WEPE637 - Poster Exhibition
Lessons learned in transitioning the Track 1.0 program administered by the Health Resources and Services Administration (HRSA)
C. Hall, P. Chiliade, A.J. Oguntomilade, M. Burnet, G. Tidwell, J. Morales
HRSA, HIV/AIDS Bureau, Office of Global HIV/AIDS, Rockville, United States
Background: The PEPFAR-funded Track 1.0 program, initiated in 2004, directly supported antiretroviral therapy (ART) delivery to over 1.5 million patients in 13 resource-constrained countries through over 1,300 treatment sites and with a cumulative budget of over US$2 billion. This program, co-administered by the Centers for Disease Control and Prevention (CDC) and HRSA, was implemented by four US-based international partners (IPs). HRSA grantees were Catholic Relief Services (CRS)/AIDSRelief consortium and Harvard School of Public Health (HSPH). Since 2009 the Track 1.0 program has progressively transitioned to local partners (LPs) consistent with a Department of Health and Human Services mandate.
Methods: To identify lessons learned in transitioning this complex multi-country ART program from IPs to LPs, US Government (USG) staff directly involved with the transition of the program was interviewed and findings from an analysis of 16 LP capacity building assessments were used.
Results: For a successful transition of multi-site treatment programs from IPs to LPs support, there should be a focus on the following: transparent planning involving local governments; open and frequent communication with all stakeholders; early identification of LPs and assessment of their capacity; collaborative approach for LPs capacity building in particular in grant management-financial management and clinical-technical oversight; support to LPs in establishing a funding mechanism; progressive transition from the IPs to the LPs with reasonable timeline and benchmarks; retention of qualified human resource capacity within the transitioning program; and close coordination between USG agencies, in-country Government, IPs, and LPs.
Conclusions: The transition of the Track 1.0 ART program to LPs highlighted the importance of: local government involvement and country ownership at various levels (central, regional, district), open communication between stakeholders, detailed planning with realistic timelines, tailored technical assistance, coordination during the progressive transition of grant functions and site oversight, but above all keeping the welfare of the patients as the prime focus.
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