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
The PMTCT national program continues to scale up not only in number of sites but also scope of services.
During FY09, PMTCT will be fully integrated into ante-natal care and also the number of sites is expected
increase from 45 sites to 110 sites. 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.
New/Continuing Activity: Continuing Activity
Continuing Activity: 12742
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
12742 12742.08 HHS/Centers for US Centers for 6273 135.08 CDC Program $6,830
Disease Control & Disease Control Support
Prevention and Prevention
Emphasis Areas
Health-related Wraparound Programs
* Child Survival Activities
* Family Planning
* Safe Motherhood
Human Capacity Development
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.01:
CDC will continue to support the MOH prevention activities; particularly adolescent health program being
funded through the COAG as they seek to find innovative ways of communicating to prevetion messages to
this target group (young people). The FTE Medical Epidemiologist position is supported through this
program activity.
Continuing Activity: 15950
15950 15950.08 HHS/Centers for US Centers for 6273 135.08 CDC Program $0
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
Program Budget Code: 04 - HMBL Biomedical Prevention: Blood Safety
Total Planned Funding for Program Budget Code: $1,277,642
Total Planned Funding for Program Budget Code: $0
Program Area Narrative:
Blood collection and storage is currently performed at eight public and private sites in Guyana. Three private hospitals access
blood for transfusion directly from the NBTS. Ten (10) public and private hospitals perform blood transfusions. These sites are
located in regions 2, 3, 4 (includes the capital, Georgetown), 6, and 10. (n.b.: Regions are administrative areas similar to
provinces.) All of the blood collected through the public health system, mainly NBTS, is tested at the National Blood Transfusion
Service (NBTS) laboratory in the capital. Limited screening is done at regional laboratories. Screening for blood collected at
private hospitals is not regulated and anecdotal reports suggest that testing is not always adequate. Of those units tested for HIV
in the private sector prior to transfusion, most are screened using only a single rapid test. Based on WHO estimates, Guyana
requires approximately 15,000 units of blood per year. In 2007, voluntary, non-remunerated donors (VNRD) contributed
approximately 61% of 5,475 units collected, or 3,345 units. As of the end of July 2008 69.94% of units were voluntary donations.
Since blood collected from VNRD has been associated with significantly lower rates of transfusion-transmitted infections (TTI),
Guyana aims to collect 100% of its blood from VNRD by 2010. The prevalence of HIV in blood donors was 0.29% in 2007. With
the introduction of HTLV I and II testing in 2006, there was an increase in the percentage of Infectious Markers. In 2006, the total
infectious markers were 4.09% compared to 5.26% in 2007. HTLV was 0.3% in 2006 and increased to 1.6% in 2007. Since 2005
the NBTS tests 100% of all blood collected by the NBTS network for HIV, HBV, HCV, Malaria, Micro-filaria and Syphilis. It is
anticipated that Chagas screening will be introduced in January 2009.
The National Strategic Plan for Blood Safety 2006-2010, established a Central Donor Recruitment Committee (CDRC) to address
these barriers and to work toward the goal of 100% VNRD by 2010. The CDRC, established in June 2006, includes
representatives from the GNBTS, private hospitals, and blood donor recruitment agencies. The committee also includes a
recruiter, a regular blood donor, a recipient of blood and the CDC country office. The CDRC's mandate is to mobilize Guyanese to
become VNRD and to coordinate the implementation of the national strategy to achieve 100% VNRD. Other committee activities
include developing an annual plan for coordinated donor recruitment and blood drives, and building a secure donor database to
track and recall VNRD. This committee has been somewhat dormant of late. While this committee was unable to develop an
action plan, such a plan was done by the PEPFAR midterm review stakeholders.
The national blood supply is managed by the NBTS, a sub-agency of the Ministry of Health (MOH). There is a revived Hospital
Transfusion Committee (HTC) at the Georgetown Public Hospital Corporation (GPHC). Suddie Hospital in Region 2 launched its
HTC on September 12, 2008. It is anticipated that the other regional hospitals namely New Amsterdam and Linden Hospitals will
have functioning HTCs by the end of 2008. Legislation establishing standards and oversight has been passed by Parliament in
the form of the Health Facilities Licensing Act (HFLA). Institutions involved in blood banking will be hosted by the MOH in the last
quarter of 2008 to address the section of the bill pertaining to transfusion services.
The NBTS has been supported by Track 1 Emergency Plan funds since 2004. The new TA provider, PAHO/WHO, assumed
responsibility in April 2007 and established an in-country presence to carry out its activities. On August 12 - 13, 2008, PAHO led
the PERFAR mid-term review meeting during which a plan of action for Blood Transfusion Services 2008-2009 in Guyana was
developed to guide the activities of the NBTS for the next year. SCMS will continue to procure medical supplies and equipment.
Management and prevention of STI, Safe Medical Injections and IV drug users will be addressed.
.
Action Plan
In FY09, Emergency Plan funds will be used to continue to address the structural and systemic constraints. Primary objectives for
FY09 include the Voluntary Blood Donor Programme that will encompass hiring of new blood donor recruiters at NBTS, Region 6
and Region 2. The Social Mobilization Committee of the MOH will assist the NBTS to develop strategies and to promote public
awareness and education among potential and current voluntary blood donors. Additionally training of new staff, collaborators
and volunteers will be done during the last quarter of 2008. Blood Collection is also an area of interest. Blood donor recruiters and
the management of NBTS with the support of PAHO will coordinate and schedule a number of blood drives with projected
numbers of collection. Training will also be done in customer service and SOPs will be developed on procurement.
With regards to Testing and Processing, during 2009, all testing for TTIs will be centralized; testing, processing and preparation of
components will be done by NBTS. Needs assessment for implementation of centralization will be done and gaps will be
addressed. A review of staff attrition is critical and remedial actions to be proposed. There will also be a revision of the
organizational structure of the institution. Clinical Use of Blood is also an important issue; activities to address this include drafting
of guidelines followed by sensitization of clinicians with the view of launching these guidelines in November 2008. Work will
continue with hospital transfusion committees with the intent to pilot in all regions. This will foster and improve the implementation
of haemovigilance in the institutions of interest.
Constraints
Despite four years of Track 1 funding and TA support, the NBTS remains a work in progress. At current collection and screening
levels, the NBTS in the first six months of 2008 provided over 80% of the request for blood. The true national need for blood and
blood products needs to be estimated. This shortfall, together with improper request procedures, has been responsible for
cancellations of surgeries in public hospitals, mainly GPHC. The situation improved during 2008, but a number of systemic
challenges remain.
Of major concern is the lack of human resource capacity at the regional level to ensure appropriate procedures for collecting,
testing, and transfusing blood products. In an effort to address this challenge, identification and training of personnel in blood
safety procedures is expected to be done in the first quarter of 2009.
A lack of coordinated training for physicians in the appropriate use of blood continues to affect the programme. This will be
addressed through a series of CMEs beginning in November, 2008.
Lack of administrative capacity to ensure grant funds are spent efficiently and appropriately, and high turnover of staff at
management level have impeded the progress of Blood Safety Programme. This challenge is intended to be corrected through
training to strengthen new management.
Weak data management systems contribute to high rates of wasted blood due to an absence of adequate tracking mechanisms.
An initial assessment of the data management system was done and there is a recommendation to implement the Delphyn data
management system from Diamed.
In addition to these structural problems, the blood service is also hampered by significant barriers within the national healthcare
system, namely the presence of multiple hospital-based blood banks that are not linked to or coordinated by the central NBTS.
Through the NBTS, the MOH has used Emergency Plan funds to develop the regulatory mechanisms (and legislation) to
centralize operational responsibility for the national blood supply within the NBTS.
Table 3.3.04:
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.
Continuing Activity: 12735
12735 12735.08 HHS/Centers for US Centers for 6273 135.08 CDC Program $0
In FY08, CDC focused on 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 FY09
CDC will fill the currently vacant position for a locally-engaged staff, a 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 severe human resource shortages.
The medical officer salary is partly funded through this program.
CDC had coordinated 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. CDC headquarters staff with expertise
in household level safe water interventions visited Guyana in December 2006 to perform an assessment
funded by Rotary International on implementation of the CDC/WHO Safe Water System (SWS) for 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 products
are sold in country using a social marketing model. The Rotary-funded assessment included water testing,
identification of a local producer for the safe water vessels, disinfectant solution and bottles, and
identification of a partner for social marketing of the SWS in the Guyanese context. Rotary International has
funded start up and maintenance of SWS in multiple countries throughout the world. The production of BCC
is sustained by continued funds from Rotary combined with cost-recovery through social marketing of the
SWS in the general population. While in Guyana the consultant developed a plan for adding the SWS to the
palliative care services package provided by the PEPFAR program. The SWS team worked with USG
Guyana and its partners to develop a distribution plan for SWS that is appropriate for PLWHA in Guyana.
The estimated cost to provide services is $12 per household per year. CDC will support and monitor the
program for 5000 households affected by HIV/AIDS. CDC Atlanta will continue to coordinate with CDC
Guyana for establishment and implementation of the service program. All efforts will be closely coordinated
with MOH, NAPS and PAHO. CDC would put addittional funds if need be in to support this initiative.
New/Continuing Activity: New Activity
Continuing Activity:
Table 3.3.08:
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 emphasized
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 FY09 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. In FY09 CDC will continue to support the care and treatment program implemented
by FXB, CRS and MOH by having CDC LES monitoring the program.
Continuing Activity: 12727
12727 3179.08 HHS/Centers for US Centers for 6273 135.08 CDC Program $49,850
8678 3179.07 HHS/Centers for Ministry of Health, 4720 2246.07 Ministry of $139,530
Disease Control & Guyana Health, Guyana
Prevention
3179 3179.06 HHS/Centers for US Centers for 2744 135.06 CDC Program $77,200
Table 3.3.09:
The CDC Guyana Office will support TB services in Guyana by funding a locally engaged staff who is a
medical officer. The position already exists in the CDC staffing matrix but was not filled in FY08 this
addittion would complete CDC full staff complement thus serving arears consider critical to the overall
response to the hiv /aids epidemic in Guyana. 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 FY09. 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 Medical Officer will also be involve with adult care and treatment ensuring that
the quality of care and treatment reaches international standards.
Continuing Activity: 15821
15821 15821.08 HHS/Centers for US Centers for 6273 135.08 CDC Program $36,570
* TB
Table 3.3.12:
Over the last four 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. In FY09
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 MOH and FXB. The National Public Health
Reference Laboratory building was completed and handed over to the MOH in July 2008. All HIV QA, CD4,
and care and treatment monitoring activities will transition to the NPHRL in FY08 and CDC will continue to
support these activities at NPHRL in FY09. In FY08 CDC provided in-country technical liaison for the
NPHRL design to the CDC-Atlanta technical review team and also provided oversight of the contract for the
NPHRL construction project; construction started in August 2007 and ended in July 2008. CDC will continue
to provide technical and policy support to the MOH for development of the staffing structure, facility
maintenance, development of new laboratory services (of early infant diagnosis, HIV viral load monitoring
and TB DST) and local certification for the NPHRL. In FY09 CDC through the MOH Co-Ag will support
some staffing, facility and equipment maintenance, and staff training for the NPHRL. Reagent support for
HIV care and treatment related laboratory services (referral and regional sites) will be provided through
SCMS. Training and technical assistance required for implementation will also be provided by laboratory Co
-Ag partners APHL, ASCP, and ASM. APHL will also facilitate the twinning of NPHRL with the North
Carolina Sate Laboratory of Public Health (NCSLPH). In FY08 CDC, through a Personal Service Contract
(PSC), provided a senior laboratory advisor to assist the MOH to establish procedures and policies and set
up the operation of the NPHRL (July 08 onwards). 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 GHCS funds and will
continue in FY09. MOH through Global Fund will procure DNA PCR equipment and CDC will continue to
provide technical assist to the MOH in the implementation of early infant diagnosis at the NPHRL. Reagent
support will be provided by Clinton Foundation until Dec 08. The CDC office will continue to provide
coordination and support for special studies as well as assistance with planning the laboratory processes for
surveillance surveys during 2009. In FY 08 MOH supported enrolment of CML, regional laboratories and
VCT sites in an External Quality Assurance program. These activities will be supported by CDC and will
continue in FY09 with enrollment in EQA programs extended to a greater number of sites, including
NPHRL. In FY09 CDC through MOH Co-Ag will support QA managers at NPHRL to travel to regional/district
laboratories and VCT sites to provide oversight, training and assessment of compliance with QA programs.
All CDC lab activities are coordinated by the above mentioned senior laboratory advisor.
Continuing Activity: 12728
12728 8110.08 HHS/Centers for US Centers for 6273 135.08 CDC Program $65,162
8110 8110.07 HHS/Centers for US Centers for 4727 135.07 CDC Program $145,000
Table 3.3.16:
CDC will continue to work in close collaboration with the Ministry of Health (MOH), the National Blood
Transfusion Services (NBTS), and all Emergency Plan (EP) partners to strengthen and support strategic
information (SI) activities including health management information systems (HMIS), surveillance,
monitoring and evaluation (M&E), and programmatic research. In FY09, CDC will emphasize improving SI
systems in the MOH, will work to improve coordination between the national statistics unit and various
program areas, and provide technical assistance to the Government of Guyana technical committee for the
Demographic and Health Survey (DHS). The CDC GAP Guyana Office will continue to work with staff at the
Francois-Xavier Bagnoud (FXB) to complete public health evaluations for TB and HIV disease monitoring
and control activities, and the treatment program. An locally employeed staff (LES) Data Manager position
and a portion of the CDC direct-hire Medical Epidemiologist position 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
implementation.
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 Government of Guyana with operationalizing
the National HIV/AIDS M&E Plan and National Strategic Plan (NSP) on HIV/AIDS. Specific support to the
MOH include short-term technical assistance (TA) and targeted trainings in data management and
surveillance. and long-term financial and technical support to the Pan American Health Organization
(PAHO) to assist the MOH in implementing a sustainable and harmonized surveillance system to monitor
and measure selected health care priorities.
Lastly, CDC will continue to work with all partners to strengthen routine program reporting utilizing
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.
Continuing Activity: 12729
12729 8089.08 HHS/Centers for US Centers for 6273 135.08 CDC Program $139,491
8089 8089.07 HHS/Centers for US Centers for 4727 135.07 CDC Program $28,000
Table 3.3.17:
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 15 positions including one ASPH Fellow, two fewer
than last year. The positions include 3 FTE, 1 PSC, and 10 LES; 8 staffs are supported under Management
and Staffing and six 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 6 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, and janitor. 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. The Program staff includes one
FTE Medical Epidemiologist who provides technical support primarily to SI, adult care and other prevention.
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 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 other program officers focus on blood safety, 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: $423,320; PMTCT: $44,221; other prevention: $23,100; Blood Safety 20,142; Palliative Care/TB:
$31,174; HIV/AIDS Treatment Services: $192,395; Laboratory - $90,000; and SI - $78,354.
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, FXB 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
oversight of the recently constructed National Public Health Reference Laboratory during the warranty
phase and also the Senior Laboratory Advisor will provide technical and managerial support in capacity
building.
The COP guidance outlines several key steps to assist country teams with the process of thinking through
staff positions with the team in mind rather than a particular agency. Further, the guidance from OGAC
promotes rational approaches to replacing staff vacancies, reducing redundancies, and leveraging the
comparative advantages of each agency. CDC, for example, conducts its business using a very different
model than USAID.
As a result, CDC offices can end up with more program area technical experts (e.g., physicians, lab
specialists, program development officers) compared to USAID. USAID, on the other hand, may have more
portfolio and grants managers with less direct responsibility for direct program implementation. This can
result in a lop-sided number of management and staff positions, often with CDC having comparatively more
staff.
Here in Guyana, a relatively small program, CDC staff out number USAID staff by about 4 to 1. Therefore,
CDC has the greatest contribution to the overall country management and staff (M&S) numbers. For FY
2008 the combined country amount budgeted for M&S was 8.6%. For FY 2009, despite the elimination of
two positions by CDC, and no growth by USAID, the overall percentage for M&S actually increased to
11.5%. Staffing footprints for countries with small budgets like Guyana are particularly sensitive to funding
reductions. As such, M&S reductions must accompany budgetary reductions in order to maintain budget
levels within the 7% earmark. Obviously a net reduction in CDC staff by two LES was not nearly enough to
compensate for a 20% decrease in the overall country budget. CDC must therefore make further reductions
in staff over the next few years.
Based on my assessment of the CDC office, conversations with other USG agencies, the maturity of the
overall program in country, and other criteria and considerations related to SFR, CDC envisions continued
efforts to reduce its staffing footprint. We have mapped out a hypothetical staffing footprint by position for
the CDC office, current compared to future. The actual time table for transitioning various positions will
depend on program priorities, work load, training needs, and other factors. However, we anticipate that in 2
years we will be much closer to the desired staffing footprint.
The total estimated cost of doing business is budgeted for $429,866 in 2009 which covers ICASS and
CSCS and ITSO. In FY09 guidance was provided to allow these costs to be budgeted under M&S ; The
CSCS charge for FY09 is substantially lower than in previous years (FY07=$240,133).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
Activity Narrative: 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.
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
within Guyana.
M&S Budget total is $1,437,263: Therefore $437,263 is for ITSO$ 108,500, ICASS $260,000, CSCS
$61,366 and other expenditure.
Continuing Activity: 12730
12730 9359.08 HHS/Centers for US Centers for 6273 135.08 CDC Program $208,987
9359 9359.07 HHS/Centers for US Centers for 4727 135.07 CDC Program $278,800
