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: 2010 2011
In August 2009, the Government of Lesotho (GOL) and the US government signed a Partnership Framework Agreement (PF) through the President's Emergency Plan for AIDS Relief (PEPFAR) to collaboratively develop, plan and implement a five-year strategy to contribute to the implementation of the National HIV and AIDS Strategic Plan (NSP) 2006-2011. Both the PF and the NSP highlight prevention as a key priority in the HIV/AIDS response in Lesotho.
In 2008, the HIV prevalence in Lesotho was 23.2 percent and incidence was estimated to be 1.7 percent or approximately 21,000 new infections in 2007 (2009 Modes of Transmission Study). A high degree of homogeneity exists in the epidemic, with prevalence above 15% in all districts and among all but a few population age groups.
Heterosexual sex is the predominant HIV transmission pathway in Lesotho, with significantly higher prevalence in women (26%) than in men (19%). The Know Your Epidemic incidence modeling concluded than the bulk of new infections (2008) occurred in both those reporting a single-partner (35%-62%) and people in multiple concurrent partnerships (32%-54%). High incidence in those reporting one single sexual partner is because it is the most populous risk group and because of high HIV discordance in steady couples (estimated at 1/3) combined with low condom use, low complete male circumcision and secret partners. Multiple concurrent sexual partnering (MCP) is exceptionally high in Lesotho with an overall MCP of 24% in 2007, compared to 10% in the region (CIET, 2008). In addition, the subjects of MCP and sexuality are personal and private subjects in Lesotho and are rarely discussed publically, within families or between couples. This necessitates the utilization of a comprehensive, well-coordinated and culturally sensitive national HIV prevention initiative that works in close collaboration with stakeholders and communities.
The Prevention TBD partner will develop and strengthen a national focus on a comprehensive, evidence-based 'combination prevention' program in alignment with the National HIV and AIDS Strategic Plan, National Behavior Change Communication Strategy (2008-13), National HIV and AIDS Policy and the PEPFAR Lesotho Partnership Framework in order to build a sustainable system at the end of five years. The TBD will assist and collaborate with MOHSW, NAC, National HIV and AIDS Communication TWG, UN Prevention TWG and other key stakeholders/partners in Lesotho. Civil society and their representatives in NGOs/FBOs/CBOs will also serve as close partners in program design and implementation especially those serving PLHIV and vulnerable groups. Capacity building and strengthening will need to be provided to government entities, civil society organization and the private sector and will be based upon robust capacity needs assessments and a few towards sustainability.
The TBD will take a coordinating role in the assessment of current prevention programming and research literature to guide the development of evidence based HIV prevention strategies, programming and policies including the development of guidelines and protocols, as necessary. It will encourage strengthened collaboration with government entities, civil society and the private sector in the implementation of HIV prevention programs, and support the collection and analysis of M&E data to guide the outputs of prevention programs. Condom social marking, family planning and improved supply chain management of condoms and other reproductive health communities will need to be a key focus to ensure that high quality condoms are available throughout Lesotho.
A comprehensive combination prevention approach will require the utilization of several communication channels, the targeting of prevention messages to a variety of vulnerable audiences, ensuring linkages and messaging among behavioral, biomedical and structural interventions. Lastly, the TBD will strengthen national and civil society technical capacities to develop, implement, monitor and evaluate comprehensive HIV prevention programming.
In late January 2010, an onsite assessment will be conducted of PEPFAR Lesotho by members of the PEPFAR Prevention TWG with the aim of developing recommendations for a TBD combination prevention initiative for COP11. This is the new updated version.
The Prevention TBD partner will develop and strengthen a national focus on a comprehensive, evidence-based 'combination prevention' program in alignment with the National HIV and AIDS Strategic Plan, National Behavior Change Communication Strategy (2008-13), National HIV and AIDS Policy and the PEPFAR Lesotho Partnership Framework in order to build a sustainable system at the end of five years. The TBD will assist and collaborate with MOHSW, NAC, National HIV and AIDS Communication TWG, UN Prevention TWG and other key stakeholders/partners in Lesotho. Civil society and their representatives in NGOs/FBOs/CBOs will also serve as close partners in program design and implementation especially those serving PLHIV and vulnerable groups.
Condom social marking, family planning and improved supply chain management of condoms and other reproductive health communities will be a key focus of this TBD partner to ensure that high quality condoms are available throughout Lesotho.
