Abstract
From 2001 to 2012, USAID/Brazil invested approximately US$35 million in TB programs aimed at expanding Directly Observed Therapy Short-Course (DOTS), the WHO-recommended strategy for TB control, in selected priority areas with the highest burden of TB. USAID programs and projects also combated Multidrug-Resistant TB (MDR-TB), improved coordination between TB and HIV/AIDS Programs, and increased public awareness of TB. USAID TB funding for Brazil ended in September 2011, i.e., two years earlier than previously expected. All activities will terminate in 2013. It is essential to capture the Agencys legacy in TB, share lessons learned and best practices, and inform the recommendations that will be provided to the Government of Brazil (GOB), other donors, and stakeholders.In October 2012, USAID/Brazil commissioned GH Tech Bridge II to conduct an independent, external performance evaluation of its TB portfolio, covering the period of fiscal year (FY) 2001 to FY 2012. Overall, USAID's TB program was perceived as highly valuable, with strategic investment that leveraged and supplemented existing, larger technical, managerial and financial resources in the National TB Program. The main legacy of USAID support to TB control in Brazil is the adoption of DOTS as the national TB control policy, and implementation of quality DOTS programs in selected intervention sites. USAID support was key in influencing policy change for adoption of DOTS and in helping to implement and expand quality DOTS in priority high burden areas. By funding relevant research, USAID played a fundamental role in provided scientific evidence to this major policy change, which included Ethambutol in the TB treatment regimen, in accordance with international standards. (Excerpt, modified)