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
In FY'08 FXB provided technical assistance and human-resource support for HIV care and treatment. In
FY'09 FXB will continue toserve as the Ministry of Health's primary partner in the implementation of a
standard package of HIV clinical care, expansion of adult and pediatric HIV care and treatment, revision of
care and treatment guidelines and protocols, and design and implementation of adherence monitoring. FXB
will provide capacity for prescribing, dispensing and monitoring antiretroviral therapy (ART) at the existing
and future MoH HIV treatment sites. FXB will also provide clinical support for hinterland areas in Guyana
through consultative support of the Ministry of Health mobile unit lead physician, recruitment of a second
physician to allow for increased frequency of mobile outreaches, and clinical support and training to task-
shift ART provision from physicians to medex in some hinterland areas.
FXB's plan for long-term sustainability of ART delivery specifically emphasizes activities that build capacity
in the Guyanese Ministry of Health. In FY'09, these activities will include finding innovative approaches to
address the human-resource shortages that threaten the advancement and sustainability of the Guyanese
treatment program, including contracting physicians to provide complete clinical coverage for all treatment
sites. Particular effort will focuse on the continuation of clinical mentoring of local clinicians to provide HIV
care and the integration of such mentoring into the training programs for pre-service clinicians returning to
Guyana from Cuba. Senior FXB clinicians will provide mentoring and consultative oversight to staff serving
the GPHC Infectious Disease Ward. Senior FXB clinicians will assist with any development and/or revision
of standard curricula on basic HIV care for all cadres of healthcare workers and support the development
and implementation of a standard HIV care curriculum for medex working within the Guyanese MoH
system. The FXB Center will also establish a formal clinical mentoring program for nurses, which will
incorporate the standard curriculum on basic HIV care for nurses.
FXB will continue to strengthen linkages between the treatment program and other care sectors in Guyana,
including PMTCT, home-based care, basic palliative care, psychosocial care, confidential counseling and
testing, and TB diagnosis and treatment. This will include streamlining referral processes, institutionalizing
coordination between outpatient ART sites and inpatient wards, and integrating ART services into primary
care including PMTCT services. FXB will continue to work collaboratively with MOH oversight committees to
support continuous quality improvement (CQI) efforts at ART sites, including the integration of the existing
CQI program with the new national HealthQUAL CQI initiative, and the transition of ownership of CQI
activities to the MOH. Ongoing CQI activities will dovetail with clinical mentoring and ongoing training for
local clinicians, and these efforts will intensify as part of the strategy for creating sustainable healthcare
infrastructure in Guyana. FXB will also continue to advocate for national CQI oversight to help inform CQI
strategies across sites.
FXB will continue to work collaboratively with the MOH and CDC to refine and implement the exit strategy,
with continued focus on sustainability of ART services in Guyana. In FY'08 FXB transitioned its laboratory
staff over to the MOH. In FY'09 FXB will initiate staggered transition of additional staff positions (community
outreach workers and counselor/testers) to the MOH, with the remaining staff positions (nurses and
physicians) to be transitioned in FY'10, the final year of this funding cycle.
Care Program TotalsTarget
Total number of service outlets providing HIV-related palliative care (including TB/HIV)19
Total number of individuals provided with HIV-related palliative care (including TB/HIV)2600
Males1170
Females1430
Total number of people trained to provide HIV palliative care (including TB/HIV)95
Treatment Program TotalsTarget
Number of service outlets providing antiretroviral therapy (includes PMTCT+ sites)16
Number of individuals receiving antiretroviral therapy at the end of the reporting period (includes PMTCT+
sites)1900
Number of individuals newly initiating antiretroviral therapy during the reporting period (includes PMTCT+
sites)360
Number of individuals who ever received antiretroviral therapy by the end of the reporting period (includes
PMTCT+ sites)2700
Total number of health workers trained to deliver ART services, according to national and/or international
standards (includes PMTCT+)20
New/Continuing Activity: Continuing Activity
Continuing Activity: 12752
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
12752 12752.08 HHS/Centers for Francois Xavier 6276 6276.08 Tx Svcs and TA $200,000
Disease Control & Bagnoud Center
Prevention
Emphasis Areas
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $120,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Program Budget Code: 09 - HTXS Treatment: Adult Treatment
Total Planned Funding for Program Budget Code: $3,153,998
Total Planned Funding for Program Budget Code: $0
Table 3.3.09:
Continuing Activity: 12736
12736 12736.08 HHS/Centers for Francois Xavier 6276 6276.08 Tx Svcs and TA $1,170,000
Health-related Wraparound Programs
* Safe Motherhood
* TB
Estimated amount of funding that is planned for Human Capacity Development $900,000
The François-Xavier Bagnoud Center (FXB) provides expertise to the Guyana National TB Programme in
the diagnosis, treatment, and management of TB/HIV co-infected patients. In FY'09, FXB will continue its
involvement in TB/HIV co-management with emphasis on vulnerable populations at key primary, secondary
and tertiary care sites.
FXB will expand TB screening for HIV-infected patients and HIV testing for TB patients. Such activities will
be focused on vulnerable populations from HIV care and treatment sites, inpatient wards, local prisons and
PMTCT sites. FXB will facilitate the continued integration of TB screening into HIV service delivery with
particular emphasis on PMTCT sites, and will aggressively encourage access to TB diagnosis, care and
treatment by strengthening the referral linkages amongst PMTCT sites, HIV treatment sites (including the
National Care and Treatment Centre (NCTC), the Infectious Disease Ward at Georgetown Public Hospital
Corporation (GPHC), regional hospitals and regional and Georgetown Chest Clinics. To expand screening
for HIV infection among patients with TB, FXB will assign a dedicated HIV counselor/tester to the inpatient
wards at GPHC and provide clinical care to TB patients on inpatient wards and in local prisons. FXB will
also emphasize referrals for patients to psychosocial support services.
FXB will continue to build the Georgetown Chest Clinic as the primary referral, consultation, and treatment
site for the management of TB/HIV co-infection by providing comprehensive high quality multidisciplinary
clinical care, mentoring and training to clinic staff to allow for continued access to services for TB/HIV co-
infected individuals in all regions of Guyana; by coordinating with DOT workers to trace patient defaulters;
and by coordinating with the clinical team to provide linkages to home-based care and psychosocial support
services. FXB physicians with expertise in TB and HIV care will continue to provide such specialty care for
co-infected individuals at the Georgetown Chest Clinic, regional hospital inpatient wards and regional Chest
Clinics, and the Infectious Diseases Ward at GPHC. To further support diagnosis and management of
individuals with TB/HIV co-infection, FXB will purchase a dedicated x-ray machine to be shared by the
Georgetown Chest Clinic and the NCTC.
FXB will facilitate ongoing continuous quality improvement (CQI) activities at the Georgetown Chest Clinic
that will ensure that TB/HIV management follows national standards, and will support the integration of the
existing CQI program with the new national HealthQUAL CQI initiative.
FXB will continue to collaborate with TB/HIV stakeholders on policy issues surrounding TB-HIV co-infection
care, including assisting the MOH with improving laboratory testing to inform MDR-TB management and
coordinating training activities with both CDC Atlanta and PAHO. FXB's efforts complement those of the
Global Fund and World Bank programs and contribute to a comprehensive HIV response in Guyana. To
ensure that duplication of effort is minimized, FXB will continue to contribute to the formulation of national
policy and collaborate with the MOH, USG partners, UN partners and other bilateral and multilateral
organizations to develop HIV and TB care and treatment protocol.
Palliative Care: TB/HIVTarget
Number of service outlets providing clinical prophylaxis and/or treatment for tuberculosis (TB) to HIV-
infected individuals (diagnosed or presumed) in a palliative care setting8
Number of HIV-infected clients attending HIV care/treatment services that are receiving treatment for TB
disease (a subset of all served with palliative care)135
Males81
Females54
Number of registered TB patients who received HIV counseling, testing, and their results at a USG
supported TB site500
Number of individuals trained to provide clinical prophylaxis and/or treatment for TB to HIV-infected
individuals (diagnosed or presumed) 32
Continuing Activity: 12756
12756 12756.08 HHS/Centers for Francois Xavier 6276 6276.08 Tx Svcs and TA $200,000
Estimated amount of funding that is planned for Human Capacity Development $45,000
Table 3.3.12:
Due to the transition of the CD4 suite and staff to the NPHRL in FY'08, FXB will not have responsibility for
the management of the CD4 testing suite; therefore, the targets for number of laboratories with CD4 testing
capacity and for the number of tests conducted have been removed.
In FY'08 FXB continued to provide laboratory support for HIV care and treatment services in Guyana and
transitioned the management and human resource support for the CD4 testing suite to the Ministry of
Health (MOH) - National Public Health Reference Laboratory (NPHRL). FXB's support in FY'09 will include
the provision of ongoing technical assistance with emphasis on increasing coverage and scope of
laboratory services available to PLHIV, ensuring quality and accuracy of laboratory test results through
maintenance of quality management systems and staff training, and continued support for NPHRL
operations.
FXB will provide technical assistance for increased laboratory coverage to meet the needs of HIV-infected
patients across Guyana through close collaboration with the NPHRL, American Society for Clinical
Pathology (ASCP) and Central Medical Laboratory (CML) at Georgetown Public Hospital Corporation, to
coordinate training on existing (ELISA, CD4, chemistry and hematology) and new laboratory assays. FXB
will also provide technical support for the procurement and maintenance of adequate stock levels of the
requisite laboratory equipment, reagents and consumables.
FXB will provide technical assistance for the implementation and monitoring of QA/QC/QI measures, which
will include providing assistance to the NPHRL for the maintenance of "satisfactory" ratings from the
external CD4 proficiency testing programs with Health Canada, CAREC and UK NEQAS. FXB will
collaborate with the MOH - Department of Technical Standards to implement laboratory quality systems
regionally, monitor laboratory quality systems at CML and conduct site visits to hospital laboratories and
specific clinical sites to provide oversight and monitoring of HIV rapid and/or CD4 assaying. FXB will
collaborate with PAHO and the MOH - National Blood Transfusion Services (NBTS) to provide oversight
and monitoring for safe blood donation, screening, storage and dispensing; update SOPs for existing
laboratory assays and develop SOPs for new laboratory assays.
FXB will provide technical assistance to enhance the quality and consistency of laboratory services in
Guyana with primary focus on collaborating with the NPHRL, NBTS, CML and regional hospital laboratories
to support ongoing training and cross-training in ELISA, CD4, hematology and chemistry assaying.
FXB will continue to work collaboratively with the MOH and CDC to refine and implement a long-term
strategic plan for sustained laboratory capacity. As part of this regard FXB will continue to provide ongoing
technical assistance for NPHRL operations and for the introduction of laboratory assays to support
diagnosis and clinical management of HIV infection in infants (HIV DNA PCR) and adults (HIV RNA PCR),
opportunistic (including TB) and sexually transmitted infections, and resistance to HIV or TB drugs. This will
entail the development of protocols, validation processes and/or correlation studies, SOPs, and training
packages for each such laboratory assay.
Laboratory InfrastructureTarget
Number of individuals trained in the provision of laboratory-related activities70
Continuing Activity: 16456
16456 16456.08 HHS/Centers for Francois Xavier 7435 7435.08 Lab TA $400,000
Gender
* Increasing gender equity in HIV/AIDS programs
Estimated amount of funding that is planned for Human Capacity Development $50,000
Table 3.3.16:
