Background: The CDC Global AIDS Program (GAP) office opened in Port au Prince, Haiti in 2003 as a co-

located office on the USAID Mission campus. Since the inception of the President's Emergency Plan for

AIDS Relief (PEPFAR) program in Haiti in 2004, CDC's management and technical staff have worked in

close collaboration with the Population Health and Nutrition Unit (PHN) of USAID to jointly manage the

planning and implementation of the PEPFAR program. CDC's technical and managerial expertise has

provided assistance and training (including financial management) to both the Ministry of Health (MOH) and

the United States Government (USG)'s institutional partners. As CDC Haiti does not operate within a larger,

in-country agency context for its administrative support service, it has sole operational and financial

responsibility for its own contingency planning, meeting US security requirements, provision of workspace

(including internet access), recruitment and training of employees and housing support for USG Direct

Hires. This is in addition to costs incurred as CDC technical experts, located in the field as well as in Port au

Prince, work with USG partners to implement activities as outlined in the Country Operational Plan (COP).

CDC and USAID, in a coordinated effort to ensure adequate technical coverage and avoid duplication of

human resources, have a complementary roster of technical advisors that is based on core institutional

competencies and experience. As of September 2007, thirty-seven (37) CDC staff members are 100%

supported by the PEPFAR budget, including (4) vacancies (one audit specialist; one procurement

assistant; one secretary; and regional care and treatment specialist). Of these 37 staff, three (3) are US

Direct Hires (USDH), including the Chief of Party, the Deputy Director, and the Laboratory Section Chief.

The fourth is a "CDC Personal Services Contractor (PSC)" who is the Prevention Section Chief. The

remaining staff, including 2 technical experts, is Locally Engaged Staff (LES). The Port-au-Prince CDC

office houses both professional (technical, financial, Information Technology (IT) staff, procurement and

inventory management) and support (secretaries and drivers) staff.

Approximately 30% of the staff, both professional and support oriented, are located in small, regional offices

throughout the country (e.g., Cap Haïtien and Saint Marc, in the north; Les Cayes; Jacmel; Jeremie, in the

south) in association with the MOH's Regional Departmental hospital system. The decentralization of CDC

staff at the regional department level is a reflection of CDC's lead role in PEPFAR care and treatment

implementation, and the need to institutionalize PEPFAR activities at the local MOH level to the maximum

extent possible. Moreover, given the ongoing security concerns in Haiti, the USG Team recognizes the

crucial need for program implementation to continue unhindered at the regional department level,

regardless of security situations which may occur in the capital. Decentralization is designed to permit

program implementation to continue, even if critical events result in further security interruptions, and other

management challenges.

In order to better implement the PEPFAR program with a goal of long-term program integration and

sustainability, CDC Haiti will undertake the following management activities in FY 2008: continue ongoing

USG team-building to assess specific training and development needs of our current employees; continued

staff recruitment for vacant field positions, especially care and treatment and health information specialists

to be located at the regional departmental level; continued attention to staffing needs within our technical

areas as well as identification of possible staffing gaps between CDC and USAID; continue to develop the

prevention section to work jointly with USAID counterparts in the area of prevention strategies for high risk

populations, with a Personal Services Contract(PSC)/Public Health Advisor, hired in FY 07, as Section

Chief; continue current warehouse operations, including laboratory storage, in partnership with the

Partnership for Supply Chain Management System (PSCMS) until they can fully undertake safe reception

and timely distribution of PEPFAR commodities throughout the country while maintaining the cold chain.

The current CDC warehouse was new in 2006, having been established when we were asked to leave the

US Embassy warehouse in 2005. The Airport Road site however, while in a better part of the insecure ‘red'

zone, is still subject to periodic security concerns; we expect to secure a new facility much nearer the new

Embassy construction area at Tabarre.

For the first time since the beginning of the PEPFAR program in 2004, CDC has a full roster of US Direct

Hire and PSC staff (total 4), and the Management and Staffing account will have to support salaries and

benefits (including housing) for these staff, requiring additional resources from previous years when there

were only 1-2 US staff. The Haiti PEPFAR team as part of the pilot for the "staffing for results" analysis

during FY 07 concluded that additional expertise is needed to fully coordinate activities for people with both

TB and HIV. This is the only new technical position being requested for CDC staffing in FY 08, although

CDC expects to provide housing costs for the new PEPFAR coordinator and SI Liaison. CDC also expects

to fill approved FY 07 vacancies which have never been staffed. (Note: a procurement assistant was

advertised and selected but was unable to secure a local security clearance; vacancies an

auditors/financial analyst and a secretary were held in abeyance due to a shortage of M&S funding during

FY 07. They will be filled in FY 08).

The move to the New Embassy Compound (NEC), which is scheduled for occupancy on March 29, 2008,

will be a costly one for all tenant agencies. In addition to the expected OBO Head Tax, levied on agencies

to "pre-fund" embassy construction, CDC was required to purchase in FY 07 fourteen (14) "desk units" for

the current professional staff at $24,000 a unit. Additional FY 08 Management and Support funding is

required to purchase desk units for support and logistics staff, in addition to new staff. These "desk units"

are provided by OBO and must be installed during the embassy construction process. Finally, the CDC

motor pool, initially procured in 2004 at the beginning of the program and which is used extensively in the

field on very difficult roads, is wearing out. In FY 08, we will purchase a new Lightly Armored vehicle (LAV)

and three non-armored vehicles.

Funds are reserved for staff training, travel for field program supervision and technical coordination in and

outside of Haiti. Commodity procurement includes purchase of additional office equipment. Infrastructure

expenses include security and related office upgrades, administrative expenses, including ICASS, as well

as internet costs. Logistics include staff overtime and vehicle maintenance, insurance and fuel.

Cost of Doing Business:

OBO Head Tax: The CDC/Haiti estimated Overseas Building Office (OBO) Head Tax, a pro rata budget

support to defray the costs of construction of the New Embassy Compound (NEC), nearing completion on

the other side of Port-au-Prince, is $300,000. The NEC schedule is currently on track and initial move-in

dates are schedule for March 29, 2008. With FY 2007 Management and Support funding, CDC was

mandated to purchase from the Overseas Building Office (OB0) approximately $322,000 for furniture and

furnishings for 14 "desk units" (4 hard wall office and 10 cubicles) for key staff.

New HHS/CDC IT Policy Implementation: We anticipate additional costs associated with the move to the

NEC but no estimates will be available until we actually move in for additional costs that may/may not be

required (particularly in the IT area, as we will be co-located in a secure Chancery for the first time, which

may have special computer/IT requirements). However, Management & Staffing funding in the amount of

$45,500 has been considered in formulating this budget (see separate activity narrative for IRM tax) to

support the mandated HHS-CDC IT conversion for CDC Haiti management and administrative personnel.

Activity Narrative: Funding to support the HHS/CDC IT conversion for program personnel is included in their respective

programs.

Early Funding Request:

Per instructions from CDC Headquarters, Posts are requested to include early funding requests in their

FY08 Country Operating Plans (COPs), so that adequate Management and Support funding will be in place

until the first Congressional Notification is approved/processed, which is estimate to be on/about April, 30

2008. During this period, the CDC Haiti office requires $2,538,600 (combined GHAI and Core funding) to

support the costs of salaries and benefits, administrative costs, overhead costs ("cost of doing business")

and some transitional funding for the planned move to the new embassy compound, scheduled for March

2008.