47045-NPL-Z-MOH-1 The Global Fund to Fight AIDS, Tuberculosis and Malaria Nepal, Multicomponent, Ministry of Health and Food Safety of Nepal Goals: Accelerate Nepal's HIV response to achieve zero new infections, zero AIDS-related deaths, and eliminate HIV inequalities by 2030, as per NHSP 2021-2026; Nepal has set a goal to decrease incidence rate from 238 in 2020/21 to 181 per 100,000 population by 2025/26; decrease mortality rate from 58 in 2020/21 to 23 per 100,000 by 2025/26; end TB epidemic by 2035; eliminate TB by 2050; and reduce the catastrophic cost to zero; Reduce the indigenous malaria cases to zero by 2026 and sustain thereafter; Sustain zero malaria mortality. Objectives: Increase access to people-centered services across the HIV prevention and care continuum; Optimize health outcomes for people living with HIV and key populations; Strengthen community and health system resilience to reduce barriers to HIV prevention, treatment and care; To build and strengthen political commitment, sustainability and patient-friendly health system to end TB; To ensure the identification of TB, diagnosis, quality treatment and prevention; To ensure proportional and equitable access to quality assured diagnosis and treatment in health facilities as per federal structure and implement effective preventive measures to achieve malaria elimination. The Global Fund to Fight AIDS, Tuberculosis and Malaria Ministry of Health and Food Safety of Nepal Ministry of Health and Food Safety of Nepal The Global Fund to Fight AIDS, Tuberculosis and Malaria The Global Fund to Fight AIDS, Tuberculosis and Malaria Communications +41 58 791 1700 website@theglobalfund.org https://www.theglobalfund.org The Global Fund to Fight AIDS, Tuberculosis and Malaria, Global Health Campus, Chemin du Pommier 40, 1218 Grand-Saconnex, Geneva, Switzerland The Global Fund to Fight AIDS, Tuberculosis and Malaria Grant Management Division Manab Basnet Fund Portfolio Manager +41 58 791 1700 manab.basnet@theglobalfund.org https://www.theglobalfund.org The Global Fund to Fight AIDS, Tuberculosis and Malaria, Global Health Campus, Chemin du Pommier 40, 1218 Grand-Saconnex, Geneva, Switzerland Nepal Multicomponent, RSSH Malaria HIV Tuberculosis Ensure healthy lives and promote well-being for all at all ages End the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases, and combat hepatitis, water-borne diseases and other communicable diseases Achieve universal health coverage HIV -> Prevention package for other vulnerable populations (OVP) -> HIV prevention communication, information and demand creation for OVP HIV -> Reducing human rights-related barriers to HIV/TB services -> Eliminating stigma and discrimination in all settings HIV -> Reducing human rights-related barriers to HIV/TB services -> Ensuring nondiscriminatory provision of health care HIV -> Treatment, care and support -> HIV treatment and differentiated service delivery - adults (15 and above) Malaria -> Case management -> Facility-based treatment Malaria -> Case management -> Integrated community case management (iCCM) Malaria -> Case management -> Intensified activities for elimination Malaria -> Case management -> Therapeutic efficacy surveillance Malaria -> Vector control -> Entomological monitoring Malaria -> Vector control -> Indoor residual spraying (IRS) Malaria -> Vector control -> Insecticide treated nets (ITNs) - Mass campaign: universal Multicomponent -> Program management -> Coordination and management of national disease control programs Multicomponent -> Program management -> Grant management RSSH -> RSSH/PP: Laboratory systems (including national and peripheral) -> RSSH/PP: Biosafety and biosecurity, infrastructure and equipment RSSH -> RSSH/PP: Laboratory systems (including national and peripheral) -> RSSH/PP: Laboratory Information systems RSSH -> RSSH/PP: Laboratory systems (including national and peripheral) -> RSSH/PP: National laboratory governance and management structures RSSH -> RSSH/PP: Laboratory systems (including national and peripheral) -> RSSH/PP: Quality management systems and accreditation RSSH -> RSSH/PP: Laboratory systems (including national and peripheral) -> RSSH/PP: Specimen referral and transport system RSSH -> RSSH: Community systems strengthening -> Community-led monitoring RSSH -> RSSH: Health financing systems -> Health financing strategies and planning RSSH -> RSSH: Health financing systems -> Routine financial management systems RSSH -> RSSH: Health financing systems -> Social contracting RSSH -> RSSH: Health products management systems -> Planning and procurement capacity RSSH -> RSSH: Health products management systems -> Supply chain information systems RSSH -> RSSH: Monitoring and evaluation systems -> Analyses, evaluations, reviews and data use RSSH -> RSSH: Monitoring and evaluation systems -> Data quality RSSH -> RSSH: Monitoring and evaluation systems -> RSSH/PP: Surveillance for priority epidemic-prone diseases and events RSSH -> RSSH: Monitoring and evaluation systems -> Routine reporting RSSH -> RSSH: Monitoring and evaluation systems -> Surveillance for HIV, tuberculosis and malaria Tuberculosis -> Collaboration with other providers and sectors -> Collaboration with other programs/sectors Tuberculosis -> Collaboration with other providers and sectors -> Private provider engagement in TB/DR-TB care Tuberculosis -> Drug-resistant (DR)-TB diagnosis, treatment and care -> DR-TB treatment, care and support Tuberculosis -> Key and vulnerable populations (KVP) - TB/DR-TB -> KVP - Children and adolescents Tuberculosis -> Key and vulnerable populations (KVP) - TB/DR-TB -> KVP - People in prisons/jails/detention centers Tuberculosis -> TB/DR-TB Prevention -> Preventive treatment Tuberculosis -> TB/DR-TB Prevention -> Screening/testing for TB infection Tuberculosis -> TB/HIV -> TB/HIV - Collaborative interventions 1384957.15 1524243.95 1594859.00 Global Fund commitment to NPL-Z-MOHP01. The Global Fund to Fight AIDS, Tuberculosis and Malaria Ministry of Health and Food Safety of Nepal 410459.00 Global Fund disbursement to NPL-Z-MOHP01 (Government). The Global Fund to Fight AIDS, Tuberculosis and Malaria Ministry of Health and Food Safety of Nepal 390000.00 Global Fund disbursement to NPL-Z-MOHP01 (Government). The Global Fund to Fight AIDS, Tuberculosis and Malaria Ministry of Health and Food Safety of Nepal 794400.00 Global Fund disbursement to NPL-Z-MOHP01 (Government). The Global Fund to Fight AIDS, Tuberculosis and Malaria Ministry of Health and Food Safety of Nepal 765119.00 Global Fund commitment to NPL-Z-MOHP01. The Global Fund to Fight AIDS, Tuberculosis and Malaria Ministry of Health and Food Safety of Nepal 765119.00 Global Fund disbursement to NPL-Z-MOHP01 (Government). The Global Fund to Fight AIDS, Tuberculosis and Malaria Ministry of Health and Food Safety of Nepal An overview of a grant over its lifetime. General terms and conditions which apply to Global Fund grants. Funding Request of funding request FR1426-NPL-T. Funding Request of funding request FR1427-NPL-M. Funding Request of funding request FR1425-NPL-H. 1 - Training Plan Prior to the use of Grant Funds by the Principal Recipient to finance training and other types of learning and studying, either in Nepal or abroad, the Principal Recipient shall submit to the Global Fund, and obtain the Global Fund’s written approval of, a Training Plan describing the topic of training, the recipients, the expected added value and the specific cost. 2 - Value Added Tax (“VAT”) Waiver By no later than 1 February 2025, the Principal Recipient shall submit to the Global Fund, and obtain the Global Fund’s prior written approval of, the Principal Recipient’s VAT waiver policy. The Grantee acknowledges and agrees, pursuant to Section 3.5 of the Global Fund Grant Regulations (as amended from time to time), that VAT shall not be applied on the NPL-Z-MOH and NPL-Z-UNDP grants. 3 - (1) Grant Funds may be used to pay for the services of an external auditor. In the case of the Principal Recipient, being the Ministry of Health and Population, the Office of the Auditor General (“OAG”) of Nepal will ensure that a Global Fund-specific audit is planned under the ‘Project Financial Statement Audit Directives,’ introduced in 2023 with the support of the World Bank. This directive provides a clear structure for focused audits on specific projects, including those funded by the Global Fund; (2) the Principal Recipient consents to the carrying out of audits of the Program by the OAG for the period covering fiscal years 2025, 2026, 2027 (and other such additional periods as the Global Fund may communicate to the Principal Recipient in writing) and to the terms of reference of the Auditor and agrees that such terms of reference may be amended from time to time. For the avoidance of doubt, the audit will also cover the 1 February 2025 – 30 June 2025 period despite the off-fiscal year status; and (3) without limiting Section 7.5 of the Global Fund Grant Regulations (as amended from time to time), the Principal Recipient shall cooperate fully with the Auditor to allow them to perform its services, including by providing all information and documents requested by the Auditor or the Global Fund. Module: Case management. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative. Numerator: 586; Denominator: 665. Numerator: 370; Denominator: 370. Numerator: 445; Denominator: 445. Numerator: 872; Denominator: 872. Numerator: 427; Denominator: 427. Numerator: 427; Denominator: 427. Numerator: 466; Denominator: 466. Module: Case management. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative. Numerator: 60; Denominator: 60. Numerator: 58; Denominator: 58. Numerator: 58; Denominator: 58. Numerator: 114; Denominator: 114. Numerator: 56; Denominator: 56. Numerator: 56; Denominator: 56. Numerator: 55; Denominator: 55. Module: Case management. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative. Numerator: 21; Denominator: 77. Numerator: 35; Denominator: 77. Numerator: 80; Denominator: 154. Numerator: 35; Denominator: 77. Numerator: 45; Denominator: 77. Numerator: 45; Denominator: 77. Numerator: 55; Denominator: 77. Module: Case management. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative. Numerator: 16; Denominator: 16; Percentage: 100%. Numerator: 4; Denominator: 4; Percentage: 100%. Numerator: 5; Denominator: 5. Numerator: 5; Denominator: 5; Percentage: 100%. Numerator: 0. Numerator: 0. Numerator: 0. Module: Case management. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative. Numerator: 94; Denominator: 94; Percentage: 100%. Numerator: 16; Denominator: 16; Percentage: 100%. Numerator: 570; Denominator: 649; Percentage: 87.83%. Numerator: 55; Denominator: 55; Percentage: 100%. Numerator: 66; Denominator: 66; Percentage: 100%. Numerator: 130; Denominator: 130; Percentage: 100%. Numerator: 64; Denominator: 64; Percentage: 100%. Numerator: 40; Denominator: 40; Percentage: 100%. Numerator: 0; Denominator: 0. Numerator: 64; Denominator: 64; Percentage: 100%. Numerator: 69; Denominator: 69; Percentage: 100%. Module: Case management. Geographic coverage: Subnational, 100% of national program target. Aggregation: Non cumulative. Numerator: 542; Denominator: 542. Numerator: 28; Denominator: 28. Numerator: 1; Denominator: 1. Numerator: 296.25; Denominator: 296.25. Numerator: 355.5; Denominator: 355.5. Numerator: 693.5; Denominator: 693.5. Numerator: 338; Denominator: 338. Numerator: 1; Denominator: 1. Numerator: 458; Denominator: 458. Numerator: 338; Denominator: 338. Numerator: 371; Denominator: 371. Module: Case management. Geographic coverage: Subnational, 100% of national program target. Aggregation: Non cumulative. Numerator: 29; Denominator: 29; Percentage: 100%. Numerator: 93; Denominator: 93; Percentage: 100%. Numerator: 1; Denominator: 1; Percentage: 100%. Numerator: 20; Denominator: 20; Percentage: 100%. Numerator: 49; Denominator: 49; Percentage: 100%. Numerator: 24; Denominator: 24; Percentage: 100%. Numerator: 25; Denominator: 25; Percentage: 100%. Numerator: 13; Denominator: 13; Percentage: 100%. Numerator: 0; Denominator: 0. Numerator: 25; Denominator: 25; Percentage: 100%. Numerator: 26; Denominator: 26; Percentage: 100%. Module: Case management. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative. Numerator: 122998; Denominator: 122998; Percentage: 100%. Numerator: 2; Denominator: 2; Percentage: 100%. Numerator: 81489; Denominator: 81489; Percentage: 100%. Numerator: 97786.81; Denominator: 97786.81; Percentage: 100%. Numerator: 175166.9; Denominator: 175166.9; Percentage: 100%. Numerator: 77380.15; Denominator: 77380.15; Percentage: 100%. Numerator: 33432. Numerator: 116070.22; Denominator: 116070.22; Percentage: 100%. Numerator: 111575.05; Denominator: 111575.05; Percentage: 100%. Module: Case management. Geographic coverage: Subnational, 100% of national program target. Aggregation: Non cumulative. Numerator: 278546; Denominator: 278546; Percentage: 100%. Numerator: 66440; Denominator: 66440; Percentage: 100%. Numerator: 203261.2; Denominator: 203261.2; Percentage: 100%. Numerator: 442094.6; Denominator: 442094.6; Percentage: 100%. Numerator: 243913.44; Denominator: 243913.44; Percentage: 100%. Numerator: 198181.16; Denominator: 198181.16; Percentage: 100%. Numerator: 89227. Numerator: 297271.74; Denominator: 297271.74; Percentage: 100%. Numerator: 293520.47; Denominator: 293520.47; Percentage: 100%. Module: Case management. Geographic coverage: Subnational, 100% of national program target. Aggregation: Non cumulative. Numerator: 66440; Denominator: 66440; Percentage: 100%. Numerator: 43049. Numerator: 79949; Denominator: 79949; Percentage: 100%. Numerator: 39146.16; Denominator: 39146.16; Percentage: 100%. Numerator: 46975.39; Denominator: 46975.39; Percentage: 100%. Numerator: 85215.3; Denominator: 85215.3; Percentage: 100%. Numerator: 38239.85; Denominator: 38239.85; Percentage: 100%. Numerator: 0. Numerator: 16122. Numerator: 57359.78; Denominator: 57359.78; Percentage: 100%. Numerator: 56741.34; Denominator: 56741.34; Percentage: 100%. Module: Differentiated HIV Testing Services. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative. Numerator: 2416; Denominator: 2570. Numerator: 841; Denominator: 885. Numerator: 841; Denominator: 885. Numerator: 841; Denominator: 885. Numerator: 652; Denominator: 686. Module: Drug-resistant (DR)-TB diagnosis, treatment and care. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative. Module: Drug-resistant (DR)-TB diagnosis, treatment and care. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative. Numerator: 546; Denominator: 693. Numerator: 398; Denominator: 468. Numerator: 1070; Denominator: 1223. Numerator: 510; Denominator: 601. Numerator: 560; Denominator: 622. Numerator: 774; Denominator: 860. Numerator: 774; Denominator: 860. Module: Drug-resistant (DR)-TB diagnosis, treatment and care. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative. Numerator: 305; Denominator: 396. Numerator: 224; Denominator: 273. Numerator: 229; Denominator: 279. Numerator: 493; Denominator: 590. Numerator: 264; Denominator: 311. Numerator: 285; Denominator: 335. Numerator: 285; Denominator: 335. Module: Elimination of vertical transmission of HIV, syphilis and hepatitis B. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative - special. Numerator: 2037.07. Numerator: 0. Numerator: 27063.93. Numerator: 153; Denominator: 214; Percentage: 71.5%. Numerator: 83; Denominator: 190; Percentage: 43.68%. Numerator: 83; Denominator: 190; Percentage: 43.68%. Numerator: 169; Denominator: 181; Percentage: 93.4%. Numerator: 86; Denominator: 181; Percentage: 47.51%. Numerator: 63. Numerator: 1. Numerator: 0. Numerator: 86; Denominator: 181; Percentage: 47.51%. Numerator: 82; Denominator: 172; Percentage: 47.67%. Module: RSSH/PP: Laboratory systems (including national and peripheral). Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative - other. Numerator: 1; Denominator: 6. Numerator: 1; Denominator: 6. Numerator: 2; Denominator: 6. Numerator: 3; Denominator: 6. Numerator: 3; Denominator: 6. Numerator: 4; Denominator: 6. Numerator: 6; Denominator: 6. Module: RSSH/PP: Laboratory systems (including national and peripheral). Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative - other. Numerator: 130; Denominator: 145. Numerator: 130; Denominator: 145. Numerator: 135; Denominator: 150. Numerator: 508; Denominator: 535. Numerator: 508; Denominator: 535. Numerator: 508; Denominator: 535. Numerator: 508; Denominator: 535. Module: RSSH: Monitoring and evaluation systems. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative. Numerator: 172; Denominator: 172. Module: RSSH: Monitoring and evaluation systems. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative. Module: TB diagnosis, treatment and care. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative. Numerator: 27063.93. Numerator: 0. Numerator: 27729; Denominator: 30125; Percentage: 92.05%. Numerator: 1372; Denominator: 3347; Percentage: 40.99%. Numerator: 2037.07. Numerator: 40128. Numerator: 22181. Numerator: 47997. Numerator: 23907. Numerator: 24090. Numerator: 20230. Numerator: 1355. Numerator: 13175. Numerator: 20712. Numerator: 774. Numerator: 26103. Numerator: 26103. Module: TB diagnosis, treatment and care. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative. Numerator: 11947; Denominator: 23425. Numerator: 13309; Denominator: 22181. Numerator: 15540; Denominator: 23907. Numerator: 31199; Denominator: 47997. Numerator: 15659; Denominator: 24090. Numerator: 18272; Denominator: 26103. Numerator: 18272; Denominator: 26103. Module: TB diagnosis, treatment and care. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative. Numerator: 51835.8. Numerator: 10963; Denominator: 40126; Percentage: 27.32%. Numerator: 6654; Denominator: 22181; Percentage: 30%. Numerator: 7172; Denominator: 23907; Percentage: 30%. Numerator: 14399; Denominator: 47997; Percentage: 30%. Numerator: 7227; Denominator: 24090; Percentage: 30%. Numerator: 2060. Numerator: 7831; Denominator: 26103; Percentage: 30%. Numerator: 7831; Denominator: 26103; Percentage: 30%. Module: TB diagnosis, treatment and care. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative. Numerator: 34410; Denominator: 37003. Numerator: 21863; Denominator: 23764. Numerator: 41555; Denominator: 45169. Numerator: 21149; Denominator: 22988. Numerator: 20406; Denominator: 22181. Numerator: 21995; Denominator: 23907. Numerator: 22163; Denominator: 24090. Module: TB/DR-TB Prevention. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative. Module: TB/HIV. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative. Numerator: 205; Denominator: 208. Numerator: 249; Denominator: 254. Numerator: 247; Denominator: 252. Numerator: 508; Denominator: 518. Numerator: 261; Denominator: 266. Numerator: 258.72; Denominator: 264. Numerator: 259; Denominator: 264. Module: TB/HIV. Geographic coverage: Subnational, less than 100% national program target. Aggregation: Non cumulative - special. Numerator: 5513; Denominator: 22421; Percentage: 24.59%. Numerator: 7576; Denominator: 25728; Percentage: 29.45%. Numerator: 10443; Denominator: 26374; Percentage: 39.6%. Numerator: 11903; Denominator: 26704; Percentage: 44.57%. Numerator: 25336; Denominator: 27039; Percentage: 93.7%. Numerator: 13433; Denominator: 27039; Percentage: 49.68%. Numerator: 11824. Numerator: 14963; Denominator: 27375; Percentage: 54.66%. Numerator: 16348; Denominator: 27381; Percentage: 59.71%. Module: TB/HIV. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative. Numerator: 430237.14. Numerator: 36285.06. Numerator: 51835.8. Numerator: 1500; Denominator: 1500; Percentage: 100%. Percentage: 100%. Percentage: 100%. Percentage: 100%. Percentage: 100%. Numerator: 1092. Numerator: 20. Numerator: 682. Percentage: 100%. Percentage: 100%. Module: TB/HIV. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative. Numerator: 33192.9; Denominator: 36881. Numerator: 31688; Denominator: 33356. Numerator: 64736; Denominator: 66396. Numerator: 31545; Denominator: 33205. Numerator: 33191; Denominator: 33191. Numerator: 33041; Denominator: 33041. Numerator: 33041; Denominator: 33041. Module: Treatment, care and support. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative - other. Numerator: 7004. Numerator: 18245. Numerator: 945; Denominator: 1097; Percentage: 86.14%. Numerator: 945; Denominator: 1018; Percentage: 92.83%. Numerator: 932; Denominator: 972; Percentage: 95.9%. Numerator: 953; Denominator: 1018; Percentage: 93.61%. Numerator: 932; Denominator: 972; Percentage: 95.88%. Numerator: 352; Denominator: 490; Percentage: 71.84%. Numerator: 407; Denominator: 512; Percentage: 79.49%. Numerator: 910; Denominator: 972; Percentage: 93.62%. Numerator: 890; Denominator: 923; Percentage: 96.42%. Module: Treatment, care and support. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative - other. Numerator: 6024; Denominator: 25728. Numerator: 7578; Denominator: 27039. Numerator: 7578; Denominator: 27039. Numerator: 8212; Denominator: 27375. Numerator: 9586; Denominator: 27381. Module: Treatment, care and support. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative - other. Numerator: 25728; Denominator: 30302. Numerator: 26374; Denominator: 30311. Numerator: 27039; Denominator: 30332. Numerator: 26704; Denominator: 30311. Numerator: 27039; Denominator: 30332. Numerator: 27375; Denominator: 30332. Numerator: 27381; Denominator: 30347. Module: Treatment, care and support. Geographic coverage: Subnational, less than 100% national program target. Aggregation: Non cumulative - special. Numerator: 165; Denominator: 214. Numerator: 86; Denominator: 95. Numerator: 172; Denominator: 90.5. Numerator: 86; Denominator: 95. Numerator: 86; Denominator: 90.5. Numerator: 86; Denominator: 90.5. Numerator: 82; Denominator: 86. Module: Vector control. Geographic coverage: Subnational, 100% of national program target. Aggregation: Non cumulative. Module: Vector control. Geographic coverage: National, 100% of national program target. Aggregation: Non cumulative.