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.
Despite several years of ambitious and highly visible prevention programming in Swaziland, the country continues to suffer from the world's worst HIV epidemic. Although HIV awareness is nearly universal, specific sexual behaviors continue to contribute to new infections. There is increasing recognition within GKOS and among key stakeholders that prevention efforts must move beyond individual behavior change strategies to boldly address the social and cultural norms that fuel the epidemic.
All HIV prevention efforts in Swaziland have the ultimate aim of interrupting transmission and reducing the number of new HIV infections. In line with the NSF, the overall goal of the Partnership Framework in the area of prevention is to reduce HIV incidence in the general population. PEPFAR will target this through two PF pillars: sexual prevention and male circumcision.
In COP10 a new award TBD Prevention will be developed to support Swaziland specific HIV prevention activities. It will target combination sexual prevention issues through the use of HVAB and HVOP funds, and CIRC funds will be used to continue supporting the national scale-up plans to circumcise 80% of 15-24 year old men over the next four years.
The geographic coverage of this activity will be national and the target populations are youth and adult males and females for sexual prevention and males, especially 15-24 year olds, for male circumcision.
This activity will contribute to health systems strengthening by building leadership and social and behavior change communication capacity for sexual prevention and strategic planning and service delivery capacity for male circumcision.
Cost efficiencies will be realized through a more unified and coordinated approach to sexual prevention that better standardizes messages and reduces duplication among implementers. Providing male circumcision services on a large scale for four years will result in economies of scale and ensure that the backlog of young adult males is addressed. Once this "catch up" phase is complete, routine costs of providing male circumcision will be reduced.
This award will incorporate the cross-cutting gender key issue of addressing male norms and behaviors.
M&E systems will be developed within this award that support and strengthen existing national M&E systems and track input, output and outcome data for program improvement.
Leaders in the MOH took an early interest in research showing the HIV prevention potential of MC and together with their partners pushed forward a plan for national scale-up. As a result, Swaziland is now on the forefront of international efforts to rapidly expand MC services. The GKOS, in partnership with PEPFAR, WHO, the Bill and Melinda Gates Foundation (BMGF) and other stakeholders, has made a commitment to reach 110,000 or 80% of all males in Swaziland, aged 15-24, with medical male circumcision services by early 2014. This effort forms part of an integrated approach to HIV prevention and will be supported by a national communication strategy to promote MC and other methods of prevention and to reduce potentially harmful misconceptions about the service. For long-term sustainability, introduction of neonatal MC is also planned to effect circumcision of 50% of male neonates by the end of the same five-year term.
The strategy for scaling up MC services is multi-pronged in order to comprehensively address policy and planning, HR, institutional capacity, leadership development, service delivery, and communications and social mobilization. The MOH led MC Task Force will provide leadership and oversight of all elements of implementation. Advocacy and support will also focus on final approval and roll out of the MC implementation strategy, service protocol and communications plan.
To date, PEPFAR has supported the MC scale up plans related to service delivery largely through a CDC cooperative agreement with Population Services International (PSI). CIRC funds were added onto an HTC award which meant that while CIRC funds began to dwarf HVCT funds, the priority of the agreement was still focused on HTC work. With the new TBD Prevention award, there is a plan forward to ensure that prevention activities in Swaziland are well balanced and coordinated. The CIRC component of this award will highlight the strengthening of five government health facilities, one stand alone men's health clinic (opened by PSI in September 2009), and an expansion of mobile outreach. Whenever possible the use of efficiency models will be targeted. The new partner will work closely with the Ministry of Health to integrate circumcision services into three public sector facilities and will support their supply, equipment, training and QA needs. Integration of neonatal MC will be done in conjunction with UNICEF.
HVAB and HVOP funds will be used together to create a holistic approach to sexual prevention. As such, the narratives for the two budget codes are quite similar except that condom activities are described solely under HVOP. The TBD Prevention award will focus on structural, social/behavioral, targeted populations and condom related issues in Swaziland.
While Swaziland's HIV epidemic is largely driven by the general population, HIV prevention among youth is a high priority for GKOS and PEPFAR. Activities and messages targeted for youth will be developed and disseminated through appropriate venues. The TBD Prevention award will engage the Ministry of Sports, Culture and Youth Affairs in sports and other development partners who can incorporate HIV prevention into sports and income generating activities for youth. The potential for enhancing and better standardizing the life skills curriculum for school-going youth will also be explored.
The TBD Prevention award is concerned with structural and leadership components of prevention in GKOS. The development of the new award will include a need for capacity building and skills transfer for local organizations to build technically sound HIV prevention activities.
As TBD Prevention award is not yet fully developed, this narrative remains fluid. The design of the award will be guided by the NSF and PF and will be shaped around key drivers of the epidemic which current programming does not adequately address. The principles of combination prevention will be utilized during the award design phase.
Correct and consistent use of condoms must be increased in Swaziland. There is a need to move beyond the routine social marketing approaches to find innovative ways to promote condom use. Through the TBD Prevention award PEPFAR will support both the public and private sector to distribute condoms and promote their use. Other activities will include expanding condom distribution, intensifying education on correct and consistent use of both the male and female condom and strengthening condom management systems.
As TBD Prevention award is not yet fully developed, this narrative remains fluid. The design of the award will be guided by the NSF and PF and shaped around key drivers of the epidemic, which current programming does not adequately address. The principles of combination prevention will be utilized during the award design phase.
