Evaluation of the Tuberculosis Control Assistance Program (TB CAP)

The TB CAP CTO seems to have provided helpful, beneficial, direct oversight and not obstructedprogress with unexpected requests. Several interviewees commented that the CTO rapidly intervenedupon request and effectively removed obstacles, such as when delays occurred at Missions.Several interviewees had a perception that the line between KNCV and the PMU was occasionallyblurred and that the PMU did not always support the interests of all partners equally, although no clearevidence was found to support this.What the PMU does to ensure effective, appropriate workplan development is unclear. Some workplansincluded activities that seemed unrealistic given the workplan timeframe. There are debilitating delays inthe process of drafting and approving country workplans. These delays do not seem to be the result ofbottlenecks in the PMU, and the PMU seems to react quickly to address them, but it does not seem tohave a system for routinely monitoring the steps in workplan development and approval against expectedlead times in order to identify and address such delays before they become critical.RecommendationsThe PMU should clarify its role in the development of workplans and consistently adhere to thedefinition. If it is to be responsible for pre-planning workplans before a coordinating partner isselected, this should always be the case, and potential coordinating partners should not be involved. Ifit is to be responsible for ensuring the technical quality and strategic relevance of workplans, this tooshould be done consistently, and the criteria should be clearly communicated to partners in advance.If it is to delegate all responsibility for workplan preparation, it should not participate at all andinstead should consistently seek partners to conduct this work.The PMU should establish a system for registering potential new core and country projects in a Webbasedsystem accessible to all partners and set out a standardized process for workplan development,approval, and implementation. It should also take responsibility for updating this system with thedates when events occur, so that it will be possible to quickly and easily identify projects at differentstages of development and flag those that may need intervention. Such a process would also facilitategeneral reporting and, if financial details were included, make financial tracking more accurate andtimely. There are several Web-based procurement systems upon which to model such a system.Financial ManagementAlthough the financial management of TB CAP was reviewed, a formal detailed audit was considered notto be within the scope of the evaluation. Based on the first two annual independent audits of TB CAP (athird audit is pending), however, it appears that KNCV has fairly represented its work in its officialannual financial statement to USAID and its cost-share statement, and is compliant with the financialrequirements in the KNCV/USAID cooperative agreements. The auditors noted no matters involvingfinancial control and operation that they considered to be material weaknesses. Furthermore, KNCVseems to have responded to many of the changes suggested by the auditors and indicating a readiness toimprove performance even when improvements were not mandatory.The cooperative agreement between USAID and TB CAP has a 17.8% cost share over the course of theentire project. In the first three years of TB CAP, the cost share far exceeded this (approximately 50%).However, the bulk of it is provided by a subset of partners.The PMU maintains a stockpile of money (similar to a vaccine buffer stock) from which it reimbursespartners upon request. It then requests USAID/ Washington to replenish the stock. The amount offinancing required at any given time, however, is not based on any systematic planning of expected futurepayments to be made. As a result, the stockpile has at times been higher than the amount planned(US$500,000 minimum).10 EVALUATION OF THE TUBERCULOSIS CONTROL ASSISTANCE PROGRAM (TB CAP)