Amendment 2 - Annex B - Business Day Full Presentation.pdf

BUSINESS DAY

Strengthening Systems for Health Security Activity

November 6, 2024 USAID/Peru

GHS as a U.S. Government PriorityGHS as a U.S. Government Priority

TIME ACTIVITY PRESENTER

8:15 - 8:55 Registration Jose Sanchez/ Andrea Araujo

9:00 - 9:10 Welcome Mr. Jose Antonio Zarzar (USAID/Peru)

9:10 - 9:20 Opening Remarks from USAID Regional Migration and Health Office Director Danielle Spinard (USAID/Peru)

9:20 - 9:35 Application Submission Guidelines Mr. Luis Garay (USAID/Peru)

9:35 - 10:05 USG GHS Strategy 2024 + Project Description Dr. Mariana Ramos (USAID/Peru)

10:05 - 10:20 COFFEE BREAK

10:20 - 10:45 CDC Peru: IHR roadmap Dr. Cesar Munayco (CDC/Peru)

10:45 - 11:00 PAHO Peru: current activities with USAID and areas of potential collaboration Dr. Manuel Loayza (PAHO/Peru)

11:00 - 11:15 FAO Peru: current activities with USAID and areas of potential collaboration

Dr. Jessica Galvez-Durand

(FAO-ECTAD)

AGENDA

TIME ACTIVITY PRESENTER

CROSS CUTTING THEMES:

11:15-11:30 USAID 2030 Vision for Health Systems Strengthening Mr. Marvin Crespin-Gamez (USAID/Peru)

11:30-11:45 Localization Mr. Jose Antonio Zarzar (USAID/Peru)

11:45-12:00 Climate change in USAID-funded activities Dr. Jaime Chang (USAID/Peru)

12:00-12:15 Private sector engagement Ms. Karina Herrera (USAID/Peru)

12:15-12:30 Inclusive development Mrs. Jimena Sanchez (USAID/Peru)

12:30-12:40 Closure and orientation on the opening room for networking Mr. José Antonio Zarzar (USAID/Peru)

12:40-14:30 COFFEE AND NETWORKING

AGENDA

Opening Remarks

Danielle Spinard Director Regional Migration and Health Office

Application Submission Guidelines

Luis Garay Assistance & Acquisition Specialist Regional Office of Acquisition & Assistance

AWARD INFORMATION

USAID intends to award one (1) Cooperative Agreement with up to $19,000,000 (USD) in total funding over a 5 (five) year period. The estimated start date will be upon the signing of this award

ELIGIBILITY: Local and non-local NGOs are welcome to apply as PRIME recipients. SUB AWARDEES are unrestricted.

AGENCY POINT OF CONTACT:

● The Agreement Officer (AO) for this NOFO is: Ms. Dion Glisan, Supervisory Regional

Agreement Officer (dglisan@usaid.gov).

● The Acquisition and Assistance (A&A) Specialist for this NOFO is: Mr. Luis Garay, A&A

Specialist (lgaray@usaid.gov).

CALENDAR:

● Deadline for Questions: November 15, 2024 at 05:00 PM Lima Time

● NOFO Amendment with Q&A: November 22, 2024 before 05:00 PM Lima Time

● Deadline for Applications: December 16, 2024 at 12:00 PM Lima Time mailto:dglisan@usaid.gov mailto:lgaray@usaid.gov

APPLICATION FORMAT

GENERAL CONTENT

● Applications must be submitted IN ENGLISH in two separate parts: TECHNICAL &

BUSINESS.

● Applications must comply with their individual page limitation, forms, certifications & assurances, file format and font size instructions.

● Applications will be reviewed and evaluated in accordance with the criteria in Section F.2.

TECHNICAL APPLICATION

● Should be specific, complete, and presented concisely, taking into account the requirements of the program.

● DON’T INCLUDE COSTS.

BUSINESS APPLICATION

● MUST REFLECT THE ENTIRE PERIOD OF PERFORMANCE and all costs associated with the technical application.

● The BUDGET NARRATIVE must contain sufficient detail to allow USAID to understand the proposed cost. KEEP YOUR EXCEL FORMULAS!

QUESTION & ANSWERS FORMAT

When submitting a question, try to be as specific as possible for a clearer answer. Mentioning the page, section and paragraph helps narrow down the subject. Q&A is also in english, must be submitted to the POC and answers will be uploaded as an amendment to the grants.gov webpage.

EXAMPLE:

DON’T:

● What do you mean by 10% Cost-Sharing?

● Can we exceed the 20 page limit on applications?

INSTEAD, DO:

● 1. Page 7, Section B: Eligibility, Subsection B.2. Cost Sharing. Can you explain what does the

10% Cost Sharing requirement mean?

● 2. Page 24, Section D, Application Content and Format, Subsection D.2 Technical

Application Format. Can we exceed the 20 page limit?

● Each PRIME Applicant must be registered in SAM.gov, maintain a current and active registration and include its UEI (Unique Entity Identifier) in each application it submits to USAID. Subrecipients must only obtain a UEI in order to receive subaward, but are not required to complete full SAM registration. The SAM registration process may take many weeks to complete.

● No deadline extensions are being considered at the moment. Keep you eyes posted on Grants.gov for any modifications.

● Next Steps:

○ Review Process (Compliance + Merit Review Review)

○ Request for Clarification, if needed

○ Green Light

○ Inception Phase

● DON’T WAIT UNTIL THE LAST MINUTE!

A FEW KEY POINTS CONSIDER…

Good luck!

USG GHS Strategy 2024 + Program Description

Mariana Ramos, MD, MSc Global Health Security Specialist Regional Migration and Health Office

GHS as a U.S. Government Priority

1. USAID in Peru

2. U.S. Government Global Health Security Strategy (GHSS) 2024: Highlights

3. Program Description

GHS as a U.S. Government PriorityCONTENTS

- More than 60 years of providing economic, development, and humanitarian assistance.

- We have over 40 activities at the bilateral and regional levels.

- We collaborate with more than $60 million annually for development activities in the country and an average of $50 million annually in South America.

GHS as a U.S. Government PriorityUSAID IN PERU

Localization

Climate Change

Private Sector Engagement

Inclusive Development

OUR GOALS

2. US Government Global Health Security Strategy 2024: highlights

GHS as a U.S. Government PriorityContents

2. US Government Global Health Security Strategy 2024: highlights

2. US Government Global Health Security Strategy 2024: highlights

Program Description

Global Health Security (GHS)

Capacity to properly prevent, detect, and respond to health emergencies, including emerging infectious diseases.

One Health

An approach that recognizes the intersections of human, animal, and environmental health

International Health Regulations (IHR)

Legal framework that defines countries’ rights and obligations in handling public health events and emergencies that have the potential to cross borders.

How to measure IHR core capacities

States Parties Self-Assessment Annual Reporting Tool (SPAR)

Voluntary External Evaluation (VEE) Joint External Evaluation (JEE)

- Peru lacks an articulated system for Global Health Security (GHS).

- High incidence of infectious diseases

- Inadequate health infrastructure

- Sub-optimal epidemiological surveillance and emergency response systems.

- Aggravating Factors:

- Diverse Geography: lack of state presence in remote areas.

- Climate Change: increase of vector-borne diseases, changes in ecosystem, internal displacement.

- Poor Health Governance: high personnel turnover and corruption, lack of health management abilities

- Existing Equity Gaps: populations disproportionately vulnerable to infectious diseases

GHS as a U.S. Government PriorityPERUVIAN CONTEXT IN GHS

Peru’s e-SPAR 2023 results (https://extranet.who.int/e-spar/)

GHS as a U.S. Government PriorityPERU’S COMPLIANCE WITH INTERNATIONAL HEALTH REGULATIONS: METRICS

● Peru's average score was 36% demonstrates severe deficiencies in the national Health Security.

● Urgent need to close capacity gaps using a One Health Approach

● Peru is not prepared prevent, detect, and respond to health emergencies if they emerge within its territory, becoming itself a threat to the region and to the world.

Peru’s e-SPAR 2023 results (https://extranet.who.int/e-spar/)

GHS as a U.S. Government PriorityPERU’S COMPLIANCE WITH INTERNATIONAL HEALTH REGULATIONS: METRICS

Peru’s weak health system and poor capabilities to prevent, detect, and respond to infectious disease and other health threats compromise national and global health security, specifically given its weaknesses across three technical areas:

Zoonotic Diseases, Surveillance, and Health Security Workforce.

GHS as a U.S. Government PriorityPROBLEM STATEMENT

IF

GHS as a U.S. Government Priority

THEN

Risk of disease transmission from animals to humans is reduced

Disease surveillance systems are improved

Skills of Peru’s health security workforce are strengthened

Peru will be able to better prevent, detect, and respond to infectious disease and health threats, reducing the severity and occurrence of pandemics and ensuring national and global health security.

THEORY OF CHANGE

HEALTH SYSTEM STRENGTHENING PRINCIPLES

Equity Quality Resource Optimization Locally-Led Evidence-Driven Resilient

STRENGTHENING SYSTEMS FOR HEALTH SECURITY ACTIVITY (SSHS)

Purpose:

For Peru to have robust capabilities in preventing, detecting, and responding to infectious disease and health threats to ensure national and global health security

OBJECTIVE 3

Effective response to infectious disease outbreaks through a skilled and competent health security workforce

OBJECTIVE 2

Better detection of infectious diseases through improved surveillance systems

OBJECTIVE 1

Better prevention of infectious diseases through the reduction of disease transmission from animals to human populations (i.e. zoonotic diseases)

RESULTS FRAMEWORK

● Peru’s poor surveillance and detection capacity increases the risk of spillover and ZOONOTIC

DISEASES.

● Peru: the potential spillover of diseases from animals to humans is significant.

○ Urbanization,

○ Deforestation,

○ Illegal mining,

○ Poor livestock handling practices,

○ Continued wildlife subsistence farming

● Peru: lacks regulatory operating procedures that establish functional coordination mechanisms among the human, animal, and environment interfaces at national and sub-national levels ( limited structured information-sharing mechanisms among the One Health interfaces)

GHS as a U.S. Government PriorityOBJECTIVE 1: TO REDUCE TRANSMISSION OF ZOONOTIC DISEASES

GHS as a U.S. Government PriorityGHS as a U.S. Government PriorityZOONOTIC DISEASES: USAID ACTIVITY EXPECTATIONS

A technical approach that can best support the GOP (national and sub-national [i.e. regional]) to properly prevent zoonotic disease transmission between animals and humans

Develop context specific multisectoral health security mechanisms that promote coordination among the One Health sectors (human, animal, environment)

Track emerging and endemic priority zoonotic diseases

Improve multisectoral response capacity to zoonotic disease outbreaks at their points of origin.

● Peru’s national SURVEILLANCE SYSTEM is weak:

○ limited early warning capacity,

○ not coordinated across the human, animal, and environment sectors.

○ limited capacity to analyze real time disease surveillance data, which prevents timely detection of an infectious disease outbreak at its origin.

○ Disease surveillance system capacity is far weaker at the regional level (i.e.

sub-national).

● Interoperability: The lack of an interoperable surveillance system increases the risk of infectious diseases and outbreaks going undetected.

○ among the animal, human, and environmental health sectors

○ between national, regional, and local level governments

● Peru’s existing system are not able to account for how climate change is impacting disease transmission and incidence across the human, animal, and environment sectors.

GHS as a U.S. Government PriorityOBJECTIVE 2: TO IMPROVE DISEASE SURVEILLANCE

GHS as a U.S. Government PriorityGHS as a U.S. Government PriorityDISEASE SURVEILLANCE: USAID ACTIVITY EXPECTATIONS

To present a technical approach that can best support the GOP (national and sub-national [i.e.

regional]) to strengthen existing disease surveillance systems incorporating a one health approach.

To improve early warning disease surveillance systems, that are climate and weather sensitive.

(better tracking and monitoring potential disease outbreaks at their points of origin)

To build a surveillance system that delivers reliable and timely disease data, and improving government capacity to collect, analyze, and interpret data on disease occurrence and patterns.

To promote interoperability between the Peruvian diagnostic and the surveillance system at the national and regional level with a one health approach

● A health security workforce may consist of an interdisciplinary group of professionals (physicians and nurses, public health and environmental health specialists, veterinarians, forest scouts, epidemiologists, communication experts, and other professionals relevant to the human, animal, and environmental health sectors). Peru lacks enough skilled human resources in health security.

● Peru lacks a formal workforce strategy that plans and budgets for the number of HUMAN RESOURCES, inclusive of the human, animal, and environment sectors, needed to prevent, detect, and respond to infectious diseases and manage the health security system.

● Peru’s current gaps in human resources inherently limit its GHS capabilities across all GHS priority areas.

● The existing workforce lacks ongoing and standardized training programs, continuous learning opportunities, or educational curricula that incorporate the One Health principles and approach.

GHS as a U.S. Government PriorityOBJECTIVE 3: TO STRENGTHEN HEALTH SECURITY WORKFORCE

GHS as a U.S. Government PriorityGHS as a U.S. Government PriorityHEALTH SECURITY WORKFORCE: USAID ACTIVITY EXPECTATIONS

To support the GOP (national and sub-national [i.e. regional]) in planning for, and building and strengthening its existing and emerging health security workforce, one that is occupationally diverse and skilled and inclusive of the human, animal, and environment sectors.

It is encouraged to partner with public and/or private academic institutions to not only incorporate a One Health foundation across educational curricula, but to foster the development of the new generation of health security professionals

It is encouraged to identify partnerships and innovative interventions with diverse sectors that may increase career pathways for individuals interested in entering the health security workforce.

The Activity is encouraged to not replace core functions of existing personnel to address workforce gaps, but rather support Peru in meeting its needs with existing and emerging human resources.

GHS as a U.S. Government PriorityGHS as a U.S. Government PriorityGOVERNANCE AS A CROSS-CUTTING THEME IN THE PROPOSAL

Particular attention in Governance

Increase management capabilities of existing and new government authorities with decision making power (at the national and regional level) needed to effectively prevent, detect, and respond to infectious diseases.

It is encouraged to improve leadership skills and administration capacity for health authorities and support them to better govern, lead, facilitate, and organize processes, procedures, and logistics that implement globally recognized tools (i.e. NAPHS and others), It is encouraged to enhance the ability of health authorities to efficiently implement policies, transparently allocate resources, use evidence for decision making, identify and close equity gaps, mobilize available local and donor resources, and coordinate responses to public health emergencies.

This Activity shall have the flexibility to use funding from this award to support the GOP in mounting a response to infectious disease outbreaks and other health threats with prior approval from USAID.

GHS as a U.S. Government PriorityEVENT DRIVEN HEALTH EMERGENCY RESPONSE

This Activity is encouraged to support the GOP to institutionalize and implement the 7-1-7 Global Goal for Early Detection and Response of disease outbreaks.

“No more than 7 days to detect a suspected infectious disease outbreak, 1 day to notify public health authorities to start an investigation, and 7 days to complete an initial response”.

https://resolvetosavelives.org/prevent-epidemics/7-1-7-early-disease-detection/ https://resolvetosavelives.org/prevent-epidemics/7-1-7-early-disease-detection/

● National, Regional and Local level with a One Health approach.

● Five regions to work should be propose, then only three will be selected during the inception phase (post award)

GHS as a U.S. Government PriorityGEOGRAPHIC APPROACH

Prevalence of Infectious Diseases: high incidence of zoonotic diseases, vector-borne diseases, AMR, or other infectious disease outbreaks and threats.

Deficiencies in Health Security Capabilities: significant weaknesses in surveillance systems, laboratories, outbreak response, according to previous GHS evaluations. Shortage of trained health personnel and limited resources.

Potential Impact on Beneficiary Population: Densely populated regions or with large urban centers, where health threats and health equity gaps could have a broader impact.

Geographic and Logistical Accessibility: Difficult to access due to their remote location or lack of infrastructure, where health capabilities are more limited, as well as border areas with a high movement of people and goods.

Commitment and Capacity of Regional Authorities: local government commitment and political will to implement health security measures.

Evidence-based approach

- Localization

- Climate change and adaptation

- Private Sector Engagement

- Health equity and Inclusive development

- Health systems strengthening principles (specific for this proposal)

GHS as a U.S. Government PriorityUSAID CROSS-CUTTING POLICIES IN THE PROPOSAL

GHS as a U.S. Government PriorityGHS as a U.S. Government PriorityMAGNITUDE OF CHANGE: WHAT DO WE EXPECT TO ACHIEVE

Magnitude of Change

With a $19 million investment over a course of five years

USAID expects a progress Peru makes in closing gaps in the three technical areas USAID/Peru has identified

Prevention, detection and response activities conducted effectively and sustainably by a fully competent, coordinated, evaluated, and occupationally diverse multi sectoral workforce.

Functioning and interoperable human, animal, and environment surveillance systems capable of identifying potential events of concern for public health and health security, and enhanced national and regional level capacity to analyze and link data from and between the different levels of the strengthened early warning surveillance system.

Functional animal, human, and environmental health systems that work individually and collaboratively together through documented mechanisms of coordination and operational frameworks, using a One Health approach, and based on international standards, guidance and best practices.

ZOONOTIC DISEASES

SURVEILLANCE

SYSTEM

HEALTH SECURITY

WORKFORCE

GHS as a U.S. Government PriorityGHS as a U.S. Government PriorityMAGNITUDE OF CHANGE: HOW TO MAKE IT SIMPLE

Magnitude of Change

Obtaining and maintaining at least a score of 3 or 4 on a scale of 5, using globally recognized tools: e-SPAR, VEE, JEE.

Thank you very much for your attention, and good luck.

IHR Roadmap Overview of Country Situation

Dr. Cesar Munayco Director General del Centro Nacional de Epidemiología, Prevención y Control de Enfermedades

Preparación frente a amenazas globales y locales

César V. Munayco Escate, MD, MSc, MPH, DrPH Director General

Preparación frente a amenazas globales y locales

2. La evaluación Externa Conjunta

1. Informe Anual de Autoevaluación de los

Estados Partes

3. Los ejercicios de Simulación

4. Los Exámenes posteriores a la acción Marco de Seguimiento y

Evaluación del RSI

Implementación de las capacidades básicas del RSI Implementar el enfoque “Una Salud”

Lista de capacidades básicas en el RSI

Promedio de las Capacidades del RSI, Perú 2012 – 2022

Fuente: Reporte Anual de los Estados Parte e-SPAR

Puntuación RSI por capacidad, Perú

El promedio general de las 15 capacidades fue de 36%, ubicando a Perú entre los 3 últimos países en la región: Guyana (31%) y Guatemala (32%).

Fuente: CDC Perú

Resultados de la evaluación de las capacidades básicas en puntos de entrada del país, 2022

•5 PE muestra menos del 50 % de capacidades evaluadas.

•Puntajes van desde el 2 % hasta el 46 %

•Paso fronterizo terrestre de Desagüadero inexistencia de capacidades.

Principales actores de la implementación del RSI

Avances implementación RSI en el Perú

Avances implementación RSI en el Perú

Plan Estratégico Sectorial Multianual (PESEM) 2024-2030 del Sector Salud, Actualización lista de puertos internacionales ante la OMS

Comisión Multisectorial RSI (D.S. N°

011-2014.SA

Talleres, simulacros, entrenamiento

Recepción primera nave en puerto Chancay

Lineamientos para el funcionamiento y organización de la Autoridad de Sanidad

Portuaria

Avance Proyecto de Ley para la aplicación del Reglamento Sanitario Internacional (RSI)

Hoja de ruta RSI – CDC, 2024 -2028

Acuerdo en el marco del CIGS

Reglamento Sanitario Internacional

TEMA La DIRESA/GERESA es responsable de: El MINSA es responsable de:

RESPONSABLE

MONITOREO

MINSA

Trabajo MulCsectorial

Conformación de grupo de trabajo mulCsectorial en la región hasta diciembre 2024; a fin de impulsar las acciones de la hoja de ruta del Reglamento Sanitario Internacional y el Enfoque “Una Salud” .

Brindar asistencia técnica sobre Reglamento Sanitario Internacional y el enfoque “Una Salud” CDC

¿Cómo implementamos el RSI a nivel regional y local?

Regional

Regional

Comité locales de salud

Sensibilización y abogacía

Incorporación de presupuesto en PLS

Capacitación, talleres, simulacrosLocal

Hoja de ruta RSI a nivel regional, 2024 -2025

Inteligencia epidémica y respuesta a eventos locales y globales

Detección

Piezas de información

Vigilancia basada en indicadores

EIOS Comunicaciones externas o alertas

Señales potenciales

Vigilancia basada en eventos y triangulación de información

Triage y evaluación de señales

Señal VerificaciónVerificación

Evaluación de riesgo

Evento de salud pública Análisis y evaluación inicial de riesgo

Reporte y diseminaciónReporte de evaluación de riesgo inicial

Respuesta

Equipos de respuesta rápida

Nacional

Regional

Local

Bio vigilancia

Monitoreo de la Capacidad de respuesta

Simulaciones y simulacros

Implementación de enfoque Una Salud

Ley de “Una Salud” Política de “Una Salud”

Avances

Taller aplicación de la herramienta de evaluación de Una Sola Salud

PAHO: Current Activities with USAID/Peru

Dr. Manuel Loayza Consultor Nacional Emergencias Pan American Health Organization (PAHO)

PAHO Peru: current activities with USAID and areas of potential collaboration

Dr. Manuel Loayza Consultor Nacional emergencias

#UniversalHealth

Marco Operacional del RSI

Accesibilidad en todo momento Canal primario para comunicaciones relacionadas a eventos entre OMS y CNE Difundir información dentro de la OMS "Activar" la evaluación de la OMS y el sistema de respuesta

Detectar Evaluar Notificar Responder

Accesibilidad en todo momento Comunicación con OMS Difusión de la información a nivel nacional Consolidación de información a nivel nacional

Capacidades básicas nacionales Sistema de vigilancia y respuesta incluidos en Puntos de Entrada

Centro Nacional de Enlace para el RSI (CNE)

Punto de Contacto del RSI

Regiones OMS

Comité Emergencia

Otras organizaciones (OMSA, OIEA etc.)

Otros Ministerios y sectores

Determinar `emergencia de salud pública de importancia internacional` (ESPII)

Formular las recomendaciones temporales y permanentes Comité Examen

Lista Expe rtos

Director General

OMS

Notificación Consulta Informe Verificación

Eventos inusuales de salud

Anexo

Art.6-12 Anexo

Art. 5, 13, 19, 20, Anexo

Marco de monitoreo y evaluación del RSI

WHA61(2) 2008 y WHA71(15) 2018

15 capacidades y 35 indicadores

Voluntario

Proyecto GHS-USAID-PAHO

Aumentar capacidad del sistema para prevenir, detectar y responder a enfermedades infecciosas nuevas, emergentes o en evolución y otras amenazas para la salud y mejorar la gobernanza y la coordinación de la seguridad sanitaria.

1. Apoyar implementación de un proceso de EEV.

2. Apoyar elaboración del Plan de Acción Nacional para la Seguridad en Salud (NAPHS) con base en los resultados de la EVV

3. Cerrar brechas técnicas de seguridad sanitaria global para mejorar la capacidad del Perú para prevenir, detectar y responder a enfermedades infecciosas y otras amenazas

Objetivos

Meta

EVVEVVEVV

EVV

Marco de Resultados proyecto GHS-USAID-PAHO

Cobertura geográfica

Cobertura Nacional y regional

Capacidades básicas (VEE) Among these, USAID/Peru has selected the following seven to focus its GHS portfolio:

P4. Antimicrobial Resistance P5. Zoonotic diseases D1. National Laboratory Systems D2. Surveillance D.3.3. Workforce Training – (One Health) R5. Risk communication and community engagement (RCCE) PoE.2. Public health response at points of entry.

Implementación proyecto GHS

Inmunizaciones Control vectorial y metaxénicas

Plan de trabajo proyecto GHS-USAID-PAHO

Entre estos, USAID/Perú ha seleccionado los siguientes siete para enfocar su cartera GHS:

P4. Resistencia a los antimicrobianos P5. Enfermedades zoonóticas D1. Sistemas Nacionales de Laboratorios D2. Vigilancia D.3.3. Capacitación de la fuerza laboral – (Una Salud) R5. Comunicación de riesgos y participación comunitaria (RCCE) PoE.2. Respuesta de salud pública en los puntos de entrada.

EVV

NAPHS

Cierre brechas

La finalización de la EVV y la NAPHS es el objetivo prioritario del primer año2024

Fortalecer las capacidades de respuesta oportuna para:

• Vigilancia epidemiológica para prevenir, detectar y responder a posibles enfermedades infecciosas y otras amenazas a la salud basadas en la NAPHS

• Capacidades de los sistemas nacionales de laboratorios para la detección de patógenos con potencial riesgo epidémico

• Capacidades de respuesta de salud pública en los puntos de entrada para la identificación de eventos de salud pública de importancia internacional.

• capacidades del talento humano a través de programas de capacitación en vigilancia de la salud humana, salud animal y medio ambiente en general con un enfoque Una Salud

• Capacidades en comunicación de riesgos y participación comunitaria para la respuesta oportuna a enfermedades con potencial riesgo epidémico.

• Capacidades en prevención, preparación y respuesta a enfermedades zoonóticas con potencial riesgo epidémico en el país.

• capacidades en la gestión de la resistencia a los antimicrobianos en enfermedades con potencial riesgo epidémico

2024-2027

Enfoque de implementación

Las actividades clave que se desarrollaron durante el proyecto se pueden mencionar en tres aspectos:

Diagnóstico y planificación.

Adquisición de equipos y suministros.

Fortaleciendo las capacidades del talento humano

NAPHS

Evaluación anual con SPAR para ver mejora de niveles cada año

Monitoreo y evaluación

En resumen…fortalecer capacidades básicas RSI permitirá………..

Reducción del impacto en la saludDetecció n tempran a

Respuesta rápida y eficaz

"aplanar la curva..."

N u m er o d e C as o s Tiempo

Po te n ci al

C as o s ev it ad o s

Gracias

FAO/Peru: Current activities with USAID

Dr. Jessica Galvez-Durand Food and Agriculture Organization (FAO)

Proyecto OSRO/PER/063/USA:

Sistemas sostenibles de sanidad animal, inocuidad alimentaria y capacidades de “Una Salud”

ECTAD – Perú

MV. Jessica Gálvez-Durand Besnard Coordinadora Proyecto ECTAD-FAO/Perú Jessica.GalvezDurandBesnard@fao.org

ENFOQUE UNA SOLA SALUD

• Alianza Cuatripartita propone el concepto de ”Una Sola

Salud” (Plan de Acción 2022-2026):

«Una Sola Salud» es un enfoque unificador integrado que procura equilibrar y optimizar de manera sostenible la salud de las personas, los animales y los ecosistemas. Reconoce que la salud de los seres humanos y la salud de los animales domésticos y silvestres, las plantas y el ambiente en general

(incluidos los ecosistemas) están estrechamente vinculadas y son interdependientes.

• “Una Sola Salud” es un esfuerzo multisectorial y multidisciplinario de prevención, preparación y respuesta a enfermedades zoonóticas o con dicho potencial tales como: rabia, IAAP, entre otras; así como la RAM.

ECTAD EN PERÚ: DESCRIPCIÓN

● Establecido en setiembre de 2022 por 5 años

(2027), con la colaboración de USAID.

● Actividades distribuidas en seis áreas técnicas1:

1Acciones de la agenda mundial de seguridad sanitaria (GHSA) en Perú

Comité de implementació n

FAO-ECTAD

Ministerio de Desarrollo Agrario y Riego-MIDAGRI

(SERFOR,

SENASA).

Ministerio de Salud-MINSA

(INS, CDC,

DIGESA,

DIGEMID).

Ministerio de la Producción-PRO

DUCE

(SANIPES).

Ministerio del Ambiente-MINAM

(SERNANP,

DGDB).

ZOONOSIS. PROCESO DE ELABORACIÓN DEL PLAN DE CONTINGENCIA MULTISECTORIAL (PCM)

PARA ENFERMEDADES ZOONÓTICAS DEL PERU

2023/Oct.

Taller de Gestión de Buenas Prácticas en la Gestión de Emergencias (GEMP) - Paracas, Ica.

2023/Nov.

Taller de Priorización de Enfermedades Zoonóticas (Rabia, Leptospirosis, IAAP, Fiebre Amarilla, Equinococosis) - Arequipa.

2024/Jul-Ago.

Taller para la formulación del Plan Multisectorial de Contingencia para la atención de Emergencias de Enfermedades Zoonóticas.

2024/Agosto-Dic.

- Desarrollo de documento preliminar.

-Petit comité

-Propuesta de plan para validación de las contrapartes.

-Gestión para su aprobación.

2026-2027

- Apoyo para su implementación en función a las prioridades que e identifiquen.

• Propósito: Los sectores de salud humana, sanidad animal y ambiente responden de forma articulada ante emergencias por enfermedades zoonóticas.

• Objetivos: Apoyar la elaboración del Plan de Contingencia Multisectorial para Enfermedades Zoonóticas.

ZOONOSIS. MAPEO DE CADENAS DE VALOR EN ANIMALES

2024/Enero a marzo:

-Estudio CAP para Brucelosis bovina y caprina.

-Gestiones para desarrollar una estrategia de comunicación de riesgos para brucelosis.

2024/Nov. –Inicio de estudio CAP para TBC bovina (Cajamarca, Lima, La Libertad y Lambayeque) y rabia de los herbívoros (Cajamarca, Amazonas, Huánuco y Apurímac)

-Desarrollo de una estrategia de sensibilización para TBC bovina y rabia de los herbívoros; así como en la cadena acuícola.

-Estudio CAP para hidatidosis y ántrax

-Asistencia técnica para implementar la estrategia de sensibilización en TBC bovina, rabia de los herbívoros y brucelosis

Desarrollo de estrategia de comunicación de riesgo para hidatidosis y ántrax

Asistencia técnica para implementar las estrategias de sensibilización según priorización.

• Propósito: Apoyar la gestión del servicio veterinario respecto a la prevención y control de enfermedades zoonóticas.

• Objetivo: Medir conocimientos, aptitudes y prácticas con respecto a la brucelosis bovina y caprina; TBC bovina y rabia de los herbívoros; hidatidosis y ántrax; a efectos de establecer estrategias de sensibilización que apoyen a cerrar las brechas identificadas.

VIGILANCIA EPIDEMIOLÓGICA/RECURSOS HUMANOS. PROGRAMA DE ENTRENAMIENTO EN

EPIDEMIOLOGÍA VETERINARIA DE CAMPO (ISAVET)

Traducción de Manuales ISAVET.

Coordinación con Dirección General de Sanidad Animal del SENASA para organizar plan de trabajo para implementación de ISAVET en el Perú.

Conformación del Comité ISAVET y desarrollo de Evaluación de Necesidades y Requerimientos (NRA) para la implementación de

ISAVET.

Formación de Capacitadores y Mentores ISAVET.

Proceso de Selección de primera cohorte ISAVET Perú.

Entrenamiento de primera cohorte ISAVET Perú.

Evaluación post entrenamiento a egresados de primera cohorte ISAVET Perú.

• Propósito: El sector de sanidad animal (incluyendo a fauna silvestre) cuenta con fuerza laboral de primera línea entrenada en epidemiología veterinaria de campo.

• Objetivos: Apoyar la implementación y adopción por parte del MIDAGRI (SENASA) del programa de entrenamiento en epidemiología veterinaria de campo.

RAM. IMPLEMENTACIÓN DE LA PLATAFORMA DE DATOS DE MONITOREO INTERNACIONAL DE LA

RESISTENCIA A LOS ANTIMICROBIANOS (InFARM) DE LA FAO

2024/Julio-octubre:

Entrenamiento en la plataforma InFARM a técnicos del SENASA, DIGESA y SANIPES

Desarrollo de un piloto, mediante el ingreso de datos al InFARM del plan piloto de la vigilancia integrada de la RAM coordinado por la ST de la CMS-RAM

Recopilación y análisis de datos de la RAM provenientes de animales y alimentos.

Taller de capacitación a puntos focales InFARM y aplicación del WHONET

Asistencia técnica al SENASA, DIGESA Y el SANIPES en la implementación de la plataforma InFARM

• Propósito: Apoyo a los esfuerzos nacionales para generar y difundir periódicamente datos fiables sobre la RAM en la alimentación y la agricultura, a fin de permitir el seguimiento y la vigilancia de la RAM a nivel nacional para fundamentar las decisiones basadas en pruebas.

• Objetivo: Fortalecer las capacidades del país para la vigilancia y el seguimiento de la RAM en los sectores de la alimentación y la agricultura, proporcionando un enfoque normalizado para la recopilación, el análisis, la interpretación y el intercambio de datos.

RAM. APLICACIÓN DE BUENAS PRÁCTICAS DE PRODUCCIÓN Y GESTIÓN, ADMINISTRACIÓN DE

ANTIMICROBIANOS Y ALTERNATIVAS A LOS ANTIMICROBIANOS EN ANIMALES

2024/Agosto-octubre:

Coordinaciones con el SENASA para el desarrollo de Guía de certificación de buenas prácticas de producción con énfasis en el uso de antimicrobianos

Validación de guía de buenas prácticas de producción desde el uso de antimicrobianos y taller de implementación dirigido al sector privado productivo priorizado (avícola, porcino o ganadero).

Desarrollo de guía sobre alternativas al uso de antimicrobianos para animales terrestres y acuáticos.

Desarrollo de propuesta de convenios con sectores productivos para implementación de la guía

Implementación de convenios con el sector productivo y desarrollo de propuesta normativa sobre alternativas al uso de antimicrobianos

• Propósito: Fortalecer la gestión del servicio veterinario con relación al cumplimiento de las buenas prácticas pecuarias, con énfasis en el uso de antimicrobianos.

• Objetivo: Desarrollar una guía de buenas prácticas pecuarias con énfasis en el uso de antimicrobianos, que apoye en la certificación de alimentos agropecuarios primarios y piensos.

LABORATORIO. APLICACION DE LA HERRAMIENTA DE MAPEO DE LABORATORIOS (LMT)

MÓDULOS LMT-CORE Y LMT-SAFETY.

• Propósito: Fortalecer las capacidades técnicas de los laboratorios para que estén preparados ante una emergencia sanitaria.

• Objetivos: Identificar las fortalezas, brechas y determinar la línea base de las capacidades diagnósticas de los laboratorios evaluados.

Laboratorios centrales evaluados: SANIPES, INS y SENASA.

-Región Loreto:

CIETROP/INS, IVITA-Iquitos UNMSM y Laboratorio Referencia Regional Loreto.

-Reunión técnica (17/07):

Identificación de las capacidades de los laboratorios (Conformación de Sistema Nacional de Laboratorios).

-Abastecimiento de equipos para vigilancia de RAM y Leptospira (Loreto)

Apoyar en la formulación de una propuesta para conformación de un-Sistema Nacional de Laboratorios con enfoque “Una Sola Salud” con una estructura orgánica nacional.

-Sistema Nacional de Laboratorios participación de lab.

centrales, privados y academia conformado.

- Capacitación en secuenciamiento y bioinformática (lab.

centrales).

-Abastecimiento de reactivos y equipos de nuevas metodologías para vigilancia de enfermedades zoonóticas y la RAM.

- Capacitación en secuenciamiento y bioinformática (lab.

regional).

BIOSEGURIDAD Y BIOCUSTODIA: CAPACITACIONES SOBRE BIOSEGURIDAD Y BIOCUSTODIA A LOS

LABORATORIOS DE SALUD ANIMAL, SALUD HUMANA Y AMBIENTE

1. Capacitación y certificación IATA (enero) para transporte de sustancias infecciosas (10 profesionales de lab.

Centrales).

2.Capacitaciones sobre Bioseguridad en laboratorios centrales (Lima) y en la región Loreto.

3. Taller de asesoría para la conformación de un Comité de bioseguridad (Salud Animal y Ambiente)

Capacitaciones sobre Bioseguridad, (lab. centrales de salud animal, salud pública, ambiente de las regiones de La Libertad, Lambayeque, Ancash).

Capacitaciones sobre Bioseguridad, (lab. centrales de salud animal, salud pública, ambiente a Cusco, Arequipa, Ica, Puno).

Re-evaluación de los laboratorios en temas de bioseguridad y seguimiento del levantamiento de las brechas identificadas.

• Propósito: Estandarizar el sistema de Gestión de Riesgo y Bioseguridad para los laboratorios de salud humana, animal y ambiente en base a la evaluación de riesgo biológico.

• Objetivos: Fortalecer las capacidades técnicas de los laboratorios evaluados.

LEGISLACIÓN. DESARROLLO DE POLÍTICAS Y LOS MARCOS LEGISLATIVOS RELACIONADOS CON LA

GESTIÓN DE RIESGOS NACIONALES Y REGIONALES EN EL MARCO DE "UNA SOLA SALUD“(USS).

Noviembre a diciembre:

Inicio de desarrollo de propuesta de Ley Una Sola Salud (USS); y evaluación de pertinencia para aplicar política de USS.

Enero a abril: Elaboración de propuesta de Ley de USS y análisis de pertinencia de desarrollar la política.

Desarrollo de política USS, alineado al Plan de acción de seguridad sanitaria global.

Validación de propuesta de Ley USS.

Validación de política de USS y gestiones para su aprobación, así como de la propuesta de Ley USS.

Apoyo para la implementación de la política USS y para la Ley

USS.

• Propósito: Fortalecer la gobernanza del país, mediante el desarrollo de una Política Pública Nacional Multisectorial que defina los objetivos prioritarios y lineamientos de abordaje de la salud humana, animal y ambiental, bajo el enfoque de Una sola salud, logre beneficiar a la población peruana.

• Objetivo: Elaborar una propuesta de análisis de pertinencia de desarrollar una política USS, así como una propuesta de Ley USS.

EVALUACIÓN DE PERFIL DE PAÍS – APLICACIÓN DE LA HERRAMIENTA DE EVALUACIÓN DE "UNA

SOLA SALUD“(OHAT)

Septiembre: Webinar sobre introducción a la herramienta

OHAT

Octubre: Pre-talleres sectoriales para aplicación de la herramienta OHAT y Taller multisectorial sobre la evaluación de perfil de país mediante la OHAT.

-Desarrollo de dos (02) pruebas de campo piloto en regiones por determinar, para la aplicación práctica de la herramienta OHAT.

-Asistencia técnica para la implementación de acciones identificadas de los mecanismos de coordinación multisectorial de aplicación de la OHAT.

Conformación del comité impulsor OH.

-Desarrollo de la herramienta OHAT adecuada a Latinoamérica.

-Asistencia técnica para la implementación de acciones identificadas de los mecanismos de coordinación multisectorial de aplicación de la OHAT.

Autoevaluación perfil país aplicando la OHAT.

Asistencia técnica para la implementación de acciones identificadas de los mecanismos de coordinación multisectorial de aplicación de la OHAT

• Propósito: Evaluar el perfil de país con relación al enfoque de Una sola salud que defina el abordaje de la salud humana, sanidad animal, fauna silvestre y medio ambiente, en beneficio de la población peruana.

• Objetivo: Aplicar la herramienta de evaluación de Una sola salud, en los cuatro sectores de salud humana, sanidad animal, fauna silvestre y medio ambiente.

Protegiendo cada día a las personas, los animales y el medio ambiente

Gracias

USAID Vision for Health Systems Strengthening 2030

Marvin Crespin-Gamez Deputy Director Regional Migration & Health Office

From WHO’s 6 Building Blocks Functions →→ → Integrated Whole-of-Society HSS Outcomes

USAID’s health systems strengthening (HSS) approach aims to accelerate countries' efforts to achieve sustainable, equitable, and resilient health systems through locally-led, evidence-driven and context-specific approaches.

HSS includes the strategies, responses, and activities that are designed to sustainably improve the performance and governance of a country’s health system.

Strong health systems can flexibly adjust resources and priorities to address emerging health needs while maintaining essential services and health security.

GHS as a U.S. Government PriorityUSAID VISION FOR HEALTH SYSTEMS STRENGTHENING 2030 https://www.usaid.gov/sites/default/files/2022-05/USAID_OHS_VISION_ExecutiveSummary_FINAL_single_508.pdf

GHS as a U.S. Government PriorityGHS as a U.S. Government PriorityUSAID VISION FOR HEALTH SYSTEMS STRENGTHENING 2030

EVIDEN-DRIVEN & DIGITIZATION - digitization efforts and systems are vital when developing high-performing health systems that use evidence for decision making.

RESILIENCE - a health system and institutions needs to possess the ability to withstand and effectively respond to shocks and stressors, and be flexible to adjust resources, policy, and focus in response to constantly emerging challenges during acute, time-bound events as well as to longer-term dynamics.

LOCALLY-LEAD - National, regional, and other health system local leaders including district and facility managers need to be equipped and capable of identifying and collaborating to resolve health care problems as they occur.

When health systems are strong and equitable, they are resilient under pressure and lead to greater national, regional and global health security.

Localization “If we truly want to make aid inclusive, local voices need to be at the center of everything we do.”

- Administrator Samantha Power

Jose Antonio Zarzar Assistance & Acquisition Specialist Regional Office of Acquisition & Assistance

● Localization has had many names and forms in the past.

● What is NOT localization? Metrics vs. Efforts

● At USAID, localization is the set of internal reforms, actions, and behavior changes that the Agency is undertaking to ensure our work puts local actors in the lead, strengthens local systems, and is responsive to local communities.

GHS as a U.S. Government PriorityWHAT IS LOCALIZATION?

Adapting Our Policies and Programs to foster locally led development that is tied to each country’s unique context, including through local systems practice and local capacity strengthening.

Shifting Power To Local Actors including, with an inclusive development lens, those from marginalized and underrepresented groups, and promoting space for them to influence and exercise leadership over priority setting, activity design and implementation, and measuring and evaluating results.

Channeling a Larger Portion of Funding Directly to Local Partners while ensuring accountability for the appropriate use of funds and achievement of development and humanitarian results.

Serving as a Global Advocate and Thought Leader using USAID’s convening power, partnerships, voice, and other tools of development diplomacy to catalyze a broader shift toward locally led development.

Localization at USAID: Vision and Approach

GHS as a U.S. Government PriorityLOCALIZATION: LINES OF EFFORT https://www.usaid.gov/localization

● Localization efforts will be taken into consideration when reviewing your application (See section F.2.1.b)

● Holistic local approach

● Localization and sustainability

GHS as a U.S. Government PriorityLOCALIZATION INCLUDED IN YOUR APPLICATION

Climate Change

Jaime Chang Public Health Project Management Specialist Regional Migration & Health Office

1. USAID approach to climate change: USAID Climate Strategy 2022–2030

2. How to include climate change in a proposal

3. Key items to consider

4. Selected references

1. USAID Climate Strategy 2022–2030 Advancing Equitable and Ambitious Actions to Confront the Climate Crisis April 21, 2022

GHS as a U.S. Government PriorityUSAID CLIMATE STRATEGY 2022–2030

Guides a whole-of-Agency approach to:

● Reduce global greenhouse gas emissions,

● Help partner countries build resilience to climate change, and

● Improve our operations.

● STRATEGIC OBJECTIVE 1: Targeted Direct Action: Accelerate and scale targeted climate actions.

○ INTERMEDIATE RESULT 1.1: Catalyze urgent mitigation (emissions reductions and sequestration) from energy, land use, and other key sources.

○ INTERMEDIATE RESULT 1.2: Strengthen climate resilience of people vulnerable to climate impacts (adaptation).

○ INTERMEDIATE RESULT 1.3: Increase the flow of and equitable access to finance to support adaptation and mitigation.

○ INTERMEDIATE RESULT 1.4: Partner with Indigenous Peoples and local communities to lead climate action.

○ INTERMEDIATE RESULT 1.5: Enable and empower women and youth and other marginalized and/or underrepresented groups to lead climate action.

● STRATEGIC OBJECTIVE 2: Systems Change: Catalyze transformative shifts to net-zero and climate-resilient pathways.

○ INTERMEDIATE RESULT 2.1: Advance transformation of key systems and essential services to reduce emissions and enhance climate resilience.

○ INTERMEDIATE RESULT 2.2: Support a transition to climate-resilient, net-zero economies and financial systems.

○ INTERMEDIATE RESULT 2.3: Strengthen responsive, transparent governance and citizen engagement for effective climate action.

○ INTERMEDIATE RESULT 2.4: Strengthen the coordination of humanitarian, development, and peacebuilding assistance to address climate impacts.

● SPECIAL OBJECTIVE: DOING OUR PART:

Strengthen operations and approaches to programming to address climate change and further climate justice within USAID and our partner organizations.

● OBJECTIVE 1:

Improving the Prevention of Infectious Diseases through the Reduction of Disease Transmission from Animals to Humans (Zoonotic Diseases);

● OBJECTIVE 2:

Improving the Detection of Infectious Disease through Improved Disease Surveillance Systems;

● OBJECTIVE 3:

Improving the Response to Infectious Disease Outbreaks through a Stronger Health Security Workforce.

GHS as a U.S. Government PriorityHOW TO INCLUDE CLIMATE CHANGE IN A PROPOSAL

Zoonotic Diseases Prevention

Disease Surveillance Systems

Health Security Workforce

Climate change

Climate change

• Risks

• Determinants

• Impacts

• Adaptation

• Resilience

• Effects

• Mitigation

• Changes in dispersal and population size of vectors and reservoirs – Endemicity

• Changes in seasonality of diseases

• Need to monitor climate and weather variables

• Vulnerability of infrastructure, equipment, personnel

• Emissions during operations Energy consumption - Efficiency Transportation Equipment operation Energy dependent infrastructure

Adaptive management

GHS as a U.S. Government PriorityGHS as a U.S. Government PriorityKEY ITEMS TO CONSIDER

Understanding of climate change

Weather, extreme weather events, climate change…

Applying the One Health Approach

Climate change and environment, animal and plant populations, and human populations.

Climate change and the relationship between environment, animal and plant populations, and human populations.

GHS as a U.S. Government PriorityGHS as a U.S. Government PrioritySELECTED REFERENCES

USAID Climate Strategy 2022–2030. Advancing Equitable and Ambitious Actions to Confront the Climate Crisis. April 21, 2022.

https://www.usaid.gov/policy/climate-strategy (Available in English, Spanish, French and Portuguese)

USAID's Global Health Security Program https://www.usaid.gov/global-health/health-areas/global-health-security

USAID Position Statement on One Health https://biodiversitylinks.org/library/resources/2024-usaid-position-statement-on-one-health.pdf

Acciones del Ministerio de Salud (del Perú) para la adaptación ante el cambio climático al https://www.minam.gob.pe/cambioclimatico/wp-content/uploads/sites/127/2019/01/6.-MINSA.pd https://www.usaid.gov/policy/climate-strategy https://www.usaid.gov/global-health/health-areas/global-health-security https://biodiversitylinks.org/library/resources/2024-usaid-position-statement-on-one-health.pdf https://www.minam.gob.pe/cambioclimatico/wp-content/uploads/sites/127/2019/01/6.-MINSA.pdf

Climate change (World Health Organization) https://www.who.int/news-room/fact-sheets/detail/climate-change-and-health

Climate Change and Health (Pan American Health Organization) https://www.paho.org/en/topics/climate-change-and-health

Strengthening Health Systems for Climate Adaptation and Health Security: Key Considerations for Policy and Programming (2022) https://pmc.ncbi.nlm.nih.gov/articles/PMC9595646/

Climate change and its impediments to global health security (2023) https://pmc.ncbi.nlm.nih.gov/articles/PMC10719958/

The Lancet Countdown on health and climate change.

https://www.thelancet.com/countdown-health-climate

SELECTED REFERENCES

https://www.who.int/news-room/fact-sheets/detail/climate-change-and-health https://www.paho.org/en/topics/climate-change-and-health https://pmc.ncbi.nlm.nih.gov/articles/PMC9595646/ https://pmc.ncbi.nlm.nih.gov/articles/PMC10719958/ https://www.thelancet.com/countdown-health-climate

The Power of Working Together Private Sector Engagement

Karina Herrera Private Sector Engagement Advisor

• PSE is about pursuing market-based approaches and investment as a means to address development or humanitarian challenges.

• PSE represents an opportunity to expand its impact and achieve development objectives in a scalable, sustainable way.

• The PSE Policy is a commitment to work hand-in-hand with the private sector to design and implement programs across all areas.

WHAT IS PRIVATE SECTOR ENGAGEMENT (PSE)?

Reference: PSE Policy https://www.usaid.gov/sites/default/files/2022-05/usaid_psepolicy_final.pdf

WHY ARE WE INVOLVED THE PRIVATE SECTOR?

● It allows us to accelerate inclusive growth and achieve greater development impact.

● For their experience in providing market-based solutions.

● Financial capacity to achieve scaling and sustainability.

● Experience and ability to address development challenges.

WHO IS THE PRIVATE SECTOR IN PSE POLICY?

● For-profit, commercial entities and their affiliated foundations;

● Financial institutions, investors and intermediaries;

● Business associations and cooperatives;

● Micro, small, medium and large enterprises that operate in the formal and informal sectors;

● American, local, regional, and multinational businesses;

● For-profit approaches that generate sustainable income (e.g., a venture fund run by a non-governmental organization (NGO) or a social enterprise)

WHAT DO WE EXPECT FROM THE PRIVATE SECTOR?

● Identify partnerships to enhance humanitarian conditions and promote sustainable development.

● Understand market limitations and private sector perspectives on impactful projects.

● Establish collaborations with companies dedicated to environmental and social sustainability.

● Identify sustainable business models aligned with long-term development goals.

P H

O

TO

• The PSE Policy provides a framework of five essential questions that USAID staff and implementing partners should consider whenever addressing a development or humanitarian issue.

• USAID and its partners are encouraged to ask and answer these guiding questions to ensure effective, scalable solutions:

INTEGRATE PSE INTO OUR WORK

TYPES OF COLLABORATION

O

TO

Goal Objective Impact Private Sector

Sustainable Development

Providing internet access and financial services in rural areas of Peru (Huánuco, San Martín, and Ucayali).

Internet access for 90 communities and over 13,000 users through telecenters.

Private investment of $3.2 million to expand coverage.

Access to financial services totaling $20.7 million.

Internet para Todos (Telefónica), Yachay, Cisco,…