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: 2008 2009
Not applicable
New/Continuing Activity: Continuing Activity
Continuing Activity: 18220
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
18220 11772.08 U.S. Agency for Family Health 8004 5878.08 ROADS project $150,000
International International
Development
11772 11772.07 U.S. Agency for Family Health 5878 5878.07 ROADS project $100,000
Table 3.3.02:
Continuing Activity: 18221
18221 11778.08 U.S. Agency for Family Health 8004 5878.08 ROADS project $175,000
11778 11778.07 U.S. Agency for Family Health 5878 5878.07 ROADS project $140,000
Table 3.3.03:
N/A
Continuing Activity: 18279
18279 18279.08 U.S. Agency for Family Health 8004 5878.08 ROADS project $100,000
Emphasis Areas
Human Capacity Development
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Estimated amount of funding that is planned for Economic Strengthening $15,000
Education
Water
Table 3.3.08:
Continuing Activity: 18280
18280 18280.08 U.S. Agency for Family Health 8004 5878.08 ROADS project $150,000
Estimated amount of funding that is planned for Economic Strengthening $10,000
Estimated amount of funding that is planned for Education $10,000
Program Budget Code: 14 - HVCT Prevention: Counseling and Testing
Total Planned Funding for Program Budget Code: $1,462,804
Total Planned Funding for Program Budget Code: $0
Program Area Narrative:
Counseling and Testing (CT)
Overview
Currently, the MOH estimates that there are 525 testing sites: 342 sites linked to hospitals and 183 community based VCT
centers. Of the 525 VCT sites, the USG is currently supporting 16. Weaknesses in the health and reporting systems as well as
delays in fund disbursements from the GF have severely affected counseling and testing services. In 2007, only 166,081 people
were counseled, 162,560 tested, and 155,087 received their test results. This is a considerable decrease from 2006 when
578,568 people were counseled, 555,041 were tested, and 509,979 received their test results. VCT programs are growing in
scale and coverage with other donor support. There is an increase in both the acceptance rate and post test attendance. In
2007, HIV prevalence in VCT centers was 10.3% (compared to 12.4% in 2006). The 2006 BSS indicated that only 8% of youth 15
-24 have ever been tested for HIV, worrisome as the 2007 annual report on HIV/AIDS issued by the GDRC indicates an increase
among youth <24 years.
According to the 2007 Demographic and Health Survey (DHS), 86% of people who tested positive for HIV in the EDS-RDC did not
know their status because they have either never been tested (82%) or they were tested but did not receive the results of their last
test (3%)
Challenges
Demand for VCT services in the DRC is high. However, the current number and capacity of VCT centers to meet the demand, as
well as the lack of services for onward referral of those who test positive are issues. Another concern is the disclosure of status to
sexual partners. Provider-initiated counseling and testing has begun through a few innovative donor programs, but it is not yet
included in national policy guidelines.
Leveraging and Coordination
Since 2002, the USG has assisted the PNLS in establishing an evidenced-based VCT program and continues to provide technical
support to strengthen national guidelines for VCT testing algorithms, standardized training and reporting, and supervision. The
USG model for VCT has been adopted by the Global Fund. A total of 280 new VCT centers nationwide were planned to open
with Round 03 funds however only 251 are operational. Bottlenecks in funding disbursements have stalled scale-up of programs
as discussed above.
The USG has also leveraged DFID support for the "ABCD Rien que la Vérité" campaign which uses multi-media (audio, video,
graphic) for VCT promotion.
Current USG Support
The USG supports a mix of community-based VCT centers and facility-based services, with rapid tests at all 16 sites. Community
VCT sites include mobile testing units which target high-risk populations that often do not use facility-based services. Integrated
VCT within TB care and family planning, and youth-friendly VCT are also supported. The mix of sites established in each city
considers local needs and epidemiology. Support includes training and supervision of counselors, procurement of essential
commodities, dissemination of prevention messages, and care and treatment services. It is a USG priority to establish VCT
programs in the four cities where BCC currently exits (Kinshasa, Matadi, Lumbumbashi, and Bukavu). Joint planning exercises
among partners will facilitate the ongoing integration of prevention messaging as well as counseling and testing information.
The USG is also providing technical support to the GDRC to update the national CT guidance, which includes norms and training
materials to integrate PICT and couples' counseling and testing into the health facilities approach. Finger-prick testing, currently
used by USG partners, is promoted as a component of national guidelines for countrywide dissemination. The updated guidance
and training manuals will be finalized in April 2009 and ready for dissemination through a cascade of trainings using USG, World
Bank, Global Fund and other donor resources.
The USG has engaged the private sector through a Global Development Alliance (GDA) with mining companies in Lubumbashi to
provide CT services for its employees and the surrounding population. A client initiated CT approach is being implemented at four
sites including three hospital based VCT centers and one mobile VCT unit to reach the artisan miner population in the area of
Kolwezi. The implementation of PICT using all entry points such STI, PMTCT, TB and hospitalization services will be rolled out
after the revision of the national CT guidance. The GDA in Katanga is comprehensive as it leverages other USAID and private
investments in the areas of education, democracy and governance, civil society, microfinance, and other health services. A
referral network has been established to ensure that HIV positive people have access to care and treatment services needed
through the GF supported programs. The existing program is ending in January 2009. The USG will grant a cost extension to the
existing VCT program in Lubumbashi through December 2009 in order to assure achievement of the Katanga mining GDA
HIV/AIDS CT results envisioned under the 2008 COP.
The current USG strategy to increase demand for testing services will continue. HIV resource centers, the HIV telephone hotline,
targeted condom social marketing efforts and the promotion of CT services in the transportation corridor will link HIV awareness
and prevention to VCT centers through referral services.
USG supports the regional ROADS II project (a five-year LWA agreement managed by USAID EA) designed as a follow-on of
ROADS I that ended in September 2008. ROADS II is delivering prevention services at the DRC/Rwanda and DRC/Burundi
borders. Through the ROADS II program a mobile VCT will be available by the end of January 2009 at SafeTStop areas in
Bukavu (Rwanda border) and Uvira (Burundi Boarder) to target transportation workers, CSWs, young adults, and others in the
surrounding community. These CT efforts will be linked to prevention and treatment programs.
USG creation of campaigns using music videos from "ABCD Rien Que La Verite" are ongoing. A series of multimedia events
starring famous Congolese musicians are highlighting prevention messages as well as the importance of knowing your status.
Live events with the musicians have been accompanied by mobile counseling and testing.
FY 09 USG Support
FY09 funds, through the new integrated HIV bilateral program (mechanism TBD), will support scale-up of CT efforts through
multiple approaches and venues, increasing the number of VCTs receiving support. Dissemination of policy updates (will be
supported by USG and their implementing partners as well as through the In partnership with the Global Fund and World
Bank/MAP, the USG will support dissemination of updated technical guidelines such as PICT, finger-prick testing, and couples'
counseling. These programs will be developed through the follow-on program of the existing activities in three major cities
(Lubumbashi, Bukavu and Matadi). ROADS II CT activities will continue in Bukavu and Uvira.
FY09 funds will also support the expansion of the Lubumbashi HIV program to Kasumbalesa, Kolwezi, Kipushi and Likasi and
Counseling and testing will remain a component of this HIV program: PICT and finger prick techniques will be implemented in CT
services and a functioning referral system will be established to increase access to comprehensive care and treatment for
PLWHA. These areas are located outside of Lubumbashi along a major trucking route which starts in South Africa and travels
north through Zimbabwe and Zambia into Lubumbashi through Kasumbalesa. FY 09 funds will allow maintaining a more
comprehensive HIV program and improve care services articulated by the MOH. This model program envisions comprehensive
health care at the site level, linkages to strengthen the continuum of care between health facilities and the communities that they
serve. The PEPFAR team will also coordinate with Global Fund activities to fill gaps in the existing package of available services.
Having one prime partner providing such comprehensive prevention, care and treatment services will avoid duplication and
ensures more ownership by the prime partner. Expansion to other ‘hotspot' areas and MARPS will be determined by increased
availability of funding, the Compact Program and HIV prevalence rates.
The USG will continue to increase CT programming among military personnel in conjunction with a FARDC prevention program
and by expanding VCT services to a third military site located in Bukavu. USG's BCC prevention program will also focus on
increasing access to and use of VCT services among military personnel and their families and increasing the capacity of the
military to conduct large-scale HIV testing. These objectives will be achieved in partnership with NGOs and the FARDC.
Efforts to support counseling and testing services in the continuum of family-centered HIV services will also continue. One barrier
to the family-based continuum approach is the unwillingness of some fathers to be counseled and tested. A special initiative will
be extended to increase the number of first time fathers/partners. Disclosure rates to sexual partners are currently low; only 24 of
the known 125 discordant couples in the Kinshasa maternity clinics shared their status with one another. Efforts will continue to
increase partner participation by expanding services to accommodate men's availability during early evening and on weekends;
providing all female clients with invitations for their male sexual partners; community outreach activities to reduce stigma and
discrimination; enhancing counselor communication skills; engaging the FB community; and availability and use of HIV rapid tests.
and prevention to VCT centers through referral services. Through the ROADS II activities, mobile VCT efforts will be available at
SafeTStop areas to target transportation workers, CSW, young adults, and others in the surrounding community. These CT efforts
will be linked to prevention and treatment programs for individuals that have tested HIV positive. Of critical concern is the lack of
sufficient stock of ART and OI medications to provide treatment to all eligible PLWH/As. USG will also work closely with Global
Fund, World Bank and other donors to leverage access to these drugs, so that when diagnosed people have services and
treatments available.
Regardless of the type of testing, USG efforts will focus on encouraging individuals to know their HIV status and to be able to take
appropriate steps to maintain sero-negativity or to seek HIV services in order to live positively. *
Program Area Downstream Targets:
9.1 Number of service outlets providing counseling and testing according to national and international standards : 141
9.2 Number of individuals who received counseling and testing for HIV and received their test results (including TB): 171,452
Male: 93,818 Female: 77,634.
9.3 Number of individuals trained in counseling and testing according to national and international standards: 600
Table 3.3.14:
Continuing Activity: 18222
18222 11801.08 U.S. Agency for Family Health 8004 5878.08 ROADS project $150,000
11801 11801.07 U.S. Agency for Family Health 5878 5878.07 ROADS project $115,000
NOT APPLICABLE
Continuing Activity: 18223
18223 11816.08 U.S. Agency for Family Health 8004 5878.08 ROADS project $75,000
11816 11816.07 U.S. Agency for Family Health 5878 5878.07 ROADS project $45,000
Table 3.3.18:
