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
This implementing mechanism is unchanged from last year.
CENAT- National Center for Tuberculosis and Leprosy Control or the National Tuberculosis Program
Goals and Activities
The goals of this implementing mechanism are to strengthen the capacity of the Cambodian National Tuberculosis Program (NTP) reliably and rapidly to diagnose tuberculosis in people with HIV and prevent the spread of multi-drug resistant Mycobacterium tuberculosis.
WHO endorses the use of liquid culture for M. tuberculosis in resource limited, high TB burden settings. The advantages of using liquid culture, including reduced time to detection as well as an increase in the yield of M. tuberculosis when compared to solid media have been well documented. Rapid differentiation of M. tuberculosis from nontuberculous mycobacterium (NTM) using cost effective identification methods is also critical. This mechanism will implement the MGIT liquid culture system and an immunochromatographic assay for identification of M. tuberculosis in the Battambang Referral Hospital. Battambang province, with a population of nearly 1,000,000, is one of the CDC/GAP's focus provinces. These methods will also be introduced at the national reference laboratory (NRL). Drug sensitivity testing (DST) using the MGIT system will be implemented at the NRL, the only government laboratory providing DST for M. tuberculosis, when the NRL meets international biosafety standards. This mechanism will fund the hiring of a TB laboratory specialist to work with the Cambodian staff to build capacity and sustain the ability of the NRL to perform TB diagnostics.
This mechanism will strengthen the capacity of the NTP to detect more rapidly TB in PLWHA and other patients. Staff will be trained in this advanced technique at both the provincial and the national levels. More rapid detection of infectious cases of TB will help reduce the TB burden in Cambodia. Prompt detection of M. tuberculosis in HIV and TB co-infected individuals can lead to more rapid initiation of treatment.
This mechanism supports TB/HIV activities and measures to prevent the spread of MDR TB in the laboratory and hospitals in the four CDC/GAP focus provinces. Renovation of the NRL will take place to ensure that the laboratory meets international standards for laboratory safety.
Procurement of laboratory supplies has been a challenge for the NTP under the existing national structure. However, the NTP is the principal recipient for Global Fund Round 7 funds and will gain direct experience in procurement of laboratory supplies and equipment. CDC/GAP will work closely with the NTP to ensure that the appropriate materials are purchased and supplied to the laboratories. The CDC/GAP has been instrumental in implementing and animating a technical working group for TB laboratories. This TWG meets monthly and includes public and private organizations with a stake in the laboratory diagnosis of tuberculosis. The NTP, through the TWG, has developed an Action Plan for TB laboratories for 2010-2014 based on the Strategic Plan for the TB Laboratory Network.
Where liquid culture is introduced, contamination of the media is initially a major challenge. Technical assistance will be provided to ensure that appropriate sputum decontamination techniques are used to reduce the contamination rate. Culture yield and contamination rates will be monitored on a monthly basis.
Target Populations and Geographic Coverage
The NTP provides services for the entire population of Cambodia. The laboratory in Battambang provides services to the provinces of Banteay Meanchey, Battambang, Pailin and Pursat. The target population is all persons with tuberculosis, with an emphasis on those TB patients coinfected with HIV.
Making the Most of HIV Resources
The NTP is seeking a long-term supply of reagents for liquid culture through the Global Fund. In addition, MSF has funded liquid TB culture at the regional TB lab in Kompong Cham.
Enhancing Sustainability
By building liquid culture capacity at the national reference laboratory, the NTP will be better able to supervise regional and provincial TB labs. As noted above, it is expected that reagents for liquid culture will come through the Global Fund in the future, making this a self-sustaining program.
M&E
Progress will be monitored by tracking the rate of contaminated cultures, which for a well functioning liquid culture lab should be approximately 10 percent.
