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Report summary for January 2012 country management and support visit to Lesotho
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    As the U.S. science-based public health and disease prevention agency, the Centers for Disease Control and Prevention (CDC) plays an important role in implementing the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) under the direction of the Department of State Office of the U.S. Global AIDS Coordinator. CDC uses its technical expertise in public health science and long-standing relationships with Ministries of Health across the globe to work side-by-side with countries to build strong national programs and sustainable public health systems that can respond effectively to the global HIV/AIDS epidemic. All CDC global HIV/AIDS PEPFAR-related activities are implemented by the Division of Global HIV/AIDS (DGHA) in CDC’s Center for Global Health.

    CDC’s Commitment to Accountability: CDC/DGHA launched the Country Management and Support (CMS) initiative in 2011 to identify any challenges resulting from the rapid scale-up of complex PEPFAR/CDC programming as part of CDC’s commitment to transparency and accountability. This initiative serves as a basis for ongoing, monitored quality improvement of CDC/DGHA’s programs and operations through internal programmatic and financial oversight. CMS is a proactive response on the part of CDC to ensure that CDC/DGHA is supporting the Presidential Initiatives, Department of State, and Office of the U.S. Global AIDS Coordinator. The CMS strategy is designed to assess CDC/DGHA’s accountability in the following key areas: Intramural Resources: Ensuring proper management and stewardship of financial resources, property, and human resources within CDC’s overseas offices; Extramural Funding: Ensuring responsible and accurate management of financial and other resources external to CDC’s overseas offices; Public Health Impact: Ensuring the delivery of consistently high quality interventions and technical assistance that positively impact the populations the program serves.

    Lesotho Country Management and Support Visit: CDC/DGHA conducted a CMS visit to the CDC country office in Lesotho from January 23-27, 2012. The principal objectives of this CMS visit were to: Perform a CDC headquarters assessment of internal controls in the field to ensure the highest level of accountability; Provide clear feedback and support to the country office to improve current internal controls; Refine, systematize, and modify CMS methodologies, processes, and associated tools for full implementation of the CMS across all CDC/DGHA-supported programs in the field.

    CDC/DGHA headquarters (CDC/HQ) in Atlanta, Georgia assembled an intra-agency multidisciplinary team of six subject matter experts in the following areas to perform the CMS assessment: country management and operations, program budget and extramural management, procurement and grants, financial management, science, and one key technical program area (laboratory). DGHA’s Program Budget and Extramural Management Branch, CDC’s Procurement and Grants Office, and CDC’s Financial Management Office conducted their assessment from Atlanta as a “desk” review, while the Country Manager, a representative from DGHA’s Country Operations Branch, and a laboratory technical reviewer spent five days in Lesotho performing an in-person assessment.

    The CMS team conducted a five-day visit to the CDC/DGHA office in Lesotho (CDC/Lesotho), which included technical site visits with grantees, one-on-one meetings with staff, and data quality spot checks. Desk reviews included phone interviews with key CDC/Lesotho and grantee staff and reviews of financial/administrative documents and internal financial controls at CDC and grantee offices. Assessment tools and checklists were developed by CMS leadership in consultation with subject matter experts at CDC/HQ. This methodology was designed to provide a “point in time” synopsis of CDC/Lesotho’s operations.

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