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.
Andhra Pradesh (AP) is the fifth largest State in India in population and geographic area with a population of about 80 million across 23 districts, all of which are "A" category districts (as categorized by Government of India). As per the revised 2007 National estimates, AP has a prevalence of 0.96 percent among the adult population. The estimated adult population living with HIV/AIDS is about 450,000.
The National AIDS Control Organization (NACO) has identified priority thrust areas under National AIDS Control Program (NACP III) that include: MARPs saturation; rapid scale up of services; improved program management systems; decentralization of program implementation and management to the district level; strengthened data and strategic information management systems; laboratory support services and systems; a focus on access to quality services; mainstreaming of HIV services to other health and non-health departments; and integration with the existing general healthcare delivery services.
In India, including Andhra Pradesh (AP), a significant level of health services (~60%) is sought in the private sector. Although the private sector provides that majority of health services, it remains untapped and unmonitored resource with regards to HIV/AIDS care and treatment. Such services continue to be constrained by insufficient entry points and access, low treatment literacy among health workers and the general population, stigma and discrimination among the providers, non-uniformity of services, noncompliance to the national strategies, and a lax or lack of systematic data reporting system in the private sector. The quality of services provided by private medical facilities range from state-of-the-art to inadequate.
Realizing the need, strengths and potential of the private health sector and seeking to utilize the private sector's untapped resources, Science Health Allied Research Education (SHARE) India formed the AP AIDS Consortium (APAIDSCON) in 2005. SHARE India has a history of being involved in several health related projects since 1986, with an aim to "advance human health".
AP, the state with the highest estimated burden of HIV in India, has over 20 private medical colleges spread across 17 districts with 2,000 medical graduates each year. These institutions are between 310 years old and are at various stages of evolution. With the state-of-the-art technical and infrastructure, these colleges are located in rural or semi-urban settings and cater to underserved populations. They offer mostly no-cost or low-cost/subsidized services. Due to the availability of accessible and affordable services in these tertiary centers, they attract a sizeable population, including people living with HIV/AIDS (PLHIVs). Therefore, these institutions have tremendous potential and opportunity to play a leading role in the HIV epidemic.
APAIDSCON is a unique consortium of 16 private medical colleges and hospitals across 12 districts formed to address HIV and medical education as well as service issues. APAIDSCON built bonds with AP Nursing Homes Association, a 5,000 member body, to extend their linkages within private sector. The focus is on strengthening HIV-related activities and programs within its member organizations through developing and promoting a comprehensive multidisciplinary strategy to combat the HIV/AIDS epidemic. The development of this consortium has led to substantive system strengthening, including the successful completion of joint training programs, curriculum sharing, advocacy for government funded HIV testing and counseling centers in all 16 colleges and around 40 private hospitals, and a linkage system for subsidized CD4 testing.
APAIDSCON continues to involve the private sector in HIV and other public health programs through variety of partnership models with leveraged supports from public sector, private health sector as well private non-health sector. APAIDSCON plays a strategic role as an advocate, a technical assistance agency, a collaborator, and a contributor.
Current ongoing and future directions for the project include the provision of technical assistance to the local government counterparts and other partners in fostering partnerships. These include the private sector for HIV clinical care, capacity building of the healthcare staff (medical, paramedical and allied staff), private sector policies, laboratory systems and innovative partnerships models. APAIDSCON is working to establish HIV testing quality assured services and design accreditation/certification models for APSACS to ensure provision of standard services across institutions both in lab settings as well as clinical care settings.
Broader Objectives of the Consortium are to:
Open doors for PLHIVs and treat them without stigma and discrimination.
Improve clinical competency of the network of physicians through in-service training programs.
Foster and strengthen private and public collaborations to leverage resources within the communities of each member organization for effective program implementation and management of resources.
Seamless introduction of national programs and policies into the private sector and seamless integration of private sector health data into the public sector monitoring and evaluation (M&E) system.
Activities undertaken:
A unique model private sector consortium of 16 private medical college institutions formed.
Structured two day and four day curriculum is being implemented for physicians for managing PLHIVs in the private sector without stigma and discrimination.
Setting up of 16 counseling and testing centers and prevention of mother to child transmission (PMTCT) centers in the state with a system of reporting to AP State AIDS Control Society (SACS) and NACO through the national Computerized Management Information System (CMIS).
Laboratory strengthening in terms of developing a quality assurance program for HIV rapid testing in both private and public sector in collaboration with APSACS, to enhance quality testing systems through structured standard operating protocols (SOP) and quality manual as per the national guidelines.
Increased and improved provision of care and support services through innovative models: infectious disease (ID) clinics concept across seven institutions; Community Care Centers (CCCs) established in line with the NACO guidelines across three institutions; links built between Medical College ID Clinics and Community CCCs across six institutions; establish cells for post-exposure prophylaxis across all 16 institutions.
Provision of HIV counseling and testing through a unique partnership model between the private sector, public sector and TA support from APAIDSCON.
TA to APSACS in establishing and operationalizing Link ART centers in three districts of AP. TA, advocacy, as well as leadership in setting up private sector ART centers in partnership with the government.
To advocate and encourage active engagement of the private sector in implementing the national HIV program effectively, APAIDSCON will continue to work with the AP government and APSACS. The aim is to expand HIV/AIDS interventions in the private sector and ensure that such services are delivered inline with the national HIV service guidelines.
The development of APAIDSCON is a noteworthy output and model for the country. One of the key outcomes of APAIDSCON is leveraging of funds of the private and public sector to implement quality programs inline with the national protocols.
