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: 2010 2011 2012 2013 2014 2015 2016 2017 2018
PEPFAR Cote dIvoire funds the CDC Lab Coalition to provide technical assistance (TA) to strengthen the Ivoirian lab system for HIV/AIDS and other health sectors. FY 2012 funds will support three partners under the Coalition umbrella: American Society for Microbiology (ASM) ($1,300,000), American Society for Clinical Pathology (ASCP) ($300,000), and a To Be Determined partner ($100,000).
ASM
Major goal is local organizational and human capacity development in quality assurance/improvement of lab testing. Objectives are to develop training programs for improved diagnosis of TB and other HIV-related opportunistic infections (OIs). Key intermediate outcomes include increased microbiological knowledge and retaining skills required to carry out quality-assured diagnosis of major infectious diseases. ASM will also support laboratory accreditation efforts previously supported by URC.
ASCP
ASCPs work aims to strengthen the capacity of Ivoirian labs and improve the skills of laboratorians through in-service and pre-service activities. In collaboration with MOH, the school of lab technicians in Abidjan (INFAS), and CDC, ASCP will work to strengthen INFAS in Abidjan and two satellite programs in Daloa and Aboisso.
Cost-efficiency and transition to national/local structures: Trainings, mentorships, course materials, etc. enable in-country partners to provide similar trainings at a lower cost.
TBD
A new sub-award will ensure TA to support implementation of WHO-AFRO accreditation scheme, including evaluation of WHO accreditation implementation at 18 sites.
For more details on cost-efficiency, transition to Ivoirian entities, and quality M&E, please see narratives in HVTB and HLAB.
Vehicles: No vehicles have been or will be purchased/leased.
In Cote dIvoire, population-based and reliable epidemiological data on sexually transmitted infections (STIs) are lacking. 2008 HIV and syphilis antenatal sentinel surveillance among pregnant women showed that the global prevalence of syphilis was 0.2%. In 2011, the prevalence of syphilis among blood donors was estimated at 0.3% among regular donors and 0.91% among new donors. STI case management is based on the syndromic approach, with four referral centers that have laboratory screening capacity, of which after the 2010-11 crisis only one is fully functioning.
PEPFAR supports secondary prevention through detection and management of STIs among key populations (KP) and people living with HIV (PLHIV), as well as promotion of the syndromic approach for other vulnerable (mobile and migrant) populations. STI kits are available in PEPFAR-supported sites implementing activities for KP. Major issues include limited access to STI treatment for other vulnerable populations and the possible development of drug resistance among KP.
COP2013 funding in HBHC will support technical assistance to help the PEPFAR team and the Ministry of Health and AIDS (MSLS) to increase coverage of effective, integrated models for STI services targeting KP and other vulnerable populations. To build capacities for STI case management and strengthen partnerships between public health sector and community-level STI/HIV/AIDS interventions targeting KP, TA to the MSLS will help:
Identify key national objectives for addressing STIs, including the evaluation of the effectiveness of drugs used for STI treatment.
Assess the capacity of national institutions and local organizations for the evaluation of STI diagnostic capacity.
Using assessment findings, support review of the national STI algorithm (last revised in 2007) and treatment guidelines, assist with developing a training curriculum on STI diagnosis and treatment, and support development of appropriate standard operating procedures for STI diagnosis and treatment.
Build capacity of health-care sites to effectively link HIV-positive patients to a continuum of care and services, including STIs case management.
Support development of a protocol to study resistance to STI drugs.
ASM will continue to assist the government of Cote dIvoire with the development and implementation of TB/HIV infection control measures. The COP12 strategy will include specific activities to assist the National TB Control Program (PNLT), including the development of the following documents for implementation: 1) National TB-IPCI Policy and Strategy; 2) National TB-IPCI Operational Plan; 3) National TB-IPCI Training Manual; and 4) National TB-IPCI assessment tools. In addition, ASM, together with the PNLT, will conduct an assessment of risk factors in pilot sites with PEPFAR implementing partners in order to make evidence-based recommendations for setting up structures for prevention and control of TB at all levels.
ASM will assist with the procurement of the newly WHO-approved TB diagnostic system GeneXpert, as well as with field testing and validation of the new equipment and revision of TB testing algorithms.
In addition, ASM will provide financial and technical assistance to the national accreditation body of Cote dIvoire (CRESAC) for the implementation of WHO-AFRO accreditation at 3 central and 6 regional laboratories. ASM will support CRESAC in developing national reference documents and implementing WHO accreditation within the national laboratory network, in accordance with national targets.
American Society for Microbiology (ASM) ($950,000):
Basic microbiology lab services for blood stream and other infections, which have high morbidity in HIV-infected patients, are limited in Côte dIvoire, as is quality assurance / quality improvement (QA/QI).
Under COP2012, ASM will provide technical assistance (TA) to the national TB control program (PNLT) to develop national guidance documents for TB infection control, and will continue to provide in-country support for microbiology and OIs, lab systems and strategic planning, standardization of protocols for cost-effective testing, and good lab and clinical practice. A major focus will continue to be human capacity development, with an emphasis on expanding training to regional labs.
Continuing activities include: 1) improvement of training for simple OI diagnosis; 2) development of an integrated quality management system (QMS) for basic microbiology, 3) review and improvements to the basic microbiology curriculum and standard operating procedures currently used in CI, 4) onsite mentoring and guidance for development of a proficiency program for OIs and STIs to begin assisting with accreditation processes; 5) TA for QMS implementation for TB culture, drug susceptibility testing, and TB molecular assays moving toward accreditation, 6) TA for quality-assured direct smear microscopy, and 7) subcontracting with an Ivoirian organization to work for the accreditation of 3 central and 6 regional labs. Technical and financial support will be provided for development and implementation of national guidelines necessary for the implementation of the WHO-AFRO accreditation program at 18 labs.
ASM will continue to work with CIs Lab Technical Working Group (LTWG) to ensure that these activities are coordinated with other organizations supporting HIV, TB, and OI diagnosis and treatment.
ASM will also provide TA to Institut Pasteur CI for the organization of a scientific meeting to present 25 years of CDC and PEPFAR research.
American Society for Clinical Pathology (ASCP) ($300,000):
ASCP will work to strengthen the school of lab technicians (INFAS) in Abidjan and two satellite programs in Daloa and Aboisso. ASCP will provide TA to INFAS to increase teaching methodologies through hands-on trainings. ASCP will also provide TA to the local association of lab technicians (ACITEB).
ASCP improves cost-efficiency and helps transition activities to Ivoirian structures through trainings, mentorships, course materials, and other strategies that enable in-country partners to provide similar trainings at a lower cost.
ASCPs M&E strategies include use of the WHO-AFRO Accreditation Checklist as a baseline and post-training assessment tool. Improvement projects administered between trainings will be evaluated and validated by trainers and site mentors.
The pre-service evaluation method comprises a situational analysis following implementation of the improved curriculum. This will be measured against the needs assessment conducted in 2008.
In-service workshops involve a pre- and post-examination of content materials to indicate the degree to which each workshop increased participant knowledge and core competencies.
TBD ($100,000):
A new sub-award will ensure TA, in collaboration with the national lab (LNSP) and regional lab support organization (CRESAC) to support implementation of the WHO-AFRO accreditation scheme, including evaluation of WHO accreditation implementation at 18 labs.
