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
To continue Yo Escojo Program with youth in communities.
New/Continuing Activity: Continuing Activity
Continuing Activity: 18425
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
18425 11878.08 Peace Corps US Peace Corps 8098 5982.08 Yo Escojo $120,000
11878 11878.07 Peace Corps US Peace Corps 5982 5982.07 Yo Escojo $103,000
Program Budget Code: 04 - HMBL Biomedical Prevention: Blood Safety
Total Planned Funding for Program Budget Code: $0
Program Area Narrative:
N/A
Program Budget Code: 05 - HMIN Biomedical Prevention: Injection Safety
Program Budget Code: 06 - IDUP Biomedical Prevention: Injecting and non-Injecting Drug Use
Program Budget Code: 07 - CIRC Biomedical Prevention: Male Circumcision
Program Budget Code: 08 - HBHC Care: Adult Care and Support
Total Planned Funding for Program Budget Code: $525,000
08-HBHC Care: Adult Care and Support
Note: Due to late initiation of the new USG/USAID contract with AED, FY07 funds were partially used to extend the CONECTA
project one more year so that the two projects would overlap and the transition to the USG HIV/AIDS program to Region V and
the border areas would be smoother. Therefore, FY08 is the first year that USG's support is concentrated in Region V and the
border areas. The border areas lack the basic infrastructure needed to support a comprehensive HIV/AIDS program, and hence
FY08 funding will focus on improving infrastructure and strengthening NGOs. It is expected that our FY09 downstream and
upstream targets will decrease from those for FY07.
Program Area Context/Services
The 2008 UNAIDS report estimates that there are 62,000 individuals (approximately 52,000 adults and 2,700 children) in the DR
infected with HIV or 1.1% of the population. Also, UNAIDS estimates that 28,000 PLHs are in need of ARVs. Prevalence appears
to be higher in rural than in urban areas. The 2007 DHS suggests that only 20.5% of women and 18.6% of men have been tested
and know their serostatus. The National AIDS Reporting System (DIGECITTS) states that, as of September 30, 2008, 10,504
PLHs (9,709 adults and 795 children) are receiving ARV treatment and an additional 11,385 HIV-infected patients are receiving
basic care (11,155 adult and 230 children) through 67 integrated care units (ICUs). Therefore, only 38% of all the PLH in need
have access to ARVs. Support for TB treatment for HIV/TB co-infected individuals, as well as for TB prophylaxis, are provided
through a USG/USAID grant to PAHO/DR and the GF grant for TB. TB/HIV is discussed in the TB/HIV section.
USAID, in collaboration with the Clinton Foundation, Columbia University and the Global Fund grant have provided support to the
National AIDS Program (DIGECITSS) at the central level in order to train health teams, review norms and implement the reporting
system, SIAI (Sistema de Información de Atención Integral). In addition, USAID has provided direct support, (equipment, staff
training, and administrative costs) to NGO and FBO clinics that provide comprehensive care and ARVs funded through the Global
Fund grant. Approximately, 6,476 adults and children have received ARVs and other services in public hospitals, NGOs and
FBOs that have received direct support from USAID. As of March 30, 2008, approximately 13,270 PLHs were receiving emotional,
psychological and social support and home-based care (HBC) provided by NGOs and FBOs supported by USG/USAID through
the CONECTA project whose support to NGOs ended March 30, 2008. The change in contractor in the second semester of FY08
delayed some home-based care (HBC) coverage attributable to the project. Through bridge grants provided by the USG/USAID
AED contract, 1,157 PLHs and their families were reached with HBC as of September 30, 2008. We do not know how many of
those who had been covered by USG services accessed the services provided by the ICUs to which they were referred. As USG
moves to a more focused geographic approach and provides two-year grants to14 NGOS, an estimated 3,117 PLHs and their
families will receive HB and other care services during 2009.
Leveraging
With GF financing, COPRESIDA provides all ARV and opportunistic infection treatment in the DR, including to NGO/FBO clinics
supported by the USG. MOH funds most of the public health teams that provide those services. The Clinton Foundation funds 12
integrated care units in public hospitals and NGOs clinics. Health teams providing services out of NGO and FBO clinics are, in
some cases, contracted by MOH with complementary support from Columbia University with funding from the Fundacion MIR. .
FY09 USG Support
In FY09, USG/USAID, via AED and its partners, will continue to work with NGOs, FBOs and PLH networks to expand their
capacity to provide clinical services and broad-based care, treatment and support in the USG focus areas, using institutional,
community, and home-based approaches. Three NGO/FBO clinics have already been given two-year grants to expand their
services to better offer comprehensive care. Several additional ones will be similarly adapted in FY09. Under the AED contract,
USG/USAID will continue to support the NGO CEPROSH in its work in bateyes (sugar plantations) and with MARPs in Puerto
Plata in Region 2 which is outside the USG target area. However, CEPROSH is an important service provider that offers an
integrated care unit that provided comprehensive HIV/AIDS services to 1,212 adults and children in FY2008.
With the purchase of the two mobile clinics with FY07 funds, USAID will provide diagnosis, treatment and care services to
populations in hard to reach areas, such as bateyes, and with MARPS. In addition to clinical services, NGOs and FBOs provide
community and home-based care, including emotional, psychological, spiritual and social support, prevention messages for HIV
positive patients, ARV adherence, home-based care (including food preparation, home hygiene and care for bedridden patients),
prevention of negligence or abuse, support to identify additional services identified by PLHs within and beyond the community
(such as dental care, legal documentation, and access to the national health insurance), legal advice and income-generating
support.
With some adjustments to make it relevant to the Dominican scene, in FY09 AED sub-partner Cicatelli Associates will implement
a community and home-based care model originally developed in Guyana. Since community and home-based care is not a high
priority for the GODR, and the public sector, including hospitals, rarely provides care and support services, nurses in rural clinics
or provincial hospitals near communities where USG-supported NGOs work will train and supervise NGO staff to provide support
at the community level to provide HBC to bedridden patients and refer them to hospitals, as needed. This will also help improve
the friendliness of clinic services for HIV positive people, thus ensuring that they have easier access to services offered at public
hospitals and clinics for treatment and care of opportunistic infections, TB diagnosis and treatment, PMTCT services, HIV
counseling and tests, ARVs and ARV adherence. The nurses will also train PLHs in self-help, integrate them into support groups
and provide nutritional and legal support, as needed. In early FY09, two-year grants were awarded to 14 NGOs, including
networks of PLHs, to provide this comprehensive care at the community level for the infected and affected populations. This
activity is being initiated with FY07 funding, with FY09 money being used to continue and scale up this activity. See the Pediatric
Care section for more information on reaching children and their families through the community and home-based care services.
Using both FY08 and FY09 funding, USG/USAID will continue to support cross-border work, including sharing patient information,
referrals for diagnostic and routine testing, treatment and follow-up, including services for children. USG/USAID through
AED/Columbia University provides monitoring and TA to ensure that health clinics within USG areas of work supply pain and OI
medications as stipulated in national norms. In addition, USG/USAID, through MEASURE, will continue to monitor and evaluate
program indicators for care and treatment offered by DOD, PC and GODR programs that do not receive direct support from
USAID. USG continues to engage the MOH in policy discussions to encourage evaluation and priority for care and support
services.
Referrals/Linkages
The adult diagnosis and treatment depends on GODR clinics and staff. USG, local partners and donors continue to advocate for
implementing the anti-discrimination laws related to HIV status, engage in a broad discussion of food security options, and for
inclusion and priority treatment of PLHs and TB patients under the existing GODR "Comer es Primero" ("Eating is Most
Important") program and the national health insurance.
Sustainability
Leveraging support for care from other international donors (except UNICEF) has been difficult. COPRESIDA, through the GF
grant, provides limited support in this area. Nonetheless, USAID was successful in its efforts to include a care component in the
2007 - 2015 National Strategic Plan (PEN) and as result in the recently approved Round 2 GF Rolling Continuation Channel,
funding for community and home-based care has been included. Moreover, because care programs in the DR depend heavily on
NGOs and FBOs with scarce or limited financial resources, this program will only become sustainable in the near future if the
GODR, through the GF grant, provides support. USAID and its local partners will also continue to advocate for a GODR policy on
care as a foundation for building long-term sustainability.
Table 3.3.08:
