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.
Subdivisions of Program Areas, these track general higher level sub-classifications of expenditure.
Subdivisions of Major categories, these are the most detailed expenditure data.
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
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
Support to National HIV/AIDS Program Management and Sustainability
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
This activity has been updated to reflect August 2008 reprogramming and the inclusion of USG regional
Building Systems Capacity of Regional, Zonal and District Health Offices for HIV/AIDS Program
This is a continuing activity from COP08 and reflects the growing complexity required to management the
National HIV/AIDS Response in Ethiopia. This activity is a compilation of two system strengthening
activities which include:
1) Support to Regional Bureaus, Zonal and District Health Offices to plan and manage HIV/AIDS activities
in key prevention, care and treatment areas of identified high prevalence and where a diversity of partners
including PEPFAR, Global Fund and private foundation activities are present ($1,300,000); and
2) Support to Federal Ministry of Health and Regional Health Bureaus in Global Fund technical assistance
In COP08, funds for this activity have been reprogrammed from CDC to USAID in August 2008. It will
continue in COP09.
There are multiple indigenous, bi-lateral and multi-lateral donors and implementers conducting HIV/AIDS-
related activities at regional and local levels. The combination of partners often presents local authorities
with challenges including coordination, monitoring, oversight and reporting.
This activity will support Regional, Zonal and District Health Offices through engagement, placement of
specialists and training to assist local authorities in planning, coordination and management of the National
HIV/AIDS Response in specific localities where PEPFAR and GFATM resources are being utilized. Initial
plans are to place approximately 30 public health management specialists in Regional and Zonal Health
Offices for a three year term, in addition to minimal equipment grants to support an enabling environment
for planning and coordination in light of chronic under financing of Zonal and District Health Offices.
PEPFAR efforts will integrate with existing MOH planning efforts, strengthening joint planning mechanisms
for regional and sub-regional authorities through the placement of professionals in regional HAPCO/Health
Bureaus as well as at district (woreda) levels to support the planning processes.
In response to the growing complexity of PEPFAR Ethiopia, the USG proposes to place public health and
management specialists at regional and sub-regional HAPCO/Health Offices in all regions, focusing on
regions of high HIV prevalence and density of HIV/AIDS services supported by USG. Specialists, seconded
through LMS would support Regional, Zonal and District level planning activities alongside GOE colleagues
and facilitate engagement with PEPFAR and community partners that may not be fully engaged in these
Despite active decentralization from the Federal government to Regions and ultimately Districts there are
serious capacity constraints that do not permit District Health Offices to adequately coordinate and plan
HIV/AIDS and Health activities. A CDC implementing partner identified several key interventions to be
completed when addressing sub-regional authorities:
Institutionalize sub-regional level comprehensive plans of action by Zonal Health Offices and District
Administrators using participatory processes involving USG and other partners working in the region.
Enhance coordination, management and implementation of regional HAPCO plans, in collaboration with
USG and other partners, to result in more efficient utilization of available resources/funds. Standardized
monitoring and evaluation protocols.
This activity intends to enable Regions, Zones and Districts to enhance their capacity to communicate and
coordinate civil society including PEPFAR partners focusing on joint planning of Plans of Action, routine
communications, standardization of materials and referral and networking between prevention, and care
and treatment providers, as well as between facility and community based partners.
Finally, this activity will support improved internal planning and coordination of activities by PEPFAR
partners ensuring links between the community and facility-based pathways of care across the care
continuum of prevention, care and treatment.
PEPFAR Ethiopia faces multiple requests for support in the development and review of Ministry of Health
processes and documents. These requests result in USG deploying significant technical specialists to
respond appropriately, many requiring specialized knowledge of GFATM processes, as well as of
management strengthening and HIV/AIDS and systems strengthening technical abilities. Relatively low
staffing levels of PEPFAR/Ethiopia's USG team and its partners -- particularly individuals with these skill
sets -- make responding to these requests difficult. While PEPFAR has discussed supporting the national
HAPCO with placement of a GFATM - PEPFAR Liaison Officer, the need for technical assistance to
HAPCO and Regional Health Bureaus (RHB) has increased as the two programs become more
The main focus of this activity is to ensure that PEPFAR has sufficient capacity to adequately support MOH
and RHB implementation of GFATM resources, and to provide needed technical support to supplement
Activity Narrative: PEPFAR staff that are frequently called to contribute to MOH and GFATM-related technical processes. The
activity will provide support to national and regional level HAPCOs and health bureaus as GFATM block
grants are received from the Federal government. The Regional Health Bureaus and Regional HAPCOS
continue to experience serious capacity constraints and require leadership and management support.
Additionally, this activity will support GFATM proposal development, management and costing exercises
supporting the national HIV/AIDS effort.
Building upon the approaches and participatory approaches developed by Management Sciences for
Health, the Leadership, Management and Sustainability (LMS) project is a cooperative international
partnership that strengthens the leadership, management and systems of public health administration
programs and organizations to improve their health outcomes. Without effective management and
leadership, the delivery of quality health services and achievement of sustainability is compromised. The
purpose of the LMS project is to support the USG and host country organizations by providing technical
assistance, approaches and strategies to strengthen institutional capacity to lead and manage HIV/AIDS
and other health programs and related social sector programs in the public, private, and NGO sectors. This
activity will allow PEPFAR to access expertise to support GFATM activities ranging from proposal
development to grant implementation.
This activity is linked to other donor and partner resources to promote the effective mobilization and
implementation of GFATM resources, critical for achievement of PEPFAR goals. Close integration with
USG support to the Global Fund Country Coordinating Mechanism activities through the World Health
Organization, as well as other PEPFAR management support partners at regional and national levels, will
be an important feature of this activity. Other linkages include GFATM, the Clinton HIV AIDS Initiative, and
the HIV Donors Forum partners including Italian Cooperation and the Department for International
Assistance will be outcome-oriented, and should strengthen local capacity. Activities will focus on
alleviating specific bottlenecks that are causing under-performance, including inadequate or poor
performance in the following areas:
Governance and Leadership (including aspects of the functioning of the CCM and GFATM resource
management by the Principal Recipient);
Program and Financial Management;
Monitoring and Evaluation.
The primary emphasis of this activity will be to strengthen management systems for Ethiopian public sector
and civil society HIV/AIDS program implementation. Capacity of Ethiopian organizations such as the
federal and regional HAPCOs will be strengthened to ensure the effectiveness of a coordinated HIV/AIDS
programming. PEPFAR Ethiopia's ability to respond to MOH requests for management and technical
support, particularly related to GFATM and national processes, will be substantially enhanced.
New/Continuing Activity: Continuing Activity
Continuing Activity: 18536
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
18536 18536.08 U.S. Agency for Management 7613 7613.08 GFATM $2,028,884
International Sciences for Technical
Development Health Support