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Center for Population, Health and Nutrition
>> Return to Home Page >> Central Programs >> Global Programs >> Population, Health and Nutrition ACTIVITY DATA SHEET
PROGRAM: Central Programs
TITLE AND NUMBER: Increased use of effective interventions to reduce the threat of infectious diseases of a major public health importance, 936-005
STATUS: Continuing
PLANNED FY 2001 OBLIGATIONS AND FUNDING SOURCE: $38,416,000 DA
PROPOSED FY 2002 OBLIGATIONS AND FUNDING SOURCE: $38,400,000 DA
INITIAL OBLIGATION: FY 1998; ESTIMATED COMPLETION DATE: ContinuingSummary: The Global Bureau's Center for Population, Health and Nutrition (the Center) addresses the threat of infectious diseases by working with its partners to prevent disease and strengthen existing health systems for prevention, treatment and control programs. The principal areas of emphasis are tuberculosis (TB), malaria, antimicrobial resistance, and surveillance.
The Center works in countries with a high infectious disease burden, to widen the use of proven cost-effective interventions. Examples of such efforts are the development and strengthening of country-level disease surveillance systems, operations research to identify, monitor, and mitigate the problems associated with drug resistance, and expanding coverage and improving the quality of TB and malaria control programs. Concurrently, the Center will continue its investments in developing new tools to prevent, diagnose, track, and treat infectious diseases such as TB and malaria while contributing to control initiatives such as the Stop TB and Roll Back Malaria movements with the World Health Organization (WHO) and other partners.
Key Results: The Center has developed a four-pronged approach to implement its infectious disease strategy. This includes: developing, testing, and disseminating new prevention and control measures; developing global strategies for diagnosis and treatment, and advocating for increased national resources; mobilizing and channeling demand at the individual, family, and community level; and improving the accessibility, quality, and effectiveness of preventive and therapeutic services.
Substantial progress was made by WHO during 2000 with USAID support in establishing a Global Antimicrobial resistance (AMR) Strategy. A draft strategy, prioritizing interventions recommended for resource constrained countries to combat antimicrobial resistance has been distributed widely and made available on the web for comment.
USAID support for the WHO sponsored Tuberculosis Diagnostics Initiative (TBDI) has already resulted in the establishment of a functioning specimen bank critical for diagnostic confirmation.
In partnership with the Centers for Disease Control and Prevention (CDC), malaria in pregnancy related efforts in Malawi have led to 75% of pregnant women routinely receiving at least one dose of the antimalarial drug SP during pregnancy, and 30% at least two doses. This has resulted in a reduction in low birthweight babies from 32% to 23%. Whereas Malawi boasts an exceptionally supportive policy environment, USAID is working to establish a "malaria and pregnancy" network to raise awareness and promote more effectively the need for more widespread access to intermittent treatment.
Under the G/PHN and ANE Bureau Mekong Regional Initiative, and in partnership with WHO regional offices, a regional drug resistance surveillance system has been established. This system includes 36 sentinel sites in the six Mekong countries for the routine and standardized monitoring of multidrug resistant malaria. A subset of these sites will also be used to test drug quality - given the high levels of counterfeit drugs in the region.
A critical area of work has been the integration of new information sources with traditional disease surveillance to improve the effectiveness and efficiency of interventions and prevention programs. In Eritrea the local national malaria control program staff are being taught to collect data on malaria prevalence and vector distribution and behavior in order to improve their understanding of malaria transmission patterns and help to select and implement interventions appropriate to local conditions. In Mozambique, USAID is introducing Geographic Information System techniques to map malaria cases in Maputo which will enable the Ministry of Health to target resources to neighborhoods of greatest need. The results are impressive and the government is now expanding the effort to five other urban centers in the country.
Performance and Prospects: G/PHN will continue to build on and expand partnerships, and support research & development of new methods and tools related to AMR, malaria, TB and surveillance. Concurrently, there will be an increased emphasis on field implementation based on operations research in the areas of AMR, TB and surveillance. For example, there will be an increased focus in AMR on the development of model programs in the field, with G/PHN actively engaging regional bureaus and Missions in order to include AMR interventions in on-going activities. G/PHN's surveillance portfolio will focus attention on the implementation needs of USAID-assisted countries at the local level. Still there are critical issues to overcome in the next year such as the need for countries to identify surveillance as an area for increased development as well as the need to integrate routine disease surveillance with vertical disease surveillance programs in a way which strengthens both.
In response to increased resources for malaria in FY 2001 and similar levels planned for FY 2002, G/PHN will continue to work in close collaboration with regional bureaus and mission colleagues to mount a strategically focused, high-impact effort in support of expanded malaria control activities. These expand efforts will complement ongoing malaria activities and will be focused largely in Africa, but also will include sub-regional efforts in South America and Southeast Asia.
In Tuberculosis, G/PHN will continue to work closely with regional bureaus and mission colleagues to expand programs in key countries, continue investments in global and regional partnerships, continue work in expanding a cadre of TB experts, and expand research investments. Our objective, at the country level, is to build the political commitment and local capacity to implement Directly Observed Therapy-Short Course (DOTS) programs effectively - including monitoring and reporting.
Possible Adjustments to Plan: No major changes in the Centers study approaches are planned at this time. However, adjustments will be made.
Other Donor Programs: Organizations such as WHO, CDC, National Institutes of Health (NIH), World Bank, U.K.'sDepartment for International Development, the Japan International Cooperation Agency, other bilateral donors, International Union Against Tuberculosis and Lung Disease, other NGOs and U.S. universities and research institutions are key partners for USAID in addressing infectious disease threats.
Principle Contractors, Grantees or Agencies: To undertake these activities, G/PHN provides support to: WHO, CDC, TB Coalition for Technical Assistance, International Clinical Epidemiology Network, Johns Hopkins University, Program for Appropriate Technology in Health, Management Sciences For Health, Abt Associates, University Research Corporation, Gorgas Memorial Institute, Academy for Educational Development, Group Africa, Quality Assurance Project, Walter Reed Army Institute of Research, the Naval Medical Research Institute, Global Health Council, Camp Dresser & McKee, NIH, U.S. Pharmacopoeia Convention, Inc.
Performance Measure Indicators:
Indicator FY97 (Actual) FY98 (Actual) FY99 (Actual) FY00 (Actual) FY01 (Plan) FY02 (Plan) Indicator 1: New and improved cost-effective interventions developed, field tested and disseminated: AMR NA 2 1 NA 1 2 Indicator 2 Development and adoption of a Global Action Plan for control of antimicrobial resistance NA NA See comments NA Dissemination of policies/guidelines NA Indicator 3: Development of the Stop TB Initiative NA NA This result has been approved NA NA NA Indicator 4: Number of countries which are collecting data relevant to their program needs in a timely manner NA NA NA 0 NA 2 Indicator Information
Indicator Level (S)or(IR) Unit of Measure Source Indicator Description Indicator 1: IR Number of new methods or diagnostics reaching development and/or field testing stage (numbers not cumulative) for: Malaria, AMR, TB PATH reports, other project reports TB and AMR: new clinical, laboratory, or community-based methods or new diagnostics to detect AMR for selected diseases. Malaria: Trials on the efficacy and usability of two new low-cost diagnostics Indicator 2: IR Number of partners and regions that have endorsed the Global Action Plan WHO and other project/partner reporting AMR global strategy developed, technical reviews conducted, action plan developed and endorsed by key partners (including WHO, the World Bank, UNICEF, USID, CDC) and global policies and guidelines disseminated. "Endorsement" means that key partners have been consulted and reached a consensus with respect to the content of the strategy and action plan. Indicator 3: IR Number of partners and regions that have endorsed the TB action plan WHO and other project/partner reporting The Stop TB Initiative aims to accelerate control of TB by greatly expanding the global coalition of partners working to control the disease, pushing TB higher on the international, political and health agendas, and increase significantly the investment in TB control. Indicator 4: IR Number of countries HPSS/INFACT reports U.S. Financing
(In thousands of dollars)
Obligations Expenditures Unliquidated Through September 30, 1999 250 DA 250 DA 0 DA 29,528 CSD 7,867 CSD 21,661 CSD 0 ESF 0 ESF 0 ESF 0 SEED 0 SEED 0 SEED 0 FSA 0 FSA 0 FSA 250 DFA 250 DFA 0 DFA Fiscal Year 2000 0 DA 0 DA 21,258 CSD 19,528 CSD 0 ESF 0 ESF 0 SEED 0 SEED 0 FSA 0 FSA 0 DFA 0 DFA Through September 30, 2000 250 DA 250 DA 0 DA 50,786 CSD 27,395 CSD 23,391 CSD 0 ESF 0 ESF 0 ESF 0 SEED 0 SEED 0 SEED 0 FSA 0 FSA 0 FSA 250 DFA 250 DFA 0 DFA Prior Year Unobligated Funds 0 DA 44 CSD 0 ESF 0 SEED 0 FSA 0 DFA Planned Fiscal Year 2001 NOA 0 DA 38,416 CSD 0 ESF 0 SEED 0 FSA 0 DFA Total Planned Fiscal Year 2001 0 DA 38,460 CSD 0 ESF 0 SEED 0 FSA 0 DFA Future Obligations Est. Total Cost Proposed Fiscal Year 2002 NOA 0 DA 0 DA 250 DA 38,400 CSD 15,729 CSD 143,375 CSD 0 ESF 0 ESF 0 ESF 0 SEED 0 SEED 0 SEED 0 FSA 0 FSA 0 FSA 0 DFA 0 DFA 250 DFA
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Last Updated on: May 29, 2002 |
