Environmental and Social Management Framework for Tanzania ...

(iii) a clear analysis of total financial needs, what other partners are doing, and
what the expected gap would be.
(iv) agreed to use one-third of the IDA country allocation to benefit from the twothirds
top up from regional funds.
1.2.1 Tanzania
The Ministry of Health and Social Welfare for mainland Tanzania oversees
laboratory services at referral and national levels and will have the overall
responsibility for the project. The 2009-2015 National Health Laboratory Strategic
Plan, prepared by the Diagnostic Services Section (DDS), aims at establishing
quality laboratory services at all levels in an effort to ensure equitable, gender
sensitive services, with an efficient and effective governance system and
establishing partnership with public and private laboratories. The plan was
developed in consultation with the national disease programs (e.g., TB, malaria), and
serves as a good framework for the project. The Laboratory Services group within
the DDS is responsible for managing the National Health Laboratory Quality
Assurance and Training Center, a new facility constructed by USG/PEPFAR, which
the government would like to develop into a regional training institute.
The Central Tuberculosis Reference Laboratory (CTRL), which will play a key role in
the regional project, heads the national TB laboratory network and will participate in
the proposed regional lab network. The reference laboratory is managed by the
National Tuberculosis and Leprosy Program and the National Institute for Medical
Research and physically located in the Central Pathology Laboratory at Muhimbili
Hospital. The current space is inadequate and instead of functioning as a public
health laboratory it responds more to the clinical needs of the hospital. The
reference laboratory is responsible for:
(i) performing acid-fast bacilli (AFB) smears,
(ii) Löwenstein-Jensen cultures, and drug susceptibility testing (DST);
(iii) maintaining AFB smear microscopy quality assurance;
(iv) conducting drug resistance surveillance (as the only public laboratory in
the country conducting drug sensitivity testing); and
(v) providing support for coordination, training, and operational research.
The National Institute for Medical Research, which will serve as a key center for
conducting operational research, collaborates closely with various stakeholders,
including the flagship Field Epidemiology Training Program, and the Medical
Research Centre within Muhimbili University of Health and Allied Sciences, which
will facilitate close links between training and research.
In Tanzania, the activities under the regional project will be carried out through the
institutions noted above. No new structures would be established for the proposed
project. The Health Sector Reform Secretariat, which manages the portion of the
Bank’s Health Sector Development Project (HSDP) that does not go through basket
financing, will have overall responsibility for coordinating the fiduciary aspects for the
proposed activities. A full time public health specialist will be recruited to coordinate
the activities under the regional project.
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