Pan American Health Organization's
Proposed Contribution to the|
United States Agency for International Development (USAID) /
Latin America and Caribbean Bureau's
Amazon Malaria Initiative (AMI):
Project Proposal and Workplans for Years 2 & 3
Funds provided by USAID to date have greatly contributed to the development and strengthening of a regional network a regional network for surveillance of antimalarial drug resistance. National surveillance networks were established in each target country to assess the efficacy of antimalarial drugs. In addition, studies of efficacy of malarial drugs for P. falciparum were initiated and studies of P. vivax drug resistance were contemplated in few countries.
The AMI includes three intermediate results:
This proposal describes the activities and related budget for the AMI project to be implemented over a two-year period and to be completed by 30 September 2004. The proposed budget for USAID funding is US $1,644,000 and US $1,065,000 for fiscal years 2002 and 2003 respectively, for a total of $2,709,000.
During AMI's second and third years, work initiated in the first year will continue with the aim of concluding drug resistance studies and providing an evidence base to support processes of ratification/reform of national malaria-treatment policies.
PAHO will continue to coordinate and monitor the implementation of the project as a whole, while providing technical cooperation to the target countries. During these two years the project will focus on completing malaria drug efficacy studies, assisting in data analysis and evaluation of alternative treatments, and on revising malaria-treatment policy (for non-complicated P. falciparum). As new treatment policies are adopted, PAHO will assist countries to plan and implement the new treatment policies, and to implement effectiveness studies to monitor the implementation of new treatment regimens. Operations research, training, and South-South activities will also be undertaken. Below are the proposed activities, by intermediate result.
IR1: Reliable and Standardized Malaria Drug-Resistance Information Available
IR2: Tools or Approaches Developed and/or Adapted, Tested and Disseminated
IR3: Partnerships to Improve Malaria Control Enhanced
PAHO will continue to use the jointly agreed upon indicators and targets to measure progress and impact of the program. Initiative-level indicators will be collected and reported in the annual report.
The coordination of AMI will be carried out through a Steering Committee with representatives of the financing agency (USAID), of PAHO, the CDC, and new partners RPM Plus (Rational Pharmaceutical Management Plus Program) and USPDQI (United States Pharmacopeia Convention Drug Quality and Information). The Committee aims to facilitate coordination and information sharing between AMI partners, and serves as a mechanism for discussion of technical issues.
The National Coordination Committees will coordinate, guide and support AMI activities at the country level, with inclusion of the focal points of PAHO, including the countries where the project is executed by USAID missions (Bolivia and Peru).
PAHO staff taking part in this project, under the direction of Dr. Renato Gusmão, Chief, Communicable Diseases Control Unit:
At country level, PAHO staff from Regional Office in Brazil, Colombia, Ecuador, Guyana, Suriname, and Venezuela will provide technical cooperation supporting the national project coordinators and Coordination National Committee in executing project activities. In Bolivia and Peru coordination of efforts will be provided by the USAID offices, with collaboration of PAHO staff.
PAHO staff from the Regional Office involved in the project:
The proposed second- and third-year budget for PAHO's proposal for USAID funding is US$ 1,644,000 and US$ 1,065,000 respectively for a total budget of $2,709,000.
PAHO will provide $390,000 total (FY 2002, $240,000 and FY 2003, $150,000) in direct contribution to malaria activities, in addition to approximately $531,000 in staff salary support ($265,500 for each year). The FY 2002 and FY 2003 budget provided by USAID and PAHO combined amounts to $2,149,500 and $1,480,500 respectively, for a total budget of $3,630,000.
Rational Pharmaceutical Management (RPM) Plus
The long-term strategy of RPM Plus is to strengthen the ability of policy-makers, health-care providers and institutions in the region to improve drug management. At the same time, RPM Plus plans to work with its partners, international health care organizations, and national and local health officials to develop policies and strategies to improve the treatment of infectious diseases. Through the USAID-funded LAC Amazon Malaria Initiative (AMI), RPM Plus will be working with the Pan American Health Organization (PAHO), CDC, USP-DQI, USAID/Peru, USAID/Bolivia, and other local mission officers to effectively develop and implement strategies to improve malaria drug management in the region. These activities will also contribute to the accomplishment of the Regional Bureau for Latin America and Caribbean's Strategic Objective: "More Effective Delivery of Selected Health Services and Policy Interventions."
Technical Objective 1: Strengthen Health Systems for the Appropriate Drug Management of Malaria in the LAC Region.
The role of RPM Plus will be to ensure that drug management for malaria is properly addressed to enhance effectiveness of the initiative activities. RPM Plus will participate on the AMI Steering Committee meetings. The data collection instrument developed with USAID BGH funds to assess malaria drug use at the community level will be tailored to the needs of the initiative partners and translated into Spanish to be used in the region. The tool will be field tested through funds provided by other partners for country activities. RPM Plus will participate in the training of country personnel to use the tool as well as to analyze the data collected.
Depending on availability of funds, RPM Plus will also adapt and translate into Spanish a module on drug management for malaria. This module may be incorporated to other training tools that initiative partners' have already developed.
RPM Plus activities in this area will contribute to the SO-level statement of AMI: "Malaria control programs in the Amazon Basin sub-region substantially incorporate selected best practices". RPM Plus participation will contribute to the achievement of the following intermediate objectives:
IR-2: Tools and Approaches Developed, Adapted, Tested and/or Disseminated
RPM Plus with funds from BGH is preparing materials for a training course on drug management for malaria. With funds from LAC/RSD RPM Plus will adapt and translate this module to be used in the LAC region. The materials will be ready for individual countries to use during training activities, and for future AMI training workshops at the sub-regional level.
In collaboration with CDC and the local AMI team the data collection instrument developed with USAID BGH funds to assess malaria drug use at the community level will be tailored to the need of the initiative partners and translated to be used in the region.
RPM Plus will provide training to local personnel in the country where the activity will take place. Coordination has been established with the Peru AMI team to conduct this activity.
RPM Plus will work with country counterparts to analyze the data and modify the tool according to results of the field test.
2. Adaptation and Translation of a Module on Drug Management for Malaria
RPM Plus with funds from BGH will prepare a module addressing the main aspects of drug management for malaria programs. With funds from LAC/RSD RPM Plus will adapt and translate this module to be used in the LAC region.
IR-3 Partnerships to Improve Malaria Control in the Subregion Enhanced
This activity includes technical activity coordination, workplan development, budget monitoring, progress monitoring, reporting, meetings, and communications with partners and collaborators.
RPM Plus will participate on technical meetings with other members of the initiative. It is expected that the AMI Steering Committee will meet at least once during the current FY. Funds will also be allocated to attend a Technical Coordination Meeting with national managers from participant countries.
US Pharmaceuticals, Drug Quality & Information (USP-DQI)
To strengthen antimalarial drug-quality assurance in the Amazon region in order to increase treatment efficacy, reduce antimalarial drug resistance, and maximize the use of health care resources for malaria.
USP-DQI proposes to initially begin in two sites selected by the AMI partner organizations in each of the selected countries. USP-DQI will assess capacity at the site, i.e. human resources, lab equipment, communications equipment, etc., and work with the NMP to identify specific people to be trained. It is anticipated that staff at four sites will be trained this fiscal year. Training modules will be based upon working currently ongoing in Africa and Asia.
The country(s) must have the following:
About RAVREDA-AMI | Project Proposal Year One (2002)