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
The MOH is continuing to establish a quality procurement system with the technical assistance of SCMS.
However, there are times when shortages of critical commodities do occur. In order to ensure that essential
commodities are available as the MOH brings its procurement system in-line, CDC will provide, on an
emergency basis, commodities for the PMTCT program to ensure that there is no break in service delivery.
The PMTCT national program continues to scale up not only in number of sites but also scope of services.
During FY08, PMTCT will be fully integrated into ante-natal care. Additionally, to address the increased
demands in M&E as the program is scaled up, the CDC will provide support for data entry and training in
statistics to MOH staff, and support for the senior program officer at CDC to oversee the PMTCT activities
and the MOH cooperative agreement and coordinate with other partners in country for the overall PMTCT
program. Support for this activity will also be provided with funds remaining from the previous fiscal year.
Although the activity is funded via a USAID mechanism, CDC is the technical lead and therefore
responsible for the targets as listed.
Funding under AB prevention will support a portion of the CDC Medical Epidemiologist who will have
extensive responsibilities related to the MARCH behavior change project funded through USAID but with
technical oversight by CDC. During the transition to an NGO and process of further integration with the
Ministry of Health, the Medical Epidemiologist will provide coordination, review of materials and activities for
appropriateness of content and public health messages and will have primary responsibility for design and
implementation of the public health evaluation of the MARCH-infused life skills curriculum in secondary
See Activity Numbers 15952.08, 15949.08, and 16336.08
The role of the CDC GAP country office is understood to be "coordinating grant activity and consultants,
ensuring utilization of available resources, and providing feedback to OGAC on program design and need
for reorientation". In addition the CDC Office will continue to implement priorities established in the national
strategic plan. In-house program staff will work closely with TA provider, CDC Atlanta, NBTS, and other
partners to support donor motivation, recruitment and retention. Additionally, CDC will support data
reporting, implementation of the PEPFAR M&E tool and SOPs for NBTS, implementation of a
hemovigilance system, and advocacy on policy issues such as blood safety regulatory legislation for
transfusion services and structure of the national transfusion system. CDC will also monitor the
management of the procurement systems by SCMS for the NBTS. CDC will liaise with the PEPFAR public
affairs officer to highlight donation activities and promote a positive public image for altruistic, regular
voluntary blood donation and support a social marketing initiative that will improve the quality and quantity
of public education.
This funding supports a blood safety project officer in the CDC office to implement the above actvities.
Although the activity is funded via a USAID mechanism, CDC is the technical lead and therefore CDC is
responsible for the targets as listed.
CDC will continue to coordinate with CDC Atlanta to provide technical assistance for implementation of a
safe water initiative as part of the package of services for basic palliative care. The CDC/WHO Safe Water
System (SWS) will be implemented in Guyana on a national level. This system combines household-level
chlorination, safe storage vessels, and a program of behavior change communication (BCC) regarding
water and hygiene practices. The Ministry of Health, in collaboration with CDC and Proctor and Gamble, is
obtaining a grant to import the flocculent-disinfectant PuR® for use as a complement to the safe water
system. Because PuR® can remove heavy metals and still leave chlorine residuals, it is an effective
disinfectant for Guyana's "black water" where ordinary chlorination products are not effective. PuR® also
flocculates out parasites and so provides protection against certain waterborne agents of opportunistic
The products will be sold in country using a social marketing model. The production and distribution of the
products will be done by a private company, who will recover those costs through social marketing of the
SWS in the general population. CDC will cover the costs of the development of the product label, product
name and behavior change communication materials. BCC materials and the products will be available to
all individuals in the HIV care and treatment program throughout the country in coordination with the
standard package of services.
The CDC Guyana Office will support TB services in Guyana by funding a locally engaged staff medical
officer. The position already exists in the CDC staffing matrix but was not filled in FY06 or FY07. As TB/HIV
services are an area of focus for the CDC Office and a current weakness of overall HIV services in Guyana,
this position will be filled in FY08. The medical officer's role will be to provide technical assistance and
organizational leadership to better integrate TB/HIV services in Guyana. The officer will liaise with the
Guyana MOH, the National TB Program, the CDC Division of TB Elimination, PAHO, and other donor
agencies to improve communication, linkages, and standards for diagnosis.
The CDC Guyana Office will support technical assistance to TB/HIV services in country. TB care in Guyana
is in a transitional phase to do changes in the portfolios of several major donors including World Bank,
Global Fund, and CIDA. In addition, in FY08 PAHO will receive USG funds to strengthen TB/HIV services in
conjunction with the roll out of the Integrated Management of Adult Illness (IMAI) initiative at the level of the
regional and district health centers. Specific needs for TA will be defined by CDC in close consultation with
the MOH and other partners. Specific activites TBD pending annual meetings of National TB Program in
CDC technical assistance in FY07 focused on systems support for treatment programs in Ministry of Health
(MOH) centers and at Georgetown Public Hospital Corporation (GPHC). In FY08, CDC will emphasize
capacity building for grants management and ongoing support to infrastructure development activities for
the MOH as it expands its care and treatment activities. CDC will support efforts to improve care for patients
with HIV/AIDS and to address treatment issues in the public sector regarding opportunistic infections and
sexually transmitted diseases, and also provide coordination for treatment activities under the MOH
cooperative agreement. The CDC Senior Program Development Officer supported through these funds will
liaise with the MOH outpatient treatment system and other partners to ensure linkages between treatment
and other services and to limit redundancies between program areas. In FY08 CDC will fill the currently
vacant position for a locally-engaged staff medical officer. This physician will assist the Senior Program
Officer as liaison to the MOH and would eventually take on these responsibilities on full time basis. This
position will thus provide program support and also afford an opportunity for building the capacity of a local
physician in HIV treatment programs. CDC will assist MOH to capitalize on connections to the diaspora
through twinning with Guyanese physicians at universities and hospitals abroad, to allow for an exchange of
clinicians and help offset Guyana's sever human resource shortages. The CDC Guyana Office will assist
MOH to organize activities around clear objectives and rigorous monitoring and evaluation to ensure best
use of funds available.
Over the last three years CDC provided HIV rapid test kits and consumables to all VCT and PMTCT sites,
QA oversight to all HIV rapid testing sites, leadership, technical assistance, and policy support for the
establishment of the NPHRL, and technical and reagent support to referral and regional laboratories. In
FY07 CDC changed from purchasing and distributing directly HIV rapid test kits, consumables, and
reagents for CD4, hematology and chemistry to providing funding to the SCMS for this activity. CDC will
continue to fund SCMS for these products and work closely with SCMS on reagent forecasting,
procurement orders, and audits of distribution of these items at program sites. CDC will continue to provide
Quality Assurance (QA) oversight for HIV rapid testing for the referral and regional hospital laboratories that
support the HIV program, working in collaboration with I-TECH, ASCP, EU, MOH and the Care & Treatment
Partner (TBD-CoAg), based on the country specific laboratory assessment tool developed in collaboration
with MOH and FXB in FY07. All QA activities will transition to the NPHRL after it is completed (expected
July 2008). CDC will continue to provide an in-country technical liaison for the NPHRL design to the
CDC/Atlanta technical review team; the CDC will also continue to provide over site of the contract for the
NPHRL construction project; construction started in August 2007. CDC will continue to provide technical
and policy support to the MOH for development of the staffing structure, maintenance and equipment plans
for the NPHRL while the construction is in progress. The CDC, through a Personal Service Contract (PSC),
will provide a senior laboratory advisor to assist the MOH to establish procedures and policies and set up
the initial operation of the NPHRL. The Advisor will also provide guidance to the laboratory director in both
technical and managerial areas and support training activities and provide overall technical expertise on
laboratory management to the MOH. The PSC activity is funded with both GAP and GHAI funds and is
found in Activity #12745.08. In collaboration with the Clinton Foundation, which will provide technical
support for the procurement of DNA PCR equipment and provide reagents for its operation, the CDC will
continue to assist the MOH in the implementation of early infant diagnosis. This function will transition to the
NPHRL during FY08. The office will continue to provide coordination and support for special studies as well
as assistance with planning the laboratory processes for surveillance surveys during 2008. All CDC
activities are coordinated by a physician-laboratory specialist working from the CDC office and serving as
liaison to MOH on all issues related to laboratory infrastructure.
CDC will continue to work in close collaboration with the MOH and all Emergency Plan (EP) partners to
strengthen and support strategic information activities including HMIS, surveillance, M&E, and
programmatic research. In FY08 CDC will emphasize improving SI systems in the MOH, improved
coordination between the national statistics unit and various program areas, and provide technical
assistance to the Government of Guyana technical committee for the DHS. The CDC Office will work with
partners to produce public health evaluations for the MARCH program, TB/HIV activities, and the treatment
program. An LES data manager and a portion of the CDC direct hire medical epidemiologist are supported
through this program activity.
CDC will continue to support the roll-out of the National Patient Monitoring System and provide technical
assistance to the MOH and other partners in utilization of the data for improving patient care and program
CDC will assist the MOH in completion of the National Epidemiologic Profile begun in FY07. In addition,
CDC will collaborate with USAID and GHARP on assisting the GOG with operationalizing the National
HIV/AIDS M&E Plan and National Strategic Plan (NSP) on HIV/AIDS. Specific support to the MOH will be
short-term TA and targeted trainings in data management and surveillance, in addition to long-term financial
and technical support to PAHO to assist the MOH in implementing a sustainable and harmonized
surveillance system to monitor and measure all health care priorities.
Lastly, CDC will continue to work with all partners to strengthen routine program reporting with standardized
reporting systems that minimize redundant efforts for different reporting pathways. In recognition of the
human resource shortages that inhibit strong SI programs in country, CDC will assist with training and
mentoring of MOH staff.
The CDC programs and activities for the five-year PEPFAR program and beyond are made with the
intention of helping Guyana become a model for the Caribbean. Today Guyana is a leader in the region in
surveillance, care, and treatment, and the integration of the rapid test into the public health system. As
projects and programs mature, Guyana should be able to demonstrate that it is possible, in a resource-
constrained Caribbean nation, to stem the tide of the epidemic, prevent nearly all HIV-positive mothers from
passing HIV to their newborns, and ensure that life-saving ART treatment is available to all those in need.
PEPFAR will contribute to Guyana's leadership in training for physicians and public health practitioners,
particularly lab practitioners, in HIV/AIDS care, surveillance, program design/implementation, and services.
The current staff for the CDC GAP office is a total of 16 positions, six fewer than last year, as well as one
ASPH Fellow. The positions include 3 FTE, 1 PSC, and 12 LES; 10 staff are supported under Management
and Staffing and 6 support specific program areas. The staffing mix for M&S in FY08 includes two US direct
hire FTEs, the Director (physician) and Deputy Director for Operations (Public Health Advisor) as well as 8
Locally Engaged Staff (LES) administrative and support staff hired on Personal Service Agreements
(PSAs). The LES include the following: IT specialist, financial specialist, administrative officer, secretary,
receptionist, janitor and two drivers. CDC also has an American Schools of Public Health (ASPH) Fellow
who provides support in various program areas and falls under M&S in the staffing plan. In FY 08 we will
also recruit an IETA fellow for the summer session for program and management support as well as for
assistance in developing the Country Operational Plan. The Program staff includes one FTE Medical
Epidemiologist who provides technical support primarily to SI and Abstinence Be Faithful. The PSC position
supports Laboratory Infrastructure, specifically for the National Public Health Reference Laboratory
(NPHRL); this position was formally for a Monitoring and Evaluation Specialist but has been changed to a
Senior Laboratory Advisor to provide guidance and technical expertise to the MOH to assist in
strengthening the capacity of the NPHRL. The M&E function that was performed by the PSC will be
incorporated into the Medical Epidemiologist's position. The 4 LES program staff hired on PSAs includes a
senior program advisor, a Guyanese physician epidemiologist who serves as the technical point of contact
for the three cooperative agreements and provides primary technical support in all facets of Care and
Treatment Services and PMTCT. Two junior program officers focus on laboratory quality assurance,
palliative care/TB, and care & treatment services. They also provide targeted technical assistance and
monitoring of the cooperative agreements. The Data Manager supports the SI activities. Staff salary and
benefits by program area is: M&S: $524,000; PMTCT: $4,500; Abstinence Be Faithful: $70,000; Palliative
Care/TB: $14,800; HIV/AIDS Treatment Services: $45,900; Laboratory - $245,000; and SI - $89,400.
In addition to the skill sets required for operating and managing an office, the current level and mix of staff
are needed to provide technical assistance and guidance to local and international partners as they develop
their own capacity in technical, administrative, and management areas. The M&S staff provides a large
amount of technical support in the areas of financial management, grant writing and reporting, and
cooperative agreement management to the MOH. Support is also provided to other partners that include the
National Blood Transfusion Service, the AIDSRelief Consortium, a Treatment Services Partner (to be
determined) and ITECH. During the current and expected near-term, the CDC will continue to assist the
MOH and others in the development and implementation of national strategic plans as well as with
strengthening internal systems to implement and monitor program activities including administration of
cooperative agreements. CDC will continue to provide oversight and technical support to programs for
which SCMS provides procurement services as well as work with SCMS to implement a modern supply
chain management system. CDC will continue to provide contract oversight of the construction contract for
the National Public Health Reference Laboratory.
In order to support the vision of serving as a regional example of successful response and management of
the epidemic in the Caribbean, given the limited technical capacity in country and the constant drain of
young professional staff (approximately 89% of all college graduates migrate out of Guyana), the CDC will
need to remain at or near its current size for the next two to three years. As policies are developed and
programs come on line to ensure retention of key staff for the public sector (MOH and NBTS) and the public
non-profit sector (St. Joseph Mercy Davis Memorial Adventist Hospital etc.), the CDC will be able to scale
back programmatic and administrative staff. A premature scale back or departure would be a lost
opportunity to help Guyana move away from their growing dependence on Cuba and China for physician
and technical staff. Staffing could be affected if CDC merges some support services with the US Embassy,
a plan currently under assessment, or if the Embassy implements the consolidation of all USG agencies at
the Embassy (plan pending funding approval for OBO modifications).
The total estimated cost of doing business is budgeted for $501,750 in 2008 which covers ICASS and
CSCS. In FY08 guidance was proved to allow proportioning these costs to the appropriate program area;
the CDC budget has proportioned these charges to appropriate program areas. It is also noted that the
CSCS charge for FY08 is substantially lower than in previous years (FY07=$240,133) due to the data
provided by the Embassy for the size of CDC staff. It is expected that in FY09 the CSCS amount will go
back to the higher level. Other charges include the Non-ICASS Security charge ($75,000) and a per-
workstation charge for IT support from CDC headquarters. This is a new charge implemented by the CDC
Information Technology Services Office (ITSO) to cover the cost of Information Technology Infrastructure
Services and Support provided by ITSO. This includes the funding to provide base level of connectivity for
the primary CDC office located in each country and connecting them into the CDC Global network, keeping
the IT equipment located at these offices refreshed or updated on a regular cycle, funds for expanding the
ITSO Global Activities Team in Atlanta as well as fully implementing the ITSO Regional Technology
Services Executives in the field. The ITSO costs have been proportionally spread within the appropriate
program areas as a separate activity.
In addition to the salary, benefits and business charges, the M&S budget includes office related costs for
rent, utilities, security, office supplies, office equipment maintenance and replacement, and travel. In
addition to salary and benefits, M&S costs associated with two FTE staff includes residential rent, utilities,
make-ready of residences, residential furniture and appliance replacement, annual R&R air fare, and
expenses for a Permanent Change of Station (PCS) move for 1 FTE. Travel includes periodic trips to
Atlanta or Washington DC for policy or related meetings, attendance at international and regional
conferences, the annual CDC Global Health Meeting, and the annual PEPFAR Meeting as well as site visits
M&S Budget Overview: Salary & Benefits for 2 US FTEs and 8 LES -$524,000; Travel-$51,400; Office and
Residential Leases and Utilities-$146,600; Local security guard service for the office and residences-
Activity Narrative: $65,600; Building maintenance, office supplies and equipment and servicing-$84,800; Miscellaneous costs
for training, renewing licenses, support for an IETA Fellow, and appreciation awards-$103,750; ICASS-
$275,000; CSCS/OBO-$38,350; ITSO-$45,500; Non-ICASS Security - $75,000. Total M&S $1,410,000.