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
ALERT National HIV/AIDS Training Centre
ACTIVITY UNCHANGED FROM FY2008 (no Update needed)
This is a continuing activity started in COP07 through the plus-up fund and continued in COP08. The
partner has been awarded the approved funds and started implementing its activities in FY08 in
collaboration with CDC, PEPFAR partners and other stakeholders.
One of the major challenges in the implementation of the national HIV/AIDS program in Ethiopia is the lack
of trained health workers to provide the required services with acceptable quality. This has become more
and more critical as the program is being scaled up throughout the country and in numerous health facilities.
There is an urgent need to train health workers in a large scale and to follow up this with continuing medical
education (CME). This becomes more important when we consider the high attrition rate of health workers
from public health facilities leaving behind a vacuum in the delivery of services which severely affects the
scale up and compromises the quality.
The Ethiopian Federal Ministry of Health has made a strong commitment to the process of establishing a
national centre of excellence for continuing medical education, combining training, research and health
services. Building the capacity of the Ethiopian health service is essential in order to address the multiple
health crises affecting the country. In particular, sustainable human resource development is a priority of the
Federal Ministry of Health (MoH). Based on these facts, there are plans to establish a national HIV/AIDS
training centre at ALERT hospital, located in the capital (Addis Ababa), to provide training to a wide range
of health workers in the field of HIV/AIDS. This would build on ALERT's comparative advantage of being an
integrated hospital with longstanding community links, a research centre and training division with solid
managerial capacities and technical expertise in various medical arenas.
ALERT is widely recognised as having an excellent reputation in research, training and services, both in the
Ethiopian health sector and at international level. The existing in-and out-patient hospital care with
community outreach programme, and continuing medical education and research institute, among others
make it an ideal site for a high quality training centre, which will be a national centre of excellence for
continuing medical and public health education.
Currently, Ethiopia's short-term medical and public health training is conducted in a piecemeal fashion. No
single institution is responsible for delivery, so training is insufficiently coordinated, standardized and
certified. Necessary changes in terms of service expansion and improved quality have not been made.
There is high and urgent need for standardized, evidence-informed training packages for CME and a
massive scale-up of training programs in the regions, which makes establishing a national Center of
Excellence for CME at ALERT a priority.
The institute will serve as a quality control institution so that effective and efficient training is guaranteed,
and also serve as a model for other national health training. The institute will be able to develop standards,
models, curricula, manuals and guidelines for different training programmes, based on in-depth needs
assessment, best practices and operational research. In addition, the experience of this national training
centre will be replicated in three selected satellite regions. The proposed national institute would
standardise and strengthen evidence-based training and provide trainees with the opportunity to combine
training with clinical practice.
In addition, the national training center will rollout training capacity to other regions. This will involve:
1) Providing technical assistance to establish accredited, satellite training-of-trainers (TOT) centers in the
regions, in collaboration with relevant regional, national, and international stakeholders, and support for
monitoring and evaluation of the satellite centers
2) Develop models for community care and area-appropriate HIV care, treatment, and support, based on
the experiences of satellite centers in different areas of the country
3) Provide training for the health professionals in the satellite TOT centers in the regions, using the models
developed
4) Monitoring the progress of the training services provided at the satellite sites.
In order to upgrade the ALERT site for the purpose of providing all aspects of HIV/ AIDS training,
considerable financial, technical and material assistance is required.
Considerable capacity building needs to take place in order for ALERT hospital to be ready to shoulder the
task. Infrastructure, human resources and IT equipment, among others, need to be significantly increased in
order for ALERT to provide practical and high quality training of trainers. Meanwhile, the existing resources
at ALERT alone are not adequate to transform the training division into a national training centre, and
additional resources are necessary.
PEPFAR Ethiopia, along with other partners like the World Bank and GFATM, supports the Federal Ministry
of Health in the effort for the development of human capacity, as this helps to build momentum and
contributes significantly for meeting the targets set. The establishment of a national HIV/AIDS training
centre will also be vital in ensuring the sustainability of the HIV/AIDS program by creating an indigenous
institutional capacity to overcome a major constraint in its implementation.
New/Continuing Activity: Continuing Activity
Continuing Activity: 18060
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
18060 18060.08 HHS/Centers for Federal Ministry of 7488 496.08 Improving $500,000
Disease Control & Health, Ethiopia HIV/AIDS
Prevention Prevention and
Control Activities
in the FDRE
MOH
Emphasis Areas
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $450,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.09:
Improving TB diagnosis and TB/HIV Monitoring and Evaluation
HIV-positive persons have to be properly screened for tuberculosis (TB) in order to receive directly
observed therapy, short course (DOTS) for active TB cases or to receive isoniazid for those free from TB.
However, diagnosis of TB in HIV-positive persons remains a challenge in Ethiopia, where both the diseases
are prevalent. In FY07, several activities focused on improvement of TB diagnostic facilities at the regional
level, including establishment of TB liquid-culture capacity, exploration of the feasibility of different
diagnostic methods (e.g., florescent microscopy, fine-needle aspiration, Microscopic Observation Drug
Susceptibility assay (MODS)), and improvement of chest x-ray services. In particular, the HIV/AIDS
Prevention and Control Office (HAPCO) used FY07 plus-up funds to assess the availability and functionality
of chest x-ray facilities in PEPFAR- supported hospitals. In addition, HAPCO purchased x-ray machines for
those hospitals that did not have them, as well as those who are serving a large number of TB/HIV cases. In
FY08, HAPCO will continue with that effort by purchasing x-ray machines for those hospitals with needs
identified in the original assessment which could not be assisted in FY07.
The activities will include: purchase and distribution of chest x-ray machines, in-service training of x-ray
technicians, and in-service training of physicians on how to read and interpret chest x-rays.
HAPCO will also continue its involvement in improving the TB/HIV data system which was initiated in
previous years. In FY07, the TB/HIV monitoring and evaluation system was established, and in FY08
HAPCO will concentrate efforts on supportive supervision and review meetings among hospital sites and
national and regional level HAPCO.
Continuing Activity: 17754
17754 17754.08 HHS/Centers for Federal Ministry of 7488 496.08 Improving $600,000
Construction/Renovation
Health-related Wraparound Programs
* Child Survival Activities
* TB
Table 3.3.12:
Support the National HIV Counseling and Testing Coordination
ACTIVITY UNCHANGED FROM FY2008
COP 08 Narrative:
Activity Narrative: Support the National HIV Counseling and Testing Coordination
This activity relates to activities TB/HIV (ID 12315), HTXS (ID 12230 and12231), Blood Safety (ID 8092), AB
(ID 10610) and all HCT activities.
This continuing activity was initiated through FY07 plus-up funds to support the national effort to strengthen
the coordination of HIV Counseling and Testing (HCT) activities.
PEPFAR will channel funds to the Federal HIV/AIDS Prevention and Control Office (HAPCO) to support the
government's Millennium AIDS Campaign (MAC) that targeted counseling and testing nearly five million
clients by the end of September 2008 and beyond. A total of 4.5 million people were tested between July
2007 and the end of June 2008. Major progress has been achieved in HCT site expansion; currently 1336
sites are providing HCT services in the country. The campaign created a big demand and the government
will continue with the same momentum.
Like the previous years MAC faces constraints and problems: the human resource crisis; accessing the
targeted most-at -risk population and child and family testing.
The objective of this activity is to strengthen HAPCO's coordination of the Millennium AIDS Campaign
(MAC) at the national level to increase uptake and improve the quality of HCT services.
FY09 activities will include:
1) Coordinating all HIV counseling and testing programs at both the national and regional level through
collaboration of all stakeholders under the leadership of HAPCO
2) Quarterly supervision of regional activities to review progress in the implementation of the campaign
2) Hosting biannual review meetings to identify strengths and gaps and provide clear program direction
3) HAPCO will provide support to regional health bureaus (RHB) and regional HAPCO to coordinate
regional implementation of the HCT program
4) Strengthening of social mobilization activities to create demand for HIV testing
5) Strengthening of central-level data compilation and reporting.
Some of the funds will be used to cover some operational costs, such as weekend activities in areas with a
high client load. Funds will also support social mobilization to create demand at the sites, and to support
regional-level data compilation and reporting.
Continuing Activity: 16647
16647 12248.08 HHS/Centers for Federal Ministry of 7488 496.08 Improving $360,000
12248 12248.07 HHS/Centers for Federal Ministry of 5490 496.07 $300,000
Disease Control & Health, Ethiopia
Prevention
Table 3.3.14:
Improving HIV/AIDS Prevention and Control Activities in the FDRE MOH
ACTIVITY AREMAINS UNCHANGED FROM FY2008
The effectiveness of a health information system in providing information support for decision-makers
depends upon well-trained staff. Not only must the mechanics of data collection and reporting be mastered,
but high familiarity with case definition, disease classification, service standards, and information use are
equally important. Thus, for a health-information system to produce valid, reliable and useful information,
staff skills must be built and maintained through pre-service and in-service training, well-planned refresher
courses, and regular follow-up with supervision.
In-service trainings for health professionals, administrative staff (regional health bureaus (RHB) zonal health
bureaus (ZHB), WHO, etc.)) and dedicated HMIS personnel were initially planned in a decentralized and
cascading fashion. Regions and zones will be master trainers who train other trainers—these TOTs will train
district health-office (DHO) staff, who will, in turn, train health professionals at the facility level -with
technical support from Tulane University. Experience during the pilot phase of training has demonstrated
that the regions, zones and districts do not have the human resources or adequate technical skills to train
facility-based health professionals and hence extensive support and capacity building is required.
Decentralized training will be conducted for Federal staff and regional/zonal/district master trainers. These
in turn will train facility-based health professionals in the respective regions and facilities. The aim is to
improve effectiveness of the training by allowing more contact time between trainers and trainees and
facilitating discussions of problems and solutions relevant to their specific local context. It also decreases
the period the trainees stay out of work.
Training focuses on the registers and formats, health data management, basic statistics, use of information
for decision making. During the training, emphasis on how to ensure collaboration between HMIS staff,
program managers and decision-makers for performance monitoring is ensured. Training materials and
training sessions have been designed by bringing all groups together to make them understand each
others' needs. Training for regional/zonal/district staff as well as for hospitals/health centers and health
extension workers on data recording, reporting, analysis, interpretation, and use will last approximately two
weeks. However, there are differences in content and length of training courses according to the level of
health institutions.
Since the pilot phase has demonstrated that training alone does not ensure information usage, follow up for
application of the skills will be done by supervision and refresher courses. TA for the training will be
provided by Tulane University.
Continuing Activity: 18899
18899 18899.08 HHS/Centers for Federal Ministry of 7488 496.08 Improving $2,300,000
Estimated amount of funding that is planned for Human Capacity Development $500,000
Table 3.3.17:
Involvement of Ethiopian Parliament in HIV/AIDS Activities
ACTIVITY WITH ONLY MINOR CHANGES FROM FY2008
This is a continuation of activity from FY08. The Federal Democratic Republic of Ethiopia has two Houses:
the House of Peoples' Representatives and the House of the Federation. The House of Peoples'
Representatives is the highest governing body of the land. The House has legislative powers in all matters
referred to by the constitution to federal jurisdiction. According to the constitution, the House has some 550
members who are accountable to the people who elected them. The 550 members are from both the ruling
and opposition parties elected during election of May 2005. Involving Parliamentarians as peoples'
representatives in HIV/AIDS prevention, care, and treatment can have a major impact.
Parliamentarians have a crucial role to play in the fight against the HIV/AIDS pandemic. They can influence
and oversight the executive body to address HIV/AIDS issues in their respective organizations and to urge
them to plan and implement programs by mainstreaming as part of their organizational duties and
responsibilities. Parliamentarians can not only be advocates for their respective constituencies, but also
address HIV prevention, care and treatment while conducting their representational duties in their
respective localities and influence national legislation and activities including through mainstreaming
HIV/AIDS in all legislation, making it regular agenda in Social Affairs Standing Committee and other
relevant Caucuses using other opportunities at governmental or non-governmental functions and with
Zonal, Woreda and Kebele administrations to enhance their focus and attention to HIV/AIDS programs.
Being close to the people, they are also in a unique position to influence public opinion and confront the
stigma and discrimination. By virtue of the elevated positions of Parliamentarians, they can effectively
mobilize, motivate, and encourage the public in preventing the spread of the disease. It is encouraging to
note the increasing commitment in HIV/AIDS awareness, prevention, support and treatment with current
parliamentarians which provides prime opportunity for this activity. These include the Speaker of the House
who was the former Minister of Sports and Youth and Chair of the HIV/AIDS Management Board for the
country and the First Lady who is Chair of the Social Affairs Standing Committee and Women's Coalition
against HIV/AIDS. While great progress has been made in the fight against HIV/AIDS, more effort is needed
to ensure the development, funding and full implementation of strategies to combat the pandemic. There is
now a demand for further increased political commitment. Parliamentarians need to speak out more openly
and frequently about HIV/AIDS. The Parliament is also expected to begin debating a law that aims to
protect the rights of people living with HIV/AIDS and address related stigma and discrimination.
The major objective of this activity is to build the capacity of members of the parliament with regard to the
current HIV/AIDS epidemiology and responses in the country and strengthening workplace HIV/AIDS
responses in the parliament. This will enable members of the parliament to make an oversight and follow up
of HIV/AIDS mainstreaming across all the sectors, and Provide supportive oversight to constituency.
In FY09, HAPCO will build upon the progress made so far and will continue the effort to mainstream
HIV/AIDS in the two Houses to enforce effective HIV/AIDS mainstreaming across all sectors. HAPCO will
implement the following major activities:-
1.Review the achievements of 08, and build o the lesson learned and successes achieved;
2.Training and orientation program for the parliamentarians will be organized to update on prevention care
& treatment and other HIV/AIDS services;
3.Support the development and distribution of appropriate IEC/BCC materials specific to the
parliamentarians;
4.Support and Strengthen HIV/AIDS committee in the parliament;
5.Continue HIV/AIDS campaign in promoting prevention, care and treatment activities in their localities
during closing of the parliament and in also during their representational duties;
6.build the capacity of parliamentarians to play a leadership roles in mobilizing community for utilization of
HIV/AIDS services;
7.Strengthen HIV/AIDS activity of the parliament in general and social affairs and relevant Caucuses in
particular;
8.Support outreach activities of parliamentarian to their respective constituency to educate their
communities on the prevention of HIV, community support to PLWH and play a role in stigma reduction;
9.Enhance the role of parliamentarians in the promotion of care, support, and treatment services;
10.Enhance the role of parliamentarians to advocate for and legislate rights-based and gender sensitive non
-discriminatory HIV/AIDS policies;
11.Support the established AIDS Resource Center in the Ethiopian parliament in order to assist and
support MPs in legislative activities of HIV/AIDS and other health related issues, and ;
12.Organize experience sharing visit to members of the parliamentarians to have better understanding of
the involvement of the parliamentarians in other countries in the fight against HIV/AIDS.
Continuing Activity: 18059
18059 18059.08 HHS/Centers for Federal Ministry of 7488 496.08 Improving $100,000
Table 3.3.18:
