47045-TZA-C-MDH-1 The Global Fund to Fight AIDS, Tuberculosis and Malaria Tanzania (United Republic), TB/HIV, Management and Development for Health (MDH) Goals: To reduce new HIV infections by 85% in 2025 from the 2010 baseline (110,000); To reduce Mother to Child Transmission by the end of breastfeeding to ≤4% by 2025; To reduce AIDS related deaths by 80% in 2025 from the 2010 baseline (64,000); To reduce HIV related stigma to <5% by 2025 from 2013 baseline of 28% for external stigma and 20.5% for internal stigma; To reduce burden and suffering from Tuberculosis and Leprosy diseases in Tanzania by 2025. Objectives: To implement efficient testing strategies so that 95% of people living with HIV will know their status by 2026; To reduce HIV related stigma to less than 5% by 2025 from 2013 baseline of 25% for external stigma and 20.5% for internal stigma; To reduce the percentage of mother to child transmission at the end of breast feeding period, from an estimated 7.9% (in 2021), to <4% by the end of 2025/6; To increase TB treatment coverage from 53percent in 2018 to 90percent by innovatively addressing barriers to access, utilization, and the needs of the key and vulnerable populations for TB care and prevention services; To strengthen TB services to the population of miners and their families by 2025. The Global Fund to Fight AIDS, Tuberculosis and Malaria Management and Development for Health (MDH) Management and Development for Health (MDH) 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 Sarah Asiimwe Fund Portfolio Manager +41 58 791 1700 sarah.asiimwe@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 Tanzania (United Republic) HIV Multicomponent, RSSH 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 -> Differentiated HIV Testing Services -> Community-based testing for KP programs HIV -> Differentiated HIV Testing Services -> Community-based testing outside of KP and AGYW programs HIV -> Differentiated HIV Testing Services -> Facility-based testing for key population (KP) programs HIV -> Differentiated HIV Testing Services -> Self-testing for KP programs HIV -> Elimination of vertical transmission of HIV, syphilis and hepatitis B -> Early infant diagnosis and follow-up HIV testing for exposed infants HIV -> Elimination of vertical transmission of HIV, syphilis and hepatitis B -> Retention support for pregnant and breastfeeding women (facility and community) HIV -> Prevention package for adolescent girls and young women (AGYW) and male sexual partners in high HIV incidence settings -> Condom and lubricant programming for AGYW in high HIV incidence settings HIV -> Prevention package for adolescent girls and young women (AGYW) and male sexual partners in high HIV incidence settings -> Condom and lubricant programming for male sexual partners of AGYW in high HIV incidence settings HIV -> Prevention package for adolescent girls and young women (AGYW) and male sexual partners in high HIV incidence settings -> HIV prevention communication, information and demand creation for AGYW in high HIV incidence settings HIV -> Prevention package for adolescent girls and young women (AGYW) and male sexual partners in high HIV incidence settings -> Sexual and reproductive health services, including STIs, hepatitis, post-violence care for AGYW and male sexual partners in high HIV incidence settings HIV -> Prevention package for adolescent girls and young women (AGYW) and male sexual partners in high HIV incidence settings -> Social protection interventions for AGYW in high HIV incidence settings HIV -> Prevention package for men who have sex with men (MSM) and their sexual partners -> Community empowerment for MSM HIV -> Prevention package for men who have sex with men (MSM) and their sexual partners -> Condom and lubricant programming for MSM HIV -> Prevention package for men who have sex with men (MSM) and their sexual partners -> Pre-exposure prophylaxis (PrEP) programming for MSM HIV -> Prevention package for men who have sex with men (MSM) and their sexual partners -> Removing human rights-related barriers to prevention for MSM HIV -> Prevention package for other vulnerable populations (OVP) -> Community empowerment for OVP HIV -> Prevention package for other vulnerable populations (OVP) -> Condom and lubricant programming for OVP HIV -> Prevention package for other vulnerable populations (OVP) -> Pre-exposure prophylaxis (PrEP) programming for OVP HIV -> Prevention package for other vulnerable populations (OVP) -> Sexual and reproductive health services, including STIs, hepatitis, post-violence care for OVP HIV -> Prevention package for people who use drugs (PUD) and their sexual partners -> Community empowerment for PUD HIV -> Prevention package for sex workers, their clients and other sexual partners -> Community empowerment for sex workers HIV -> Prevention package for sex workers, their clients and other sexual partners -> Condom and lubricant programming for sex workers HIV -> Prevention package for sex workers, their clients and other sexual partners -> HIV prevention communication, information and demand creation for sex workers 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 rights-based law enforcement practices HIV -> Treatment, care and support -> HIV treatment and differentiated service delivery - adults (15 and above) HIV -> Treatment, care and support -> HIV treatment and differentiated service delivery - children (under 15) HIV -> Treatment, care and support -> Integrated management of common co-infections and co-morbidities (adults and children) Multicomponent -> Program management -> Grant management 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 -> Routine reporting RSSH -> RSSH: Monitoring and evaluation systems -> Surveys Tuberculosis -> Collaboration with other providers and sectors -> Collaboration with other programs/sectors Tuberculosis -> Collaboration with other providers and sectors -> Community-based TB/DR-TB care Tuberculosis -> Collaboration with other providers and sectors -> Private provider engagement in TB/DR-TB care Tuberculosis -> Removing human rights and gender related barriers to TB services -> Community mobilization and advocacy, including support to TB survivor-led groups Tuberculosis -> Removing human rights and gender related barriers to TB services -> Reducing TB-related gender discrimination, harmful gender norms and violence Tuberculosis -> TB diagnosis, treatment and care -> TB screening and diagnosis Tuberculosis -> TB/HIV -> TB/HIV - Screening, testing and diagnosis 14879674.00 13927605.11 12202173.97 21843476.51 Global Fund commitment to TZA-C-MDHP01. The Global Fund to Fight AIDS, Tuberculosis and Malaria Management and Development for Health (MDH) 3258148.28 Global Fund disbursement to TZA-C-MDHP01 (Other Local Organizations). The Global Fund to Fight AIDS, Tuberculosis and Malaria Management and Development for Health (MDH) 0.00 Global Fund commitment to TZA-C-MDHP01. The Global Fund to Fight AIDS, Tuberculosis and Malaria Management and Development for Health (MDH) -18585328.23 Global Fund commitment to TZA-C-MDHP01. The Global Fund to Fight AIDS, Tuberculosis and Malaria Management and Development for Health (MDH) 2561321.00 Funds returned to the Global Fund from TZA-C-MDHP01 (Other Local Organizations). Management and Development for Health (MDH) The Global Fund to Fight AIDS, Tuberculosis and Malaria -2561321.00 Global Fund commitment to TZA-C-MDHP01. The Global Fund to Fight AIDS, Tuberculosis and Malaria Management and Development for Health (MDH) 1221.00 Funds returned to the Global Fund from TZA-C-MDHP01 (Other Local Organizations). Management and Development for Health (MDH) The Global Fund to Fight AIDS, Tuberculosis and Malaria -1221.00 Global Fund commitment to TZA-C-MDHP01. The Global Fund to Fight AIDS, Tuberculosis and Malaria Management and Development for Health (MDH) 640724.00 Expenditure reported by Management and Development for Health (MDH) for TZA-C-MDHP01, Jan 2024 to Jun 2025. Management and Development for Health (MDH) 55909.00 Expenditure reported by Management and Development for Health (MDH) for TZA-C-MDHP01, Jul 2025 to Jul 2025. Management and Development for Health (MDH) An overview of a grant over its lifetime. General terms and conditions which apply to Global Fund grants. Funding Request of funding request FR1550-TZA-C. 1 - Personal Data (1) Principles. The Principal Recipient, acknowledges that Program Activities are expected to respect the following principles and rights (“Data Protection Principles”): (a) Information that could be used to identify a natural person (“Personal Data”) will be: (i) processed lawfully, fairly and transparently; (ii) collected for specified, explicit and legitimate purposes and not further processed in a manner not compatible with those purposes;  (iii) adequate, relevant and limited to what is necessary for the purposes for which they are processed; (iv) accurate and, where necessary, kept up to date; (v) kept in a form which permits identification of the individuals for no longer than is necessary for the purposes for which the Personal Data is processed; and (vi) processed in a manner that ensures appropriate security of the Personal Data; and (b) Natural persons are afforded, where relevant, the right to information about Personal Data that is processed; the right to access and rectify or erase Personal Data; the right to data portability; the right to confidentiality of electronic communications; and the right to object to processing. (2) Limitations. Where collection and processing of Personal Data is required in order to implement Program Activities, whether by the Principal Recipient, a Sub-recipient, or Supplier, the Principal Recipient should respect the Data Protection Principles: (a) to the extent that doing so does not violate or conflict with applicable law and/or policy; and (b) subject to the Principal Recipient balancing the Data Protection Principles with other fundamental rights in accordance with the principle of proportionality, taking into account the risks to the rights and freedoms of natural persons. 2 - With respect to Section 7.6 (Right of Access) of the Global Fund Grant Regulations (as amended from time to time), (1) the Global Fund may collect or seek to collect data, and it is possible that such data may contain Personal Data, and (2), prior to collection and at all times thereafter, the Principal Recipient shall take all necessary actions to ensure that the transfer of such information to the Global Fund does not violate any applicable law or regulation. 3 - (1) In accordance with the Global Fund’s Sustainability, Transition and Co-financing Policy (GF/B35/04) (the “STC Policy”), the commitment and disbursement of USD 60,456,025 being 15% of the HIV and TB components (the “Co-Financing Incentive”), is subject to the Global Fund’s satisfaction of the Grantee’s compliance with the requirements listed at 5.3(1)(a) and 5.4(1)(b) below (“Co-Financing Requirements”). The Principal Recipient acknowledges and agrees that the Global Fund may reduce Grant Funds during the current or any subsequent Implementation Period in the event the Grantee fails to: (a) progressively increase government expenditure on health to meet national universal health coverage goals; and/or (b) increase domestic funding of Global Fund-supported programs, with a focus on progressively absorbing the key costs of national disease plans, as identified in consultation with the Global Fund. (2) In order to satisfy the Co-Financing Requirements, the Grantee shall, as set out in Commitment Letter signed by the Permanent Secretary of the Ministry of Finance and Planning, dated 29 May 2023 (the “Commitment Letter”), unless otherwise agreed in writing by the Global Fund: (a) fulfil a total minimum co-financing commitment of USD 324.60 million for HIV, TB and RSSH investments from 2023/2024 to 2025/2026 (inclusive), comprising investments in: i. HIV of USD 138.26 million; ii. TB of USD 28.37 million; and iii. RSSH of USD 157.97 million; and (c) provide to the Global Fund each year of the Implementation Period and the year following the end of the Implementation Period, evidence supporting achievement of the Co-Financing Requirements, including: i. the Approved Annual Budget Estimates, including allocation for HIV/TB/Malaria/ RSSH, and overall health for the upcoming year by 1 of July of every year; ii. the Annual Budget Performance Report, including total expenditure for HIV/TB/ Malaria/RSSH, and overall health incurred in the previous fiscal year by 31 December of every year; and iii. Co-financing Monitoring Report on the execution of co-financing commitments in the previous fiscal year by 31 December of every year. 4 - The Program budget may be funded in part by Grant Funds disbursed under a previous Grant Agreement, which the Global Fund has approved to be used for the Program under the current Grant Agreement (“Previously Disbursed Grant Funds”), as well as additional Grant Funds up to the amount set forth in Section 3.6. hereof. Accordingly, the Global Fund may reduce the amount of Grant Funds set forth in Section 3.6. hereof by the amount of any Previously Disbursed Grant Funds. Previously Disbursed Grant Funds shall be governed by the terms of this Grant Agreement. 5 - The Global Fund may disburse Grant Funds in a currency other than that specified in the Grant Confirmation. In such cases, the exchange rate used to calculate the amount of the disbursement into its equivalent in the currency specified in the Grant Confirmation shall be the relevant exchange rate reflected in the Program budget. Module: Collaboration with other providers and sectors. Geographic coverage: Subnational, less than 100% national program target. Aggregation: Non cumulative. Numerator: 3094; Denominator: 4364. Numerator: 1636.5; Denominator: 2182. Numerator: 1854; Denominator: 2182. Numerator: 2018.56; Denominator: 2432. Module: Differentiated HIV Testing Services. Geographic coverage: Subnational, less than 100% national program target. Aggregation: Non cumulative - other. Numerator: 5298; Denominator: 27621. Numerator: 6763.44; Denominator: 7514.93. Numerator: 9393.66; Denominator: 10437.4. Numerator: 13151.12; Denominator: 14612.36. Module: Differentiated HIV Testing Services. Geographic coverage: Subnational, less than 100% national program target. Aggregation: Non cumulative - other. Numerator: 57304; Denominator: 251001. Numerator: 83912.11; Denominator: 384477. Numerator: 139853.51; Denominator: 384477. Numerator: 206050.84; Denominator: 384477. Module: Differentiated HIV Testing Services. Geographic coverage: Subnational, less than 100% national program target. Aggregation: Non cumulative - other. Numerator: 27743; Denominator: 31902. Numerator: 25021.01; Denominator: 173757. Numerator: 50042.02; Denominator: 173757. Numerator: 75063.02; Denominator: 173757. Module: Elimination of vertical transmission of HIV, syphilis and hepatitis B. Geographic coverage: Subnational, less than 100% national program target. Aggregation: Non cumulative - special. Numerator: 186418; Denominator: 190146.36. Numerator: 93209; Denominator: 186418. Numerator: 93209; Denominator: 186418. Numerator: 94141; Denominator: 188282. Module: Key and vulnerable populations (KVP) - TB/DR-TB. Geographic coverage: Subnational, less than 100% national program target. Aggregation: Non cumulative. Module: Prevention package for adolescent girls and young women (AGYW) and male sexual partners in high HIV incidence settings. Geographic coverage: Subnational, less than 100% national program target. Aggregation: Non cumulative - other. Numerator: 251001; Denominator: 664108. Numerator: 115343.1; Denominator: 384477. Numerator: 192238.5; Denominator: 384477. Numerator: 249910.05; Denominator: 384477. Module: Prevention package for men who have sex with men (MSM) and their sexual partners. Geographic coverage: Subnational, less than 100% national program target. Aggregation: Non cumulative. Module: Prevention package for men who have sex with men (MSM) and their sexual partners. Geographic coverage: Subnational, less than 100% national program target. Aggregation: Non cumulative - other. Numerator: 5898; Denominator: 27621. Numerator: 9393.66; Denominator: 52187. Numerator: 13046.75; Denominator: 52187. Numerator: 18265.45; Denominator: 52187. Module: Prevention package for sex workers, their clients and other sexual partners. Geographic coverage: Subnational, less than 100% national program target. Aggregation: Non cumulative. Module: Prevention package for sex workers, their clients and other sexual partners. Geographic coverage: Subnational, less than 100% national program target. Aggregation: Non cumulative - other. Numerator: 31902; Denominator: 38643. Numerator: 34751.4; Denominator: 173757. Numerator: 69502.8; Denominator: 173757. Numerator: 104254.2; Denominator: 173757. Module: TB diagnosis, treatment and care. Geographic coverage: Subnational, less than 100% national program target. Aggregation: Non cumulative.