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: 2007 2008 2009
ACTIVITY UNCHANGED FROM COP 2008
1. LIST OF RELATED ACTIVITIES
This activity relates to SCMS activities in other program areas: Laboratory Infrastructure, HIV/AIDS
Treatment: ARV Services, Counseling and Testing, HIV/AIDS Treatment: ARV Drugs and Palliative Care:
TB/HIV.
2. ACTIVITY DESCRIPTION
The Partnership for Supply Chain Management Systems, SCMS, will support all of PEPFAR Kenya's
service delivery activities through provision of an uninterrupted supply of HIV/AIDS- related commodities.
Commodities will come through a regional warehouse established in Kenya (Regional Distribution Center-
RDC), significantly decreasing the lead time in procurement. From the regional warehouse, supplies will
enter into existing supply chain management systems, including the national distribution system, run by
KEMSA, and in some cases, "buffer" stocks to ensure that PEPFAR sites have adequate commodities when
there is national shortage. The project will receive forecasting and quantification information from existing in
-country partners. This activity will also liaise and strengthen local procurement and distribution partners
such as MEDS and KEMSA, by working transparently and collaboratively with them. SCMS will be asked to
procure commodities with a focus on results - ensuring not only that the product is delivered, but that there
are the required maintenance, inputs and upgrades so that the target number of tests are achieved. 2009
funds will be used to procure reagents and consumables for Early Infant Diagnosis (EID) worth $416,865.
This will help address any gaps experienced in improving services for children identified through provider
initiated counseling and testing in MCH clinics, pediatric wards and pediatric out-patient clinics to increase
the number of children on care and follow up. Infants identified as HIV positive through early infant
diagnosis will also require more laboratory work up to put them on care and treatment.
3. CONTRIBUTIONS TO OVERALL PROGRAM AREA
This program will contribute to counseling and testing of pregnant women at PMTCT facilities by ensuring
adequate supply of rapid test kits and identification of infants requiring early treatment within the program.
4. LINKS TO OTHER ACTIVITIES
This activity relates to all service delivery activities offering counseling and testing to pregnant women and
EID through PCR, as well as the RPM+/MSH activity in logistics information management, distribution
support, and forecasting and quantification, in ARV Drugs; KEMSA logistics and information management
and distribution systems; and SCMC procurements in HVCT, HLAB, and HTXS. It also links to the SCMS
activity in Palliative Care: TB/HIV.
5. POPULATIONS BEING TARGETED
The target populations for this activity are pregnant women in the general population for HIV/AIDS testing. It
will also target families of the HIV-positive pregnant women.
6. KEY LEGISLATIVE ISSUES
Through the SCMS, procured commodities will be utilized to help address gender equity in HIV
programming and improve service delivery to pregnant women, their infants and spouses.
7. EMPHASIS AREAS
The major area of emphasis for this activity is commodity procurement.
New/Continuing Activity: Continuing Activity
Continuing Activity: 14950
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
14950 8757.08 U.S. Agency for Partnership for 6985 4924.08 $454,417
International Supply Chain
Development Management
8757 8757.07 U.S. Agency for Partnership for 4924 4924.07 $800,233
Table 3.3.01:
ACTIVITY UNCHANGED FROM 2008
1. ACTIVITY DESCRIPTION
The Partnership for Supply Chain Management (SCMS) will support all of PEPFAR Kenya's service delivery
activities through provision of an uninterrupted supply of HIV/AIDS- related commodities. Under Blood
Safety SCMS will procure equipment necessary for safe storage of blood and blood products at hospitals.
The National Blood transfusion service (NBTS) has recently trained personnel in several hospitals to form
hospital transfusion committees which serve to enforce appropriate blood use. These committees will be
guided by the recently released Standards for Transfusion services in Kenya and the Guidelines for
Appropriate Blood Use. This activity will support the NBTS to procure equipment to support provision of
safe blood and blood products for the Kenya National Blood Transfusion Service for the production of blood
and blood products. To improve hospital transfusion practice SCMS will procure essential blood banking
equipment such as platelet mixers, hospital blood bank fridges and freezers for storage of blood
components.
2. CONTRIBUTIONS TO OVERALL PROGRAM AREA
This activity will contribute to prevention of HIV through blood transfusion. Kenya aims to collect 140,000
units of blood from low risk volunteer blood donors. All the blood will be tested for HIV, hepatitis B, Hepatitis
C and syphilis. This activity will facilitate blood component preparation through procurement of equipment.
Components will increase blood availability through appropriate use and also reduce the occurrence of
adverse transfusion events. Blood donors will be notified of their test results and given information to
promote healthy positive living so that negative donors become regular repeat blood donors. HIV positive
donors will be counseled and referred for evaluation care and treatment as appropriate. Appropriate blood
use will minimize unnecessary transfusions which may expose healthy individuals to HIV infection. The
World Health organization estimates that 10% of HIV may be attributed to transfusion with infected blood.
3. LINKS TO OTHER ACTIVITIES
This activity relates to all service delivery activities by SCMS which will enhance efficiency by maximizing on
economies of scale achieved through mass procurements and timely delivery of commodities. This activity
also links to Cooperative agreements with NBTS and American Association of Blood Banks (AABB) for the
provision of safe and adequate blood supplies.
4. POPULATIONS BEING TARGETED
This activity will benefit the general population by supporting the acquisition of blood free of HIV infection.
5. EMPHASIS AREAS
Continuing Activity: 16293
16293 16293.08 U.S. Agency for Partnership for 6985 4924.08 $720,000
Table 3.3.04:
1. ACTIVITY DESCRIPTION AND EMPHASIS AREAS
This activity relates to the prevention of HIV transmission among health care workers, medical waste
handlers and the community. It is estimated that up to 5% of HIV infections arise from unsafe injections
given in health care facilities. Injection safety can be enhanced by rational injection use, improved injection
practices and proper disposal of medical sharps. Every year, close to five million blood draws and finger
pricks for blood collection are performed within the public health care sector in Kenya. The expansion of HIV
testing and care has resulted in a dramatic increase in blood collection for the purpose of HIV testing and
monitoring of those with HIV infection. In this activity Supply Chain Management Systems will procure
safety boxes for disposal of medical sharps, color coded waste disposal bins, bags and transfer trolleys,
safety lancets and safe lock needles. Blood and Intravenous fluid giving sets will also be procured. These
will facilitate safe injection practice, segregation of health care waste and its appropriate disposal. These
supplies will be distributed to health facilities through various partners in the Kenya Injection safety program.
Safe injections and sharps waste management will contribute towards reduction of HIV transmission. A
Policy for safe injection practice was launched by the Ministry of Health in 2007. The Ministry of Health has
committed to increase procurement of auto-disable injection devices and health care waste disposal
containers as well as increased guidance and supervision for injection safety and infection prevention and
control at health care facilities. These supplies will only serve to ensure that stock outs do not occur. John
Snow, Inc. - Making Medical injections Safer, (JSI-MMIS) partners with Academy for Educational
Development (AED) and Program for Appropriate Technology in Health (PATH) to implement the three-step
strategy recommended by the World Health Organization (WHO) and the Safe Injection Global Network
(SIGN) to implement the PEPFAR Injection Safety program in several countries including Kenya. The world
Health Organization (WHO) estimates of global burden of disease suggest that unsafe injections around the
world account for 5% of HIV infections. A 2004 survey in Kenya revealed that over 70% of respondents
received an average of 1.5 injections per year. Needle stick injuries within the previous six months were
reported by 58% of health care workers. These findings supported those of an earlier study by the
University of Nairobi among 214 nurses in Nairobi, which reported 61 % needle stick injuries in health care
workers over a three-month period. Needle recapping accounted for 46% of the injuries while 12% occurred
during disposal of sharps. A majority of health facilities surveyed reported having experienced a shortage of
disposable injection supplies in the 12 months prior to the survey, particularly in the curative sector. This
reflects a less than optimal logistics system for forecasting, procurement, distribution and stock monitoring
that may contribute to re-use of injections. Analysis of the status of injection logistics in the country revealed
that there was no data to support rational forecasting of injection requirements. Procurement was based on
previous consumptions. Appropriate product selection was poor due to lack of national standards for
injection devices, registered suppliers of injection equipment and an appropriate board to handle non-
pharmaceutical equipment. Injection safety activities in Kenya commenced in 2004 under PEPFAR. The
aim is to: • Improve training of health workers and managers on safe injection practices, infection control
and disposal procedures. • Institute an advocacy strategy to decrease demand for injections by the
population. • Establish reliable estimates of re-use prevention injection device equipment requirements,
minimum stock levels and effective supply and distribution systems for re-use prevention injection device
equipment. • Institute monitoring and supervision procedures to ensure adequate supplies at all levels and
correct practices by health workers. • Ensure safe disposal of used injection equipment through the
progressive introduction of appropriate incinerators. • Secure the required budget for injection safety and
infection control including safe disposal of used equipment. Significant reduction in prescription of injections
and regular use of sharps disposal containers has occurred in all health facilities that have benefited from
this intervention regions. This activity has a major emphasis on procurement.
This activity will avert at least 5% of HIV transmission in Kenya. To date over 18,000 health care workers
(clinicians, logistical officers and medical waste handlers) have been trained in safe injection practices and
medical sharps waste management. Interventions have been implemented in six provinces (Central,
Nyanza, Western, Eastern (part), Coast and the Kenyatta National Hospital. In FY09 an additional 8,000
health care workers will be trained in Nairobi (City Council clinics and hospitals) and Eastern provinces.
3. POPULATIONS BEING TARGETED
• Health care workers • Community • Medical Waste handlers • Policy makers
New/Continuing Activity: New Activity
Continuing Activity:
Table 3.3.05:
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS FROM COP 2008:
+ the activity description has been expanded to include specific information on activities.
COP 2008
This activity relates to activities in health systems strengthening
SCMS will procure voluntary medical male circumcision (VMMC) commodities and supplies. Kits will be
procured to support 500,000 VMMC procedures.
This SCMS project will contribute to the VMMC scale up as one of the HIV prevention strategies.
This activity links to activities in systems strengthening and the interventions for comprehensive HIV
prevention, care and treatment.
This activity targets 18 to 30 year old men and their family members living in both rural and small urban
settings. It targets unmarried as well as married males, those who are HIV negative. It also targets women
to change their social norms and to support men during the healing period after undergoing VMMC.
6. KEY LEGISLATIVE ISSUES ADDRESSED
The activity will promote prevention by providing service providers with tools to conduct VMMC procedures.
Continuing Activity: 14955
14955 12504.08 U.S. Agency for Partnership for 6985 4924.08 $400,000
12504 12504.07 U.S. Agency for Partnership for 4924 4924.07 $400,000
Table 3.3.07:
This activity relates to SCMS activities in the following program areas: HLAB, PMTCT, HVTB, PDTX and
Blood Safety. It also supports all PEPFAR service-delivery activities.
Supplies Chain Management System (SCMS) will support all of PEPFAR Kenya's service delivery activities
through provision of an uninterrupted supply of HIV/AIDS- related laboratory commodities based on
procurement plan agreed upon between USG agencies and GOK counterparts. To facilitate this, SCMS will
conduct an assessment of the existing lab supply chain management system (KEMSA and MEDS) and
develop options for the comprehensive logistics system(s) capable of supporting the national HIV/AIDS
program. This will cascade into an assessment of the existing provincial and district level infrastructure and
HR capacity for lab supplies consumption, tracking and monitoring pipelines and provision of quality data for
quantification and supply planning. A stakeholder forum to select parameters and agree on the proposed
laboratory logistics systems will be required; SCMS will lead this activity to ensure arrival at a consensus at
country level. SCMS will also offer technical assistance in develop comprehensive logistics related SOPs for
the lab system, in addition to offering related training and implementation support on maintaining lab
logistics system. SCMS will also support the development of a transparent national laboratory procurement
planning process to support lab at the facility level to quantify lab commodity needs in support of ART.
Regular laboratory commodities quantification and supply plans review/sanitization workshops will be
conducted to ensure uninterrupted supply and minimal losses due to expiry of the lab commodities that are
characterized by a generally short shelf life. SCMS will also be required to conduct relevant training and
implementation of lab logistics system, as well as training stakeholders in forecasting and quantification for
lab reagents and supplies. SCMS will also regularly review and address the outcomes of the provincial and
district level assessment for the quantification data and supply planning system .This will culminate in
SCMS setting up a national system for quantification and pipeline monitoring. This activity will also liaise
and strengthen local procurement and distribution partner/central warehouse identified through the initial
assessment by SCMS. In this 12-month period, SCMS will procure CD4 reagents, hematology and
biochemistry reagents to support the treatment monitoring needs of 300,000 patients. The list and quantities
of required for the 12 month period, with a clear delivery schedule per quarter will be presented to SCMS at
the last quarter of COP 2008. Commodities will come directly through the central warehouse for distribution
to health facilities and/or network sites. Buffer stocks will be maintained in the central warehouse and a third
of this corresponding buffer at facility level to ensure uninterrupted supply. SCMS will be asked to procure
commodities with a focus on results - ensuring not only that the product is delivered, but that there are the
required equipment maintenance, inputs and upgrades so that the target number of tests are achieved.
Required record management for equipment service and maintenance, inputs and upgrades will be
maintained and updated by SCMS so that the target number of patients is served.
This program will contribute to provision of Adult HIV Treatment services by ensuring adequate supplies of
needed commodities.
This activity relates to all service delivery activities offering counseling and testing to all HIV positive
patients, as well as the SPS/MSH ARV Drugs activity in logistics information management, distribution
support, and forecasting and quantification, the USAID ARV procurement contract, KEMSA logistics and
information management and distribution systems and SCMS procurements in Laboratory Infrastructure
and PMTCT.
HIV positive populations
6. EMPHASIS AREAS
The area of emphasis for this activity is commodity procurement with minor emphasis on asset
management.
Continuing Activity: 18815
18815 18815.08 U.S. Agency for Partnership for 6985 4924.08 $2,450,000
Table 3.3.09:
ACTIVITY UNCHANGED FROM COP 08:
This activity relates to SCMS activities in the following program areas: HLAB, PMTCT, HVTB, HTXD and
planning process to support lab at the facility level to quantify lab commodity needs in support of Early
Infant Diagnosis (EID) and pediatric ART. Regular laboratory commodities quantification and supply plans
review/sanitization workshops will be conducted to ensure uninterrupted supply and minimal losses due to
expiry of the lab commodities that are characterized by a generally short shelf life. SCMS will also be
required to conduct relevant training and implementation of lab logistics system, as well as training
stakeholders in forecasting and quantification for lab reagents and supplies. SCMS will also regularly review
and address the outcomes of the provincial and district level assessment for the quantification data and
supply planning system .This will culminate in SCMS setting up a national system for quantification and
pipeline monitoring. This activity will also liaise and strengthen local procurement and distribution
partner/central warehouse identified through the initial assessment by SCMS. In this 12-month period,
SCMS will procure reagents and supplies to perform early HIV infant diagnosis for 43,500 HIV exposed
infants in Kenya. The list of reagents and consumables required for the 12 month period, with a clear
delivery schedule per quarter will be presented to SCMS at the last quarter of COP 2008. Commodities will
come directly through the central warehouse for distribution to health facilities and/or network sites. Buffer
stocks will be maintained in the central warehouse and a third of this corresponding buffer at facility level to
ensure uninterrupted supply. SCMS will be asked to procure commodities with a focus on results - ensuring
not only that the product is delivered, but that there are the required equipment maintenance, inputs and
upgrades so that the target number of tests are achieved. Required record management for equipment
service and maintenance, inputs and upgrades will be maintained and updated by SCMS so that the target
number of patients is served.
This program will contribute to provision of pediatric HIV treatment services by ensuring adequate supplies
of EID commodities.
This activity relates to all service delivery activities of Early Infant Diagnosis services, as well as the
SPS/MSH ARV Drugs activity in logistics information management, distribution support, and forecasting and
quantification, the USAID drug distribution contract, KEMSA logistics and information management and
distribution systems and SCMS procurements in Laboratory Infrastructure and PMTCT.
HIV exposed infants and children in whom HIV diagnosis has been confirmed
Table 3.3.11:
Updated April 2009 Reprogramming. Increased by $250,000. Partnership Framework: Supplies (ZN
reagents, sputum containers, slides, etc.)
The only changes to the program since approval in the 2007 COP are:
+ Partnership for supply chain management will use the $400,000 allocated in 08 to procure TB culture test.
This will go along way in strengthening MDR/TB surveillance.
This activity relates to SCMS activities in the following program areas: Laboratory Infrastructure (#8763),
PMTCT (#8757), and Counseling and Testing (#8783). It also supports all PEPFAR service-delivery
activities.
SCMS will support all of PEPFAR Kenya's service delivery activities through provision of an uninterrupted
supply of laboratory test kits and other supplies for TB/HIV and other clinical settings. In this 12-month
period, SCMS will procure test kits and reagent supply that will cover 10 million HIV tests, 500,000 sputum
microscopy, 1.4 million syphilis tests, and 1.5 million HIV clinical diagnostic and monitoring tests. The list of
commodities required for the 12 month period, with a clear delivery schedule per quarter will be presented
to SCMS at the last quarter of COP 2008 to facilitate procurement planning by SCMS. Commodities will
ensure uninterrupted supply. Required asset management for equipment service and maintenance, inputs
and upgrades will be maintained and updated by SCMS so that equipment is optimally in good condition
and use to serve the target number of patients. SCMS will also support the development of a transparent
national laboratory procurement planning process to support labs at national and facility level to quantify lab
commodity needs in support of ART. Regular laboratory commodities quantification and supply plans,
sensitization and review workshops will be conducted to ensure uninterrupted supply and minimal losses
due to expiry of the lab commodities that are characterized by a generally short shelf life. SCMS will also
conduct relevant training and implementation of lab logistics system, as well as training stakeholders in
forecasting and quantification for lab reagents and supplies. SCMS will review and address the outcomes of
the provincial and district level assessment for quantification data and supply planning system .This will
culminate in SCMS setting up a national system for quantification and pipeline monitoring. This activity will
also liaise and strengthen local procurement and distribution partner/central warehouse identified through
the initial assessment by SCMS. Required record management for equipment service and maintenance,
inputs and upgrades will be maintained and updated by SCMS so that the target number of patients is
served.
This program will contribute to counseling and testing of HIV infected persons presenting for care in health
settings by ensuring adequate supply of rapid test kits and TB lab supplies.
This activity relates to all service delivery activities offering counseling and testing to TB/HIV patients and
pregnant women, as well as the MSH/SPS ARV Drugs activity in logistics information management,
distribution support, and forecasting and quantification (#6989), the mission competitive procurement
(#6997), KEMSA logistics and information management and distribution systems (#6969) and SCMS
procurements in Laboratory Infrastructure (#8763), PMTCT (#8757), and Counseling and Testing (#8783).
The target populations for this activity are adults and children in the general population for HIV/AIDS and TB
testing, people living with HIV/AIDS for monitoring, and TB tests.
The major area of emphasis for this activity is commodity procurement with minor emphasis on asset
Continuing Activity: 14952
14952 8754.08 U.S. Agency for Partnership for 6985 4924.08 $825,000
8754 8754.07 U.S. Agency for Partnership for 4924 4924.07 $300,000
Table 3.3.12:
Updated April 2009 Reprogramming. Increased by $600,000. Partnership Framework: Purchase EID Test
Equipment for Kisumu (Tachman); placement will be confirmed by MoH.
+ Provide TA towards a comprehensive lab logistics system(s) capable of supporting the national HIV/AIDS
program
+setting up a national system for quantification and pipeline monitoring for lab commodities
+asset management for EP procured equipment (service and maintenance, inputs and upgrades) to be
maintained and updated so that equipment is optimally in good condition and use to serve the target
number of patients.
+ Other (NON-SUBSTANTIVE) change will include the following:
SCMS will continue to procure HIV/AIDS test kits and reagents for hematology and chemistry that will be
provided to major labs. It is estimated that SCMS will procure test kits and reagent supply to cover 10
million HIV tests, 500,000 sputum microscopy, 1.4 million syphilis tests, and 1.5 million HIV clinical
diagnostic and monitoring tests
This activity relates to SCMS activities in other program areas: PMTCT , Treatment: ARV Services ,
Counseling and Testing , and TB/HIV . It also supports all PEPFAR service-delivery activities.
through provision of an uninterrupted supply of HIV/AIDS- related commodities. Commodities will come
through a regional warehouse established in Kenya, significantly decreasing the lead time in procurement.
From the regional warehouse, supplies will enter into existing supply chain management systems, including
the national distribution system, run by Kenya Medical Supplies Agency (KEMSA), and in some cases,
"buffer" stocks to ensure that PEPFAR sites have adequate commodities when there is national shortage.
The project will receive forecasting and quantification information from existing in-country partners. This
activity will also liaise and strengthen local procurement and distribution partners such as Mission for
essential drugs and Supplies (MEDS) and KEMSA, by working transparently and collaboratively with them.
SCMS will be asked to procure commodities with a focus on results - ensuring not only that the product is
delivered, but that there are the required maintenance, inputs and upgrades so that the target number of
tests are achieved.
This program will contribute to patient monitoring by ensuring the supply and maintenance of diagnostic
machines and reagents, test kits, TB cultures, and medical equipment for the use in laboratories of
government and mission hospitals providing HIV/AIDS treatment and care.
This activity relates to all service delivery activities, as well as the RPM+/MSH activity in logistics
information management, distribution support, forecasting and quantification, , MEDS, in ARV Drugs ;
KEMSA logistics and information management and distribution systems, and SCMC procurements in
HVCT , HLAB and HTXS.
The major area of emphasis for this activity is commodity procurement
Continuing Activity: 14954
14954 8763.08 U.S. Agency for Partnership for 6985 4924.08 $13,620,000
8763 8763.07 U.S. Agency for Partnership for 4924 4924.07 $6,823,300
Table 3.3.16:
