TDR Approved Programme Budget for the 2010-2011 Biennium · Approved Programme Budget 2010-2011...

TDR/PB/2010-2011/rev.1

TDR Approved Programme Budget for the 2010-2011 Biennium

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TABLE OF CONTENTS

1. INTRODUCTION.................................................................................................................. 1

1.1 TDR VISION AND STRATEGY ........................................................................................................1

2. TDR BUSINESS PLAN AND BUDGET PROJECTION FOR 2008-2013 ...................... 2

2.1 BUSINESS LINES ............................................................................................................................2

2.2 PROJECTED TDR BUDGETS FOR 2008-2013 ..................................................................................2

3. TDR BUDGET FOR 2010-2011............................................................................................ 4

3.1 SUMMARY OF BUDGET 2010-2011 ................................................................................................4

3.2 BUDGET DETAILS FOR BUSINESS LINES ........................................................................................5

BL1 Stewardship ....................................................................................................................................5

BL2 Empowerment .................................................................................................................................6

BL3 Lead discovery for drugs ................................................................................................................8

BL4 Innovation for product development in disease endemic countries ..............................................10

BL5 Innovative vector control interventions ........................................................................................11

BL6 Drug development and evaluation for helminth and other neglected tropical diseases ...............12

BL7 Accessible quality assured diagnostics.........................................................................................14

BL8 Evidence for treatment policy of HIV and TB co-infection...........................................................15

BL9 Evidence for antimalarial policy and access................................................................................17

BL10 Visceral Leishmaniasis elimination..............................................................................................18

BL11 Integrated community-based interventions...................................................................................19

3.3 BUDGET DETAILS FOR PROGRAMME SUPPORT ............................................................................21

3.4 PROGRAMME SUPPORT (EXCLUDING PORTFOLIO POLICY AND DEVELOPMENT) .........................22

3.5 CONSEQUENCES OF THE BUDGET .............................................................................................24

4. RESOURCE MOBILIZATION ......................................................................................... 27

Approved Programme Budget 2010-2011 Page 1

1. INTRODUCTION

This document describes the TDR budget for 2010-2011. This is the second biennium under the new TDR Vision and Strategy1 and the TDR business plan for 2008-20132. The budget is based on the strategic and operational considerations of the overall TDR business plan, and on detailed business plans and budgets for 11 TDR business lines operating under three strategic functions. Following a short overview of the new TDR strategy below, chapter 2 summarizes key elements of the TDR business plan for 2008 to 2013, including budget projections and justifications for the anticipated budget growth over these six years. Chapter 3 provides a detailed description of the budget for 2010-2011, including a summary of the activities, end-products and budgets for 11 business lines. A budget scenario is presented for US$ 121 million. This is less than the US$ 146 million projected in the TDR business plan due to the impact of the global financial crisis. The rationale for the prioritization of resources within the business lines is discussed, as are the costs of providing core support to the Programme. Key outputs anticipated from TDR in the 2010-2011 biennium and over the 2008-2013 business plan are also presented. Chapter 4 summarizes the resource mobilization strategy and planned activities for the biennium. 1.1 TDR VISION AND STRATEGY TDR's renewed vision is to foster: “An effective global research effort on infectious diseases of poverty, in which disease endemic countries play a pivotal role”. In order to achieve the new vision, TDR will use a three-pronged strategy to: provide a collaborative framework and information service for research partners; empower scientists from disease endemic countries (DECs) as research leaders; and support research on neglected priority needs. This implies three major strategic functions for TDR: 1. Stewardship for research on infectious diseases of poor populations: a major new role as

facilitator and knowledge manager to support needs assessment, priority setting, progress analysis and advocacy, and to provide a neutral platform for partners to discuss and harmonize their activities.

2. Empowerment of researchers and public health professionals from DECs moving beyond traditional research training to build leadership at individual, institutional and national levels so countries can better initiate and lead research activities, develop a stronger presence in international health research and effectively use research results to inform national/ regional policy and practice.

3. Research on neglected priority needs that are not adequately addressed by other partners. This focuses on three research functions:

a) Foster innovation for product discovery and development b) Foster research on development and evaluation of interventions in real life settings c) Foster research for access to interventions.

1 Ten Year Vision and Strategy. UNICEF/UNDP/World Bank/WHO Special Programme for Research and

Training in Tropical Diseases. World Health Organization. Geneva. Document TDR/GEN/06.5/EN/Rev.2 2 TDR Business Plan 2008 - 2013. UNICEF/UNDP/World Bank/WHO Special Programme for Research and

Training in Tropical Diseases. World Health Organization. Geneva. Document TDR/GEN/07.1/EN/Rev.1

TDR/PB/2010-2011 Page 2

2. TDR BUSINESS PLAN AND BUDGET PROJECTION FOR 2008-2013

To implement its new strategy, in 2008-09 TDR restructured its operations into 11 business lines (BLs). Each BL is supported by a robust business plan that details deliverables, timelines, milestones and partnerships. The move to a business line structure was based on stakeholder consultations, scientific opportunities in the field and opportunities arising from TDR's previous portfolio. The new structure has provided the necessary focus to achieve TDR’s objectives and to ensure the desired accountability. 2.1 BUSINESS LINES Two of the business lines correspond to the strategic functions of Stewardship (BL1) and Empowerment (BL2). The other nine business lines correspond to the strategic function of Research on Neglected Priority Needs and may change over time. These include: • Lead discovery for drugs (BL3) • Innovation for product development in DECs (BL4) • Innovative vector control interventions (BL5) • Drug development/evaluation for helminths and other Neglected Tropical Diseases (BL6) • Accessible quality assured diagnostics (BL7) • Evidence for treatment policy of HIV and TB co-infection (BL8) • Evidence for antimalarial policy and access (BL9) • Visceral leishmaniasis elimination (BL10) • Integrated community-based interventions (BL11) While the Stewardship and Empowerment business lines span across all upstream and downstream research areas, the other nine, supporting Research on Neglected Priority Needs, have varying levels of upstream/downstream focus with an increasing overall emphasis on downstream research. Some are functionally specific, while others are focused on specific diseases. From a geographical perspective there is a strengthened focus on research in disease endemic countries with an emphasis on Africa. The scope of the business lines is reviewed annually by TDR’s Scientific and Technical Advisory Committee, using clearly defined criteria to ensure optimal use of resources and continued relevance. Full details of each of the business lines can be found in their individual business plans. 2.2 PROJECTED TDR BUDGETS FOR 2008-2013 Table 1 below provides an overview of the TDR budgets as projected in the TDR business plan for the three biennia of 2008-2013. It shows the projected biennial budget for the strategic functions of stewardship, empowerment and research on neglected priorities, portfolio policy and development, and programme support costs. The increase over the six years represents an 8% year on year growth in budget from the 2006-2007 biennial budget of US$ 100 million. Table 1: TDR Budget by as per the TDR Business Plan for 2008-2013

Budget in US$M

2008-2009 2010-2011 2012-2013

Total Biennium Budget 121.0 146.0 161.6


The business plan envisaged steady growth over the period 2008-13 to enable TDR to meet its scaled up objectives, notably the introduction of its new Stewardship function, and its increasing need to interface with many partners to leverage maximum impact. The growth to achieve its target of US$ 121 million was hit by the financial crisis of 2008-9 and the fall in the value of European currencies against the US dollar. At the time of writing it is unclear what will be the expenditure in 2008-2009, but it is likely to be around US$ 100 million, significantly above previous levels for TDR, but below its aspirational level of US$ 121 million. With this in mind, the scenario for the 2010-2011 budget in chapter 3 anticipates modest growth to meet a base budget of US$ 121 million. The first two years of TDR's new strategy implementation have seen a stronger strategic engagement with many of the key players in global health and TDR's strategic significance has consequently increased. With the recruitment of a stronger, larger External Relations and portfolio management team that can secure active follow up of fund-raising opportunities and ensure that our portfolio is aligned to the needs of our main development partners, we believe we will further improve on our resource mobilization in the coming biennium. Table 2: TDR Budget Overview (by Activities and Personnel)

Budget in US$M

Description 2008-2009 2010-2011 2012-2013

Activities 89.6 86.5 106.0

Personnel 31.4 34.5 40.0

TDR Total 121.0 121.0 146.0

Personnel as a % of TDR Total 25.9 28.5 27.0

Personnel costs remain significant and account for 26-29% of the budget, in line with that of recent biennia. Much of TDR's work is personnel intensive, notably the stewardship and empowerment activities. Increasingly, all research activities of TDR are demanding of staff time to engage with partners, provide advice and negotiate interfaces and collaborations. Furthermore, the research activities in which TDR engages are becoming more complex and demanding of project management time. TDR continuously works with partners to leverage resources for its collaborative activities through channels other than TDR. The increase in personnel costs over the three biennia reflects the headcount increase required to implement activities under the new structure. Recruitment of new staff will be conservatively kept in line with anticipated projected income.

TDR/PB/2010-2011 Page 4

3. TDR BUDGET FOR 2010-2011

3.1 SUMMARY OF BUDGET 2010-2011 The TDR budget for the biennium 2010-2011 reflects the new TDR strategy and the priority activities identified in the TDR business plan, in particular for the planned 11 business lines. A detailed business plan and budget have been prepared for each business line, and these are summarized later in this chapter. The overall TDR budget for the biennium is the aggregate of the 2010-2011 operational budgets for the 11 business lines, plus personnel and programme supports costs (including portfolio policy and development). A summary of the budget by these business line and support elements is provided in table 3. JCB (30) agreed on the aspirational level of US$ 121 million for the 2010-2011 biennium and encouraged TDR to explore proactively and innovatively all avenues to attract funding to meet the budget level. JCB (30) emphasized that TDR's activities should be fully aligned with the new strategy, whatever the level of available resources, and requested that priorities among and within the business lines be kept continuously under review in light of this principle. JCB (30) noted that difficult choices may need to be made to respond to eventual funding constraints. Table 4 shows the relative level of budget allocated to activities, including programme support costs, and personnel. Table 3: TDR Budget by Business Line Budget in US$M

BL Business Line (BL) Name 2010-2011

1 Stewardship 6.9

2 Empowerment 9.5

3-11 Research on Neglected Tropical Diseases:

3 Lead discovery for drugs 6.9

4 Innovation for product development in DECs 1.0

5 Innovative vector control interventions 4.9

6 Drug development and evaluation for helminths & other NTDs 7.9

7 Accessible quality assured diagnostics 7.9

8 Evidence for treatment policy of HIV and TB co-infection 7.3

9 Evidence for antimalarial policy and access 8.4

10 Visceral leishmaniasis elimination 2.4

11 Integrated community-based interventions 2.9

12 Other research activities 7.2

Total BL Budget 73.2

Personnel 34.5

Programme Support 13.0

Innovation Fund 0.3

Total Biennium Budget 121.0


Table 4: TDR Budget Overview by Activities and Personnel Budget in US$M

Description 2010-2011

Activities 86.5

Personnel 34.5

TDR Total 121.0

3.2 BUDGET DETAILS FOR BUSINESS LINES The following section provides basic information on business line activities, their rationale, overall objective, specific objectives, end-products and both the business plan and reduced biennial budget scenarios. The significance of the budget differences is highlighted. BL1 Stewardship Needs and Opportunities

In recent years, there has been considerable new momentum and increased financial support for research and control of infectious diseases of poverty. While this is a positive development, it has also resulted in fragmentation of efforts and greater scientific inequality between developing and developed countries. There is little coordination among different research initiatives and it is becoming increasingly difficult for all stakeholders to know what research is being undertaken and to what extent current research efforts meet priority needs for infectious disease control. Overall Objective

To facilitate and foster knowledge management, needs assessment, priority setting and progress analysis for health research on infectious diseases of poverty, and to provide a neutral platform for stakeholders to discuss and harmonize their activities with disease endemic countries playing a pivotal role in the agenda setting. Specific Objectives

1. Assess stakeholder environments (including donors' initiatives) and provide a global information platform on health research needs, opportunities and activities on infectious diseases of poverty.

2. Develop an evidence and analysis-driven forum for the identification of priority needs and major research gaps through stakeholder consultations and enhance the relevance of infectious disease research priorities to control needs.

3. Provide a neutral platform for partners to discuss their activities, reach the highest possible level of consensus and enhance their collective efficiency and advocacy for infectious diseases of the poor with active involvement of disease endemic countries.

4. Synthesize global evidence and provide a strategic overview of infectious diseases research 5. Advocate for support of health research and effective utilization of its results in the control of

infectious diseases of poverty at international, regional and national policy level. 6. Foster research networks and kick-start innovative research initiatives.

TDR/PB/2010-2011 Page 6

End-Products

• Knowledge management platform (TropiKA.net) for sharing scientific information • Disease and thematic research topic expert groups for strategic analysis, identification and

prioritization of research gaps and needs. • Biennial global report on infectious disease research: priority research needs, gaps and global

progress (first publication early 2011). • Advocacy by high level groups and consortia for increased support for research and utilization

of research outputs as identified in the biennial global report • New and innovative networks to expand opportunities and link researchers worldwide Budget

A rapid scale-up of personnel and activities was envisaged for this endeavour resulting in a high budget for an initial activity. It is critical that the key elements of this activity be put in place so that end-products, including the delivery of a biennial report on infectious disease priority research needs, gaps and global progress by, can be achieved on time (early 2011). The identification of priority research needs and gaps forms the heart of the business line's objectives, feeding into the biennial report on infectious disease priority research needs, gaps and global progress by early 2011. This activity is therefore given top priority. Table 5: 2010-2011 Budget for Stewardship (Business Line 1) US $ x 1000

Objective Description 2010-2011

1 Knowledge acquisition, management and sharing 2,955 2 Identification of priority needs and major gaps 2,655 3 Consensus building on health research 550 4 International stewardship at policy level 50 5 Fostering networks and kick-starting innovative initiatives 0 6 Coordination (Scientific Committees, Travel & Consultants) 665

Total Activities 6,875

BL2 Empowerment Needs and Opportunities

Research capacity in DECs has grown over the last decades and several countries are committing more of their own resources to health research. However, there remains a major need for expanded capacity strengthening, especially at a more strategic level and in support of priority setting and research planning. Strong health research capacity is needed in DECs to inspire innovation and direct high quality research programmes that address national and regional priorities. Overall Objective

To develop excellence and leadership in health research so that institutional and national systems identify and manage their own research priorities.


Specific Objectives

1. To support the development of responsible health research leadership in DECs at all levels. 2. To enhance the quality and relevance of health research in developing countries within the

context of institutional and national frameworks by promoting: a. strong links between research, academia and control institutions b. best practices for research and associated decision-making c. Strengthening structures and systems that support equity in health research

3. To leverage TDR's role in health research by fostering national and regional initiatives to promote and empower researchers to meet their own health research priorities.

End-Products

• Leadership by DEC researchers and research institutions: o Research leaders in DECs with internationally recognized research projects o DEC universities effectively managing research projects in collaboration with other

institutions o Inventory of TDR researchers and research institutions in DECs, including alumni, experts

and recognized laboratories and institutions, so that their expertise can be utilized o Training courses established in research and management topics, maintained and sustained

in DECs • Enhancing the quality and relevance of health research within national frameworks:

o Networks of DEC researchers, research institutions and control partners involved in discussions on national research needs

o Efforts in place to facilitate the transfer of research results into practice o Internationally recognized standards increasingly being met by laboratories and researchers,

human subjects protection programmes, ethics committees and data management centres • Regionally based initiatives and networks established to address unmet needs, local ownership

and sustainable locally generated funding by health research in DEC. Budget

In order to achieve the goals referred to above, TDR activities are divided into four main categories: training; funding of DEC-initiated research; promotion of leadership through research networks and leverage. There is a major need for TDR to support training grants and fellowships, which have provided a major source of outreach to the DEC research community and have lain at the heart of much that TDR has accomplished over the years. A core level of funding needs to be made available for this activity.

TDR/PB/2010-2011 Page 8

Table 6: 2010-2011 Budget for Empowerment (Business Line 2) US $ x 1000


1 Training 3,400 Individual Training 1,400 WHO/TDR Immuno centres 600 Capacity for Training 550 Regional career fellows 200 Recognition programme 400 Coordination for Training 250 2 Research 4,450 Multilateral Initiative for Malaria (MIM) 2,500 Re-entry Grants 850 LDC institutions grant 700 Coordination for Research 400

3 Leadership and Networks 1,230 Regional Network 500 Information Exchange 60 Small grants 550 Coordination for Network 120

4 Leverage Initiatives 100 5 Coordination (Scientific Committees, Travel & Consultants) 340 Total Activities 9,520

BL3 Lead discovery for drugs Needs and Opportunities

In recent years there has been an expansion of product development activities for tropical diseases through a number of new public-private partnerships (PPPs) for malaria, tuberculosis and certain neglected tropical diseases. However, there remains an innovation gap and a dearth of credible drug leads to feed the development pipeline of these PPPs and there is an urgent need for a vibrant drug discovery initiative to produce such leads. Overall Objective

To facilitate and support the discovery of new drug leads for tropical diseases through networks and partnerships between pharmaceutical companies, academia and DEC institutions Specific Objectives

1. Identify quality lead compounds for drugs and diagnostics for tropical diseases and facilitate the transfer of those leads to PPPs, industry, and other innovative partnerships for further development

2. Identify drug candidates for helminth infections (specifically schistosomiasis, lymphatic filariasis and onchocerciasis) through the Helminth Initiative and transfer the candidates to appropriate partners for development


3. Promote the global coordination of drug discovery activities through the network and partnership model

4. Promote technology transfer and innovative drug discovery in DECs through the North/South collaboration networks and partnerships

5. Support targeted fundamental research on the generation of new tools to facilitate drug discovery

End-Products

• 10 leads discovered by 2013, 1 lead transferred to a partner every other year • 2 drug candidates for helminthiases identified through the helminth drug initiative by 2013 • Coordinated drug discovery strategy, based on networks and partnership • Open access high-impact publications, target product profiles and standard operating

procedures for lead discovery • DEC scientists and institutions participating in lead discovery • Open access database of drug targets (starting 2007, www.tdrtargets.org) Budget

The activities of this business line are closely integrated so it is difficult to target one area without impacting on many objectives. It is also an area that requires investment in many projects to deliver a high quality lead that can be taken further into discovery and development. The development of networks maximizes opportunities, reduces risk and facilitates capacity development and is thus a key element of this business line Table 7: 2010-2011 Budget for Lead Discovery (Business Line 3) US $ x 1000


1 Lead identification 3,455 Screening network 3,055 TDR Compound bank 200 Throughput screening 200

2 Drug targets 700 Drug target database 600 Fundamental research 100

3 Lead Optimization 1,730 PK/ metabolism network 530 Medicinal chemistry 1,200

4 Toxicology 0 5 Helminth Initiative 100 6 Coordination (Scientific Committees, Travel & Consultants,

network and regular operational meetings on lead/candidate selection)

890

Total Activities 6,875

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BL4 Innovation for product development in disease endemic countries Needs and Opportunities

There is a growing need expressed by many developing countries for the capacity to discover, develop and produce pharmaceutical products so that they are not solely dependent on innovation from outside sources to meet their needs. There is also a desire by many countries to better access and utilize indigenous knowledge for pharmaceutical products. Overall Objective

To facilitate and foster the discovery and development of novel drugs, diagnostic and other products in disease endemic countries. Specific Objectives

1. Define gaps and opportunities for innovative R&D in the South through regional mapping of the R&D landscape.

2. Facilitate the design, creation and implementation of innovative regional networks and public private partnerships in the South dedicated to the discovery, development and delivery of drugs, diagnostics and other health products and technologies in DECs.

3. Identify and support competitive discovery and development projects for tropical diseases in DECs that can feed into the regional networks.

4. Facilitate interface between regional networks and existing north-south and south-south initiatives to enhance technology utilization and transfer

5. Coordinate the development of standard operating procedures and facilitate policy development for product R&D, including for legal negotiation and IP management, for the discovery and development of pharmaceuticals in DECs

End-Products

• Four regional consultations implemented and mapping exercises and reports published. • Regional Networks established for the discovery, development and delivery of drugs,

diagnostics and other health products and technologies in DECs. • Three innovative potential health products transferred from the product discovery to the product

development phase • Agreements established between new regional initiatives and existing partnerships to promote

technology transfer • Centres established with a range of SOPs for drug discovery and best practice, and with

capacity to negotiate IP agreements. Budget

The main achievement of this business line to date has been the initiation of an African Network for Drugs and Diagnostics Innovation (ANDI) under the framework of the Global Strategy and Plan of Action for Public Health, Innovation and Intellectual Property. There is a top priority to see this network established as an independent organization housed and governed from within Africa in the coming biennium. There is also a drive to develop similar regional and sub-regional networks for innovation. If funding is limited resources will be allocated primarily to ensure the establishment of the African Network for Drugs and Diagnostics Innovation.


Table 8: 2010-2011 Budget for Innovation for Product Development in DECs (Business Line 4)

US $ x 1000 Objective Description 2010-2011

1 Mapping (Database development) 150 2 Funding for full projects 0 3 Exploratory projects 300 4 Support centres and networks 150 5 Coordination (Scientific Committees, Travel & Consultants) 380 Total Activities 980

BL5 Innovative vector control interventions Needs and Opportunities

Most neglected tropical diseases are transmitted by insect vectors and there is a major need for research to develop improved vector control tools and strategies for prevention of these diseases. Genome sequencing of the main vectors of malaria, dengue and human African trypanosomiasis (HAT) brings the promise of radically improved vector control methods, but their development will require careful coordination and field evaluation of the new approaches. Overall Objective

To support the development and evaluation of improved and innovative vector control methods for the prevention of neglected diseases. Specific Objectives

1. Promote the development and testing of new methods for improving HAT vector control and support the generation and exploitation of Glossina genome sequence data.

2. Advance the development and evaluation of new and improved integrated methods for malaria and dengue vector control.

3. Progress the development and evaluation of alternative methods to prevent re-infestation and control Chagas disease vectors.

End-Products

• Improved tsetse control methods and strategies developed and evaluated by 2012 • Glossina genome sequence data generated and made available for exploitation by 2011 • Best guidance for deployment of GM vectors developed and evaluated by 2013 • Improved methods for packaging integrated malaria vector control approaches by 2012 • Improved methods for targeted and integrated dengue vector control by 2012 • Methods for preventing re-infestation by triatomine bugs developed and evaluated by 2012 • Strategies for complementary or alternative Chagas disease vector control developed and

evaluated by 2013 Budget

This business line brings together multiple research activities across a range of insect vectors of disease and covers early laboratory research to field research. Many of the activities link, complement and help leverage the work of other groups. The budget of this business line supports a well defined set of objectives, including for the neglected diseases of human African

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trypanosomiasis and Chagas' disease, that need to be fully met to maintain the integrity of this activity. Table 9: 2010-2011 Budget for Innovative Vector Control Interventions (Business Line 5) US $ x 1000


1 African Trypanosomiasis 1,560 Tsetse mass-trapping 1,310 Glossina (Tsetse fly) genome sequencing 250

2 Malaria and dengue vector control 2,150 Requirements for GM vectors deployment 700 Improving integrated malaria vector control 810 Improving targeted dengue vector control 640

3 Chagas Vector Control 900 Origin of Triatomine bugs re-infestation 500 Methods for Chagas disease vector control 400

4 Coordination (Scientific Committees, Travel & Consultants) 300 Total Activities 4,910

BL6 Drug development and evaluation for helminth and other neglected tropical diseases Needs and Opportunities

Helminthiases are responsible for an enormous burden of disease in developing countries. This has been highlighted in recent years through WHO's development and promotion of an integrated strategy to address neglected tropical diseases. Although many new PPPs have been established for the development of drugs against certain neglected infectious diseases, none of them address the drug needs for human helminths and a variety of other diseases. Overall Objective

To develop new and optimize the use of currently available drugs for helminths and other neglected tropical diseases (NTDs). Specific Objectives

1. Development, registration and field evaluation of new drugs for onchocerciasis, lymphatic filariasis, schistosomiasis and other helminthiasis.

2. Generation of evidence for improved use of currently available drugs for NTDs to support disease control, elimination or eradication strategies with emphasis on integrated disease management or prophylactic chemotherapy including: a. evaluation of the efficacy and safety of modifications of currently used doses or treatment

regimens b. evaluation of efficacy and safety of combinations of currently available drugs for the same

disease c. assessment of safety and efficacy of co-administration of drugs to address multiple diseases d. evaluation of product safety and efficacy in children and pregnant women e. potential to generate and prevent emergence of drug resistance


3. Development of products for other neglected diseases when an opportunity emerges and no other organization is available or has the know-how to do so.

End-Products

• Pre-clinical and clinical evidence of efficacy and safety of new drugs against helminths that support registration by pharmaceutical partners (e.g. registration of moxidectin by 2013).

• Evidence that the registered drugs are safe for large-scale use and more effective than currently used drugs in the control of onchocerciasis, lymphatic filariasis, schistosomiasis and other helminthic diseases (e.g. impact of moxidectin on onchocerciasis transmission).

• New information for the utilization of drugs for diseases targeted for the integrated approach and multi-intervention packages for disease control (e.g. optimized praziquantel regimens).

• Evidence for improved use of currently available drugs to support disease control, elimination or eradication strategies (e.g. effect of benznidazole on chronic Chagas disease).

• Clinical studies to improve management and treatment of disease (e.g. revised dengue classification and updated case management guide).

Budget

The major single cost for this business line continues to be the assessment of moxidectin as a macrofilaricide that might interrupt transmission of onchocerciasis, opening up possibilities for eradication of the disease. This is the most important end product of the business line. Other activities support evaluation of existing drugs and seek to develop new therapies for diseases neglected by other organizations. Many of these activities are exploratory in 2010-2011 with an anticipated scale-up of activity over the next biennium. It is important that this exploratory phase remains if a strong portfolio of activities is to be generated in future biennia. Table 10: 2010-2011 Budget for Drug Development and Evaluation for Helminths and Other

Neglected Tropical Diseases (Business Line 6) US $ x 1000


1 Development and registration of new helminth drugs 6,300 Moxidectin for onchocerciasis 5,600 Onchocerciasis clinical development 500 Schistosomiasis drug candidate 50 Soil Transmitted Helminth drug candidate 150

2 Evidence for improved use of currently available drugs 1,010 Drugs for Africa Trypanosomiasis 100 Drug resistance in helminth 300 New projects 610

3 Development of products for other NTDs 390 Dengue classification 390


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BL7 Accessible quality assured diagnostics Needs and Opportunities

Diagnostics are a critical component of efforts to reduce disease burden and help countries realize their health-related Millennium Development Goals. Unfortunately, although many high-quality diagnostic tests for infectious diseases are available, they are neither affordable nor accessible to patients in developing countries. Overall Objective

To promote and facilitate the development, evaluation and application of diagnostic tests appropriate for use in primary health care settings in developing countries. Specific Objectives

1. Define diagnostic needs for diseases of poverty and set standards for diagnostics quality. 2. Facilitate research for test development. 3. Assess and assure diagnostic performance and quality. 4. Increase access to appropriate diagnostics in the developing world, taking into account

socioeconomic factors and issues of gender equity. End-Products

• Diagnostic needs and product specifications defined for each priority disease • International standards and guidelines for the design and conduct of diagnostic evaluations

published for each priority disease • Establishment of specimen and strain banks for target diseases • Diagnostic trial site development • Networks for diagnostics target discovery and validation in collaboration with BL3 and BL4 • Reports on performance and operational characteristics of tests for priority diseases, with the

publication of at least ten evaluations of diagnostics for primary health care settings in developing countries by 2012

• Generic guides and workshops for establishment of external quality assurance programmes • A validated framework and roadmap, developed through implementation research, to

accelerate the introduction and sustainable adoption of promising diagnostics into the developing world (in collaboration with BLs 8 - 11)

Budget

This budget reflects a facilitating role for diagnostics development and the establishment of quality assured mechanisms for their evaluation and implementation. It is imperative that ongoing evaluation and implementation research on existing products continues in line with our current obligations and commitments.


Table 11: 2010-2011 Budget for Accessible Quality Assured Diagnostics (Business Line 7) US $ x 1000


1 To define needs and set standards for diagnostics quality 300 Needs and Standard - TB 150 Needs and Standard - Other diseases 150

2 To facilitate test development 1,200 Facilitate test development - TB 500 Facilitate test development - Other diseases 700

3 To assess and assure diagnostic performance and quality 2,360 Performance and quality - TB 300 Performance and quality - Malaria 660 Performance and quality - STI 700 Performance and quality - Other diseases 700

4 To increase research for access to diagnostics in the developing world

3,650

Research for Access - TB 300 Research for Access - Malaria 450 Research for Access - STI 2,500 Research for Access - Other diseases 400

5 Coordination (Scientific Committees, Travel & Consultants, including defining diagnostic needs) 350

Total Activities 7,860 BL8 Evidence for treatment policy of HIV and TB co-infection Needs and Opportunities

Resource limited countries are constrained in their ability to cope with the rising burden of HIV driven TB due to the limited evidence on strategies to optimize treatment and case management. Overall Objective

To develop evidence for optimizing treatment and case management/delivery of care for all patient populations with tuberculosis and tuberculosis/HIV co-infection, including patients with additional co-morbid diseases. Specific Objectives

1. Develop evidence to shorten and simplify the treatment of TB in TB in HIV-infected TB patient populations.

2. Develop evidence for the timing of treatment and optimal management of HIV-infected TB patients:

3. Implementing optimal case management approaches and treatment strategies in resource-limited settings of high burden countries in support of the scale-up of antiretroviral therapy.

TDR/PB/2010-2011 Page 16

End-Products

• Simpler/shorter TB treatments, including; (i) registration and evidence for use of gatifloxacin-containing fixed-dose combination (FDC) for four months by TB Control Programmes (2013); (ii) evidence of safety and efficacy of 4-FDC TB therapy in HIV-infected and non-infected pulmonary TB patients (2011)

• Evidence for the optimal timing and concomitant use of TB treatment and HAART for improved management of HIV-infected TB patients (TB-HAART) (preliminary data 2010 for initial policy decisions; complete data by 2013)

• Use of rifabutin-containing TB regimen (rifampicin-free regimen) for management of HIV-infected TB patients failing first line antiretrovirals (2013)

• Evidence for the utility of bio/surrogate markers and immunomodulation for improved care of patients presenting with IRIS and HIV-infected TB (2013)

• Evidence to develop guidelines for improved access to care for HIV-infected TB patients. Budget

The immediate objectives of this business line build on ongoing work to evaluate drug regimens that shorten treatment time for TB and assess the optimal timing and concomitant use of drugs to treat HIV-infected TB patients. It also anticipates implementation research linked to scaling up optimal care and delivery of HIV and TB treatment embedded within national, ministry led control programmes and developing some innovative new concepts to address issues of TB and HIV co-infection. The core ongoing activities on shortened TB treatment, the safety and efficacy of fixed dose combinations and the timing of HIV and TB treatment linked to CD4 levels are commitments that must continue. Table 12: 2010-2011 Budget on Evidence for Treatment Policy of HIV and TB Co-Infection

(Business Line 8) US $ x 1000


1 Development and evidence for simplified TB treatment 2,700 Shortened TB treatment 2,150 Safety and efficacy of FDC 550

2 TB HAART 3,745 When to start HAART in TB/HIV patients 3,745

3 Optimal Care and Delivery 462 4 Immunopathology of TB 0 Immunomodulators as adjunct therapy 0 Surrogate markers 0



BL9 Evidence for antimalarial policy and access Needs and Opportunities

WHO estimates that malaria is responsible for over one million deaths per year. These deaths are avoidable using artemisinin-based combination therapies (ACTs), but most malarial fevers are not treated appropriately. Many patients seek treatment too late or do not reach public treatment facilities, and obtain health care from the private or informal sector, where they often get inappropriate and poor quality treatment. There is an urgent need for research to complement existing malaria control policies and strategies through providing evidence for malaria treatment policy and for effective management of malaria at the community level. Overall Objective

To improve access to effective treatment for malaria and case-management of malaria and other childhood infections at all levels of the health system with the aim of reducing childhood mortality. Specific Objectives

1. To provide stewardship and a convening platform that can facilitate assessment of the safety, effectiveness and access to antimalarial drugs in 'real-life conditions of use, at different levels of the health system

2. To contribute to the assessment of antimalarial interventions and combined interventions in special groups and vulnerable populations. .

3. To develop and assess an integrated implementation strategy, based on tools of proven efficacy, for the treatment of malaria episodes of various degrees of severity at the community level

4. To develop an integrated case management strategy for malaria, pneumonia and other febrile illnesses at the community level and to measure its public health impact.

End-Products

• Functional and highly utilized knowledge and stewardship platform available to facilitate specific objective 1 (2009)

• A field-tested, community-accepted, safe and effective treatment package for malaria episodes of varying degrees of severity at the community level (2010)

• Evidence of the impact of the comprehensive diagnostic and treatment package to reduce severe malaria morbidity and mortality (2012)

• Guidance on how to scale up coverage with an effective diagnostic and treatment package for malaria made available to policy-makers (by 2013)

• Socially acceptable and operationally feasible treatment delivery model for prompt management of children with uncomplicated malaria, pneumonia and diarrhoea by community care providers (2011)

• Evidence on the impact of an integrated management package for malaria, pneumonia and diarrhoea at the community level on under-five mortality (2013)

Budget

The budget is broken down into four main activities to deliver on the objectives and end products. A major new objective was added to this business line in 2009 by the scientific advisory committee, endorsed by TDR's overall Scientific and Technical Advisory Committee, namely to play a 'Stewardship role' to assist assessment of the safety, effectiveness and access to antimalarial drugs in 'real-life conditions of use, at different levels of the health system. This element is covered within the coordination segment of the budget. The budget of this business line supports a well defined set of objectives that need to be fully met to maintain the integrity of this activity.

TDR/PB/2010-2011 Page 18

Table 13: 2010-2011 Budget on Evidence for Antimalarial Policy and Access (Business Line 9) US $ x 1000


1 Evaluation of new antimalarials 2,500 2 Community malaria treatment packages 2,500 3 Fever Management 1,550

4 Coordination (Scientific Committees, Travel & Consultants including stewardship role for objective 1) 1,810

Total Activities 8,360 BL10 Visceral Leishmaniasis elimination Needs and Opportunities

Visceral Leishmaniasis (VL) is a fatal disease with an estimated incidence of 500,000 cases per year. Diagnosis and treatment of VL has always been very difficult, but the recent developments of new drugs (e.g. miltefosine - first oral drug - ambisome and paromomycin) and diagnostics (e.g. rK39 rapid diagnostic test) has created a major new opportunity for improved control and a commitment to eliminate the disease on the Indian sub-continent by 2015. Overall Objective

To develop and validate innovative and efficient interventions and strategies for the elimination of visceral leishmaniasis on the Indian sub-continent. Specific Objectives

1. Steward the defining of research needs and priorities and provide technical guidance to research for elimination of visceral leishmaniasis.

2. Generate evidence on the most cost-effective elimination strategies using optimal interventions across diagnosis, treatment and vector control.

3. Develop and evaluate new and improved diagnostics, drugs and combination therapies. End-Products

• Ongoing functional link with the regional technical advisory group (RTAG), stakeholders and interested parties to assess and advise on tools and strategies for elimination (now until 2013)

• Consensus reached on VL elimination strategies (2013) • Optimal and most cost-effective elimination strategy defined, combining case detection /

management and vector control: • Evidence on real-life cost-effectiveness of the chosen drug combinations (2013)

Budget

The budget covers four types of activities to achieve the above end-products: (i) stewardship through technical advice and support on research issues to the Regional and Technical Advisory Group for VL elimination in the Indian sub-continent, (ii) optimization and scaling up treatment strategies, (iii) research to support vector management and (iv) research to evaluate and incorporate new drugs and diagnostics regimes into the elimination programme. The budget of this business line supports a well defined set of objectives that need to be fully met to maintain the integrity of this activity.


Table 14: 2010-2011 Budget for Visceral Leishmaniasis Elimination in Indian Sub-Continent (Business Line 10)

US $ x 1000


1 Stewardship 280 2 Treatment strategies 750 3 Vector management 630 4 Drugs and Diagnostics 600 5 Coordination (Scientific Committees, Travel & Consultants) 190

Total Activities 2,450 BL11 Integrated community-based interventions Needs and Opportunities

Several effective and simple interventions are available to prevent or treat malaria and NTDs such as schistosomiasis, lymphatic filariasis, onchocerciasis and African trypanosomiasis. However, these interventions often do not reach the affected populations which need them the most, in particular the poor and rural populations in Africa. Overall Objective

To develop innovative, effective and efficient strategies for implementing community-based interventions in poor populations. Specific Objectives

1. Develop an analytical framework for integrated community based interventions. 2. Conduct research on critical factors in the scale-up of community-based intervention strategy

exploring its efficient introduction in new areas 3. Develop and test alternative community-based intervention strategies targeting underserved

populations. 4. Develop strategies that enhance communities' capacity to demand for and implement

community-based interventions. End-Products

• Policy briefs on integrated CBI and tool box for design of integrated CBI (2010) • Strategy for CDI in areas where community directed treatment of ivermectin has not been

installed (2012) • Alternate CBI strategies targeting urban areas and underserved populations (post-conflict,

nomadic and transitory populations (2012) • Strategies that enhance communities' capacity to demand for and implement CBI (2012) Budget

The budget for the biennium covers four objectives. Work on the analytical framework is covered under item three of the budget. Item one of the budget covers upscaling and expanding the scope of community directed interventions, building on the results from a major multi-country study published in 2008 demonstrating their potential for the integrated delivery of interventions against neglected tropical diseases and malaria. Item two of the budget relates to the development of

TDR/PB/2010-2011 Page 20

alternative models for urban and post-conflict areas. A few small studies have begun to address this issue, but there is a need to upscale this research in order to generate conclusive results that will have policy impact. The last objective covered by the budget for the biennium concerns research on strategies for community empowerment and the role of incentives that are critical for all community level intervention models. Table 15: 2010-2011 Budget for Integrated Community-Based Interventions

(Business Line 11) US $ x 1000


1 Community Directed Interventions 1,500 Upscaling CDI 500 Community directed interventions in areas without

Community Directed Treatment with ivermectin for onchocerciasis 1,000

2 Other community-level delivery models 1,130 Urban areas 655 Post-conflict areas 475

3 Framework for co-implementation 70 4 Incentives and empowerment 100 Social science research on incentives 80 Innovative solutions 20


Other Neglected Priority Research Activities

In addition to the work of the research business lines there are some support activities that need to be undertaken under the oversight of the Research function, namely clinical coordination and quality management of research. TDR needs to ensure that any research that it funds is carried out to best practice and is appropriately monitored and audited from a technical perspective. Both these activities will seek to engage as much as possible scientists and institutions from developing countries in the development of the quality management, monitoring and auditing systems that need to be put in place. There are also several research activities that fall outside the research business lines. These fall into two categories. The first are some special research initiatives that consist of: (i) a limited number of small projects started before the implementation of TDR's new strategy that TDR has an obligation to finish; and (ii) a special project in collaboration with IDRC that is assessing the interface of environment, community and vector control for dengue and Chagas' disease in Asia and the Americas. This project is in response to request from TDR's governing bodies that it engages more in research associated with environment and climate change. As it develops it may be appropriate to merge this activity with an existing business line (e.g. vectors or community based activities) or develop it into a strategic stand-alone activity. However, at the time of preparing this budget it is judged that for the time being it remains as a special project.


The second category of research activity that falls outside the business lines has been research in support of health systems strengthening, linked to the 'Positive Synergies' project. This area of activity focuses on the interface between infectious disease focused programmes e.g. on HIV, TB and malaria and their interface with the health system as a whole. It is an area that could link effectively expand to encompass a more strategic approach to operations and implementation research for infectious diseases of poverty that is currently under discussion with some of TDR's development partners. As with the IDRC research collaboration, if it develops it may be appropriate to merge this activity with an existing business line (e.g. community based activities) or develop it into a strategic stand-alone activity. Once again, at the time of preparing this budget it is judged that for the time being it remains as a special project. Budget

The budget covers the activities outlined above.

Table 16: 2010-2011 Budget for Other Neglected Priorities Research (Business Line 14) US $ x 1000


1 Coordination (Travel & Consultants) 100 2 Quality Management 980 3 Clinical Coordination 400 4 Special Research Initiatives 2,800 5 Health Systems Strengthening 2,890 Total Activities 7,170

3.3 BUDGET DETAILS FOR PROGRAMME SUPPORT

Programme support covers a portfolio policy and development unit as well as several other activities. Because of the strategic significance of portfolio policy and development the budget of this unit is discussed in detail before moving on to the other areas of programme support, namely programme management, external relations, strategic alliances and communications. Within the portfolio policy and development unit there is a budget line for an innovation fund. As this funds operational activities, rather than standard overhead costs, it is itemised separately in Table 1 for reasons of transparency Portfolio Policy and Development Rationale

There is a need to ensure the coherent development and delivery of TDR's portfolio objectives and to put in place monitoring and evaluation processes that facilitate this. Innovative opportunities to build on and enhance the portfolio also need to be captured and fostered through appropriate processes. There is a need to optimize linkages, synergies and compatibility within TDR's portfolio of activities. In addition there is a need to strategically optimize linkages, synergies and compatibility with other activities within WHO (headquarters, regions and countries) and the other co-sponsoring agencies.

TDR/PB/2010-2011 Page 22

Overall Objective

To put in place and oversee systems and mechanisms that provide coherence to the TDR portfolio of activities, and enable its optimal development as a co-sponsored special programme within WHO as its executing agency. Specific Objectives

1. To put in place and oversee systems and mechanisms that facilitate transparency of business line activities, the establishment of clear objectives and milestones, the sharing of information within and outside TDR and supportive monitoring and evaluation of the business line portfolio.

2. To help develop and optimize common technical processes, such as calls for proposals and their review, which can facilitate the operation of individual business lines.

3. To assist in negotiations with WHO departments and co-sponsoring agencies to identify functional frameworks around common objectives and to define responsibilities and mechanisms of working to meet those common objectives.

4. To manage an innovation fund that enables TDR to support innovative ideas and concepts that fall within the broad mandate of its mission and which could lead to sustainable future activities, either outside TDR or within TDR e.g. as the basis for a new business line or as an extension to an exiting business line or activity..

Budget

Objectives 1 to 3 fall under the Portfolio monitoring activity and are labour intensive, with limited operational costs. So far, a lack of resources has prevented implementation of the innovation fund, but one activity has been initiated (ESSENCE) in collaboration with several development and research agencies. Table 17: 2010-2011 Budget for Portfolio Policy and Development US $ x 1000


1 Coordination (Travel & Consultants) 300 2 Portfolio monitoring 220 3 Innovation Fund 320 Essence 320 Other 0 Total Activities 840

3.4 PROGRAMME SUPPORT (EXCLUDING PORTFOLIO POLICY AND DEVELOPMENT)

Programme support consists in addition of the key units and support elements identified in Table 18 below. Most of the costs associated with this support are fixed in the short term. Programme Management

Programme Management is the largest programme support unit. Its main role is to provide management support within TDR on financial, human resource, facilities and contract management. It works in close collaboration with the TDR's business line and other programme support units, and with units within WHO's General Management department.


The July 2008 introduction of the WHO Global Management System (GSM) led to some teething difficulties but is now facilitating improvement in the efficiency and effectiveness of WHO's administrative operations. With the establishment of GSM, the appointment of a new Programme Manager, and in collaboration with the Portfolio Policy and Development unit, TDR will take this opportunity to review and improve its own operational procedures. WHO Administrative support costs are currently assessed at 4% of relevant TDR expenditures. They hence vary with budgeted expenditure levels. External Relations and Governance

This small unit manages and coordinates the interactions, meetings and interfaces involved in TDR's governance and coordinates external relations and resource mobilization activities. The Joint Coordinating Board (JCB) normally meets once a year and is the top governing body of TDR. It sets the strategic direction and budget for the Programme. It consists of the four co-sponsoring agencies, members selected from among the governments providing financial resources to TDR, governments representing the six WHO regions and members selected by the Board itself. The JCB is advised by the TDR Scientific and Technical Advisory Committee (STAC), consisting of leading scientists in the research areas covered by the Programme. STAC also normally meets once per year. The Standing Committee comprises the four co-sponsors of the Programme, including ex officio the chair of STAC and the JCB chair and vice-chair. The Standing Committee meets two to three times per year to monitor and review progress, and to deal with specific issues as they might arise. The external relations and resource mobilization activities are coordinated by the unit and support the efforts of the Director and other senior professional staff. The external relations and governance unit works closely with the strategic alliances unit and the communications unit concerning the promotional material required in support of the resource mobilization activities. Strategic Alliances

This small unit seeks out and promotes technically based strategic interactions with partners that both promote TDR related activities and might lead to technical and / or resourcing opportunities for TDR supported activities. Such resources may be provided outside of TDR or through TDR. The focus is on building strategic interfaces with the many organizations and individuals, both new and established, in the international health field. This unit operates primarily as a 'door opener' to opportunities for alliance and partnership development, which are then taken up in the medium to long term by the responsible unit. Communications

The communications unit manages the overall communications and advocacy activities for TDR. It works with the Director and all areas of TDR to develop coherent messaging and facilitate resource mobilization. It also works closely with the external relations and governance and strategic alliances units. It provides support and materials to promote the technical activities of TDR and advocate for common causes with partners.

TDR/PB/2010-2011 Page 24

Table 18: 2010-2011 Budget for Programme Support US $ x 1000


1 Director's office 200 2 Programme Management and Administration 8,705 Information technology 400 Postage and telecom 600 Rent, parking, cleaning 2,260 WHO administrative support costs 4,735 Staff development 150 Supplies, Consultant, Audit 370 Special TDR supported project 190

3 External Relations & Governance 1,650 JCB 900 STAC 350 Standing Committee 250 Travel 50 Donor meetings 100

4 Strategic Alliances 294 Coordination (Scientific Committees, Travel & Consultants) 294 Special Project (the Global Fund) 0

5 Communications 1,644 Scientific publications and materials 117 Newsletter 470 Advocacy materials and support 522 Other operations support 535 Total Activities 12,493

3.5 CONSEQUENCES OF THE BUDGET The objectives, end-products and costs outlined in the business plan and in this budget document are directed to meet the challenges of the strategy and the vision that drives it, namely 'to foster an effective global research effort on infectious diseases of poverty, in which disease endemic countries play a pivotal role'. Funding the business plan will allow delivery of the end-products with their accompanying impact. Failure to fully fund the business plan scenario will result in reduced output and reduced impact. A major effort has been undertaken to scale up the Stewardship function in the first biennium, given its central role in the new strategy and further scale up is needed in 2010-2011. Funds would be used to extend and consolidate the knowledge management infrastructure and relevant stakeholder consultations to achieve critical early end-products. The main output of the Stewardship activity in 2010-11 will be the first of a series of biennial reports on the status of research on infectious diseases of poverty, outlining expert and consensus driven priorities.


The Empowerment function needs to be consolidated so that it can expand, particularly in the area of networks and leverage. It is anticipated that there will be at least 175 peer reviewed scientific publications (50% of TDR's total) where the first author originates from a disease endemic country institution, arising from TDR supported research. The strategic function of Research for Neglected Priorities forms the major component of the budget and is the function that delivers products, interventions and implementation strategies likely to have an immediate impact on infectious diseases of poverty. Key outputs from the research BL's in 2010-2011 are as follows: BL3: At least two lead compounds transitioned into fully funded lead optimization discovery

research, either funded within TDR or transitioned to another organization or regional innovation network.

BL4: An African Network for Drug and Diagnostics Innovation established as an entity within Africa with African leadership and governance.

BL5: Complete and annotated genomic sequence of the tsetse fly genome

BL6: Completion of phase 3 recruitment for moxidectin development

BL7: A validated framework and roadmap to accelerate the introduction and sustainable adoption of syphilis diagnostics in Africa.

BL8: Data will be available in 2010 to inform policy decisions on the timing of combined TB and antiretroviral therapy depending on CD4 status

BL9: A field-tested, community-accepted, safe and effective treatment package for malaria episodes of varying degrees of severity at the community level

BL10: Cost-effective case detection strategy determined, feasibility and operational costs of combined Indoor residual spraying / long lasting insecticide treated nets approach established, and improved treatment interventions developed.

BL11: Policy briefs on integrated community based interventions and a tool box for design of integrated community based interventions

The strength of TDR lies in its action-oriented approach to problems and issues. Its impact on policy is dependent on its technical credibility, which in turn relies on delivery of its technical promises. In addition to the major output indicators of success outlined above for 2010-2011 a check-list is provided below of the outputs TDR plans to technically deliver over the 2008-2013 time horizon and their current status. If TDR is successful in generating the resource levels identified in the business plan and achieves the budgets for 2010-2011 and subsequently 2012-2013, we believe the Programme will be able to meet the expectations provided below.

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6-year deliverables (2008-2013): Status

• Series of biennial reports on the status and priority research agendas of tropical disease research

On track

• At least 10 new research leaders from developing countries On track

• Establishing 8 product R&D projects under developing country leadership

On track

• Criteria for bio-safety and efficacy evaluation of genetically modified mosquitoes for malaria control

On track

• Improved integrated vector control methods developed and validated for several diseases

On track

• Macrofilaricide drug for onchocerciasis opening up opportunities for eradication

On track

• Point of care, accessible diagnostics evaluated for 10 neglected diseases On track

• New TB combination drug that reduces treatment from 6 to 4 months and evidence to inform treatment of HIV/TB co-infected patients

On track

• Community packages developed for malaria, pneumonia and diarrhoea On track

• Comprehensive package of interventions and delivery strategies to support visceral leishmaniasis elimination on the Indian sub-continent

On track

• Strategies developed and assessed, with cost-effectiveness analysis, for scaling up community based interventions in new environments

On track


4. RESOURCE MOBILIZATION

A communications strategy has been developed to support the fundraising effort. It will run in several stages. The first stage has been to obtain buy-in and support for TDR's new strategy internally within its key governance-related stakeholders. The second stage, running from July 2007 to June 2009, sought to raise TDR's profile externally to support for its expanded fundraising goals. The third stage will run form June 2009 to January 2011 and will seek to sustain a broad base of interest in both TDR's scientific and fundraising goals. With support from WHO and other co-sponsoring agencies and stakeholders, funding will be sought at two major levels. The first level will be undesignated and will support the Programme in its entirety. The second level of funding will be at the level of the business line. The business line structure facilitates straightforward communication about the value of TDR's research activities and business lines will be empowered to proactively raise funds. Three major sources of funds have been identified: governmental and international public sector; philanthropy / nongovernmental organization (NGO) sector and private sector. As a public sector based programme, with a strategy that is primarily directed at public sector goals, governmental and intergovernmental agency contributions should remain at the core of TDR's resource base. The Programme envisages obtaining 70% of its resources from this sector. The significance and importance of the philanthropy / NGO sector, both as stakeholders in the broadest sense, as cooperating parties able to attend JCB sessions and as resource contributors and / or providers of technical and / or scientific support to the Programme, are greatly appreciated and recognized. They may frequently also be partners in research activities and may co-fund those activities with TDR. Recognizing that most contributions from this sector are likely to be designated contributions, attempts will be made to secure funds at the business line level. A target for 20% of funding from this sector will be set. TDR continues to benefit from good interactions with the private sector and will seek to enhance this through continued private sector funding, subject to WHO's guidelines. The Programme also sees an opportunity to obtain funds from private individuals as well as from corporations. A target of 10% of funding will be set for this sector. In summary, TDR will attempt to proactively seek a greater percentage of funding from the private and philanthropy/NGO sector. However, with its goal to increase its overall resources, TDR will also require significant additional resources from governmental and international public sector sources. Given the significance of the public sector funding sources to the TDR strategy, TDR plans to make a special effort to maintain engagement with current government contributors, re-engage past government contributors and recruit new government contributors, including from disease endemic countries. TDR recognizes that it needs to deliver on its vision, strategic objectives, end-products and effective utilization of resources, as well as communicate this effectively, to have its desired impact. By successfully linking these deliverables to its resource requirements and generating a feeling of common ownership, stakeholdership and commitment to the Programme among its resource contributors, TDR can both meet its resource targets and effectively deliver on its vision and strategy.

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