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
1. ACTIVITY DESCRIPTION & EMPHASIS AREA
This will be a continuation of the 2008 activity. New York University (NYU) will support treatment at the
Bomu Clinic and one satellite site in Mombasa, and will expand services to support PMTCT activities for the
pregnant women attending the Bomu clinic as well as the satellite site in Mombasa. In 2009 COP, the
program will support implementation of PMTCT activities and will target to reach 1,800 pregnant women
with HIV counseling and testing and facilitate CD4 count test as well as WHO clinical staging for all HIV +ve
women. Based on the results and National PMTCT guidelines on the use of ARVs in pregnancy, 36 HIV +ve
pregnant women with CD4 cell count < 350 or if in WHO stage II or II of HIV disease will be initiated on triple
ART, while 900 other HIV +ve women who do not meet this criteria will be given the combination
prophylaxis of single dose Nevirapine (sd NVP) and AZT starting 28 weeks of gestation. The minimum
prophylaxis of sd NVP will be given to 864 HIV+ve women presenting in late gestation for their 1st ANC
visit. This program also supports safe obstetric practices by facilitating delivery based activities. The
program will ensure that all women who come into labor and delivery with unknown HIV status will be
offered HIV counseling and testing and will administer the appropriate ARV prophylaxis. All the 100 HIV
exposed infants will receive the ARV prophylaxis as per the national guidelines and will have DBS taken at
6 weeks for Early Infant HIV diagnosis. All HIV exposed infants will be given Co-trimoxazole prophylaxis
starting at 6 weeks while all those with an HIV PCR test will be initiated on pediatric ART and follow up care.
Other care activities for the infants include growth monitoring, immunization as well as other services within
the Child Survival frame work. The mothers will receive follow up care that includes Cotrimoxazole
prophylaxis, counseling on correct and appropriate infant feeding practice, TB screening, post natal care
and linkage to Family planning services. The "Mother-to Mother "approach will be used to ensure
psychosocial networks and support for the mother both at the facility and community level. Primary
prevention within PMTCT setting will be addressed through encouraging couple HIV counseling and testing
and /or availing HIV testing and counseling to the male partners. The program will target to reach 200 men
with this intervention and will use the Men as Partners strategy to enhance this as well as to increase male
partner support and participation in PMTCT activities. Prevention with Positives (PwP) is another important
strategy that will be adopted to strengthen prevention. In implementation of these PMTCT activities, the
program will work in collaboration with the other HIV Care and Treatment and Pediatrics HIV Care services
in Bomu to ensure the HIV+ve women and their HIV exposed/infected infants receive a c complete package
of care. NYU has a long history of providing quality AIDS care in a variety of settings and over the past
several years has expanded capacity and expertise related to the provision of treatment in resource limited
settings like Africa. The AIDS Research and Family Care Clinic (ARFCC) was established in May 2001 and
provides a comprehensive range of free medical and psychosocial services to families living with HIV in and
around Mombasa. The clinic is served by a dedicated laboratory that offers HIV confirmatory testing, basic
hematology and chemistry tests, and CD4 counts. The program will strengthen the linkage between PMTCT
program and the ARFCC as well as the Laboratory services to ensure that all HIV +ve pregnant women and
their infants receive comprehensive HIV care services that include CD4 testing, baseline laboratory
investigations, access to HAART for all eligible pregnant women in line with the National PMTCT and ART
guidelines, Early Infant diagnosis for HIV exposed infants and linkage to treatment for all infants with a +ve
PCR HIV test, screening for TB for the women, HIV testing for the woman's partner and psychosocial
support and counseling. The women will also receive nutrition counseling for their own health as well as
counseling on correct infant feeding practices. Additionally the women and infants will receive the available
nutritional supplement. The Bomu Clinic uses a unique and elaborate referral and linkage system to ensure
patients receive care in the various service delivery points within the facility. This will be used to track and
ensure pregnant mothers receive the full package of care including safe delivery/skilled delivery attendance.
The Bomu clinic is a private clinic that provides general medical services to thousands of patients and has
recently expanded their capacity to provide specialized HIV services for adults and children. NYU has
supported development of a program that was providing treatment to over 2,000 patients by April 2008,
including 384 children. NYU brings particular expertise in pediatric treatment, and this site is expected to
rapidly expand treatment for children. A key barrier to expansion of the program at the moment is space.
NYU has received grant funding from other sources to establish an annex to the main clinic building that will
facilitate a significant expansion in pediatric treatment, and Emergency Plan funding will be used for
substantial renovations and refurbishment. This activity includes minor emphasis in commodity
procurement, community mobilization, development of networks/linkages/referral systems, human
resources, infrastructure, logistics, quality assurance and supportive supervision, strategic information,
targeted evaluation, and training.
2. CONTRIBUTIONS TO OVERALL PROGRAM AREA
These activities will contribute increased PMTCT program coverage by availing HIV testing and counseling
services to women and children attending the MCH and maternity units and providing the ARV prophylaxis
thereby contributing to prevention of pediatric HIV infections in the country. These activities will contribute to
the results of expansion of ART for clinically to the results of qualified HIV-positive patients, strengthened
human resource capacity to deliver adult and pediatric ART, tighten linkages between prevention, care, and
treatment activities, and strengthen referral networks for AIDS services..
4. LINKS TO OTHER ACTIVITIES
These activities link to non-ART services supported by NYU and FHI, referral to adult and pediatric HIV
services provided at Coast Provincial Hospital through FHI, a network center, and ART services coordinated
by and supported through the National AIDS and STD Control Program (NASCOP). There are also further
links to area VCT, PMI and community-based activities currently supported by FHI, advanced training in HIV
care supported through FHI, and network strengthening activities being implemented by the Kenya Pediatric
Association, a sub-partner of the Umbrella TBD.
5. POPULATIONS BEING TARGETED
These activities target people (adults, children, infants) living with HIV/AIDS. A key focus of the family clinic
is the provision of services to children with HIV, and the identification of children with HIV as a way of
reaching entire families that are affected by HIV. Treatment services for diagnosis and treatment of very
young children will be established through a relationship with Kenya Medical Research Institute (KEMRI),
whereby filter paper samples are transported to the KEMRI lab for polymerase chain reaction (PCR) infant
testing. Public health care providers, including doctors, nurses, pharmacists, and laboratory workers are
Activity Narrative: targeted for increased HIV care and treatment knowledge and skills. Included among the populations
served by these services will be participants in U.S. government funded research programs.
6. KEY LEGISLATIVE ISSUES ADDRESSED
This activity addresses legislative issues related to stigma and discrimination through community
sensitization activities.
New/Continuing Activity: New Activity
Continuing Activity:
Emphasis Areas
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
* Reducing violence and coercion
Health-related Wraparound Programs
* Malaria (PMI)
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:
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS FROM COP 2008:
+ New activity emphasis on prevention with positives among patients coming for care and treatment
services.
SECONDARY CROSS-CUTTING BUDGET ATTRIBUTIONS
The Partner will use $20,000 to procure nutrition supplements.
COP 2008
1. LIST OF RELATED ACTIVITIES
This activity relates to activities in Adult ARV Services, Pediatric care and support, Pediatric ARV Services,
TB/HIV and PMTCT.
2. ACTIVITY DESCRIPTION
New York University (NYU) will support palliative care services for 12,000 people with HIV/AIDS, at Bomu
Clinic and two satellite sites in Mombasa. This will be accomplished by continuing to offer on-site material
and technical support to build the capacity of this local facility to provide the services. The package of
palliative care services will include cotrimoxazole prophylaxis, treatment of opportunistic infections,
nutritional supplementation, TB screening, and sexually transmitted infection (STI) diagnosis and treatment,
improved access to malaria prevention interventions, and safe water for pediatric households. Funds will
provide salary support for health care workers in accordance with Emergency Plan guidance and training for
25 health care workers to deliver HIV palliative care. Activities will include community mobilization,
strengthening of logistics capacity (particularly pharmacy management), and procurement of commodities
such as laboratory reagents. Data concerning the numbers of patients receiving services will be collected
and reported both nationally and through the Emergency Plan. Activities will be conducted in close
collaboration with the Provincial ART coordinating officer for Coast Province. NYU has a long history of
providing quality AIDS care in a variety of settings and over the past several years has expanded capacity
and expertise related to provision of care and treatment in resource limited settings like Africa.
The AIDS Research and Family Care Clinic (ARFCC) was established in May 2001 and provides a
comprehensive range of free medical and psychosocial services to families living with HIV in and around
Mombasa. The clinic is served by a dedicated laboratory that offers HIV tests, basic hematology and
chemistry tests, and CD4 counts. The Bomu clinic is a private clinic that provides general medical services
to thousands of patients and has recently expanded their capacity to provide specialized HIV services. NYU
has supported development of a program that was providing palliative care services for more than 4,000
patients by March 2008,including more than 200 children. Given that NYU has particular expertise in
pediatric care and treatment, this site is expected to rapidly expand care and treatment for children. A key
barrier to expansion of the program at the moment is space. NYU has received grant funding from other
sources to establish an annex to the main clinic building that will allow substantial expansion of pediatric
care and treatment, and Emergency Plan funding will be used for renovations and refurbishment.
3. CONTRIBUTIONS TO OVERALL PROGRAM AREA
These activities will contribute to the results of expansion of access to palliative care services for more than
3,000 people with HIV/AIDS, strengthened human resource capacity, and a strengthened referral network
for provision of these services.
These activities link closely to adult ART services, pediatric care and support, and pediatric ART services
supported by NYU, and through referral to adult and pediatric HIV services provided at Coast Provincial
Hospital, a network center supported by FHI.
reaching entire families that are affected by HIV. Public health care providers, including doctors, nurses,
pharmacists, and laboratory workers are targeted for increased HIV care and treatment knowledge and
skills. Included among the populations served by these services will be participants in US government
funded research programs.
7. EMPHASIS AREAS
This activity includes minor emphasis in commodity procurement, community mobilization, development of
networks/linkages/referral systems, human resources, logistics, quality assurance and supportive
supervision, strategic information and training.
New/Continuing Activity: Continuing Activity
Continuing Activity: 14946
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
14946 4133.08 HHS/Centers for New York 6984 286.08 $175,000
Disease Control & University
Prevention
7014 4133.07 HHS/Centers for New York 4270 286.07 $175,000
4133 4133.06 HHS/Centers for New York 3217 286.06 $100,000
Estimated amount of funding that is planned for Food and Nutrition: Commodities $20,000
Table 3.3.08:
ACTIVITY UNCHANGED FROM COP 2008
This activity relates to activities in Palliative Care, PMTCT, pediatric care and support, Pediatric treatment
and OVC.
Bomu Clinic and one satellite sites in Mombasa, resulting in 8,000 (new 3,500) individuals receiving
antiretroviral treatment (ART) services. This will be accomplished by providing on-site material and technical
support, which will increase the capacity of this local facility to sustain treatment services for people with
HIV. Funds will provide salary support for health care workers in accordance with Emergency Plan guidance
and training for 25 health care workers. Activities will include community mobilization, strengthening of
logistics capacity (particularly pharmacy management), procurement of commodities such as laboratory
reagents, and infrastructure improvement (e.g., renovations of the facilities). Data concerning the numbers
of patients receiving services will be collected and reported both nationally and through the Emergency
Plan. "Treatment activities will be conducted in close collaboration with the coastal Provincial Aids and STI
Coordinating Officer. NYU has a long history of providing quality AIDS care in a variety of settings and over
the past several years has expanded capacity and expertise related to the provision of treatment in
resource limited settings like Africa. The AIDS Research and Family Care Clinic (ARFCC) was established
in May 2001 and provides a comprehensive range of free medical and psychosocial services to families
living with HIV in and around Mombasa. The clinic is served by a dedicated laboratory that offers HIV
confirmatory testing, basic hematology and chemistry tests, and CD4 counts. The Bomu clinic is a private
clinic that provides general medical services to thousands of patients and has recently expanded their
capacity to provide specialized HIV services for adults and children. NYU has supported development of a
program that was providing treatment to over 2,000 patients by April 2008, including 384 children. NYU
brings particular expertise in pediatric treatment, and this site is expected to rapidly expand treatment for
children. A key barrier to expansion of the program at the moment is space. NYU has received grant
funding from other sources to establish an annex to the main clinic building that will facilitate a significant
expansion in pediatric treatment, and Emergency Plan funding will be used for substantial renovations and
refurbishment.
These activities will contribute to the results of expansion of ART for clinically qualified HIV-positive patients,
strengthened human resource capacity to deliver adult and pediatric ART, tighten linkages between
prevention, care, and treatment activities, and strengthen referral networks for AIDS services.
links to area VCT and community-based activities currently supported by FHI, advanced training in HIV care
supported through FHI, and network strengthening activities being implemented by the Kenya Pediatric
targeted for increased HIV care and treatment knowledge and skills. Included among the populations
networks/linkages/referral systems, human resources, infrastructure, logistics, quality assurance and
supportive supervision, strategic information, targeted evaluation, and training.
Continuing Activity: 14949
14949 4134.08 HHS/Centers for New York 6984 286.08 $1,340,000
7015 4134.07 HHS/Centers for New York 4270 286.07 $1,425,000
4134 4134.06 HHS/Centers for New York 3217 286.06 $560,000
Table 3.3.09:
ACTIVITY UNCHANGED FROM COP 2008:
This activity relates to activities in ARV Services (#7015, #8813), PMTCT #8649), and Palliative Care: Basic
Health Care and Support (#8934).
New York University (NYU) will support palliative care services for 1,200 children with HIV/AIDS, at Bomu
and expertise related to provision of care and treatment in resource limited settings like Africa. The AIDS
Research and Family Care Clinic (ARFCC) was established in May 2001 and provides a comprehensive
range of free medical and psychosocial services to families living with HIV in and around Mombasa. The
clinic is served by a dedicated laboratory that offers HIV tests, basic hematology and chemistry tests, and
CD4 counts. The Bomu clinic is a private clinic that provides general medical services to thousands of
patients and has recently expanded their capacity to provide specialized HIV services. NYU has supported
development of a program that was providing palliative care services for more than 350 children exposed or
infected with HIV. Given that NYU has particular expertise in pediatric care and treatment, this site is
expected to rapidly expand care and treatment for children..
5000 people with HIV/AIDS, strengthened human resource capacity, and a strengthened referral network
These activities link closely to ART services supported by NYU and FHI (#7015, #8813), and through
referral to adult and pediatric HIV services provided at Coast Provincial Hospital, a network center
supported by FHI (#8649). There are further links to area VCT and community-based activities currently
supported by FHI including Palliative Care: Basic Health Care and Support (#8934).
Table 3.3.10:
This activity relates to activities in Palliative Care (#7014, #8934), PMTCT (#8649), pediatric care and
support, Pediatric treatment and OVC.
New York University (NYU) will support treatment at the Bomu Clinic and two satellite sites in Mombasa,
resulting in 1,000 children (850 new) receiving antiretroviral treatment (ART) services. This results in a total
of 1,200 ever being in treatment. This will be accomplished by providing on-site material and technical
support that will increase the capacity of this local facility to sustain treatment services for people with HIV.
Funds will provide salary support for health care workers in accordance with Emergency Plan guidance and
training for 25 health care workers. Activities will include community mobilization, strengthening of logistics
capacity (particularly pharmacy management), procurement of commodities (e.g., laboratory reagents), and
infrastructure improvement (e.g., renovations of the facilities). Data concerning the numbers of patients
receiving services will be collected and reported both nationally and through the Emergency Plan.
Treatment activities will be conducted in close collaboration with the coast Provincial Aids and STI
the past several years has expanded capacity and expertise related to provision of treatment in resource
limited settings like Africa. The AIDS Research and Family Care Clinic (ARFCC) was established in May
2001 and provides a comprehensive range of free medical and psychosocial services to families living with
HIV in and around Mombasa. The clinic is served by a dedicated laboratory that offers HIV confirmatory
testing, basic hematology and chemistry tests, and CD4 counts. The Bomu clinic is a private clinic that
provides general medical services to thousands of patients and has recently expanded their capacity to
provide specialized HIV services for adults and children. NYU has supported development of a program that
was providing treatment to over 2,000 patients by March 2008, including 384 children. NYU brings particular
expertise in pediatric treatment, and this site is expected to rapidly expand treatment for children.
Association, a sub-partner of the Cooperative Housing Foundation.
Table 3.3.11:
This activity relates to activities in Prevention of Mother-to-Child Transmission, Adult Care and Support,
Pediatric Care and Support, and Adult and Pediatric ARV Services.
New York University (NYU) will support TB/HIV services for approximately 6,000 patients, at Bomu Clinic
and two satellite sites in Mombasa, Coast Province. Intensified TB screening and treatment for 3,000 HIV
patients and HIV screening for 250 TB suspects/patients will be offered as a standard of care in all the
facilities; approximately 125 patients will be identified as being infected with both TB and HIV. Funds will
support refresher training of laboratory staff and improvement of basic laboratory microbiology capacity in
order to meet the increased needs for TB testing. 10 health care workers will be trained to provide clinical
prophylaxis and/or treatment for TB to HIV-infected individuals. Funds will support expanded and
strengthened delivery of integrated HIV and TB services including strengthened referral systems. Additional
activities will include community mobilization and dissemination of educational materials to patients. NYU
will maintain data concerning the numbers of people served and will report both nationally and through the
Emergency Plan. NYU has a long history of providing quality AIDS care in a variety of settings and over the
past several years has expanded capacity and expertise related to provision of care and treatment in
living with HIV in and around Mombasa. The clinic is served by a dedicated laboratory that offers HIV tests,
basic hematology and chemistry tests, and CD4 counts. The Bomu clinic is a private clinic that provides
general medical services to thousands of patients and has recently expanded their capacity to provide
specialized HIV services. NYU has supported development of a program that was providing palliative care
services for more than 5,000 patients by March 2008, including more than 300 children. Given that NYU has
particular expertise in pediatric care and treatment, this site is expected to rapidly expand care and
treatment for children. A key barrier to expansion of the program at the moment is space. NYU has received
grant funding from other sources to establish an annex to the main clinic building that will allow substantial
expansion of pediatric care and treatment, and Emergency Plan funding will be used for renovations and
These activities will contribute towards the provision of integrated HIV/TB services for dually infected
patients care by reducing TB morbidity and mortality in HIV-infected individuals and also reducing HIV
related morbidity and mortality in TB patients co-infected with HIV. These activities will strengthen referral
systems, improve diagnostics and treatment of TB among HIV-positive patients and strengthen capacity of
health workers to provide integrated HIV and TB services.
The overall program activity links closely to Adult Care and support, Pediatric care and support,
Adult/pediatric ARV Services currently supported by this partner as well as HIV/TB services supported by
DLTLD.
These activities target adults and children living with HIV/AIDS. Public health care providers, including
doctors, nurses, pharmacists, laboratory workers will receive training in the diagnosis and management of
TB using government guidelines.
This activity includes minor emphasis in commodity procurement, development of networks/linkages/referral
systems, community mobilization, human resources, local organization capacity development, quality
assurance, quality improvement and supportive supervision, and training.
Continuing Activity: 14947
14947 12460.08 HHS/Centers for New York 6984 286.08 $75,000
12460 12460.07 HHS/Centers for New York 4270 286.07 $50,000
Table 3.3.12:
This activity relates to activities in Adult care and support, Adult ARV services, PMTCT, pediatric care and
support, Pediatric ARV services.
The Muangalizi component of the program will be enhanced to include post disclosure support to normalize
the experience of HIV in the family, with a focus on households looking after HIV positive children under the
Muangalizi model. The activity will also support the evaluation of the Muangalizi pilot in collaboration with
the other 4 USG supported and participating sites to facilitate lessons learnt and identification and
documentation of the effectiveness of different approaches to facilitate scale up. This activity was begun
with 2007 plus-up funds and is part of a five-site effort to strengthen the link between clinical and household
settings for HIV+ children. All sites meet regularly with a sixth entity, AED/Capable Partners, for real-time
sharing of lessons learned and review the effectiveness of different approaches in preparation for scale-up.
The Mwangalizi model is being tested in response to concern expressed by clinicians that assuring optimal
care for HIV+ OVC was difficult in many instance because they were accompanied to different clinic visits
by different relatives or community members, necessitating constant re-education of adults managing care
of children. Central to the approach is recruitment of adult patients who are successfully managing their
own care to accompany pediatric patients to all clinic visits when a consistent caregiver from the household
is not available. A total of 32 "accompagnateurs" will be trained to be on watch for 150 children for
development of side effects or complications, remunerated for their time, and expected to perform home
visits to monitor medication consumption. They will also be expected to develop an ongoing and supportive
relationship with the OVC household, assess the social environment and refer for needed services, and
seek wherever possible to identify a household or community contact who can be prepared to assume the
long-term responsibility of being a treatment advocate for the child. Sites were carefully selected to
represent a cross section of Nairobi and coastal urban slum (Eastern Deanery, Coptic, and Bomu), peri-
urban (AMPATH/Eldoret, Bomu) and rural (Kericho District Hospital) communities. Standard measures of
household and clinician satisfaction with the value-added by the accompagnateur, accompagnatuer
satisfaction with the experience, and clinical progress of OVC participating in the program will be tracked.
Numbers of OVC served are captured under care and treatment activities.
These activities will contribute to the results of expansion of ART for clinically qualified HIV-positive children,
and strengthen referral networks for AIDS services.
These activities link to non-ART services supported by NYU and FHI, referral to pediatric HIV services
provided at Coast Provincial Hospital through FHI, a network center, and ART services coordinated by and
supported through the National AIDS and STD Control Program (NASCOP). There are also further links to
community-based activities currently supported by FHI, advanced training in HIV care supported through
FHI, and network strengthening activities being implemented by the Kenya Pediatric Association, a sub-
partner of the Umbrella TBD.
These activities target, children living with HIV/AIDS. A key focus of the family clinic is the provision of
services to children with HIV, and the identification of children with HIV as a way of reaching entire families
that are affected by HIV. Treatment services for diagnosis and treatment of very young children will be
established through a relationship with Kenya Medical Research Institute (KEMRI), whereby filter paper
samples are transported to the KEMRI lab for polymerase chain reaction (PCR) infant testing. Public health
care providers, including doctors, nurses, pharmacists, and laboratory workers are targeted for increased
HIV care and treatment knowledge and skills. Included among the populations served by these services will
be participants in U.S. government funded research programs.
This activity includes minor emphasis in community mobilization, development of networks/linkages/referral
systems, human resources, and training.
Continuing Activity: 14948
14948 12476.08 HHS/Centers for New York 6984 286.08 $150,000
12476 12476.07 HHS/Centers for New York 4270 286.07 $150,000
Table 3.3.13:
