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: 18474
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
18474 18474.08 HHS/Centers for US Centers for 8062 5918.08 CDC-GAP $75,000
Disease Control & Disease Control
Prevention and Prevention
Table 3.3.01:
N/A
Continuing Activity: 18533
18533 18533.08 HHS/Centers for US Centers for 8062 5918.08 CDC-GAP $10,000
Table 3.3.03:
Continuing Activity: 18354
18354 11846.08 HHS/Centers for US Centers for 8062 5918.08 CDC-GAP $63,719
11846 11846.07 HHS/Centers for Center for Disease 5918 5918.07 CDC GAP $20,000
Disease Control & Control and BASE
Prevention Prevention,
Department of
Sexually
Transmitted
Diseases
Program Budget Code: 05 - HMIN Biomedical Prevention: Injection Safety
Total Planned Funding for Program Budget Code: $19,115
Total Planned Funding for Program Budget Code: $0
Table 3.3.05:
Continuing Activity: 18478
18478 18478.08 HHS/Centers for US Centers for 8062 5918.08 CDC-GAP $25,000
Program Budget Code: 09 - HTXS Treatment: Adult Treatment
Total Planned Funding for Program Budget Code: $645,072
Table 3.3.09:
NOT APPLICABLE
Continuing Activity: 18356
18356 11802.08 HHS/Centers for US Centers for 8062 5918.08 CDC-GAP $40,000
11802 11802.07 HHS/Centers for Center for Disease 5918 5918.07 CDC GAP $26,500
Continuing Activity: 18480
18480 18480.08 HHS/Centers for US Centers for 8062 5918.08 CDC-GAP $20,000
Table 3.3.12:
Continuing Activity: 18512
18512 18512.08 HHS/Centers for US Centers for 8062 5918.08 CDC-GAP $10,000
Table 3.3.14:
Continuing Activity: 18357
18357 11818.08 HHS/Centers for US Centers for 8062 5918.08 CDC-GAP $145,000
11818 11818.07 HHS/Centers for Center for Disease 5918 5918.07 CDC GAP $11,800
Program Budget Code: 18 - OHSS Health Systems Strengthening
Total Planned Funding for Program Budget Code: $527,321
Program Area Narrative:
Health Systems Strengthening
Overview
In the DRC, the health sector has demonstrated a strong institutional commitment to HIV/AIDS prevention and control. However,
a common vision and clear roles from other GDRC ministries are needed for a comprehensive, multi-sector response. USG
agencies are well-positioned to promote integrated policy development within key ministries including the Ministries of Health,
Planning, Education (Primary and Higher), Defense, Social Affairs, and Agriculture.
In the DRC, civil society has been significantly weakened by conflict which has contributed to deteriorating infrastructure and
limited local capacity. The USG-supported 2006 Kinshasa School of Public Health (KSPH) HIV Services Mapping Exercise found
that few local organizations working in HIV/AIDS have the capacity to organize, design, implement, and manage programs). Local
NGOs involved in health and HIV services require technical assistance in planning, implementing, and reporting. Lack of access
to donor-sponsored projects in the 1990s has limited their experience and capacity to manage resources and achieve results. The
Global Fund CCM and Principal Recipient (UNDP) have begun addressing these issues.
Leveraging and Coordination
USG assistance will target the implementation of the "Three Ones" to assure a more coordinated and results-oriented national HIV
response. The "Three Ones" are: one coordinating body, one national strategic plan, and one monitoring and evaluation plan.
Working with the GF, MAP, as well as other donors and implementing partners, the USG will promote improved local capacity with
a focus on quality proposal development and effective program implementation. As most donor agencies' HIV programs are
limited in scope, strong coordination is paramount to ensure a continuum of care from prevention, to diagnosis, to care and
treatment.
The USG will continue to work with GDRC structures to refine strategic plans of action and strengthen the overall systems. The
USG will also promote improved donor coordination in policy development, dissemination, and implementation. Some donor
agencies lack sufficient technical expertise and have requested USG assistance in developing and improving their HIV programs
(Global Fund, DFID). In 2007, the USG provided to the Global Fund CCM to improve coordination and collaboration. This
assistance helped the CCM to successfully secure three awards: (1) $70M Phase 2, Round 3 grant; (2) $22.6M Phase 1, Round 7
grant; and (3) $262,911,091 Round 8 funds.
Current USG Support
USG support focuses on integrating quality HIV service delivery into the existing health care system, a priority recently articulated
by the MOH. USG also promotes a National HIV Strategic Framework that uses data for decision making and institutionalizes the
national response. This approach is taken to reduce duplication of efforts as well as minimize ad hoc approaches to human
resource development and supply/distribution systems. The USG contributed technical expertise to develop the MOH 2008-2013
National HIV Strategic Framework which was completed in June 2008. The USG continues to be actively engaged in the
development, dissemination, and implementation of other key HIV documents which will serve as the foundation for strengthening
health systems:
•Five-year HIV Multi-Sector Strategic Framework;
•Condom, Prevention, and Communication Policy (approved by prevention technical working group and awaiting MOH signature);
•Provider Initiated Counseling and Testing (PICT) & Couple Counseling and Testing Policy (technical assistance underway);
•Anti-stigma Policy for PLWHA (adopted by Parliament and signed by the President);
•Policy on the Sustainable Financing of ART (in progress);
•Policy for Interruption of ART (in progress);
•National Plan of Action for OVC (in progress);
•PMTCT Protocol revision shifting from single dose Nevirapine to a combined ARV regimen (adopted by the PMTCT task force
and awaits MOH signature);
•"Three Ones" Implementation Framework (in progress); and,
•TB/HIV Co-infection Policy (developed).
Related to capacity building, one priority is the development of a comprehensive approach to pre-service, in-service, and
continuing education to provide quality HIV services. Training is currently done on an ad hoc basis by each implementing partner
in the areas of clinical care, community-based services, program management, and strategic information. In support of the
National Programs, the USG will advocate for the development of pragmatic training programs that are based on standardized
international and national policies, guidelines, and training curricula. Training for coverage, access and monitoring of HIV services
is limited and therefore a priority. Training will focus on clinical and support services, community-based services, program
management, and strategic information.
The military, through USG technical assistance and funding to the PNMLS/MAP-WB, developed the PALS, its three-year sectional
strategic plan covering the 2007-2009 period. In addition, technical assistance will be provided to the Ministry of Defense to create
and implement a comprehensive HIV management policy and funds will sponsor the attendance of military commanders at
regional military conferences on HIV/AIDS policies to address HIV stigma and discrimination.
The USG will advocate for dialogue among public and private partners to engage civil society. This approach will create a platform
for policy implementation and a national HIV response. USG is helping to open up the public dialogue through innovative mass
media channels. Radio call-in shows and televised interviews with well-known Congolese provide an opportunity to reach large
audiences with appropriate HIV prevention and testing promotion messages. These mass media approaches also provide
opportunities to increase public awareness and an understanding of Living Positively while reducing the stigma of HIV. These
efforts complement and reinforce USG supported BCC programming.
The USG is providing technical assistance to the Ministry of Social Affairs to develop a national OVC assessment to inform a
national action plan. The assessment will also enhance the Ministry's OVC response at the national, provincial, and local levels.
The USG will also support capacity building in strategic information, advocacy, civil society engagement, and policy making. The
USG's support on the national OVC action plan is in collaboration with UNICEF (UNICEF co-funds the local costs of activities via
direct support to MINAS). The USG support to MINAS has focused on assessment of provincial MINAS' offices and leadership
support through MINAS' Direction of Planning. The USG engaged MINAS in a south-south exchange on OVC issues with the
Ivory Coast. USG supported MINAS' delegates from national and provincial offices, civil society delegates and representatives
from the MINAS cabinet levels to exchange lessons learned on OVC interventions with the OVC team in Ivory Coast. It was an
opportunity to learn from this francophone PEPFAR focus country since the context is similar to that of DRC. Both countries are
developing National Action Plans for OVC.
The USG-supported community-based programs are also providing capacity building to more than 100 organizations in Matadi,
Lubumbashi, and Bukavu, as well as along transport corridors through the ROADS II program.
In October 2008, USG conducted an assessment on the DRC pharmaceutical and logistics system. Preliminary findings reveal
that pharmaceutical products enter DRC through numerous channels including private wholesalers, local drug manufacturers,
NGOs, FBOs, and donors. However, none of these channels are working effectively. Private wholesalers are the main source of
pharmaceutical products, however, with variable drug quality. In addition to the major donors who supply ARVs and ACTs, few
private vendors are approved by the government to supply these drugs. Most donors supply pharmaceutical products through
their own channels, but these are disparate and uncoordinated. Overall, the pharmaceutical situation in DRC is bleak: stock-outs
of critical products are commonplace; the number of private vendors which can procure certain drugs is limited. And, often,
privately procured drugs are of questionable quality. The USG will build a program to strengthen the DRC pharmaceutical system
based on recommendations from this assessment.
USG FY09 Support
The USG will continue to assist the DRC national programs to refine policies and treatment protocols as well as disseminate these
key documents to health development partners. Specifically, the USG will provide technical support to update the national
guidelines for VCT algorithms. Revised guidelines will also integrate couple CT and PICT as well as standardized training,
supervision, and reporting. The USG will contribute to support the development of the National Multi-sector HIV/AIDS Strategic
Framework. The KSPH has conducted workshops on the application of public health principles to the National HIV response and
the DOD will provide TA to the Ministry of Defense to create and implement a comprehensive HIV management policy addressing
stigma, male norms, violence and alcohol issues. The DOD will also provide support for HIV prevention, counseling and testing,
care and treatment programs. Support to the MINAS will continue to inform the development of OVC policy based on the RAAAP
findings, standardizing services, and monitoring and evaluation systems.
Additionally, the USG will continue to support capacity building and institutional strengthening (both technical and managerial) of
indigenous organizations such as Amo-Congo and Foundation Femme Plus. These organizations are among the few local health
development partners engaged in wide-reaching HIV/AIDS programming. Presently, these partners have CT, OVC, and palliative
care programs in Lubumbashi, Matadi, and Bukavu. The ROADS II activities in the Eastern Corridor initiative will continue to
support 93 different associations, women's groups and CBOs with technical assistance in monitoring and evaluation and
community mobilization /advocacy. The USG will aim to identify other CBOs and FBOs to support with similar capacity building
approaches. These efforts will aim to provide local partners with strong enough managerial and technical expertise to be in a
position to receive direct donor support by 2012.
FY09 support will continue to strengthen the DRC pharmaceutical and logistic system to ensure availability of HIV related
commodities at the service delivery sites. *
Program Area Downstream Targets:
14.1 Number of local organization provided with technical assistance for HIV-related policy development: 7
14.2 Number of local organization provided with technical assistance for HIV-related institutional capacity building: 115
14.3 Number of individuals trained in HIV-related policy development: 4
14.4 Number of individuals trained in HIV-related institutional capacity building: 1,167
14.5 Number of individuals trained in HIV-related stigma and discrimination reduction: 239
14.6 Number of individuals trained in HIV-related community mobilization for prevention, care and/or treatment: 1,640
Table 3.3.18:
