1. TFM Progress Update Malaria Tobgyel, Dy. Chief Programme Officer Vector-borne Disease Control 31st CCM meting, 28th August, 2015

2. Country: Bhutan Title of the Grant: Sustaining Malaria control and prevention in Bhutan Component: Malaria Grant No. BTN-708- G05-M Start Date: 1st July 2013 Total Funding $820, 766 Round: TFM Phase: Principal Recipient: Ministry of Health Report Period: from: 1 st July 2013 to: 30 th June 2015 Latest Rating: A1 Local Fund Agent: UNOPS Fund Portfolio Manager: Ms. Cristina Riboni Prepared by: VDCP/CCM Secretariat Report preparation date: 8 th August 2015 31st CCM meting, 28th August, 2015

3. Financial Management (Budget ) 31st CCM meting, 28th August, 2015 Approved budget vs Disbursement Year I: Approved budget: USD 6,60,499 Total disbursed: USD 4,05,271 % disbursed: 61% 30% was saving from LLIN procurement Year II Approved budget:USD1,60,267 Total Disbursed:USD 2,91,463 % disbursed: 182% 82% re-appropriated from saving budget Overall burnout rate: 85% Rest 15% saving from net procurement and HR Approved budget vs Disbursement Year I: Approved budget: USD 6,60,499 Total disbursed: USD 4,05,271 % disbursed: 61% 30% was saving from LLIN procurement Year II Approved budget:USD1,60,267 Total Disbursed:USD 2,91,463 % disbursed: 182% 82% re-appropriated from saving budget Overall burnout rate: 85% Rest 15% saving from net procurement and HR

4. Total Budget & Expenses 31st CCM meting, 28th August, 2015 GF disbursement: Year I Fund disbursed : USD 405271 Expenditures: USD 392617 Utilization rate: 97% Year II: Fund disbursed: USD291463 Expenditures: USD 270408 Utilization rate: 93% Overall Utilization rate: 95% GF disbursement: Year I Fund disbursed : USD 405271 Expenditures: USD 392617 Utilization rate: 97% Year II: Fund disbursed: USD291463 Expenditures: USD 270408 Utilization rate: 93% Overall Utilization rate: 95%

5. Objective wise Budget Vs actual Expenditures 31st CCM meting, 28th August, 2015 Objective I : Approved budget:USD 6,59,367 Expenditures: USD 369401 56% fund was saving from net procurement. Other two objectives: The expenditures were more than approved budget, due to new activities proposed from the saving budget from objective I and approved by CCM & GF Objective I : Approved budget:USD 6,59,367 Expenditures: USD 369401 56% fund was saving from net procurement. Other two objectives: The expenditures were more than approved budget, due to new activities proposed from the saving budget from objective I and approved by CCM & GF

6. Approved Budget & Expenditures as per Cost Category Cost Category Total budget for Y1+Y2 USD Total ExpendituresVariancesRemarks Human Resources49,200.00 41,342.09 7,857.91 Assistant Data manager resigned and we are not able to recruit in between for a duration of almost 1 yr. Technical Assistance0.00 47,782.01 (47,782.01) TA was recruited during NFM as requirement by the Global Fund. Budget proposed from saving fund. Training25,200.00 101,875.45 (76,675.45) Additional training programme were proposed from the saving budget of TFM year 1 Health Products and Health Equipment467,406.75 285,957.53 181,449.22 Saving budget from health product year 1, proposed for TA/M&E and Training Medicines and Pharmaceutical Products1,596.00 - Saving as we have enough medicine in stock due to drastic reduction of malaria cases in the country Procurement and Supply Management Costs158,318.95 43,329.46 114,989.49Saving from PSM year 1 & 2 Communication Materials36,000.00 32,922.65 3,077.35saving Monitoring and Evaluation60,004.00 86,959.65 (26,955.65) additional activities such as malaria elimination sensitization for districts Medical Officers and Labor screening in projects sites etc. Planning and Administration23,040.00 22,856.57 183.43saving 820,765.70663,025.41 157,740.29 31st CCM meting, 28th August, 2015

7. Last fund disbursement: Calendar days Expected (days) Actual (days) Days taken to submit final PU/DR to LFA 45 15 Days taken for disbursement to reach PR 45 40 Days taken for disbursement to reach SRs 0 0 Management Indicators

8. 31st CCM meting, 28th August, 2015

9. ComponentProducts Stock level expressed in months of treatment for all current patients Months of safety stock Difference between current stock and safety stock MALARIA ACT6.02.04.0 0 0.0 0 Management Indicators

10. Programmatic Indicators Year I: Planned for Mass distribution to risk population Total LLIN procured: 97,531 Total distributed: 101573 Achievement: 104% Year II: Planed for targeted population Total Procured: 10,000 Total distributed: 6833 Achievement: 68.33% (distribution on-going as and when required) Year I: Planned for Mass distribution to risk population Total LLIN procured: 97,531 Total distributed: 101573 Achievement: 104% Year II: Planed for targeted population Total Procured: 10,000 Total distributed: 6833 Achievement: 68.33% (distribution on-going as and when required) 31st CCM meting, 28th August, 2015 LLIN distribution

11. Year I: In Year I reporting period, 48 malaria cases were reported and here is no clinical malaria reported, so the achievement is 100% against the target of 95% in this reporting period. Year II: In year II, 54 malaria cases were reported and there was no clinical malaria reported, and the achievement is 100% Year I: In Year I reporting period, 48 malaria cases were reported and here is no clinical malaria reported, so the achievement is 100% against the target of 95% in this reporting period. Year II: In year II, 54 malaria cases were reported and there was no clinical malaria reported, and the achievement is 100% Percentage of confirmed malaria cases among all reported cases (clinical and confirmed cases 31st CCM meting, 28th August, 2015

12. Year I: In this reporting 48 malaria cases were diagnosed. 1 patient diagnosed at the project site was not treated as per the treatment guideline, the set target was not achieved. Year II: 54 malaria cases were reported and all were treated as per the Standard treatment protocol. Year I: In this reporting 48 malaria cases were diagnosed. 1 patient diagnosed at the project site was not treated as per the treatment guideline, the set target was not achieved. Year II: 54 malaria cases were reported and all were treated as per the Standard treatment protocol. 31st CCM meting, 28th August, 2015 Percentage of malaria cases treated as per national treatment guideline

13. Performance Indicators 31st CCM meting, 28th August, 2015 IndicatorsTargetAchieved 0% - 59%60% - 89%> 90% Comments Number of LLIN distributed to risk population 10,0006,83368% In this reporting period, the programme has procured 10,000 LLIN for the targeted population through VPP. The LLIn was received in the month of April, 2015 only, therefore we are not able to reach the distribution to all target risk population within these two months of distribution acheiving just 68%. The distribution is on going. Percentage of confirmed malaria cases among all reported cases (clinical and confimed cases) 95%100%105% There is no clinical malaria reported in this reporting period, so all the are confirmed cases showing the 100% Percentage of malaria cases treated as per national treatment guideline 100% In 2014 there were 54 malaria cases reported in the country from public health centers (50) and private screening facilities (4). All cases were either diagnosed through RDTs or microscopes. RDTs posstives were confirmed microscopically and were treated as per our treatment guidelines acheiving 100% as targeted. Number of CAG supported per year 3040133% This reporting period we are able to train and support the CAG's activities such as Technical support in work plan preparation, support in cleaning campaigns/ review meeting etc for 40 CAG groups Percentage of health facilities sending timely and complete report 22021598% out of 220 health centers in the country a215 health centers has reported through fax and telephone

14. Challenges/issues Policy challenges: Stringent donor & government rules (Procurement/ Financial policy). No clear cross border collaboration instituted on disease surveillance Financial Challenges Difficulties in getting fund balance for audit certification Fund balance of TFM Programmatic challenges: Difficult coordination of planned activities among stakeholders Less cooperation and participation from communities Policy challenges: Stringent donor & government rules (Procurement/ Financial policy). No clear cross border collaboration instituted on disease surveillance Financial Challenges Difficulties in getting fund balance for audit certification Fund balance of TFM Programmatic challenges: Difficult coordination of planned activities among stakeholders Less cooperation and participation from communities 31st CCM meting, 28th August, 2015