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.
A fundamental objective of the US-Caribbean Regional Partnership Framework (PF) is to move the region toward sustainability of HIV/AIDS programs. Goal #5 of the Framework is Sustainability: To improve the capacity of the Caribbean national governments and regional organizations to effectively lead, finance, manage, and sustain the delivery of quality HIV prevention, care, treatment and support services with Objective 5.1 being to Improve Financial Management Capacity of National HIV Programs. Achieving measurable progress on this critical objective will require a major effort as most country governments currently provide very limited national budget resources to their own HIV and AIDS programs, relying to an alarming degree on external funding much of which has come from the Global Fund and the World Bank, with smaller support from bilateral donors. Objective 5.2 aims to Improve Integration and Efficiency of National HIV Partners and will require greater efforts to integrate HIV/AIDS programs and services more fully into the delivery of primary health care systems and across all sectors, to ensure greater efficiency of resources and the reduction of HIV related stigma and discrimination.
It is anticipated that from among the U.S. Government interagency Framework team USAID will assume the responsibility for planning and implementing technical assistance to Caribbean partners to improve their ability and capacity to plan for sustainability through cost-effective management of human and other resources, and better integration of ongoing interventions into health and social services. This will be facilitated across all 12 PF countries as warranted.
A dialogue between the field and USAID/Washington has begun regarding how the PF can access technical expertise to address the financial sustainability objective. USAID will explore various options to expand and diversify domestic financing (private and public) and non-USG external financing. Among the opportunities that are under discussion: (a) increasing program efficiency (doing more with less) through changes in structure (e.g. service integration), organizational arrangements, payment systems (e.g. payments reward efficiency as well as quality), and optimizing resource allocation to the most cost-effective interventions for the country's epidemic profile; (b) improving the competence of operational-level financial management of HIV/AIDS-related programs; (c) initiating or expanding coverage (financing) of services through risk pooling/insurance both private and public; (d) increasing country capacity to mobilize and manage non-USG external resources for capital and recurrent costs; and (e) increasing the transparency and accountability of budgeting and spending to ensure that plans and commitments are carried out.
Further, technical assistance will be provided to improve integration and efficiency of national HIV partners. The objective would be to increase the capacity of key national agencies, non-governmental and civil society organizations to fully deploy their respective strengths to improve the efficiency and cost-effectiveness of their respective contributions to the national HIV/AIDS response. There are four main aspects of this Objective: 1) Mapping of partners at the national level so that the national AIDS program knows which public, private, and civil society partners are working on HIV prevention, care and treatment; 2) Work with national governments to create strategies for improving cost-efficiency and sustainable approaches in programming; 3) Develop joint planning opportunities for national governments to meet with their partners and engage in strategic dialogue and jointly plan to cooperatively implement activities for greater impact and minimal duplication; 4) Work with national governments to integrate and decentralize their national HIV/STI programs and to provide a more broad base of services at the community level to make them more cost-effective, efficient and less stigmatizing.
Health Systems 20/20, a five-year (2006-2011) cooperative agreement, funded by the U.S. Agency for International Development (USAID) is the most likely potential partner for these activities. This mechanism can provide USAID with technical assistance solving problems in health governance, finance, operations, and capacity building. By working on these dimensions of strengthening health systems, the project will help to ensure greater access to and use priority population, health, and nutrition (PHN) services. Health Systems 20/20 integrates health financing with governance, and operations initiatives. This integrated approach focuses on building capacity for long-term sustainability of system strengthening efforts. The project acts through global leadership, technical assistance, brokering and grant making, research, professional networking, and information dissemination.
USAID will seek to access technical assistance through Health Systems 20/20 to support this activity. The scope of work will be finalize following an initial assessment of the financial systems and health planning dynamics in each of the PF countries which will be conducted in February 2010.
