Rwanda Roadmap to Achieve RBM Targets September 2009 – December 2010

Country Summary InterventionUnits usedNeed to 2010Already covered Funded and expected to be distributed before end 2010 Gap LLINs (Universal Access – avg 1 net for 2 pp) Nets6,035,6824,822,1841,213, targets will be achieved ACTsTreatments6,596, targets will be achieved RDTsNumber of tests1,147, targets will be achieved IPTpWomen to be treatedRevision of the policy NA IRSFinancial / USD5,157,1472,525,0002,632,143 M&EFinancial / USD 15,253,6287, 626,814 BCC/IECFinancial / USD 8,808, targets will be achieved Human Resources (incl Capacity Bldg as training) Financial / USD 1,588, 562 Population at risk: Please include ALL GF grants (new rounds, Ph II, RCC, etc) under negotiation (*) Please indicate if a grant is under negotiation

LLIN resources available to achieve the 2010 targets FUNDS AVAILABLE (US $)SOURCECOMMENT 5,272,199R5The process of the tender is on going 35,076,654R8The process of the tender is on going 2,000,000USAID/PMIMOP 09 Early funding allocated (For children<5 and routine distribution) 2,896,000USAID/PMIMOP 09 funding obligated not allocated yet (For children<5 and routine distribution) 300,000USAID/PEPFA R COP 09 funding obligated not allocate yet (for PLWHA) (*) Please indicate if funds are under negotiation

LLIN Ordering & Distribution to end 2010 Quantities (same as summary)4,628,743 (1,601,101 for U5 and 1,814,144 for HH,HF and BS;1,213,498( ANC,EPI and HH) Procurement datesTender is in process Expected deliveryDecember 2009, May 2010 Planned Campaign Date (if applicable) January 2010 and june 2010 BCC / IEC (dates, types)BCC strategy will be available in December 2009 (Drama, TV scketches, Radio spots, radio songs, fat promotion materials, MVU sessions,billboards) every month before the mass compain during six month Community mobilization (dates, types) Sensitization of opinion leaders, seensitization meetings on prevention and LLINS distribution before the mass campain Distribution (locations, dates, quantities, etc.) During the campaign (1,663,531 LLIN for U5 and 1,814,144 LLIN for HH), during ANC and EPI services( 1,213,498 LLIN) Distribution mechanisms (routine, integrated or stand alone campaign, house to house etc.) Routine, integrated or stand alone campaign, house to house Monitoring and evaluation (dates of surveys, types, etc.) District monthly reports, MIS 2009, DHS 2010, HH visits by CHW in 2010

ACT resources available to achieve the 2010 targets FUNDS AVAILABLE (US $) SOURCECOMMENT 3,665,910R5 GF AMFm proposal on going 34,932RCC of R3/GFAMFm proposal on going

Case management ACTs required (Quantity = same as summary. Please explain how calculated) 3,359,634 doses for the public and the private sector in 2009; 3,237,141 doses for the public and the private sector in 2010 For the public sector the calculation is based on the consumption and the annual growth of the population of 2,8% RDTs required (Quantity & please explain how calculated)1,147,625 Considering that 1/5 of children U5 will be treated at the community level and considering also the fact that the country will have a reduction of malaria morbidity of 20% in 2009 and 30% in 2010 Procurement schedulesOctober 2009 and october 2010 BCC / IEC (dates, types)BCC strategy will be available in December 2009(Drama, TV scketches, Radio spots, radio songs, fat promotion materials, MVU sessions,billboards, production of guidelines) Sensibilisation of health care providers, CHW on case managment Distribution MechanismsThrought district pharamacies and health facilities Drug Efficacy Monitoring (dates, how)Survey of side effect due to ACT July 2010 ACTs treatment observance May 2010 Efficacy of ACT treatment July 2011 Monitoring and evaluation (dates, types) Monthly district reports on number of cases tested and cases treated Quarterly end –use assessment QuarterlyHealth facilities assessment

Indoor Residual Spraying Total Households targeted 291,000 DDT required (quantities) 8000 kg deltamethrine/24000 kg lambdacyalothrine Pyrethroids required (quantities) 7000 kg deltamethrine/22000 kg lambdacyalothrine Procurement schedules November 2009, may 2010 Distribution (Locations) December 2009, July 2010 Training (dates) December 2009-march2010, august-october 2010 BCC / IEC (dates, types) December 09-march2010, august-october2010 Spraying (dates, locations) January-March 2010, August-October 2010 Monitoring and evaluation (bioassays, insecticide resistance etc) Bioessay survey, Supervision of the spraying Post evaluation meetings

Intermittent Preventive Therapy Number of Pregnant women targeted Policy in review SP doses requiredPolicy in review Procurement schedulesPolicy in review Distribution modalities (ANC, etc.) Policy in review TrainingPolicy in review BCC / IEC (dates, types) Policy in review Monitoring and evaluationPolicy in review

Other core interventions to be delivered by the end of 2010 Intervention (description)Dates IRS: cross border interventions Community based management (extension in six district) Review of malaria strategic plan2010 Development of malaria strategic plan 2010 Epidemic prepardness IPT: change of policy2010 Home management of malaria: testing, quality control/assurance, reporting BCC campaign

Summary of rate-limiting factors over the next 17 months ProblemsSolutions Delays in disbursements of fundsTo provide the request for funds on time and ensure that funds are used properly Procurement delaysTo elaborate a procurement plan taking in account the procurement procedures and related deadline, to implement it and monitor it at all level Availability of commodities on the marketTo have updated information on different products and services to be procured and change strategy accordingly Staff attrition and retentionGouverment provide incentive in oder to motivate and maintain staff in differents services. Change in morbidity of malariaMinistry of Health maintains oversight controlling malaria activities and improve his monitoring and evaluation system Donor confidenceMaintain good relations with partners and respect signed protocols

Summary of technical assistance needs over the next 17 months NeedsDatesDurationPartner End –use verification of antimalarial drugs Oct-093 monthsUSAID/Deliver BCC strategy Oct-091 monthWHO/JHU/PMI/GF Need assessment/Programme review Nov-092 month WHO Support of drug quality assurance Dec-09 2 weeksCDC Surveillance of MIP Apr-10 1 weekCDC Assessment of RDT on the community level Sep-09 2 weeksMSH Environmental Compliance Sep-09 2 weeks RTI Vector Control Strategy Feb-10 3 weeks GF PCR/Elisa Technical Lab Mar-10 2 weeks GF MIS Oct-10 4 months WHO/NISR/PMI HFS Sep-10 2 month WHO/Tulane university/NISR DHS Feb-10 6 months Macro/NISR/MOH