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.
THIS IS AN ONGOING ACTIVITY:
The National Institute of Public Health (NIPH), with technical assistance from HHS/CDC, will continue its
work in establishing a national public health laboratory network. The objective of the laboratory network is
to increase availability of a minimum package of laboratory tests, decrease dependence on the NIPH
Laboratory (NIPHL) in Phnom Penh for such tests, and reduce the proportion of samples that need to be
sent to NIPHL for testing.
NIPH will continue to emphasize quality laboratory systems and will support the development of guidelines
and standard operating procedures (SOP) for integrated laboratories, including equipment, operations, and
cross-training of staff. With support from the MOH Technical Working Group for Blood Safety and Clinical
Laboratory Services, which includes USG and international organizations staff, NIPH has been a champion
for drafting the National Policy Guidelines for Medical Laboratory Services of Cambodia.
NIPH, with technical support from the USG and the Clinton Foundation, will expand the capacity of NIPHL
to provide DNA polymerase chain reaction (PCR) testing for the timely diagnosis of HIV infection in infants.
Expansion of infant diagnosis is urgently needed.
To date, collection sites of dried blood spots (DBS) for DNA PCR testing has been expanded to 12
additional provinces. A molecular laboratory has been renovated and additional thermocyclers purchased.
We fully expect that the number of exposed infants tested will increase substantially during the next year.
Moreover, USG will continue to support NIPH to implement quality assurance both at NIPH and at sample
collection sites for early infant diagnosis.
CD4 testing, important for assessing eligibility for and monitoring ARV treatment, is available at NIPHL and
in three provincial hospital laboratories. Three new additional Fluorescence Activated Cell Sorting (FACS)
count machines will be placed soon in the provinces. The USG will continue to work with NIPHL where an
estimated 40,000 CD4 tests will be performed in 2008. NIPH, with USG technical assistance, will support a
quality assurance network for CD4+ testing in the other provincial laboratories, to include the monitoring of
samples quality, turn around time of tests results, the implementation of SOPs and logs for daily
maintenance of equipments and temperature charts, and the follow-up of corrective actions. Hospital
Directors, Laboratory Heads and Deputy Heads and Laboratory Assessors in USG focus provinces will be
trained on assuming their managerial roles for assuring testing quality for all tests performed and delivered
by the laboratories under their authorities.
Due to rapid scale up of access to antiretroviral therapy (ART), from less than 3,000 people in 2003 to
29,589 in the second quarter of 2008, it is extremely important that health care providers monitor the
effectiveness of treatment and drug toxicity in HIV patients receiving ARV. The demand for viral load and
toxicity monitoring is expected to increase as an increasing number of persons living with HIV/AIDS survive
longer due to benefits of receiving ARV treatment. Presently, within the Ministry of Health and the national
laboratory network, viral load assays are only available at NIPHL and this testing has only just become
available. NIPH, with technical assistance from the USG, will work to ensure and maintain the quality of
sample collections for viral load assays performed with Global Fund support. NIPH cooperative agreement
funds will be used for reagents for confirmatory HIV diagnostic testing, biochemistry and hematology along
with internal quality control reagents and enrollment in overseas proficiency testing programs to support
ARV treatment at NIPHL and USG focus provinces laboratories.
To enable laboratories to provide reliable HIV antibody test results, NIPHL will continue to produce and
distribute serum panels to laboratories throughout the country. The number of laboratories supported by the
external quality assurance (EQA) scheme has been expanded to include national hospitals and voluntary
confidential counseling and testing (VCT) sites under the supervision of NCHADS. Presently, NIPHL
distributes EQA panels to the blood transfusion centers and voluntary counseling and testing (VCT) sites.
However, the number of VCT sites has increased to 213, and it is expected that EQA panels will have to be
provided to all of 213 VCT sites in 2009. In 2007, 320,000 people were tested in VCT sites.
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
COP 09 funds will support NIPHL in improving and expanding HIV laboratory testing as outlined in the
Program Area Context. These activities are a continuation from last year, and will focus on assuming their
leadership and functions as the National HIV Reference Laboratory. As NIPH continue their pursuit of
International Organization for Standardization (ISO) 15189 accreditation in some laboratory sections, it will
be necessary for them to maintain the competence of their staff. They will provide continuing education and
workshops to their staff and the USG focus provinces laboratory staff.
This funding will also support the development of a Training Unit at the NIPH. The training unit staff will be
dedicated to designing courses and workshops with the help of subject matter experts. They will be
knowledgeable in adult learning methodology and will be themselves trained on teach back methodology to
be more effective in delivering customized training to different audiences.
NIPH will develop training manuals to train a team of laboratory assessors to conduct rigorous and cost-
effective supervision with follow-up on the implementation of corrective actions and monitor subsequent
improvement in maintaining quality and safety in laboratories in the field
Additionally, the NIPHL staff will provide training and supervision at one provincial hospital laboratory to be
used as a model for integrated laboratory development and supervisory visits to other provincial
laboratories. As biosafety is a major concern in clinical laboratories, part of this funding will address the
issue of biohazard waste management including autoclaving, and maintenance, inspection and certification
of Biological Safety Cabinets in laboratories supported by USG.
These activities are consistent with the strategic approaches for strengthening laboratory capacity and
Activity Narrative: infrastructure outlined in the USG Cambodia HIV/AIDS Strategy 2006-2010. In summary, the USG will
support: quality assurance (QA) systems, laboratory staff capacity building, equipment for expanding
diagnostic and monitoring capacity, reagents and supplies, facilities, laboratory staff, supervision and
networking, and establishment of regional and national referral networks to increase coverage and access
to necessary diagnostic tests, and ARV treatment monitoring.
New/Continuing Activity: Continuing Activity
Continuing Activity: 18459
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
18459 11299.08 HHS/Centers for National Institute 7346 7346.08 NIPH CoAg $250,000
Disease Control & of Public Health GHAI
Prevention
11299 11299.07 HHS/Centers for National Institute 5756 5756.07 NIPH CoAg $100,000
Emphasis Areas
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $39,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.16:
