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
ACTIVITY UNCHANGED FROM FY2008
This is a continuation of activity from FY08.
The American International Health Alliance (AIHA), through a cooperative agreement with the US
Department of Health and Human Services' Health Resources and Services Administration (HRSA/DHHS),
has established an "HIV/AIDS Twinning Center" to support partnership and volunteer activities as part of the
implementation of PEPFAR. Through twinning partnerships, volunteers, and supportive assistance
programs, the Twinning Center (TC) will contribute significantly to building human and organizational
capacity by: training and mentoring HIV caregivers; strengthening existing and new training and educational
institutions; and developing models of care for improved organization and delivery of services for rapid scale
-up of interventions to help meet the goals of PEPFAR.
Components of the AIHA TC are: institutional partnerships based on AIHA's Twinning Methodology; and a
volunteer Healthcare Corps to recruit, select, place, and support volunteers with professional expertise for a
period of six weeks to one year.
The AIHA Twinning Center is supported by PEPFAR Ethiopia to achieve two main objectives:
oTo increase human and organizational capacity to prevent and treat HIV/AIDS by engaging professionals,
primarily from the Ethiopian diaspora, in volunteer assignments at ARV clinics and HIV/AIDS service
organizations; and
oTo increase human and organizational capacity to prevent and treat HIV/AIDS through institutional
twinning partnerships. The identification and management of institutional partnerships is a continuing
activity from FYO7.
As of July 2007 the TC had initiated the following partnerships:
?AIDS Resource Center (ARC-Ethiopia)/AIDS Treatment Information Center (ATIC-Uganda) Partnership:
This south-south twinning relationship facilitates knowledge and skills transfer between two organizations
that share the similar experience of working in a resource-constrained environment. The objectives of this
partnership are to increase the capacity of the ARC to strategically plan for and implement a call center that
provides a clinical "warmline" and HIV/AIDS pharmaceutical and laboratory service-delivery system, monitor
and evaluate the call center's warmline, and analyze the logistical, educational, and infrastructural need to
disseminate the information to appropriate partners.
?Addis Ababa University School of Pharmacy (AAU), the Drug Administration and Control Authority
(DACA), and Howard University School of Pharmacy and Continuing Education: The objectives of this
partnership are to strengthen pharmacy services within the healthcare system by establishing two drug
information centers, one at DACA of Ethiopia and another at AAU's School of Pharmacy. The drug
information centers will support the expansion and provision of quality ART and strengthen the clinical
capacity of pharmacists to provide quality ART through continuing education.
?Hospital to Hospital Partnerships:
Through an open solicitation process, the TC has identified two US-based hospitals to partner with Debre
Berhan and Ambo hospitals to increase human and institutional capacity in hospital management and the
provision of clinical care. The partnerships will create professional development opportunities for hospital
staff and managers through training and mentoring. Elmhurst Hospital in New York is partnering with Debra
Berhan Hospital and Jersey Shore University Medical Center in Neptune, NJ, is partnering with Ambo
Hospital.
?Addis Ababa University School of Social Work (AAU)/Jane Addams College of Social Work (JACSW),
Chicago USA/Institute of Social Work (ISW)-Tanzania:
This triangular partnership between the AAU School of Social Work, JACSW, and the ISW in Tanzania will
focus on training facility-based case managers at the pre-service level, in close collaboration with in-service
efforts of Washington University (I-TECH) and Management Sciences for Health, and the overall efforts of
the Ethiopian government and PEPFAR partners. Partners will use the existing relationship between
JACSW and ISW to provide south-south professional exchanges and resource sharing for the Ethiopian
partners.
All these activities are going well and will continue to be implemented in COP09. TC will work to maintain
these activities, but there will not be new partnership initiation because headquarters costs, which were
initially funded centrally, are covered by country level COP funding (starting from COP08).
These partnerships and the volunteer program focuses on building capacity and developing the local
institutions' abilities to provide quality ART services, in collaboration with other USG implementing partners.
USG partners implementing the ART services will report on the number of individuals receiving HIV clinical
services, such as ART and treatment for opportunistic infections; thus, these twinning partnerships and
volunteer program will report on the number of institutions providing services and number of service
providers trained, to measure the effect of the TC Program on sustainable strengthening of HIV/AIDS ART
services in Ethiopia.
New/Continuing Activity: Continuing Activity
Continuing Activity: 16711
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
16711 5678.08 HHS/Health American 7517 3806.08 Twinning $2,756,000
Resources International Initiative
Services Health Alliance
Administration Twinning Center
10562 5678.07 HHS/Health American 5537 3806.07 $1,400,000
Resources International
5678 5678.06 HHS/Health American 3806 3806.06 $950,000
Table 3.3.09:
COP 08 Narrative:
Activity Narrative: Twinning Partnership to Strengthen the Quality of VCT Services
The American International Health Alliance (AIHA), through a Cooperative Agreement with the Health
Resources and Services Administration (HRSA), has established an "HIV/AIDS Twinning Center" to support
partnership and volunteer activities as part of the implementation of PEPFAR. Through twinning
partnerships, volunteers, and supportive assistance programs, the Twinning Center will contribute
significantly to building human and organizational capacity through: a) training and mentoring caregivers; b)
strengthening existing and new training and educational institutions; and c) developing models of care for
improved organization and delivery of services. This will allow rapid scale-up of interventions to help meet
the goals of PEPFAR in Ethiopia to prevent, treat, and care for HIV-positive individuals and AIDS orphans.
To strengthen the provision of voluntary counseling and testing (VCT) services in Ethiopia in FY07, AIHA is
initiating a South-South twinning partnership between the Liverpool VCT Program (LVCT—an indigenous
Kenyan organization) and Ethiopian national institutions responsible for VCT. The partnership assists in
quality assurance, policy development, and materials development to increase capacity of the Federal
Ministry of Health (MOH) and regional health offices to develop and support VCT sites throughout Ethiopia.
A team of PEPFAR partners traveled to Kenya for experience sharing visit through the twining program. The
Ethiopian and Kenyan team developed a concept paper on how to implement the program.
In FY09, LVCT support to the MOH and regional health bureaus (RHB) will include:
1) Provision of support in the implementation of QA strategies at the national and regional level
2) LVCT in partnership with HAPCO and US based partners assist sites with the implementation of QA
programs at facility level
3) Conduct training of trainers (TOT) at the regional level for further expansion of the program.
In FY09, LVCT support will further expand training of counselors to assure quality of service at the site level.
Additional 30 sites will be identified for the implementation of the QA system in collaboration with PEPFAR
partners. Documented "best practices" and lessons learned will be replicated in other sites. Furthermore,
LVCT will revise the QA tool based on lessons learned from site-level implementation.
AIHA is requesting continued funding in 2009 to ensure the robust progress of this South-South partnership.
As the partnership transitions out of the first year/initiation phase, AIHA will require increased funding levels
to support a greater level of activities and allow for an adequate number of professional exchanges,
trainings, and technical assistance to accomplish their goals and objectives. Further, in the first three years
of the Twinning Center cooperative agreement, HRSA provided central funding (received from
PEPFAR/Office of the Global AID Coordinator headquarters) to AIHA to subsidize the initiation of programs
and cover in-country office and headquarters operations. Now, HRSA is phasing out its central funding to its
cooperative agreement partners; therefore these costs are now included in this country funding request.
The Twinning Center will operate as a traditional US government partner, receiving all its programmatic
funding, including operations for the in-country office and headquarters, from the US government country
programs (through the Country Operational Plans) and will cease to receive central funding from HRSA.
The country office and headquarters will continue to operate in a streamlined fashion without addition of
new staff or office costs.
Since this partnership focuses on building capacity and developing local institutions' abilities to provide
quality VCT services, it works with other USG implementing partners. USG partners implementing VCT
services will report on the number of individuals who were counseled, tested, and received results; thus, this
twinning partnership will report on numbers of institutions providing services and numbers of service
providers trained, to measure the effect of the Twinning Center Program on sustainable strengthening of
HIV/AIDS VCT services in Ethiopia. The targets represent institutions and individuals we expect the
partnership to reach in FY09 to strengthen both human resources and institutional ability to provide HIV
VCT services.
Continuing Activity: 16710
16710 10583.08 HHS/Health American 7517 3806.08 Twinning $211,000
10583 10583.07 HHS/Health American 5537 3806.07 $176,000
Table 3.3.14:
