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Technical Assistance Consultant's Report

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Technical Assistance Consultant's Report Technical Assistance Consultant’s Report Project Number: 48118-002 June 2016 Cambodia, Lao People’s Democratic Republic, Myanmar, Viet Nam: Greater Mekong Subregion Health Security Project (Part 1/4) Prepared by Conseil Sante Clichy, France For Asian Development Bank This consultant’s report does not necessarily reflect the views of ADB or the Government concerned, and ADB and the Government cannot be held liable for its contents. All the views expressed herein may not be incorporated into the proposed project’s design. Greater Mekong Subregion Health Security Project ADB PPTA 8842 - REG HEALTH ANALYSIS 2016 For Asian Development Bank by Conseil Santé 1 TABLE OF CONTENTS Acronyms ..................................................................................................................................................... 2 I. INTRODUCTION ................................................................................................................................... 6 II. THE CHALLENGE ................................................................................................................................ 6 a. Global Health Threats ....................................................................................................................... 6 b. Public Health Security ..................................................................................................................... 10 III. GMS DEVELOPMENTS ................................................................................................................. 12 a. Economic Development .................................................................................................................. 12 b. Vulnerable Groups .......................................................................................................................... 15 c. Health Sector Trends ...................................................................................................................... 16 IV. GMS HEALTH SECURITY ............................................................................................................. 18 a. Reported Infectious Diseases ......................................................................................................... 18 b. Public Health Security Performance ............................................................................................... 19 c. Legislation and Coordination ........................................................................................................... 21 d. Surveillance and Response ............................................................................................................ 22 e. Laboratory services ......................................................................................................................... 29 f. Infection Prevention and Control ..................................................................................................... 30 g. CDC in Border Areas ...................................................................................................................... 33 h. Regional Cooperation ..................................................................................................................... 35 V. DISEASE CONTROL PROGRAMS ................................................................................................... 36 a. HIV/AIDS ......................................................................................................................................... 36 b. Tuberculosis .................................................................................................................................... 38 c. Malaria ............................................................................................................................................. 39 d. Dengue ............................................................................................................................................ 41 e. Childhood infections ........................................................................................................................ 42 f. Other infectious diseases ................................................................................................................ 44 VI. HEALTH SYSTEM ISSUES ............................................................................................................ 44 a. Sector Coverage ............................................................................................................................. 44 b. Quality of Care ................................................................................................................................ 45 c. Governance ..................................................................................................................................... 46 d. Financing ......................................................................................................................................... 48 e. Monitoring ........................................................................................................................................ 51 VII DEVELOPMENT COORDINATION................................................................................................ 52 a. External Assistance ......................................................................................................................... 52 b. Aid Coordination .............................................................................................................................. 55 c. ADB Performance ........................................................................................................................... 55 VIII. PROJECT DESIGN ........................................................................................................................ 57 a. Project Outline ................................................................................................................................. 57 b. Discussion ....................................................................................................................................... 58 c. Justification ...................................................................................................................................... 59 IX. CONCLUSIONS AND RECOMMENDATIONS .............................................................................. 66 a. Conclusions ..................................................................................................................................... 66 b. Recommendations .......................................................................................................................... 68 c. Further Work ................................................................................................................................... 68 Appendix 1: Problem Tree ........................................................................................................................ 71 Appendix 2: Surveillance and Response Issues and Options in CLMV countries ............................ 72 Appendix 3: Laboratory Services Issues and Options in CLMV countries ......................................... 74 Appendix 4: Public Health Security Issues addressed by Proposed Project ..................................... 76 Appendix 5: Sector Results Framework ................................................................................................. 78 Appendix 6: Major Development Partners .............................................................................................. 79 Appendix 7: GMS Health Security Project Target Locations and Populations .................................. 81 2 Acronyms ADB Asian Development Bank ADF Asian development fund AIDS acquired immunodeficiency syndrome APLMA Asia Pacific Leaders Malaria Alliance APSED Asia Pacific strategy for emerging diseases ART anti-retroviral treatment ASEAN Association of South East Asian Nations ARI acute respiratory infection BOD burden of diseases CDC communicable disease control CDCD Communicable Diseases Control Department (MOH Cambodia) CEU Central Epidemiology Unit (MOH Myanmar) CLMV Cambodia, Laos, Myanmar, Viet Nam COP community of practice CPS country partnership strategy DCDC Department of Communicable Diseases Control (MOH Laos) DMF design and monitoring framework DOTS direct observed treatment – short course DPIC Department of Planning and International Cooperation, MOH Laos EGDP ethnic group development plan EGM effective gender mainstreaming EHF Ebola hemorrhagic fever EID emerging infectious diseases EIRR economic internal rate of return EMG ethnic minority group EOC operation center for prevention and control of diseases EPI expanded program on immunization EWARN early warning and response network FETP field epidemiology training program FMA financial management assessment FSW female sex workers GDP gross domestic product GAP gender action plan GDPM General Department of Preventive Medicine GFHTM Global Fund to Fight HIV/AIDS, Tuberculosis, and Malaria GHE government health expenditure DHC Department of Health Care (MOH Laos) DHIS Department of Planning and Health Information Systems (MOH Cambodia) DHS Department of Hospital Services (Cambodia) DMS Department of Medical Services, MOH Myanmar DPH Department of Public Health, MOH Myanmar GMS Greater Mekong Subregion HFMD hand, foot and mouth disease HIV human immunodeficiency virus HIS health information
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