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
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.
COP 2008
1. LIST OF RELATED ACTIVITIES
This activity relates to activities in pediatric treatment, Pediatric care and support, Adult treatment, TB/HIV,
and PMTCT.
2. ACTIVITY DESCRIPTION
Columbia University's International Centre for AIDS Care and Treatment (CU-ICAP) will strengthen ongoing
adult care and support activities in 40 health facilities (25 in Nyando and 15 in Kisii districts) in Nyanza
province. The activities include support for provision of facility based care and support services for 30,000
people with HIV and support for training for 120 health care workers. Laboratory and clinical network
centers will be supported at the District Hospital in Nyando. Points of service will include dispensaries,
health centers, and sub-district and district facilities in the district
CU-ICAP supports the development of high quality HIV care and treatment services in low-resource
settings. CU-ICAP programs currently support HIV/AIDS activities in 11 African countries. In Kenya, CU-
ICAP has established a foundation for HIV/AIDS program activities, including PMTCT-Plus and care and
treatment. With regionalized planning for care and treatment services, CU- ICAP-Kenya was designated the
primary United States Government (USG) care and treatment partner for Eastern South and Central
Province and now working in Nyanza. CU-ICAP has established an efficient administrative and operations
base in Nairobi and is working closely with CDC-Kenya.
At each site ICAP Nyanza will provide technical assistance, equipment and supplies, infrastructure
improvement, laboratory capacity improvements, laboratory reagents, adherence counseling, assistance
with monitoring and reporting, cotrimoxazole prophylaxis to prevent opportunistic infections, treatment of
opportunistic infections, improved access to safe drinking water, establishment of psychosocial support
groups linked to each clinic and additional community-based services. The activities scope includes
identification and treatment of HIV-infected children and adults and the provision of care in remote areas.
The latter will be facilitated by mobile teams that move between rural health centers and dispensaries,
particularly those providing PMTCT services or TB treatment, an important step towards decentralization.
3. CONTRIBUTIONS TO OVERALL PROGRAM AREA
These activities will contribute to the results of expansion of palliative care services for people with HIV,
strengthened human resource capacity to deliver palliative care services, and an improved referral network
for these services. In addition, these activities will contribute to the expansion of care for HIV-infected
children, in particular by supporting infant testing at sites supported both by this partner and other
Emergency Plan partners.
4. LINKS TO OTHER ACTIVITIES
These services link to supported adult care treatment services as well as other ART and non ART services
provided by other Emergency Plan Partners, such as the University of California, San Francisco, Catholic
Relief Services, and Mildmay in Nyanza Province. They also tie into well-established referral linkages with
local VCT and PMTCT programs.
5. POPULATIONS BEING TARGETED
The target population for this activity is people with HIV. The main geographic region served by these
activities is Nyanza Province, a priority region because it has the highest prevalence of HIV in Kenya
(15.3% compared to 7.4% nationally). Most of the services are provided to the general population with HIV
but special services are provided to women through PMTCT-plus services, participants in U.S. government
funded research programs and their families, and the mentally ill. Discordant couples are targeted by
behavior change counseling and other prevention activities focused on HIV-infected patients.
6. KEY LEGISLATIVE ISSUES ADDRESSED
This activity addresses legislative issues related to stigma and discrimination through involvement of
PLWAs in service provision and community sensitization activities.
7. EMPHASIS AREAS
This activity includes minor emphasis on commodity procurement, development of network/linkages/referral
systems, human resources, logistics, local organization capacity building, and quality assurance and
supportive supervision, training, and strategic information.
New/Continuing Activity: Continuing Activity
Continuing Activity: 19412
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
19412 19412.08 HHS/Centers for To Be Determined 8673 8673.08 Nyanza Care
Disease Control & and Treatment
Prevention FOA
Table 3.3.08:
ACTIVITY UNCHANGED FROM COP 2008
This activity relates to activities in Pediatrics treatment, Adult care and support, Pediatrics care and support,
and TB/HIV.
Columbia University's International Centre for AIDS Care and Treatment (CU-ICAP) in Nyanza will provide
treatment activities to cover 25health facilities (11 in Kisii and 13 in Nyando) in Nyanza province. CU-ICAP
Nyanza will be transitioning the PGH activities to another partner in collaborating with KEMRI. The activities
include provision of antiretroviral treatment (ART) to 15,000 HIV-positive individuals (10,000 new patients)
and support for training for 200 health care workers. Laboratory and clinical network centers will be
supported at the District Hospitals in Kisii, and Nyando. Points of service will include all districts and sub-
district Hospitals in the regions served by these referral hospitals, as well as many health centers and
dispensaries.
CU-ICAP Nyanza key focus areas will include: identification and treatment of HIV-infected children and
adults, identification and treatment of infected patients in the in-patient setting, and provision of care in
remote areas. Because the PMTCT and TB treatment programs have been effectively decentralized, the
support for services at these sites is an important step toward decentralization of treatment services for
people with HIV.
These activities will contribute to the results of expansion of ARV treatment for clinically qualified HIV-
positive patients, strengthened human resource capacity to deliver ARV treatment, strengthened referral
networks for provision of ART, and expansion of treatment services for children.
This activity links to CT, pediatric care and treatment, PMTCT and training services supported by other
Emergency Plan partners (e.g. APHIA II, UCSF, KEMRI, and Mildmay).
The target population for this activity is people with HIV. Nyanza is high priority because of the very high
prevalence of HIV (15.3%). Most of the services are provided to the general population with HIV, but special
services are provided to women and children through pediatric and PMTCT-plus services, to participants in
US government funded research programs and their families, and to mentally ill patients. Discordant
couples are targeted by behavior change counseling and other prevention activities focused on HIV-infected
patients.
This activity includes minor emphases on commodity procurement, development of
network/linkages/referral systems, human resources, logistics, training, targeted evaluations, and quality
assurance and supportive supervision.
Continuing Activity: 19414
19414 19414.08 HHS/Centers for To Be Determined 8673 8673.08 Nyanza Care
Table 3.3.09:
ACTIVITY UNCHANGED FROM COP 2008:
This activity relates to activities in pediatric treatment, adult care and support, Adult treatment, TB/HIV, and
Orphans and Vulnerable Children.
Columbia University's International Centre for AIDS Care and Treatment (CU-ICAP) Nyanza will strengthen
ongoing pediatric care and support activities in 40 health facilities (25 in Nyando, 15 in Kisii districts) in
Nyanza province. The activities include support for provision of facility based palliative care services for
3000children with HIV and support for training for 100 health care workers. Laboratory and clinical network
centers will be supported at the district hospital in Nyando. Points of service will include the district and sub-
district hospitals in the region, as well as many health centers and dispensaries. At each site ICAP Nyanza
will provide technical assistance, equipment and supplies, infrastructure improvement, improvement of
laboratory capacity, laboratory reagents, adherence counseling, assistance with monitoring and reporting,
cotrimoxazole prophylaxis to prevent opportunistic infections, treatment of opportunistic infections, improved
access to safe drinking water, establishment of psychosocial support groups linked to each clinic and
additional community-based services. The activities scopes include identification and treatment of HIV-
infected children and adults and provision of care in remote areas..
strengthened human resource capacity to deliver palliative care services, and a strengthened referral
network for these services. In addition, these activities will contribute to expansion of care for HIV-infected
provided by other Emergency Plan Partners like University of California, San Francisco, Catholic Relief
Services, Mildmay and CRS Umbrella in Nyanza Province. They also tie into well-established referral
linkages with local VCT and PMTCT programs.
The target population for this activity is children infected or exposed to HIV. The geographic region served
by these activities is Nyanza Province, a priority region because it has the highest prevalence of HIV in
Kenya (15.3% compared to 7.4% nationally). Most of the services are provided to the general population
with HIV, but special services are provided to children through pediatric and PMTCT-plus services, to
participants in US government funded research programs and their families, and the mentally ill.
Table 3.3.10:
This activity relates to activities in Adult treatment, Adult care and support, Pediatrics care and support,
TB/HIV, and Orphans and Vulnerable Children.
Columbia University's International Centre for AIDS Care and Treatment (CU-ICAP) Nyanza will provide
treatment activities to cover 25 facilities (14 in Nyando and 11 in Kisii districts) in Nyanza province. The
activities include provision of antiretroviral treatment (ART) to 1,600 HIV-positive children (1,000 new
patients) and support for training for 100 health care workers. Laboratory and clinical network centers will
be supported at the district hospitals in Nyando and Kisii. Points of service will include all facilities in the
district including health centers and dispensaries. ICAP Nyanza key focus areas will include: identification
and treatment of HIV-infected children and adults, identification and treatment of infected patients in the in-
patient setting, and provision of care in remote areas. Because the PMTCT and TB treatment programs
have been effectively decentralized, the support for services at these sites is an important step toward
decentralization of treatment services for people with HIV.
This activity links to CT, adult care and treatment, PMTCT and training services and OVC supported by
other Emergency Plan partners (e.g. Engender Health, UCSF, APHIA and Mildmay)
services are provided to children through pediatric and PMTCT-plus services, to participants in US
government funded research programs and their families, and to mentally ill patients.
Table 3.3.11:
CT, and PMTCT.
Columbia University's International Centre for AIDS Care and Treatment (CU-ICAP Nyanza will support
TB/HIV services for patients in 2 districts in Nyanza Province through direct support or through quality
assurance processes to selected partners. TB screening for 15,000 HIV patients and HIV screening for
4,000 TB suspects/patients will be offered as a standard of care in all the facilities; approximately 3,200
patients will be identified as being infected with both TB and HIV.
In FY 2009, CU-ICAP Nyanza will expand collaborative TB/HIV activities in Nyanza Province, including HIV
testing of TB suspects (reaching >95% of all TB cases) and monitoring and treatment of HIV in TB clinics
(reaching 100% of TB patients with cotrimoxazole and 50% of those eligible with ART). PEPFAR funds will
support provincial and district TB/HIV stakeholders meetings, train workers in and implement enhanced TB
screening, diagnosis, treatment, and referral, coordinated delivery of integrated HIV and TB services
through the expansion and strengthening of technical supportive supervisions, and develop and print IEC
materials. Activities will focus on capacity building, provision of equipment, minor renovation, and
procurement of supplies including cotrimoxazole (CTX), HIV test kits, staffing, and laboratory reagents.
Mechanisms of referral to TB clinics and back-referral to HIV care settings (including ART) will be
strengthened.
Funds will also be used to assist the MOH to implement infection control practices to prevent TB
transmission of TB to PLWHA and health care providers in selected health facilities. In order to improve and
expand manpower base for TB laboratory services, Emergency Funds will also be used to hire staff to
supplement similar support from the Global Fund. Prevention with positives (PWP) activities in TB settings
will be emphasized. The EP will support prevention within discordant couples through support services,
training, and condom provision. In addition, communication and education efforts will increase knowledge
about HIV discordance within TB settings and strategies to decrease HIV transmission. TBD Nyanza will
collaborate closely with other programs to ensure that HIV-infected children are considered in all TB/HIV
policies and programs, including IPT for HIV-infected children whose parents have active TB.
These activities will result in strengthened delivery of integrated TB/HIV services, including strengthened
referral systems, improved diagnostics and treatment of TB among HIV-positive patients and of HIV in TB
patients, strengthened capacity of health workers to provide integrated TB/HIV services and strengthened
systems capacity for program monitoring and evaluation and management of commodities. There will be a
special focus on screening for TB in at least 50% of the HIV-infected patients from the PSC/CCC and
medical in-patient wards. The proportion of HIV-positive TB patients on ARVs will be increased from 30% to
50% with 100% CTX coverage..
These activities will be linked to ongoing CT, Adult Care and Support, Pediatric Care and Support, Adult
and Pediatric ARV Services, and PMTCT activities in Nyanza.
TB suspects (adults and children), TB patients, HIV+ persons identified from PSC/CCC/medical inpatient
wards, and PLWHA organizations - deliberate action will be taken to intensify TB screening and TB case
finding among PLWHA.
Provider-initiated HIV testing for all TB patients will be given on an "opt out" principle. Guidelines on HIV
testing based on consent, confidentiality and counseling will be observed as part of standard practice.
Increased availability of CT in clinical settings and increased access to HIV-related care for TB patients will
help reduce stigma and discrimination.
7. EMPHASIS AREAS TB screening, DTC, commodity procurement, quality assurance, community
mobilization, infrastructure, targeted evaluation, network/linkages/ referral systems, treatment for latent TB
infection, infection control, laboratory strengthening, and training.
Continuing Activity: 19416
19416 19416.08 HHS/Centers for To Be Determined 8673 8673.08 Nyanza Care
Table 3.3.12:
