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.P.AB11: Botswana Defence Force—AB Prevention
ACTIVITY UNCHANGED FROM FY2008
From COP08:
This activity will provide technical assistance and support for the BDF military personnel, their families,
housemaids, couples, and community projects which address HIV prevention including changing male
norms, reducing violence, reducing the number of partners and concurrent partnerships. Activities will be
undertaken on the BDF bases.
BDF wives' clubs, building on activities already started by the BDF, will be further supported with TA and
IEC materials, and a curriculum they can use for their meetings. Wives' clubs will focus on providing HIV
prevention, care and treatment education and a supportive environment for those seeking testing and
coping with either their own or others' HIV seropositive status. Leaders of the wives support group will
participate in the Healthy Living program and be trained to teach the curriculum. Inclusion of the
housemaids will be assessed and implemented if appropriate.
The eight BDF Chaplains will receive ongoing training by other military chaplains to further their capacity on
working with those with HIV or encouraging others to know their status.
Community outreach projects will continue. These have been initiated by the BDF, as a part of the Men's
sector and have provided education and testing opportunities to communities that are hard to reach. One of
the foci for the outreach is to discuss reduction of partners and reducing multiple partners. They also
promote changing male norms, encouraging men to support women's equality. The BDF conducts one
outreach event each month, and reach an average 18,000 men in the course of a year.
This activity supports the vision of PEPFAR Botswana to reduce the number of new infections and to
increase the number of people receiving care and treatment. It will also increase the number of people
seeking testing.
The BDF has agreed to co-host a Military HIV/AIDS Prevention Conference for all PEPFAR countries and
other regional countries as funds permit. The theme of the conference will be HIV/AIDS Prevention in the
military with an exchange of information on best practices, lessons learned, etc. One of the major themes
of the conference will be Male Circumcision. Participants will include Senior Officers responsible for the HIV
program within each military, the officer responsible for program execution/coordination, and clinical
officers. Approximately 100 persons will attend.
New/Continuing Activity: Continuing Activity
Continuing Activity: 17401
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
17401 10097.08 Department of Botswana Defence 7745 1332.08 ODC/BDF $330,000
Defense Force
10097 10097.07 Department of Botswana Defence 5287 1332.07 ODC/BDF $115,000
Emphasis Areas
Gender
* Addressing male norms and behaviors
* Reducing violence and coercion
Military Populations
Workplace Programs
Human Capacity Development
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.02:
09.C.TB06: Botswana Defence Forces - TB Training
Funding will be used to send 3-5 BDF Medical Personnel to Uganda for specific training on identification
and treatment of TB. Training will ensure that BDF personnel are prepared to take full advantage of the
laboratory equipment provided by PEPFAR, and that the Botswana Defence Force (BDF) is able to provide
identification and care of TB patients without increasing the burden on the civilian health care system.
Training will ensure there is a TB trained professional at each of the 4 major BDF treatment locations
Continuing Activity: 17714
17714 17714.08 Department of Botswana Defence 7745 1332.08 ODC/BDF $15,000
Health-related Wraparound Programs
* TB
Estimated amount of funding that is planned for Human Capacity Development $15,000
Table 3.3.12:
09.C.CT04: DOD/BDF - HIV Counseling and Testing
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING
In 2007, The Department of Defense (DOD) and the Botswana Defense Force (BDF) plan to train additional
Counselors to operate the new voluntary counseling and testing (VCT) centers that are currently being
constructed in Selibe-Phikwe and Gaborone using the FY2007 funds. At this time, twenty BDF Officers
have been trained to the Certificate level in an HIV/AIDS Counseling course.
In FY2009, it is important that training continue with these officers on VCT protocol for same day results,
performing the rapid tests, couples counseling, adherence counseling, and counseling supervision. IDM, the
key counselor training institution in Botswana, uses a curriculum for training that incorporates basic HIV
Counseling approved by the Ministry of Health (MOH) and the CDC protocol for VCT and couples
counseling.
FY2009 funds will also be used to support refresher courses for peer educators and counselors with a focus
on Care of the Care-givers. Often counselors experience burn-out and stress due to their experiences with
HIV clients, hence it is vital that we offer them retreat-seminars to refresh, learn, and share experiences.
Counselor supervisors will be trained to ensure delivery of quality services in counseling and to provide
support to their staff, including de-briefing sessions.
Additionally, the BDF will organize Male and Female Peers seminars to address gender-related issues,
such as gender-based violence, incest and male involvement in sexual and reproductive health (SRH).
The Botswana Defense Force (BDF) will conduct an HIV bio-behavioral survey which provides an
estimation of the prevalence of HIV and behavioral risk factors including those associated with deployment,
sexual risk, alcohol use, and male norms. The target group for the survey will be active duty BDF personnel.
Due to the low number of women in the BDF the sample will be limited to men. The BDF will participate in
all planning and execution of the survey.
The HIV testing for the survey will be conducted in counseling and testing setting with participants able to
know their results immediately. Those testing positive will be referred to care/treatment. Prevention activities
will be organized to occur on the same day as the survey capitalizing on the heightened awareness created
by participation in the survey. Results from the survey will enable better service delivery planning, and
targeting of prevention programs to those behaviors associated with highest risk in the military.
This activity will support the strategic plan by providing information on male behaviors in Botswana and
directly linking behaviors to sero-positivity.
Continuing Activity: 17403
17403 5131.08 Department of Botswana Defence 7745 1332.08 ODC/BDF $50,000
9829 5131.07 Department of Botswana Defence 5287 1332.07 ODC/BDF $200,000
5131 5131.06 Department of Botswana Defence 3488 1332.06 ODC/BDF $135,000
* Increasing gender equity in HIV/AIDS programs
* Family Planning
Table 3.3.14:
This is a request of additional funds(US$ 150,000) to the project that was planned in COP 2007 ref(07 -
C0905: Botswana Defense Force/US DoD- C&T) to purchase a PREFAB to be used as a VCT centre by
Botswana Defense Force at the East Military Garrison in the town of Selibe-Phikwe. This activity will target
military personnel, their dependents, other government department employees and the general public
around the Garrison since the camp is located some distance from town and this makes accessibility of
services difficult for the military personnel and those residing near their establishments
New/Continuing Activity: New Activity
Continuing Activity:
Program Budget Code: 15 - HTXD ARV Drugs
Total Planned Funding for Program Budget Code: $8,292,500
Total Planned Funding for Program Budget Code: $0
Program Area Narrative:
In response to the challenges that HIV and AIDS present to Botswana, efforts continue to be made to diversify approaches, fine
tune technical support, and plan for future program sustainability with the support of the Presidents' Emergency Plan for AIDS
Relief (PEPFAR). The national HIV prevalence rate is 23.9% among adults ages 15 to 49, according to recent UNAIDS data, and
an estimated 300,000 are living with HIV/AIDS. About 53.2% of Batswana know their HIV status up from 25% in 2004, 95% of
pregnant mothers gaining that information through the Prevention of Mother to Child Transmission program. The Botswana 2007
Sentinel Survey indicated that HIV prevalence among pregnant women (15-49 years) is 33.7%, though the overall trend appears
to be decreasing from 37.4% in 2003. The Department of HIV/AIDS Prevention and Care reports that, as of the end of July 2008,
a total of 109,991 patients were receiving HAART, 97% of the 113,000 patients estimated to require treatment. Challenges
remain, however, with prevention, particularly the issue of multiple concurrent partnerships, alcohol abuse, nascent civil society,
and human capacity development.
The GOB supports financially 50% of ARV drugs procurement and receives assistance from PEPFAR, the Bill and Melinda Gates
Foundation, Merck Foundation, Glaxo-Smith Kline, Boerhinger Ingelheim, Clinton Foundation and Pfizer in the form of donations
of anti-retrovirals (ARV), drugs for treatment of opportunistic infections (OI) and ARV price reductions. The Clinton HIV/AIDS
Initiative (CHAI) supported procurement of pediatric and second line ARV'S.
The GOB procured ARVs through the Ministry of Health's (MOH) Drugs Regulatory Unit (DRU), which is responsible for
registration of medicines for use in Botswana on the basis of quality, safety and efficacy; the National Drug Quality Control
Laboratory (NDQCL),which is responsible for testing all medicines and related medical products; and Central Medical Stores
(CMS), which performs all the supply chain functions including procurement, quality assurance, warehousing and distribution of
drugs and related medical products to all health facilities countrywide. These institutions are supported by the President's
Emergency Plan for AIDS Relief (PEPFAR)-funded Supply Chain Management (SCMS), which provides technical assistance to
strengthen various systems, including the Quality Management System, the ARV Forecasting/Quantification, the Drug
Registration applications documentation process management, and an evaluation in-house mentoring/training.
The GOB program faces human capacity constraints in terms of: (1) ARV logistics; (2) ARV quality control; (3) ARV security
infrastructure; (4) ARV procurement; and (5) ARV registration. In FY2008, the GOB continued with strengthening the procurement
and distribution of ARVs and other medicines. Sixteen percent of the total GOB budget for ARVs was provided from the FY2007
funds. The results included: (1) increased procurement of pediatric formulations; (2) procurement of pharmacopoeial reference
standards and reference textbooks; (3) the strengthening of the supply chain by hiring skilled personnel; (4) the development and
implementation of quality management systems for CMS; (5) the training of health care practitioners on pharmacovigilance and
adverse drug reactions reporting; (6) Good Manufacturing Practice (GMP) inspections of manufacturers of ARVs and OI
medicines; (7) the training of NDQCL staff in various areas of pharmaceutical analysis; (8) study tours to laboratories and other
organizations with Laboratory Information Management Systems (LIMS) installed. The funds were used to strengthen process
management systems, support the technical assistance of a consultant for further in-house training of DRU staff and evaluate
dossiers for registration as well as support the salaries of pharmacists. The DRU was able to register nine non generic ARVs, forty
-nine generic ARVs, and fifteen medicines for OIs as a result of the training and GMP inspections.
FY2009 PEPFAR funds will support activities to strengthen and standardize supply chain systems, quality control, and medicines
regulation. SCMS will continue to support the DRU by providing short term technical assistance and mentoring, training in post
market surveillance and support for two project positions. The funds will also continue to support GMP inspection of
manufacturers of drugs for treatment and management of OIs and the procurement of pharmacopoeial reference standards and
reference textbooks. In addition, an SCMS-supported effort to incorporate drug supply and prescribing information in the national
electronic patient management database to improve logistics will continue with PEPFAR funding in FY2009.
Training activities to improve NDQCL staff analytical testing and evaluation skills will continue. CMS will team up with SCMS to
monitor and evaluate the quality system and its implementation as well as strengthen the supply chain management systems at
the health facilities. A Quality Management System and document management system will be developed for DRU and NDQCL.
Table 3.3.15:
09.T.LS04: Botswana Defense Force - Laboratory Support
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
Since 2005, PEPFAR has supported the Botswana Defense Force Laboratory infrastructures. Through this
support, laboratory space has been improved and training and equipment provided for the monitoring of
patients on anti-retroviral (ARV) treatment.
In FY2008, PEPFAR funds were requested to provide support to the BDF laboratories in Francistown,
Selibe Pikwe, as well as the Sir Seretse Khama Base (SSKB) and Thebephatswa Airbase (TAB)
laboratories.
FY2009 funds are requested to strengthen the Eastern Military Garrison Lab at Thebephatshwa Airbase.
Currently, there are more than 155 patients on ARV treatment and about 651 HIV-positive civilians, 78 of
whom are on ARVs, seeking care and treatment at the TAB. There is a need to provide a CD4 machine to
the TAB laboratory because they are referring CD4 and viral load testing to the SSKB laboratory, which is
overwhelmed by the more than 300 specimens that are processed weekly. Funds will be used to provide a
high throughput machine to the SSKB laboratory and the small CD4 machinewill be moved to TAB
laboratory, thereby improving the turn around time and managing the patients more effectively.
FY2009 funds are requested to put a laboratory at the Maun Camp in the northern part of Botswana where
the majority of the military deployment occurs. The camp has been selected to be an ARV center and, for
that reason, an Infectious Disease Care Clinic (IDCC) is being built for treatment and monitoring of soldiers
and civilians living in the surrounding area. The laboratory will be able to provide basic investigations for
patients, while CD4 and Viral load testing will be referred to the MOH Hospital where high throughput
machines have been installed. The funds will serve to provide hematology, chemistry, TB and bacteriology
capacity.
In FY2009, BDF staff will be trained on various laboratory techniques, such as TB testing, bacteriology,
quality assurance, and safe laboratory practices, and the laboratory will be enrolled in the National Quality
Assurance Scheme, as well as External Quality Assurance program, with funds provided by PEPFAR.
Laboratory activities will continue building the capacity of BDF laboratories begun in 2005 and continued
through FY2007. Funding will be supplemented by $40,000 in Foreign Military Financing remaining from
FY05 funds.
Funding will ensure that capacity exists in each major BDF laboratory facility to conduct Hematology, Blood
Chemistry, and TB smear testing, and that regional laboratories in Gaborone and Francistown areas have
the capacity to conduct VL and CD4 testing for the BDF and support the MOH on an as needed basis.
Equipment and renovations by site are estimated to be: SSKB Laboratory $39,000, Thebephatswa Airbase
$129,000, Francistown 359,500, and Selibe Phikwe $179,000. An estimated $39,895 will go to support
training for BDF laboratory personnel with 29,895 to fund BDF participation in MOH supported training,
$5,000 for Biosafety Training in South Africa, and $5,000 for TB training in Uganda.
These laboratories will support testing for an estimated 9,000 BDF personnel and their families on a regular
basis and an additional 3,000 BDF personnel from other camps on a rotational basis for an estimated target
of 50,000.
Continuing Activity: 17404
17404 4990.08 Department of Botswana Defence 7745 1332.08 ODC/BDF $742,000
9828 4990.07 Department of Botswana Defence 5287 1332.07 ODC/BDF $300,000
4990 4990.06 Department of Botswana Defence 3488 1332.06 ODC/BDF $100,000
Table 3.3.16:
09.X.SI09: BDF - Monitoring and Evaluation Support
In FY2008, we supported the Botswana Defense Force (BDF) to undertake an HIV bio-behavioral survey so
as to enable estimation of the prevalence of HIV and behavioral risk factors including those associated with
deployment, sexual risk, alcohol use, and male norms. In F2009, we plan to use $ 50,000 for a data
meeting with the BDF to review the survey results and produce reports for them.
We will continue to send BDF officers to advanced Monitoring and Evaluation of HIV/AIDS Programs
training in South-Africa in FY2009. The training, which will cover research methods, will be crucial for the
BDF if they are to do their own research work in the future, as well as to support and inform their strategic
plans.
$75,000 of this activity will purchase 25 computer systems for use by BDF Social Welfare workers,
Chaplains, and Medical Counselors. In FY07 we provided computers to the BDF ART sites, but the BDF
has identified a need for automation in the offices of the personnel who counsel and support HIV positive
personnel. Currently counseling sessions are recorded manually making it difficult to adequately track
which HIV positive personnel are receiving required counseling, who is missing appointments, and to
coordinate support between the various medical, social welfare, and religious offices who are providing
support to an HIV positive soldier or family member. The lack of automation also makes it difficult for
counseling to continue as soldier deploy to other camps in support of anti-poaching or border security
missions. An additional benefit is that those involved in counseling and support activities will now have
access to on-line support materials and a wider network of expertise.
$25,000 of this activity will be used to pay expenses related to the training of personnel from the BDF
HIV/AIDS program office, chaplain's office, social welfare office, and medical services in monitoring and
evaluation techniques and reporting. This is currently one of the weakest aspects of the BDF effort.
This activity will specifically target military personnel and their family members, especially those living with
HIV AIDS. Estimated current target population is between 800-1600.
The BDF will assume responsibility for the inclusion of these computers into the Defense Force Network.
$50,000 of this activity is allocated to an HIV bio-behavioral survey which will enable estimation of the
prevalence of HIV and behavioral risk factors including those associated with deployment, sexual risk,
alcohol use, and male norms. The target group for the survey will be active duty BDF personnel. Due to the
low number of women in the BDF the sample will be limited to men. The BDF will participate in all planning
and execution of the survey. The HIV testing for the survey will be conducted in a counseling and testing
setting with participants able to know their results immediately. Those testing positive will be referred to
care/treatment. Prevention activities will be organized to occur on the same day as the survey capitalizing
on the heightened awareness created by participation in the survey. Results from the survey will enable
better service delivery planning, and targeting of prevention programs to those behaviors associated with
highest risk in the military.
Continuing Activity: 17909
17909 17909.08 Department of Botswana Defence 7745 1332.08 ODC/BDF $150,000
Table 3.3.17:
09.X.SS05: BDF Policy Support
ACTIVITY UNCHANGED FROM FY 2008
While the BDF has an HIV Policy, it needs to be reviewed and updated. To facilitate this review, this activity
will fund BDF Participation in a policy workshop (15K) and the PEPFAR annual Meeting (10K).
Continuing Activity: 17913
17913 17913.08 Department of Botswana Defence 7745 1332.08 ODC/BDF $25,000
Table 3.3.18:
09.X.MS05: DOD - Management and Support
This position will oversee the President's Emergency Plan for AIDS Relief (PEPFAR) fund execution and
coordinate integration of other DOD programs into the overall HIV treatment and prevention effort. Funds
will pay the salary, training and other administrative costs for this employee.
The funds will be paid through the DOD Coordinating Office at the Naval Health Research Center. This
position will oversee PEPFAR fund execution and coordinate integration of other DOD programs into the
overall HIV treatment and prevention effort. Funds will pay salary, training and other administrative costs for
this employee.
Continuing Activity: 17888
17888 10328.08 Department of US Department of 7889 5453.08 ODC $100,000
Defense Defense Mechanism
10328 10328.07 Department of US Department of 5453 5453.07 HQ $50,000
Defense Defense
Table 3.3.19:
