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.
Subdivisions of Program Areas, these track general higher level sub-classifications of expenditure.
Subdivisions of Major categories, these are the most detailed expenditure data.
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
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
NOTICE - Per the recommendation from OGAC that Malawi as an FY2008 Compact Country, submit a mini
-COP (i.e. program area level narratives only), this activity level narrative has not been updated prior to the
submission of the FY09 Full COP. The Malawi country team anticipates updating narratives upon
completion and final approval of the negotiated 5-year Compact between the United States Government
and the Government of Malawi.
The activities in this area will focus on strengthening the pharmaceutical management for HIV/AIDS
commodities at facilities in line with the Ministry of Health's (MoH) policy to integrate HIV/AIDS
pharmaceuticals into the Ministry's supply system and the rational use of ART drugs. It will address the
capabilities in monitoring the system, and will involve training of service providers, development of Standard
Operating Procedures (SOP's), facilitating their implementation at the facility level, and the introduction of
management tools. In addition, technical assistance (TA) to the MoH for reviewing, updating and
disseminating essential drugs list and standard treatment guidelines will be provided.
With FY 2008 Emergency Plan (EP) funding, MSH/SPS will support the MoH scale up plans for counseling
and testing, ART, and PMTCT services by facilitating the integration of HIV/AIDS medicines into the general
supply chain to improve overall pharmaceutical management for HIV/AIDS programs. Current support in
pharmaceutical management addresses each HIV/AIDS area individually and there is need to consolidate
these efforts under the umbrella of the National Drug Policy in terms of drug selection, procurement,
distribution, and rational use.
Experiences, lessons learned, and tools from other countries supported by MSH within the region will be
drawn on to strengthen the pharmaceutical management of HIV/AIDS commodities in Malawi.
The procurement of all medicines and medical supplies in Malawi is done in accordance with the Malawi
National Drug List and the Essential Health Package. The National Drug Committee is charged with the
responsibility of selecting drugs and reviewing the Essential drug list and standard treatment guidelines
(STG). MSH/SPS will work with the MoH to update the Malawi Essential Drug List as well as STG with
HIV/AIDS medicines, to provide a facilitative policy environment for HIV/AIDS commodities integration into
routine supply chain systems, and their rational use at facility levels.
The expected results include improved ART dispensing and management of ART patients at facility levels
and improved management of ART drugs. Also, it is expected that the HIV/AIDS unit will have the capacity
to quantify HIV drugs for the country.
With EP funding, MSH/SPS will increase the number of ART service providers trained in proper
management of ART drugs using updated training materials that are incorporated in the national training
materials for all health workers, as well as increase the capacity at the facility and CMS level to estimate
more accurately HIV/AIDS commodities requirements and promote the rational use of ART drugs.
MSH/SPS will work closely with the DELIVER Project and the MoH (the new HIV/AIDS M and E unit) to
ensure a seamless complementarity of assistance and training between the two projects. This activity
focuses on pharmaceutical management and rational drug use while the JSI - Deliver project focus is on
logistics and information systems.
Activity 1: Review and Dissemination of EDL
MSH/SPS will support the updating and dissemination of the Malawi Essential Drugs List (MEDL) and
Malawi Standard Treatment Guidelines (MSTG) to incorporate the new drugs being used for treatment of
HIV/AIDS, opportunistic infections, and in PMTCT. This will be a wraparound initiative with the Presidential
Malaria Initiative (PMI), as the review and dissemination will include the new Malaria drugs (i.e. ACT) into
the MEDL and MSTG. The EP funds for this activity will be used to support 3 review workshops of the
National Drug Committee, and dissemination of guidelines through training of 1325 health workers on the
proper use of the guidelines.
Activity 2: Incorporate HIV Pharmaceuticals into Pharmaceutical Training Curricula
This activity will support the incorporation of a management for HIV/AIDS medicines module in the pre-
service pharmaceutical training curriculum for all health workers. The revised curricula will address issues of
pharmaceutical management of HIV/AIDS medicines. These would include prevention of adverse drug
reactions, the promotion of drug safety including rational use, preventing medication errors, and minimizing
factors that contribute to therapeutic ineffectiveness. Examples include non adherence, poor quality drugs,
drug interactions, and microbial resistance. These topics will be covered during pre-service training not only
of health workers directly involved in ART, but other health staff working in primary health care settings. The
activity will initially target the Malawi College of Health Sciences and CHAM (private sector hospitals)
Activity 3: Pharmaceutical Management of ART Drugs
With EP funding, MSH will build capacity of health workers in the pharmaceutical management of ART
commodities to improve management of ART drugs and supplies and the quality of care provided at facility
level. Building capacity of health workers involved in managing ART at facility level as well as Central
Medical Stores in pharmaceutical management of HIV drugs will involve training through a Monitoring,
Training, and Planning (MTP) approach. The training will be given to 340 health workers (at least two from
each ART site) from public sector as well as the private sector through the Malawi Business Coalition for
HIV/AIDS and will focus on adherence monitoring, rational use, recognizing suspected adverse drug
interactions and how to report them, and drug interactions. In facilities where both ART services and malaria
Activity Narrative: treatment are provided, deliberate effort will be made to link the pharmaceutical management of ART and
Activity 4: Strengthening ART Pharmaceutical Care Management Procedures at the Facilities that Provide
ART services Including Central Medical Stores.
The activity will primarily involve:
(i) Introduction of SOPs for ART management in both public and private sector (e.g. CHAM Hospitals).
These SOPs will ensure standardized drug management procedures in all facilities that are providing ART
and will focus on stock management, dispensing, medication counseling, ADR reporting, medication errors,
and side effects management.
(ii) Introduction of the ART dispensing tool in the district hospitals to promote good medicines and patient
management as well as dispensing leading to improved care and treatment of HIV/AIDS patients. The
manual management of data on patient profiles and treatment regimens is a challenge as the number of
patients enrolled in the ARV program progressively increases. There are currently 100,000 patients enrolled
in the program. The ART dispensing tool will be used in conjunction with existing software in the district
hospitals. Additional funding will be needed/leveraged to procure hardware to support those district
hospitals that will need new hardware.
(iii) Coordinate with Deliver/USAID and national stakeholders for policy decisions leading to the
development of an ART inventory management system at CMS to track ART consumption at facility level,
identification, and installation of inventory management software for CMS that can accommodate the ART
management information system.
New/Continuing Activity: Continuing Activity
Continuing Activity: 18515
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
18515 18515.08 U.S. Agency for Management 7872 7872.08 MSH - SPS $500,000
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