Successful GFGC7 Grant Proposal enhanced TB diagnostic capabilities and fast transition to the latest MDR TB Regimen in Ghana
In Ghana, the TB program faces significant challenges due to limited external support and underfunding. The National TB Program (NTP) receives minimal attention in Country Coordinating Mechanism (CCM) meetings, with the Global Fund being the primary external donor. The TB program's strategic plan is severely underfunded, receiving less than 40% of the required $30,000,000 annually, with current funding at less than $7,000,000 per year. This funding shortfall hampers the program’s ability to find and treat missing TB cases effectively. Additionally, targets set for the NTP are misaligned with available resources, negatively impacting grant implementation performance.
To address these challenges, the LEAP Local program, supported by USAID and led by Genesis Analytics, embedded a Senior Technical Advisor focusing on TB and Global Fund grant management within Ghana's NTP. The advisor led the development of a highly successful Grant Cycle 7 (GC7) grant proposal, securing approval for direct grant-making at the first submission to the Global Fund Technical Review Panel (TRP). The TA managed the integrated country proposal request for TB, HIV, and Resilient and Sustainable Systems for Health (RSSH), creating the Google document, and acting as the administrator. Additionally, the advisor facilitated Ghana's adoption and implementation of the latest World Health Organization (WHO) recommended MDR-TB treatment regimens, including the BPaL regimen for Extensively Drug Resistant TB (XDR-TB). The advisor supported the design and implementation of a sputum sample referral network linking 1,000 peripheral facilities to 169 GeneXpert testing sites, improving access to GeneXpert testing for over 90% of outpatient department (OPD) attendees. Efforts were also made to ensure universal access to GeneXpert testing as the first line of diagnostic testing for TB, with continuous support for the deployment of GeneXpert machines and updating policy guidelines. In response to the COVID-19 pandemic, the advisor helped write the COVID-19 mitigation plan and TB grant documents, introducing key interventions like bidirectional screening and testing for TB and COVID-19, integrated sample transport and uninterrupted supply of laboratory commodities leading to significant improvements in case notifications.
These concerted efforts led to significant improvements. The GC7 grant proposal was approved at the first submission, ensuring critical funding for the TB program. The adoption of the latest MDR-TB treatment regimens allowed for the timely implementation of WHO recommendations. The strengthened sputum sample transport network and universal access to molecular testing significantly enhanced TB diagnostic capabilities across Ghana. The effective COVID-19 mitigation strategies led to a substantial increase in TB case notifications, demonstrating the resilience and adaptability of the TB program.
“COVID-19 was a threat as well as an opportunity for the TB program, which brought new lessons and opportunities” – Ghana 2023 TB and HIV Midterm Programme Review Team
The LEAP Local initiative has demonstrated the profound impact of strategic technical support and innovative approaches on national health programs. By securing vital funding through the successful GC7 grant proposal and enhancing TB diagnostic processes, the initiative has addressed immediate challenges and laid a sustainable foundation for ongoing improvements in TB management. These efforts have not only strengthened Ghana’s capacity to detect and treat TB but have also built a more resilient health system capable of adapting to future challenges. This comprehensive approach ensures a brighter future for TB control in Ghana, contributing significantly to global TB eradication efforts.
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