PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Years of mechanism: 2007 2008 2009
09.C.PC07: RPSO - Construction of Nutrition Unit
ONGOING ACTIVITY FOR WHICH NO ADDITIONAL FY2009 FUNDS ARE REQUESTED- -- DELAYED
IMPLEMENTATION
From COP08:
In FY2007, USG funds supported the construction of a rehabilitation unit for malnourished children infected
and affected by HIV/AIDS in NRH in Francistown.
The rehabilitation unit would serve several purposes:
1.Affected children would served at the Unit for supportive care and proper nutrition management
2.The unit would serve as a training center for family care givers in the care of malnourished children
3.NGOs/ CBOs/FBOs working with OVC would refer needy cases to the Unit and their staff would get
proper advice and regular training
4.The Unit would provide office space for the Project staff
Due to inflation rates and increase in building materials and other related factors, the amount budgeted for
and approved in FY2007 ($800,000) is insufficient to support the construction of such a unit in PMH in
Gaborone.
It is estimated that the construction of one unit will cost $1million. Furthermore, GOB requested USG if a
similar unit could be supported in NRH in Francistown. Therefore, in this COP08, USG Botswana is
requesting an additional US$1.2million;$200,000 will go towards the completion of the one in PMH and
1million will go towards the construction of the second unit in Francistown.
New/Continuing Activity: Continuing Activity
Continuing Activity: 17813
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
17813 10224.08 Department of Regional 7892 5420.08 RPSO $1,200,000
State / African Procurement
Affairs Support
Office/Frankfurt
10224 10224.07 Department of Regional 5420 5420.07 contract $500,000
Emphasis Areas
Construction/Renovation
Human Capacity Development
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.10:
09.T.PT03: RPSO - Pediatric Clinic
CONTINUING ACTIVITY UNDER A PERFORMANCE PASS:ONGOING ACTIVITY FOR WHICH NO
ADDITIONAL FY2009 FUNDS ARE REQUESTED
As per request from the Ministry of Health, the clinic will be built in Francistown at Nyangabgwe and not in
USG will construct a new pediatrics building on space adjacent to the pediatrics wards and the Botswana-
Baylor Centre of Excellence for Pediatric HIV Treatment (COE). There are multiple needs for this building,
all of which complement or directly serve PEPFAR implementation for children. When complete, this facility
will provide in its first year of function an access pathway to HIV care and treatment for approximately 200
newly diagnosed HIV-infected children. It will provide care for 3,000 children with HIV and co-morbidities
such as TB and other OIs. It wills erve as a training clinic for 250 HCWs on care and treatment of HIV-
infected and affected children. It will provide a place for followup care for discharged HIV-infected and
uninfected children. It will provide a place for general and HIV-related pediatrics training of medical
students, interns, and residents. It will permit coordinated care at the largest hospital in the country. FY08
funds will be used by the US Department of State (DOS) Regional Procurement Service Organization
(RPSO) for construction.
Some of the challenges of providing adequate HIV care and treatment are those related to geographical
distribution of the population across a large land mass. The COE is working with the MOH to address the
treatment and palliative care needs of children served by health care facilities in the periphery through
training and mentoring activities supported by PEPFAR.
Other challenges result from the fact that most attention to pediatrics HIV care has focused on prevention of
vertical transmission in the PMTCT program and on the early infant diagnosis program with referral to
treatment and care of HIV + babies in the first 2 months of life. Those HIV+ children who have survived
infancy and early childhood are often unidentified and moving through life with suboptimal health. The
system is not actively screening these older children for HIV and OIs to prevent illness through early
identification and care. These secondary prevention activities need a programmatic and facility focus.
Space and staff capacity are two major problems posing a barrier to adequate pediatric care at PMH.
Excellent care and treatment for children with HIV/AIDS is provided for those 1,400 children who have found
their way to the COE at PMH. Aside from the COE and two old pediatrics wards, Princess Marina Hospital
(PMH), the largest referral hospital in the largest population center in the country, does not have any
dedicated space for any pediatrics care. This situation results in inadequate attention to children with HIV
infection as well as inadequate attention to general pediatrics preventive, acute and chronic care and
treatment. For example, children under 5 are at increased risk of acquiring TB when exposed to infectious
adults at home or in other settings. In a country which has approximately the third highest rate of TB and
HIV in the world, it is important to screen children for TB. There is no place for this to take place other than
adult TB clinics, which also serve children once they are identified. Although the PMH is a referral hospital,
people use it for ambulatory acute and chronic care as well as specialty care in the same way that people
do in the US.
A few clinics use borrowed space from other medical services on an intermittent basis. Children with HIV,
who reportedly comprise about 50% of inpatients, are not always registered patients at the COE and thus
are not always seen by COE staff in the inpatient facilities or referred to the COE at discharge. Further, the
COE is at its maximum number of patients so another pathway for HIV screening and referral, followup after
hospital admissions, and chronic management of TB and other OIs needs to be developed.
Medical training in general and HIV-related pediatrics is in urgent need of space and staffing to train medical
students, interns, and pediatrics residents. In 2008, all these training programs will begin simultaneously.
The lack of a pediatrics clinic attached to PMH is a dire deficit for all these training programs.
Nearly half of Botswana's population is under 15 years of age. Thus the need for pediatrics care is critical at
PMH where pediatric care is currently patchy, incoherent, and inadequate.
Continuing Activity: 17816
17816 17816.08 Department of Regional 7892 5420.08 RPSO $2,000,000
Table 3.3.11:
09.C.TB02: RPSO - Infection Control (two districts)
ONGOING ACTIVITY FOR WHICH NO ADDITIONAL FY2009 FUNDS ARE REQUESTED - LARGE
PIPELINE
Infection control is an important aspect of prevention of TB in high HIV settings, such as Infectious Diseases
Care Clinics (IDCC) and wards. Botswana has no dedicated infectious diseases hospital, and none of the
hospitals have TB wards. Recent reports of extensively drug resistant tuberculosis (XDR-TB) from
neighboring South Africa have raised the concern about possible cross-border movement of patients with
similar TB. The current DRS that is being conducted with FY07 funds will provide more accurate data about
the extent of drug resistant TB.
Infection control policies are currently under development with FY07 funds. PEPFAR funds are supporting
the renovation of a TB isolation ward at the HHS/CDC/BOTUSA site in Gaborone, which will be staffed by
PMH personnel. With funding from the GFATM, the MOH is constructing a TB isolation ward at Bamalete
Lutheran Hospital in Ramotswa. FY07 Plus Up funds were requested for the installation of a prefabricated
building at a district hospital that will be selected by the MOH.
2008 Plans
FY2008 funds are requested to procure two prefabricated buildings to be converted into isolation wards for
TB patients. The wards will be located at sites to be determined in consultation with the MOH. Prevention of
TB infection in congregate settings is a major component of collaborative TB/HIV activities. These activities
therefore will support Botswana's Round 5 TB grant from the GFATM, which among other goals, seeks to
strengthen TB/HIV collaborative activities.
Continuing Activity: 17747
17747 17747.08 Department of Regional 7892 5420.08 RPSO $200,000
Health-related Wraparound Programs
* TB
Table 3.3.12:
09.T.LS02: RPSO - National Health Laboratory Infrastructure Support
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
HIV drug resistance testing has been a challenge for both the Ministry of Health (MOH) and CDC/BOTUSA,
as specimens are regularly sent to CDC for re-testing and quality assurance/quality control (QA/QC)
purposes. In order to build the capacity in the country to support the 100,000 people under treatment in the
anti-retroviral (ARV) program, we are planning to set up a genotyping laboratory for HIV resistance. Funds
are requested to transform an existing porta-cabin into a laboratory, in order to set up the genotyping lab.
Funds will also be used to provide furniture and commodities in the laboratory after renovation.
MLG: Prefab laboratories for 6 selected clinics in the districts: $600,000
Three prefab laboratories and equipment were provided in FY2007 to Tlokweng clinic (South East district)
and Area W clinic in Francistown. In FY2008 the same activities will continue, and prefab laboratories will
be provided to clinics to improve the diagnostic capabilities of HIV and TB and to reduce the work load of
Primary and Districts laboratories; 6 sites have been identified.
Renovation of Institute of Health Sciences: $100,000
In FY2007 PEPFAR, provided support to the Institute of Health Sciences to improve the intake of laboratory
technicians and pre-service training. The target is to double the number of laboratory technicians trained
from 15 trained every three year to 30.
FY2008 fund will help improve the old classrooms to accommodate the increase of the students. The old
building of the initial school is not used because the classrooms are not adequate.
Continuing Activity: 17807
17807 10258.08 Department of Regional 7892 5420.08 RPSO $700,000
10258 10258.07 Department of Regional 5420 5420.07 contract $1,085,227
Table 3.3.16:
09.X.MS04: RPSO Renovation and Expansion of BOTUSA
ONGOING ACTIVITY FOR WHICH NO ADDITIONAL FY2009 FUNDS ARE REQUESTED
The current location of the HHS/CDC/BOTUSA offices is becoming overcrowded. The MOH is in the
process of finding extra space for HHS/CDC/BOTUSA/ PEPFAR which will be provided rent free. It is likely
that MOH space in the recently vacated USAID Regional Office will be provided to PEPFAR. $50,000 is set
aside to make this space ready for PEPFAR occupancy as we co-locate with the MOH.
Continuing Activity: 17897
17897 10335.08 Department of Regional 7892 5420.08 RPSO $50,000
10335 10335.07 Department of Regional 5420 5420.07 contract $200,000
Table 3.3.19:
