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.
The purpose of this mechanism is to assist countries within the region in the implementation of the ISO 15189 Quality Management System (QMS) and accreditation of their laboratories. Previous Caribbean-led regional laboratory strategies have trained over 1,000 laboratory personnel within the region on the ISO 15189 QMS but due to extensive requirements and the involved process for obtaining laboratory accreditation, the training alone did not lead to accreditation of laboratories in the region. Recognizing the challenges of past accreditation efforts, the USG, in collaboration with a TBD partner, will provide financial and technical support to laboratories to achieve accreditation using the user friendly WHO-AFRO stepwise approach. This activity will target the four National Reference Laboratories of Barbados, Jamaica, Bahamas, and Trinidad and Tobago. This mechanism is in direct support of the USG Caribbean Partnership Framework Laboratory Systems Goal 3,Objective 3.2:Improve laboratory systems and services, Sub-Objective 3.2.2: Accreditation.
Through this mechanism, national and regional capacity for quality management systems and monitoring of laboratory quality through accreditation will be improved. Such an inbuilt system with a participatory approach will ensure both short and long-term ownership and sustainability of laboratory quality management systems within the entire Caribbean region.
The USG and TBD partner will work in close collaboration with the government of Barbados, Jamaica, Bahamas, and Trinidad and Tobago countries to ensure compliance and monitoring during the three year accreditation process, including quarterly reports outlining progress within the WHO-AFRO stepwise laboratory accreditation process. The overall indicator will be the number of laboratories accredited.
This mechanism will also assist countries within the region to effectively implement and participate in Proficiency Testing (PT), which is a critical aspect of EQA. The mechanism will support the purchase and distribution of PT panels to the National Reference Laboratories of all the twelve countries within the region to assist in monitoring the quality of clinical laboratory results. The skills of Quality Officers among the 12 countries to prepare and distribute DST to monitor HIV rapid testing will also be improved through this mechanism.
Various countries within the region currently lack the skills and knowledge to set-up and manage PT programs. Lack of PT standards has an impact on the quality of results. Through this mechanism, USG will work in collaboration with a TBD partner to assist countries to establish EQA preparation, procurement and distribution systems. It is anticipated that at the end of the third year, countries within the region would have acquired the necessary skills and be able to effectively manage their own EQA programs.
An average of three PT panels is shipped to clinical laboratories per year. This mechanism will be monitored by the number of PT panels that each laboratory participated in per year as well as the scores obtained. A minimum of 95% proficiency score per year will be considered adequate.
The PAHO Caribbean Regional Office in collaboration with the CDC Global AIDS Program Atlanta International Laboratory Branch, have initiated discussions with the WHO-AFRO on the introduction of the recently launched WHO-AFRO stepwise laboratory accreditation scheme within the Caribbean region. AFENET in collaboration with USG (lead by CDC GAP Atlanta and CDC CRO) will use this scheme and work with the 4 National Reference Laboratories of the Barbados, Jamaica, Bahamas, and Trinidad and Tobago to outline opportunities to enhance current practices, identify gaps and barriers to the achievement of Good Clinical Laboratory Practices (GCLP) and provide mentorship towards accreditation of these laboratories. AFENET will organize work sessions with in-country government officials, laboratory personnel, and management and quality officers to introduce the WHO stepwise scheme. AFENET will carry out the following activities: conduct gap analysis, collect and document all relevant information within the laboratory QMS, identify and document non-conformances, and classify laboratories according to the WHO checklist. Furthermore, AFENET will participate in the resolution of non-conformances, assist in establishing laboratory documents including laboratory policy manuals, SOPs, and procedures, fully implement the ISO 15189:2003 QMS, and define steps and actions to move laboratories to WHO-AFRO accreditation scheme step five. This activity will continue for a period of three years.
AFENET will work with National Reference Laboratories of the twelve countries under the current USG Partnership Framework to register and participate in EQA proficiency testing (PT) for HIV serology, CD4, hematology, chemical pathology, and TB diagnosis. In addition, the Barbados Reference Laboratory and laboratories in Jamaica, Bahamas, Trinidad and Tobago and Suriname with molecular testing capacity will be registered to participate in PT for viral load and DNA PCR. AFENET will work with the Regional Reference Laboratory (RRL) in Barbados, Jamaica, Bahamas, Trinidad and Tobago, Belize and Suriname to implement the Dried Tube Specimen PT activity for HIV rapid testing. Specifically, AFENET will organize training workshops on quality assurance for HIV testing for the Dried Tube Specimen (DTS) technology for EQA in serology, printing and dissemination of standardized logbooks for use at all HIV testing sites. AFENET will assist in developing SOPs and shipment guidelines for the RRL in Barbados to prepare and ship DTS to OECS countries, as well as for the other countries in the region. In summary, AFENET will support the distribution of PT panels, collection of results, and supervisory activities.
