective use of Grant funds, it being

understood that if there is no bidding or if the lowest acceptable bid has not been selected, this

will be duly explained and recorded.

Procurement undertaken by WHO using Grant funds

disbursed to it will be done in accordance with WHO's standard regulations, rules, and

procedures for procurement.

Other Met No procurement done by WHO to date.

Any procurement made by the PR are made

through its supply division in Copenhagen and China.

Any minor items such stationary are procured locally.

Condition Precedent

9. Without limiting the provisions of Article 19 of the Standard Terms and Conditions of

this Agreement, vehicles and motor cycles procured by the Principal Recipient using Grant

funds will, in accordance with agreements reached with the Host Government, be made

available to the Host Government and WHO on a loan basis using the Principal Recipient's

standard vehicle loan agreement.

Other Met

Last Updated on: 26 January 2016

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CP

#

Comments

Condition Precedent

10. The Principal Recipient will notify the Global Fund in advance of any proposed material

change to the implementation

arrangements described in this Annex A.

Any such material

change in the implementation arrangements will be subject to prior approval of the Global

Fund.

Other Met

Condition Precedent

11. It is understood and agreed that the Program constitutes an integral part of the UNICEF

Country Programme of Cooperation with the Host Government, which is

implemented as a

unified program by the UNICEF staff and consultants stationed in the UNICEF DPR Korea

Office and other UNICEF offices world- wide that support the implementation of that program

of cooperation (including the Program that is funded from the Grant Funds), regardless of the

funding source for the costs of such staff and consultants. Accordingly, while it is understood

and agreed that all UNICEF staff and consultants paid for from the Grant funds will work

almost exclusively on implementation of the Program and on other UNICEF programs funded

by the Global Fund, nothing in this Agreement will prohibit such staff and consultants from

working on other components of the UNICEF Programme of Cooperation with the Host

Government as long as this does not in any way compromise the implementation of the

Program or any other UNICEF programs funded by the Global Fund.

Other Met .

Condition Precedent

12. In making its determination, following consultation with the Global Fund (as contemplated in the Article 19 of the Standard Terms and Conditions) and within the

framework of its standard agreements with the Host Government, as to the transfer or

disposition of assets remaining at the completion of the Program or termination of this

Agreement, UNICEF will, consistent with its normal practice, take into account the following

principles: (i) the responsible, transparent and orderly closure of the Grant, (ii) the intention that

Program assets continue to be used for the same or similar purposes as the Program

purposes,(iii) the accountable disposition of Program assets.

Met This STC is not applicable to disbursements.

Last Updated on: 26 January 2016

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CP

#

Comments

Condition Precedent

13. The Principal Recipient agrees that the Global Fund will disburse US$ 50,000 of Grant

funds for each relevant year of the Program Term directly to the Green Light Committee of the

World Health Organization for assistance with the procurement of pharmaceuticals for multidrug

resistant tuberculosis.

Met PHASE 1

Condition Precedent

13. is amended as follows: “The Principal Recipient shall cooperate with the relevant office of the Green Light Committee (the “GLC”) in the GLC’s efforts to provide support to the Principal Recipient with respect to the

implementation, management and monitoring of the MDR-TB-related services provided in-country and any needed scale-up

of such services. Accordingly, the Principal Recipient shall budget and authorize the Global Fund to disburse up to a maximum of US$ 50,000, or a lower amount as agreed with GLC and the Global Fund, each year to pay for GLC services.”

Other Met PHASE 2

Condition Precedent

14. It is understood and agreed that Global Fund funds will not be used to support

activities undertaken in any county or counties to which staff or agents of the Principal

Recipient, the Sub-Recipient, or the Local Fund Agent are not permitted access by the Host

Government. The Global Fund has requested the Host Government to notify the Principal

Recipient, the Sub-Recipient, and the Local Fund Agent, in advance, of any changes in the

level of access to grant implementation sites, and should the Principal Recipient, the Sub-

Recipient and the Local Fund Agent receive such notification the parties will consult and

agree on appropriate measures.

Met This condition is being followed by the MoPH and the government of DPRK.

The LFA is requested to keep track of such changes.

Condition Precedent

15. Prior to the use of funds for International Travel and Training of Government Staff, the

Global Fund and UNICEF, in consultation with the WHO, will agree on a plan for such travel

and training.

Met

Condition Precedent

16. is added, which shall read as follows:

“For the purposes of Article 6(a) of the Standard Terms and Conditions, the Principal Recipient will, from 15 June 2012, submit disbursement requests to the Global Fund every six (6) months (as per dates

specified in the performance framework), for an amount equal to the Principal Recipient’s anticipated expenditures during the following nine (9) months with the final date being 14 June 2015.”

Met PHASE 2

Last Updated on: 26 January 2016

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CP

#

Comments

Condition Precedent

“For the purposes of Article 10(b)(2) of the Standard Terms and Conditions, the Principal Recipient’s responsibility to maintain a system to assess the capacity of Sub-recipients shall be required only in instances where there is a new Sub- recipient or the existing Sub-recipients will be implementing additional activities for which they were not initially assessed.

Monitoring

of performance and assurance of regular reporting by the Sub-recipient, within the framework of collaborations within the United Nations System, remain continuous obligations of the Principal Recipient throughout the Program term.”

Met PHASE 2

Condition Precedent

18 is added, which shall read as follows:

“For the purposes of Article 13(b)(1) of the Standard Terms and Conditions, the Principal Recipient will submit the required report every six (6) months during the term of this Agreement, and the report shall reflect the activities during the preceding six (6) month period in question.”

Met PHASE 2

Condition Precedent

“No later than 31 January 2013, the Principal Recipient shall deliver to the Global Fund information on the cash balances of the Principal Recipient and Sub-Recipient as of 14 June 2012. The commitment amount listed in the Block 7 of the Face Sheet of this grant agreement shall be revised to

reflect this cash balance information, as to be confirmed by the LFA.”

Met PHASE 2

Condition Precedent

“In collaboration with partners, the Principal Recipient shall deliver to the Global Fund a report from GLC confirming the ability of the National Tuberculosis Program to scale up the MDR-TB treatment program in Phase 2.

This GLC report should be translated by the Principal Recipient and its incountry partners into an operational plan with realistic timelines and submitted to the Global Fund no later than 31 January 2013.”

Met Phase 2: Following the GLC Mission in September 2012, PR received the GLC report and updated the PMDT Operational Plan for DPR Korea together with the in-country partners.

The revised PMDT Operational Plan was submitted, among other MDR-TB related documents, to GFATM on 31 January 2013.

This STC is considered as Met.

Condition Precedent

“Following the GLC mission in September 2012 and no later than 31 January 2013, the Principal Recipient shall submit to the Global Fund the updated National M&E Plan along with the revised Performance Framework for Years 3, 4 & 5 of the Program and updated workplan and budget for Years 3, 4 & 5 of the Program, all of which shall incorporate the conclusions of the GLC mission.”

Met PHASE 2: Following the GLC Mission in September 2012 and the GLC Report, the following documents were submitted by PR to GFATM on 31 January 2013:

1) Revised Budget and work plan;

2) Revised Phase 2 performance framework for years 3,4 and 5;

3) PMDT Operational plan for DPRK;

4) Revised MDR TB expansion Plan;

5) Revised National TB M&E Plan.

These documents are pending for GFATM official approval.

This STC is considered as Met.

Last Updated on: 26 January 2016

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2.1. Program Impact and Outcome Indicators

Goal 1 To reduce the burden of TB in DPR Korea

Impact indicator TB incidence rate Baselines

Value Year

344 2008

Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8 Year 9 Year 10 Year 11 Year 12 Year 13 Year 14 Year 15

Target 344 327 310 295 280

Result 345

Data source of Results

Impact indicator TB mortality rate Baselines

Value Year

39 2008

Target 39 37 35 33 32

Result 23

Outcome indicator Case detection Baselines

Value Year

70% 2008

Target N:

D:

P: 74%

N:

D:

P: 82%

N:

D:

P: 86%

N:

D:

P: 86%

N:

D:

P: 86%

N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: %

Result N:

D:

P: 81%

N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % Data source of

Results

Outcome indicator Treatment success rate, new smear positive TB cases Baselines

Value Year

87% 2008

Target N:

D:

P: 85%

N:

D:

P: 85%

N:

D:

P: 90%

N:

D:

P: 91%

N:

D:

P: 91%

N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: %

Result N:

D:

P: 90%

N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: 91%

N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % N:

D:

P: % Data source of

Results

Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8 Year 9 Year 10 Year 11 Year 12 Year 13 Year 14 Year 15

2010 2011 2012 2013 2014 2010 2016 2017 2018 2019 2020 2021 2022 2023 2024

2. Key Grant Performance Information

Last Updated on: 26 January 2016

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Outcome indicator Case Notification Rate: All forms TB Cases Baselines

Value Year

344 2010

Target 374 394 379 406 406

Result 436 431

Impact indicator TB prevalence rate Baselines

Value Year

459 2008

Target N/A N/A N/A N/A TBD

Result Data source of Results

Outcome indicator Notification rate of new smear positive TB cases Baselines

Value Year

127 2010

Target 139 149 149

Result 145

Last Updated on: 26 January 2016

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2.2.2. Program Objectives, Service Delivery Areas and Indicators

Period 1 Period 2 Period 3 Period 4 Period 5 Period 6 Period 7 Period 8

Target

N: 5,891 D: 6,931 P: 85%

N: 11,276 D: 13,266 P: 85%

N: 17,673 D: 20,792 P: 85%

N: 23,562 D: 27,720 P: 85%

N: 5,950 D: 7,000 P: 85%

N: 11,900 D: 14,000 P: 85%

N: 17,850 D: 21,000 P: 85%

N: 23,799 D: 27,999 P: 85%

Result

N: 6,256 D: 6,914 P: 91%

N: 12,293 D: 13,731 P: 90%

N: 17,810 D: 19,823 P: 90%

N: 24,645 D: 27,387 P: 90%

N: 7,089 D: 7,914 P: 90%

N: 13,897 D: 15,427 P: 90%

N: 20,786 D: 23,076 P: 90%

N: 27,631 D: 30,648 P: 90%

Target

N: 12,775 D: 14,194 P: 90%

N: 13,640 D: 15,155 P: 90%

N: 14,580 D: 16,201 P: 90%

N: 15,812 D: 17,472 P: 91%

N: 15,813 D: 17,472 P: 91%

N: 23,994 D: 26,367 P: 91%

N:

D:

P: %

N:

D:

P: % Result

N: 12,865 D: 14,194 P: 91%

N: 13,776 D: 15,155 P: 91%

Pending result

N: 14,320 D: 15,818 P: 91%

N: 14,567 D: 15,998 P: 91%

N: 22,532 D: 24,957 P: 90%

N:

D:

P: %

N:

D:

P: % Year

Value Baseline

Is Top 10 indicator? (Y/N)

Is Training indicator? (Y/N)

Level 3-People reached 23613 2009 Y N

Indicator 1.1 - Number and percentage of new smear positive TB cases that are successfully treated, of all new smear positive cases registered

Target Result

Target 16,200 17,472 17,472 17,578 17,580 26,485

Result 14,995 15,821 Pending result 16,511 16,335 26,669

Year Value

Baseline Is Top 10 indicator? (Y/N)

Indicator 1.8 - 1.2: Number of new smear positive TB cases notified during the reporting period High Quality DOTS

Objective 1 - Provide DOTS services to all TB patients, sustain current successes and improve case detection and treatment success rates

N/A 15.Jun.10

30.Sep.10

01.Oct.10 31.Dec.10

01.Jan.11 31.Mar.11

01.Apr.11 30.Jun.11

01.Jul.11 30.Sep.11

01.Oct.11 31.Dec.11

01.Jan.12 31.Mar.12

01.Apr.12 14.Jun.12 2.2.1. Reporting Periods

2.2. Programmatic Performance

Last Updated on: 26 January 2016

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Period 1 Period 2 Period 3 Period 4 Period 5 Period 6 Period 7 Period 8 Target

Result

Target 44,184 47,652 47,651 47,942 47,942 72,231

Result 43,620 45,970 Pending result 49,468 48,348 80,053

Year Value

Indicator 1.9 - 1.3: Number of all forms of TB cases notified during the reporting period

Target

Result

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

Target

N:

D:

P: 22%

N:

D:

P: 22%

N:

D:

P: 22%

N:

D:

P: 22%

N:

D:

P: 22%

N:

D:

P: 22%

N:

D:

P: %

N:

D:

P: % Result

N:

D:

P: 21%

N:

D:

P: 22%

N:

D:

P: %

N:

D:

P: 21%

N:

D:

P: 21%

N:

D:

P: 21%

N:

D:

P: %

N:

D:

P: % Year

Value

Is Training indicator? (Y/N) Level 3-People reached 21.7%

(6365/2 9349)

2012 N N

Indicator 1.10 - 1.4: Percentage of new smear positive TB cases who are women aged 15-44 years out of all NSP cases.

Target

Result

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

Target

N:

D:

P: 90%

N:

D:

P: 90%

N:

D:

P: 90%

N:

D:

P: 93%

N:

D:

P: 93%

N:

D:

P: 95%

N:

D:

P: %

N:

D:

P: % Result

N:

D:

P: 91%

N:

D:

P: 93%

N:

D:

P: %

N:

D:

P: 93%

N:

D:

P: 93%

N:

D:

P: 93%

N:

D:

P: %

N:

D:

P: % Year

Value

Is Training indicator? (Y/N) Level 2-Service Points

supported

88.7%

(259/29 2)

2012 N N

Indicator 1.11 - 1.5: Percentage of laboratories showing adequate performance in EQA for smear microscopy among the total number of laboratories that undertake smear microscopy during the reporting period

Improving diagnosis

Last Updated on: 26 January 2016

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Result

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

Target

N: 190 D: 190 P: 100%

N:

D:

P: %

N:

D:

P: % Result

N: 190 D: 190 P: 100%

Pending result

N: 190 D: 190 P: 100%

N:

D:

P: %

N:

D:

P: % Year

Value

supported

100%

(190/19 0)

2012 N N

Indicator 1.12 - 1.6: Number and percentage of counties reporting no stock-out of first-line anti-TB drugs during the reporting period Procurement and Supply management

Target

Result

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

Target

N: 190 D: 190 P: 100%

N:

D:

P: %

N:

D:

P: % Result

N: 190 D: 190 P: 100%

Pending result

N: 190 D: 190 P: 100%

N:

D:

P: %

N:

D:

P: % Year

Value

supported

100%

(180/18 0)

2012 N N

Indicator 1.13 - 1.7: Number of counties visited by provincial supervisory team for monitoring of TB program during the period M&E

Last Updated on: 26 January 2016

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Result

Target 0 1,015 0 1,015 0 1,015

Result 1,015 1,015 0 1,015

Year Value

Level 1-People trained NA NA N N

Indicator 2.2 - 2.1 Number of health workers/doctors in non-health sectors (NGOs) trained during the reporting period

All care providers (PPM / ISTC - Public-Public, Public-Private Mix (PPM) approaches and International standards for TB care)

Objective 2 - Establish partnerships with non-health sectors, departments and organizations to increase access to quality TB services

Last Updated on: 26 January 2016

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Result

Target 120 50 80 125 125

Result 120 Pending result 78 132 125

Year Value

Indicator 4.3 - 4.1: Number of MDR-TB cases enrolled on second-line anti TB treatment during the reporting period.

Target

Result

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

Target

N:

D:

P: 0%

N:

D:

P: 0%

N:

D:

P: 70%

N:

D:

P: 70%

N:

D:

P: 75%

N:

D:

P: 75%

N:

D:

P: %

N:

D:

P: % Result

N:

D:

P: %

N:

D:

P: %

N:

D:

P: %

N:

D:

P: 86%

N:

D:

P: 76%

N:

D:

P: 91%

N:

D:

P: %

N:

D:

P: % Year

Value

Level 3-People reached 2012 N N

Indicator 4.4 - 4.2 Interim result- culture conversion rate at 12 months: percentage of MDR-TB cases initiated on a second-line anti-TB treatment regimen who have a negative culture at the end of 12 months of treatment

MDR-TB

Objective 4 - Develop and implement DOTS-Plus for the management of MDR-TB

Last Updated on: 26 January 2016

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Latest reporting due period : 14 (01.Jan.15 - 30.Sep.15)

Period Value Period Value

Target Result

90%

60%0% 30% 100%

Level 3-People reached

14

N: 23,994 D: 26,367 P: 91 %

14

N: 22,532 D: 24,957 P: 90.3 %

99%

Indicator 1.1 - Number and percentage of new smear positive TB cases that are successfully treated, of all new smear positive cases registered

90%

60%0% 30% 100%

Level 3-People reached 14 26,485 14 26,669 101%

Indicator 1.8 - 1.2: Number of new smear positive TB cases notified during the reporting period

90%

60%0% 30% 100%

Level 3-People reached 14 72,231 14 80,053 111%

Indicator 1.9 - 1.3: Number of all forms of TB cases notified during the reporting period

90%

60%0% 30% 100%

14

N:

D:

P: 22 % 14

N:

D:

P: 20.5 %

93%

Indicator 1.10 - 1.4: Percentage of new smear positive TB cases who are women aged 15-44 years out of all NSP cases.

SDA High Quality DOTS

90%

60%0% 30% 100%

Level 2-Service Points supported

14

N:

D:

P: 95 % 14

N:

D:

P: 92.8 %

98%

Indicator 1.11 - 1.5: Percentage of laboratories showing adequate performance in EQA for smear microscopy among the total number of laboratories that undertake smear microscopy during the reporting period

SDA Improving diagnosis

90%

60%0% 30% 100%

14

N: 190 D: 190 P: 100 %

14

N: 190 D: 190 P: 100 %

100%

Indicator 1.12 - 1.6: Number and percentage of counties reporting no stock-out of first-line anti-TB drugs during the reporting period SDA Procurement and Supply management

90%

60%0% 30% 100%

14

N: 190 D: 190 P: 100 %

14

N: 190 D: 190 P: 100 %

100%

Indicator 1.13 - 1.7: Number of counties visited by provincial supervisory team for monitoring of TB program during the period

SDA M&E

Objective 1 Provide DOTS services to all TB patients, sustain current successes and improve case detection and treatment success rates

2.2.3. Cumulative Progress To Date

Last Updated on: 26 January 2016

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90%

60%0% 30% 100%

Level 1-People trained 14 1,015 14 1,015 100%

Indicator 2.2 - 2.1 Number of health workers/doctors in non-health sectors (NGOs) trained during the reporting period

SDA All care providers (PPM / ISTC - Public-Public, Public-Private Mix (PPM) approaches and International standards for TB care)

Objective 2 Establish partnerships with non-health sectors, departments and organizations to increase access to quality TB services

90%

60%0% 30% 100%

Level 3-People reached 14 125 14 125 100%

Indicator 4.3 - 4.1: Number of MDR-TB cases enrolled on second-line anti TB treatment during the reporting period.

90%

60%0% 30% 100%

14

N:

D:

P: 75 % 14

N:

D:

P: 91 %

120%

Indicator 4.4 - 4.2 Interim result- culture conversion rate at 12 months: percentage of MDR-TB cases initiated on a second-line anti-TB treatment regimen who have a negative culture at the end of 12 months of treatment

SDA MDR-TB

Objective 4 Develop and implement DOTS-Plus for the management of MDR-TB

Last Updated on: 26 January 2016

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Summary Period Budget: 8,220,218 252,686 820,947 480,082 4,907,580 504,328 249,408 219,444 Budget

Period 1

Budget Period 2

Budget Period 3

Budget Period 4

Budget Period 5

Budget Period 6

Budget Period 7

Budget Period 8 Period Covered From: 15.Jun.10 01.Oct.10 01.Jan.11 01.Apr.11 01.Jul.11 01.Oct.11 01.Jan.12 01.Apr.12 Period Covered To: 30.Sep.10 31.Dec.10 31.Mar.11 30.Jun.11 30.Sep.11 31.Dec.11 31.Mar.12 14.Jun.12

Currency: EUR EUR EUR EUR EUR EUR EUR EUR

Cumulative Budget Through: 8,220,218 8,472,904 9,293,852 9,773,934 14,681,514 15,185,841 15,435,249 15,654,693

Expenditure Categories

Program Activities

Implementing Entities

Summary Period Budget: 11,084,738 2,240,252 467,244 1,090,160 9,297,840 402,551 242,322 258,577 Budget

Period 9

Budget Period 10

Budget Period 11

Budget Period 12

Budget Period 13

Budget Period 14

Budget Period 15

Budget Period 16 Period Covered From: 15.Jun.12 01.Oct.12 01.Jan.13 01.Apr.13 01.Jul.13 01.Oct.13 01.Jan.14 01.Apr.14 Period Covered To: 30.Sep.12 31.Dec.12 31.Mar.13 30.Jun.13 30.Sep.13 31.Dec.13 31.Mar.14 30.Jun.14

Currency: USD USD USD USD USD USD USD USD

Cumulative Budget Through:

Implementing Entities

Summary Period Budget: 8,333,891 152,660 624,710 173,085 3,602,223 Budget

Period 17

Budget Period 18

Budget Period 19

Budget Period 20

Budget Period 21

Budget Period 22

Budget Period 23

Budget Period 24 Period Covered From: 01.Jul.14 01.Oct.14 01.Jan.15 01.Apr.15 15.Jun.15 15.Sep.15 15.Dec.15 15.Mar.16 Period Covered To: 30.Sep.14 31.Dec.14 31.Mar.15 14.Jun.15 30.Sep.15 14.Dec.15 14.Mar.16 14.Jun.16

Currency: USD USD USD USD USD USD USD USD

Cumulative Budget Through:

Implementing Entities 2.3.2. Program Budget

Grant Duration (months) 64 months Grant Amount 45,454,650 $

% Time Elapsed (as of end date of the latest PU) 100% % disbursed by TGF (to date) 100%

Time Remaining (as of end date of the latest PU) 0 months Disbursed by TGF (to date) 45,454,650 $ Expenditures Rate (as of end date of the latest PU) 0% Funds Remaining (to date)

2.3.1. Grant Financial Key Performance Indicators (KPIs) 2.3. Financial Performance

Last Updated on: 26 January 2016

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2.3.4. Cumulative Program Budget, Expenditures and Disbursement to Date

Rating Description

A1 Exceeding expectations

A2 Meeting expectations

B1 Adequate

B2 Inadequate but potential demonstrated

C Unacceptable

2.4. Progress Update and Disbursement Information 2.3.3. Program Expenditures

Period PU14: 01.Jan.15 - 30.Sep.15 Actual Cash Outflow

Cumulative Budget

Cumulative

Cash Outflow Variance 1. Total cash outflow vs. budget $ 16,469,031 $ 37,693,890 $ -37,693,890

1a. PR's Total expenditure $ 16,179,810 $ 33,951,366

1b. Disbursements to sub-recipients $ 289,221 $ 2,421,357

1c. Expenditure Adjustments $ 1,321,167

2. Pharmaceuticals & Health Product

expenditures vs budget $ 11,662,754 $ 18,966,115

2a. Medicines & pharmaceutical products $ 9,095,648 $ 14,494,452

2b. Health products and health equipment $ 2,567,106 $ 4,471,663

Reason for variance

Reason for adjustments

Last Updated on: 26 January 2016

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Progress Updates Disbursement Information

PU PU Period TGF

Rating DR DR Period

Covered PR Request Disbursement Amount

Disbursement Date

0 15.Jun.10 - N/A 1 15.Jun.10 -

31.Dec.10 8,471,904 € 8,472,904 23 Jun 2010 Summary of Progress Reasons for variance between PR Request and Actual Disbursement This is the first disbursement no variance

Disbursement Date 1 15.Jun.10 -

30.Sep.10 B1 2 01.Oct.10 -

31.Mar.11 681,350 N/A

Summary of Progress Reasons for variance between PR Request and Actual Disbursement This PU/DR was received at the same time as the subsequent PU/DR and thus the disbursement request was treated as integral to the subsequent PU/DR (see below disbursement for period Jan-June 2011).

Disbursement Date 2 01.Oct.10 -

31.Dec.10 B1 2 01.Jan.11 -

30.Jun.11 1,302,884 € 842,399 07 Apr 2011 Summary of Progress Reasons for variance between PR Request and Actual Disbursement Based on the cumulative results as reported until 31

December 2010, the grant performance rating is calculated at B1 or “Adequate”. This result is mainly due to the delayed activities under two training indicators (2.1 “Number of health workers/doctors trained” and 5.1 “Number of county level staff trained”, achieving 4% and 16% of the target respectively).

With the exception of these two indicators, the overall performance of the grant is very satisfactory, with a majority of indicators reaching 90 to 100% (or higher) of their cumulative targets for the period.

The PR’s financial performance has been evaluated less positively, given a cumulative expenditure rate of 15% only.

Due to the slow financial performance, we have reduced the disbursement amount by 20%. In addition, the budget for the following items was removed:

1) Recovery costs in the amount of 68,885.60 EUR;

2) Remaining balance of the HR budget: 181,000 EUR.

Disbursement Date 3 01.Jan.11 -

31.Mar.11 A2 3 01.Apr.11 -

30.Sep.11 5,287,961 € 2,410,230 19 Jul 2011 Summary of Progress Reasons for variance between PR Request and Actual Disbursement

This is the first tranche of the fourth disbursement which covers the funding for first-line TB drugs. The remainder of the PR's disbursement request is under review and will be processed as a second tranche.

Last Updated on: 26 January 2016

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31.Mar.11 A2 3.1 01.Apr.11 -

30.Sep.11 5,287,961 € 2,815,175 26 Oct 2011 Summary of Progress Reasons for variance between PR Request and Actual Disbursement

The PR's forecasted budget for Q4 was 7,044,078 EUR, based on the revised workplan/budget (inclusive of outstanding commitments or "back log activities" from previous periods). This was corrected to 7,022,521.42 EUR based on approved reprogrammed budget. Unicef and WHO overheads had been previously disallowed but based on recent discussions in-country the Country Team agreed to disburse these in advance systematically (to be reconciled with actual expenditure at a later stage).

The forecasted budget for Q5 (buffer) is 4,907,580.36 based on the approved budget.

As a result the total forecasted amount for the period is 7,022,521.42 (Q4) + 4,907,580.36 (Q5) = 11,930,102 EUR (rounded), from which we deduct:

- PR cash balance: 5,821,298 EUR

- Cash in transit (07/04/11 disbursement #3 + 19/07/2011 disbursement

#3.1, which was made after PR submitted the PUDR): 842,399 + 2,451,230 = 3,293,629 EUR

The final disbursement amount is: 11,930,102- 5,821,298 - 3,293,629 = 2,815,175 EUROS

Disbursement Date 4 01.Apr.11 -

30.Jun.11 A2 4 01.Jul.11 -

31.Dec.11 4,896,880 N/A

Summary of Progress Reasons for variance between PR Request and Actual Disbursement Programmatic performance in this period has been

excellent, with all indicators achieved or overachieved but one (#1.4 "Number of fully functional microscopy centers in place") which nonetheless reached 87% of its target for the period.

Average Top Ten indicator achievement was 111%.

Financial performance in this period remains slow - however this is mainly due to the need to reprogram a number of activities in order to respond to increased procurement costs.

The PR's cash balance remains high at 5.8 million EUR while the cumulative expenditure rate has increased from 15% to 20%. In the period under review, the PR's expenditure rate was 52%

(including disbursements to SRs - it was 29% if these are not counted). A reprogrammed budget was approved with an increased procurement budget which had not yet been implemented at the close of this PU, and which accounts for 93% of the underspend in this period (and 50% of the cumulative underspend).

As noted previously, the PR's high cash balance is not reflective of actual availability of cash due to the fact that large sums are in fact requisitioned amounts (i.e. "blocked" for a specific activity line in the system, thus not available for reallocation to other purposes - see "committed amounts" in PR forecast).

In view of the above factors, while the PR's financial performance is not yet satisfactory, it is expected that the implementation of the procurement budget in the next periods will allow the PR to catch-up on its expenditure rate, so overall this is not a cause for

During the clarifications process, it was found that the PR had made substantial errors in their disbursement forecast, and in light of the amount disbursed in October (against the previous PU), no disbursement was in fact needed.

Last Updated on: 26 January 2016

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Disbursement Date 5 01.Jul.11 -

30.Sep.11 A2 4 01.Oct.11 -

31.Mar.12 N/A

Summary of Progress Reasons for variance between PR Request and Actual Disbursement

Last Updated on: 26 January 2016

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This is a combined review based on two PU/DRs for this grant - Q4 (April - June 2011) and Q5 (July - Sept 2011). No disbursement was made against the April-June 2011 PU.

Programmatic performance in this period continues to be very strong, with all indicators achieved or overachieved (or nearly achieved) but two as follows:

- indicator #1.4 "Number of fully functional microscopy centers in place" reached 74% of its target for the period, compared to 79% in the previous period. This decrease is due to the delays in procurement of new microscopes for replacement of the old ones currently in use - with the completion of the procurement process it is expected that the results for this indicator will catch up in subsequent periods.

- indicator #5.1 "Number of county level staff trained in program management" reached 80% of its target (382 trained against 475 planned). However the PR had reported this result as overachieved by including trainings which were funded by the local

government. Overall result is acceptable.

Average Top Ten indicator achievement was 104%.

A1 rating is appropriate.

Impact indicator results were reported for the year 2010, which can only be partially linked to the Global Fund grant (which was started in mid-2010 and for which drugs were not delivered until March 2011):

- TB incidence rate: 345 / 100,000 (no significant change of trend since 2008)

- TB mortality rate: 23 / 100,000 (per WHO report), showing a significant decrease from the 2008 baseline of 39

In the case of outcome indicators, the results cover the whole first year of the grant (June 2010-June 2011) and show achievement of targets overall, as follows:

- TB case detection rate: 81% (against 74% target).

- Treatment success rate: 90% (against 85% target).

This figure is relatively stable over the past few years.

- Case notification rate: reported as 436 / 100,000 by National TB Program (against 374 target). Overall trend shows gradual increase, which may be due to improved access and involvement of other sectors for TB care (per WHO).

Financial performance remains slow for this grant with a 12% burn rate against this period's budget and a 22% burn rate cumulatively. The variance is mainly attributable to procurement

(pharmaceuticals/health equipment = 65% of underspend) and HR budgets (15% of underspend) which have been slow to implement. In the case of the former, there have been delays in

procurement/delivery of drugs to the country (although most amounts are in fact "committed"

expenditure, pending delivery and payment); in the case of the latter (HR), it should be noted that delays in implementation are caused by the fact that budgets for HR were frontloaded for 2 years in Q1 - so a delay in recording expenditure is expected.

In light of the above factors, a substantial portion of the underspend can be considered as commitments - and the revised cumulative expenditure rate would be 74%, which is acceptable generally speaking.

Consistent with the above comments, the PR's cash balance appears high (7.8 million USD, of which 7.6 million are commitments).

No disbursement is requested at this stage.

Last Updated on: 26 January 2016

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Disbursement Date 6 01.Oct.11 -

31.Dec.11 A2 4 01.Jan.12 -

30.Jun.12 N/A

Summary of Progress Reasons for variance between PR Request and Actual Disbursement Of 13 indicators, 2 in the SDA of MDR TB are not

due for reporting. Of the remaining 11 indicators, 7 have achieved or overachieved the targets.

While indicator 1.2 Number of new smear positive TB cases registered during the reporting period continue to perform at 96% with no improvement from last Qr, 3 other indicators show low performance as follows:

1.4 Number of fully functional microscopy centers in place (71%). This achievement is lower than the last Qr.( 74%) as 2 more microscopes during this period have broken down making these centres non functional. With the distribution of 100 new microscopes at end of the reporting period, this situation will improve. However, due to lack of a proper plan to train the concerned staff on use of new microcopes as well as indecision with regard to suitable places for installation of the new

microscopes in the microscopic centres, it will take time for their full functioning;

1.5 Number of laboratories showing adequate performance among those that received External Quality Assurance (EQA) for smear microscopy during the reporting period (76%). This result is also lower than that of last Qr. (81%). The low figure is due to fall in number of laboratories that have undergone EQA. Only 219 out of 258 existing laboratories have received EQA;

5.1 Number of county level staff trained in TB program management (67%). Again, this result is lower than that reported in last Qr. (80%). This is a Top 10 indicator. tied to the current grant and no training has been conducted during this reporting period. Last training for 382 county level staff took place in Qr.4. Further work plan and budget do not show any allocation for such an activity for this Qr.

while it has a budget but for Qr.8 only. PR has included the 264 trained under the National Program with government funding in reporting the results based on GFATM's agreement to change the targets from "tied to current grant" to "tied to national program" (Enkhjin e-mail of 13 Dec. 2011 refers). If considering that GFATM has agreed to change the target to be "tied to the national program", it is acceptable that PR has included the number of participants (264) trained under the routine national program. In such a case, the target achievement would be 113% (646/570).

Of the 6 Top 10 indicators, 5 show achievement of target while 1 training indicator 5.1 as above mentioned is showing low achievement (67%) but indicator 5.1 has a target achievement of 113% if considering GFATM's agreement to change the nature of the target. Top 10 Indicators rating is A1 (101.5%) if considering the Indicator 5.1

achievement rate at 67% and the rating is still A1 (109%) if considering the Indicator 5.1 achievement rate at 113%. All Indicators rating is A2 (96%). The final quantative rating is A1, however the grant rating is downgraded to A2 owing to procurement delays and delays in the MDR-TB program start-up.

In light of the large cash balance available at PR level, a disbursement is not required against the forecast for this period.

Last Updated on: 26 January 2016

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31.Mar.12 B1 5 01.Apr.12 -

30.Sep.12 1,242,098 € 1,051,045 24 Aug 2012 Summary of Progress Reasons for variance between PR Request and Actual Disbursement Grant performance was very good in Period 6 with a

quantitative indicator rating of A1 and an average indicator performance of 103%. Detailed results and rating appear in the attached Grant Rating Tool for the same period.

At the end of Period 7 however, the quantitative indicator rating had gone down to B1 - mainly as a result of a "zero" achievement rate for Top-Ten indicator #4.2 "Number of MDR-TB cases initiated on MDR-TB treatment". While MDR-TB case detection had progressed in this period to reach the

anticipated target (25 cases or 100% achievement), delays in procurement of second-line drugs have caused delays in enrolment of same patients on treatment. However it is acknowledged that the transition period and unclarity in GLC-related requirements in the second half of 2011 were partially a cause for this delay.

On the other indicators, the results are satisfactory overall, with an average performance of indicators of 95% (all indicators). In particular, treatment success rate is 90% (106% achievement of target), and cases registered were 21,747/22,180 (98%). Progress on the refurbishment and equipment of microscopy centers was also made, although the results are still below target (85%).

The disbursement decision is based on the following calculations:

A: Forecasted carry-over activities and outstanding commitments from Q1- Q7 (ending March 2012): 5,811,982 EUR

B: Approved budget for April-Sept 2012 = Q8 (219,443) +Q9 (2,775,082 EUR) = total 2,994,525 EUR

C: PR cash balance: 7,755,462 EUR

Equals A + B - C = 5,811,982 + 2,994,525 - 7,755,462 = 1,051,045 EUR

Disbursement Date 8 01.Apr.12 -

30.Jun.12 A1 6 01.Jul.12 -

31.Dec.12 5,396,247 $ 5,519,029 06 Dec 2012 Summary of Progress Reasons for variance between PR Request and Actual Disbursement The overall performance during the reporting period

was excellent. The results for Y2 for the two impact indicators are not yet available - the WHO Global TB Report 2012 has not been published yet. All the targets for the three outcome indicators are met or exceeded. Out of 13 output indicators, 10 have nearly met, met or exceeded their intended targets, 3 have achieved 74%, 84% and 89% (Number of lab- confirmed MDR-TB patients detected,

Number of MDR-TB patients initiated on MDR-TB treatment, and Number of fully functional microscopy centers in place). The performance of the MDR-TB treatment indicator could have been better if not for the problems with quality of an MDR-TB medicine (Cycloserine), which was found to have irregularities when QA/QC was conducted by the PR at a qualified lab. A certain batch of these drugs had to be replaced, and the replacement shipment arrived at the very end of this reporting period (on 25 June 2012).

The PR included an amount of 432,967 as a recovery fee from the catch- up activities (funds that are allready at the PR's bank account and are charged the recovery fee of 7%), The GLC fee of 25,000 is not paid for the Year 2 of the grant. This is being added to the forecast. The GLC fee payment (for the Year 2 and Year 3) is made separately.