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
This is a continuing activity under COP08.
SCMS Mozambique staff will collaborate with programs that use HIV tests, CMAM, CHAI, and any other
sources of financing and procurement of rapid HIV tests for the MOH by providing technical assistance in
the monitoring and management of the incoming HIV test kit pipeline and their distribution in country.
SCMS will facilitate annual HIV test forecasts and quarterly updates to the national supply plan of HIV tests,
enabling timely identification and response to any inbound supply constraints that may arise. SCMS will
assist CMAM and the Laboratory Section of MOH to facilitate the communication of Rapid HIV test kit
availability among MOH Program Managers that depend on Rapid HIV Test Kits and PEPFAR.
SCMS will procure $550,000 in HIV test kits, approximately 80% of national needs for rapid HIV tests
required to support PMTCT and Blood Safety goals of the MOH.
Technical assistance will be provided to the MOH in monitoring and supervision of the Redesigned Logistics
System for Rapid Tests (August, 2007). SCMS will collaborate with the MOH and PEPFAR partners to
integrate Lab Logistics training modules into the Pre-Service Training Curriculum.
The FY2007 narrative below has not been updated.
This activity is related to activities CT 9156, HTXD 9117, HLAB 9254, and HBHC 9136.
The Supply Chain Management System (SCMS) project will support MOH to strengthen its logistics
management of the medicines and consumable supplies necessary for a range of HIV/AIDS prevention,
care, and treatment services such as antiretroviral (ARVs) medicines for treatment and PMTCT, HIV test
kits, laboratory reagents and consumables, medicines for the treatment of opportunistic infections, items for
home-based care kits, etc. All of the activities are related to increasing the ability of MOH staff at all levels to
collect and use information for decision-making and will contribute directly to improving the availability of
drugs and related medical supplies.
SCMS will assist the CMAM (the MOH Central Medical Stores), in collaboration with other MOH
departments, programs and sectors, such as DAM (the MOH Department that supervises hospitals), and
Laboratory section and to strengthen the capacity of the appropriate MOH staff in the following areas:
ARV - for treatment and MTCT - Quantification and Procurement: SCMS will assist CMAM in forecasting
ARV needs through at least one complete forecast annually and quarterly updates and train CMAM Staff in
Quantimed (quantifying ARV needs) and PipeLine (scheduling procurement shipments to maintain
appropriate inventory levels) software; analyze the basic processes in each software package to theoretical
concepts and practical processes that can be integrated into the existing systems currently used at CMAM.
Procurement: CMAM would like to move to more flexible contracting mechanisms in its own procurement.
SCMS will provide short-term technical assistance to CMAM to develop its capacity in procurement.
Importation: Because SCMS will procure and transport ARVs for use in Mozambique, it will need to provide
CMAM/Medimoc with all of the necessary documentation for importation of the commodities. SCMS will
prepare a process map of the importation process to become fully aware of the applicable Mozambican
regulations and requirements affecting drug importation, in order to be able to provide a high level of
customer service to MISAU, evidenced by shipments of PEPFAR funded ARVs arriving on time.
Distribution and Storage: Given the increasing volume and value of ARVs and other drugs procured by
MISAU and to be donated under PEPFAR, SCMS will work with CMAM to improve the quality and security
of storage facilities at central, provincial, and district warehouses, as well as at individual ART sites which
are expected to expand from approximately 45 (end April 2006) to nearly 105 sites by the end of 2006.
ARV SOP Development: CMAM currently calculates the number of ARV drugs to be received by each ART
site (a ‘push' system). However, as the number of sites increases, CMAM staff will be increasingly
challenged to keep up with this level of centralized calculation. SCMS can support CMAM´s need to design
a decentralized ("pull") ARV logistics system that is flexible and responsive to support scale up efforts, and
to institutionalize the system through creation of tools and training for staff at all levels of the supply chain.
Logistics Information System Implementation: SIGM is an information management tool which will greatly
increase the quality of management data available to CMAM and provinces in managing MOH´s integrated
logistics system for all medicines, including ARVs. The SIGM software has been developed with previous
USAID funding through release 2, and has been implemented at the Central level sites of CMAM and
Medimoc Headquarters, and the three Central Warehouses. During COP07, SCMS will assist CMAM in
implementing the SIGM at 10 provincial warehouses, 3 central hospitals and 3 general hospitals, fund a
service-level agreement (SLA) including help desk support, develop release 3 of the SIGM software and
Support CMAM´s ability to use information produced by SIGM for monitoring, management and evaluation.
To support the collection of ARV data through the SIGM, SCMS will develop an additional module of the
SIGM specifically for the unique needs for ARV data.
Supply of Nevirapine (NVP) for single dose prophylaxis to antenatal care (ANC) services were most PMTCT
services have been provided so far, has been supported by MOH CMAM for some sites, by NGOs involved
in PMTCT service provision at other sites. With the introduction of AZT and the development of a
prophylactic drug protocol that includes more than one drug, only those ANC or PMTCT services located in
physical proximity to Day Hospitals were able to introduce this new prophylactic regimen. In FY07, the MOH
PMTCT program and PMTCT partners intend to more rapidly expand the provision of NVP-AZT dual
prophylaxis to a larger number of PMTCT service sites, not all of them co-located with treatment sites, as
there are currently more antenatal care sites providing PMTCT services than treatment sites.
In addition, protocols for prophylaxis and treatment for pregnant women continue to undergo frequent
changes and are generally moving towards more complex protocols with a use of combinations of drugs,
the Mozambique program following and carefully analyzing revised WHO recommendations each time,
which pose a challenge to the MOH PMTCT program and CMAM staff in terms of the need for re-
adjustments. SCMS will provide technical assistance to the MOH in this process
This is a continuing activity under COP08 with the following updates.
SCMS Mozambique staff will work with the MOH programs, CMAM, and PEPFAR partners to identify
priority OI and STI drugs for which there is a need and a political commitment to achieve a "full supply". For
this list of priority drugs, SCMS will provide the MOH and PEPFAR partners with technical assistance in
preparing an annual forecast of need, conducting a central and provincial stock status assessment,
developing a national supply plan, integrating all sources of financing, and identifying any gaps in financing
that prevent the drug from being managed as a "full supply" commodity. As these priority drugs are
managed through the Via Classica system, SCMS will continue to provide technical assistance to CMAM
and Provinces in the strengthening of that system. The supply plan will be monitored and updated on six-
month intervals. SCMS will help CMAM to facilitate the communication of information on availability of
these priorities OI and STI drugs between the Central and Provincial levels of the MOH, relevant MOH
programs, and PEPFAR. SCMS will procure priority OI and STI drugs in the supply plan valued at $2
million.
availability among MOH Program managers that depend on Rapid HIV Test Kits and PEPFAR. SCMS will
procure $300 million in HIV test kits, approximately 80 % of national needs for rapid HIV tests required to
care program goals of the MOH (CT, CD and YAFS).
Additional Funds to SCMS will be used supplement activities planned in FY07 to strengthen the CMAM
(Central medical stores) system for procurement and distribution of OI medicines to health facilities in the
country. PLus-up funds in particular will allow SCMS to assist CMAM to quantify for a selected group of OI
drugs taking into consideration the increase in service capacity of the national health system, given the
massive rollout of training in the OI STGs within training institutions and in-service training to health system
staff
This activity is related to activities HVCT 9156, HTXD 9117, HLAB 9254 and MTCT9142.
More than 120 commodities are required to provide prevention, care and treatment to people living with
HIV. SCMS will assist CMAM (the MOH Central Medical Stores) and other PEPFAR implementing partners
to support improved logistics for a number of commodities such as drugs for opportunistic infections,
palliative care kits, TB drugs, therapeutic supplements, and any other drug or medical supply related to the
care and treatment of people living with HIV.
SCMS will conduct a needs assessments to define specific commodities to be the focus of system
improvement activities; develop action plans to improve the logistics management of specific commodities;
assist CMAM in preparing annual forecasts for specific items, as identified; regularly monitor the stock
levels of specific items in the supply chain, as identified and conduct formal or on-the-job training in logistics
management of specific commodities as defined in the action plan.
SCMS will build CMAM and relevant program staff capacity to better quantify needs of specific products,
improve ability to resolve distribution problems, and take actions in time to prevent logistic bottlenecks.
Some patients do not have a sustained response to antiretroviral agents for multiple reasons, including poor
adherence, drug toxicities, drug interactions, or initial acquisition of a drug-resistant strain of HIV-1 and,
therefore, the lack of OI Drugs in treatment facilities will continue to cause substantial morbidity and
mortality in patients with HIV-1 infection.
Information collected in two of the three uniformed services treatment facilities (Military & Police) show that
around 70% of their HIV patients present some kind of opportunistic infection. This information makes us
believe that the situation will most certainly be the same in the military treatment facility recently opened in
Nampula. We can estimate that the 3 facilities will be providing care to around 5,500 people registered as
seropositive. Some of them will need both ARV and OI drugs.
Prophylaxis against specific OIs continues to provide survival benefits even among persons who are
receiving ARV drugs. Preventing and treating opportunistic infections not only helps HIV-positive people to
live longer, healthier lives, but can also help prevent TB and other transmissible opportunistic infections
from spreading to others.
Despite the fact that most of the OIs can be prevented or treated, DOD knows that most Mozambican
military and police seropositive patients are not receiving proper care for OIs due to unavailability of drugs.
Therefore, the proposed funds will be used to cover part of the needs for OI drugs expecting that the needs
will be completed with drugs received through MOH channels of distribution.
Activity Narrative: This is a continuing activity under COP08 with the following updates.
August 08 Reprogramming: Funding reprogrammed per OGAC guidance and COP technical reviews.
Reprogramming August08: Funding increase $500,000.
ARV needs for Mozambique was quantified for calendar year 2007, 2008, and 2009. Future consumption is
based on a scaling-up model that for 2007 assumes that 99,550 total patients will be treated with ARVs by
the end of calendar year, 132,000 patients by the end of 2008 and 165,000 patients by the end of 2009,
based on targets set in the National Strategic Plan (PEN). PEFAR funding will be used to purchase FDA
approved ARVs. MOH and UNITAID/CHAI funding will be used to purchase ARVs that are non necessarily
FDA-approved (but WHO pre-qualified). Due to ARV combination therapies, some patients will receive a
mix of FDA and non-FDA approved drugs. This mix does not allow patient targets to be differentiated
according to funding source.
SCMS Mozambique staff will collaborate with CMAM, CHAI, and any other sources of financing and
procurement of ARVs to the Mozambique TARV program by providing technical assistance in the
monitoring and management of the incoming ARV pipeline and distribution of ARVs in country. SCMS will
facilitate quarterly updates to the national forecast and supply plan, enabling timely identification and
response to any inbound supply constraints that may arise. SCMS will help CMAM to facilitate the
communication of ARV commodity availability between the MOH and PEPFAR.
SCMS will procure $ 13.6 million in ARVS in support of the ART program in Mozambique. This represents
approximately 50% of all ARVs for the national ART program, of which 10% are children.
Previous COPs have funded the redesign of the ARV logistics system and analysis for the development of
the ARV module for the SIGM. With COP 08 technical assistance funds, SCMS will conduct follow up site
visits to sites using the redesigned LMIS forms, and support the development and implementation of the
ARV module within each province and decentralize the logistics data reporting and data entry through the
use of ICT.
COP 08 funding will support the development of future releases of the SIGM software, capacity building of
CMAM staff in codification, monitoring and troubleshooting of the SIGM, as well as support and
maintenance agreements for the database, application and user support.
SCMS will continue to roll out the integrated logistics management information system to 10 new sites at
provincial warehouses and central hospitals. PEPFAR funding will support the upgrading of IT
infrastructure at sites (hardware, network, internet connectivity), classroom, on-job-training, implementation
and post implementation support needed to bring 10 new sites onto the SIGM system for managing
medicines warehouses and distribution between the Central and Provincial levels.
ARV logistics: SCMS will assist the CMAM (the MOH Central Medical Stores), in collaboration with other
MOH departments, programs and sectors, such as DAM (the MOH Department that supervises hospitals),
and Laboratory section and to strengthen the capacity of the appropriate MOH staff in the following areas:
ARV Quantification and Procurement: SCMS will assist CMAM in forecasting ARV needs through at least
one complete forecast annually and quarterly updates and train CMAM Staff in Quantimed (quantifying ARV
needs) and PipeLine (scheduling procurement shipments to maintain appropriate inventory levels) software;
analyze the basic processes in each software package to theoretical concepts and practical processes that
can be integrated into the existing systems currently used at CMAM.
service-level agreement including help desk support, develop release 3 of the SIGM software and Support
Activity Narrative: CMAM´s ability to use information produced by SIGM for monitoring, management and evaluation. To
support the collection of ARV data through the SIGM, SCMS will develop an additional module of the SIGM
specifically for the unique needs for ARV data.
Provincial Logistics Advisors (PLA) to support the Provincial Health Directorates (DPS) of Sofala and
Zambézia : The PLAs will build provincial level capacity for use of the SIGM, institutionalize updated SOPs
for management of ARVs, implementation of new SOPs for Lab reagents and consumable supplies,
troubleshoot logistics problems related to drugs for opportunistic infections and manage the implementation
of $100,000 in funds earmarked for improving storage conditions and security in warehouses and medicine
storerooms in each of these two provinces.
Sustainability: SCMS will assist MAM and the Laboratory Sector to develop improved logistics processes,
procedures and tools and build the capacity of their staff to use these, with the goal of improving the
capability and performance of the existing MISAU supply chains that deliver the approximately 120
medicines, laboratory reagents, and other consumable supplies. The activities to be implemented by SCMS
are all in support of the 2007 MOH Annual Operational Plans being prepared by CMAM and the Laboratory
Sector.
Capacity Building : The most critical resource in the supply chain (after the valuable supplies!) is the people
that make the system work. The CMAM staff transition plan has placed a large number of new technical
staff in all departments of the organization who are at the beginning of their careers. The logistics functions
of the supply chain are relatively new to them. Proposed work plan activities will provide opportunities for
structured on-the-job training, formal training courses, and mentoring by experts in logistics management of
HIV/ÃIDS commodities for MISAU staff at all levels of the supply chain, as appropriate.
ARV Procurement: Through SCMS the USG will procure anti-retroviral drugs in support of MOH's treatment
program for AIDS for 2007 and subsequent years. ARV needs for Mozambique were quantified for
calendar year 2006, 2007, and 2008 using a combination of the Quantimed and Pipeline software
packages. Quantimed, developed by the Rational Pharmaceutical Management Plus Project of MSH,
quantifies overall drug needs. Inputs to Quantimed are available through the ARV database established by
CMAM which include the drugs, regimens, and percentages of patients on each regimen. Future
consumption assumes that 55,000 total patients (including 5,000 children<14) will be treated with ARVs by
the end of 2006, 96,000 (including 9,642 children<14) patients in 2007 and 132,000 (including 13,228
children<14) patients in 2008, based on targets set in the National Strategic Plan (PEN).
Pipeline Software, developed by the Deliver Project of JSI, Inc., takes the data from Quantimed and the
known stock currently on hand and all known shipments already expected and suggests additional new
shipments to ensure that the ARV supply chain is appropriately stocked. Inputs to Pipeline are available
through data from Medimoc and from CMAM. Future shipments are based on keeping about 4 months of
supply in the entire system at any one time.
The Supply Chain Management System (SCMS) project supports MOH to strengthen its logistics
care, and treatment services. All of the activities are related to increasing the ability of MOH staff at all
levels to collect and use information for decision-making and will contribute directly to improving the
availability of drugs and related medical supplies.
SCMS assists the CMAM (the MOH Central Medical Stores), in collaboration with other MOH departments,
programs and sectors, such as DAM (the MOH Department that supervises hospitals), and Laboratory
section and to strengthen the capacity of the appropriate MOH staff in the following areas: ARV, OI and STI
drugs, HIV Rapid Test Kits, Laboratory Reagents, HIV DNA PCR Tests and Clinical Microbiology
equipments and reagents quantification, procurement, importation, distribution and storage.
Forecasting: SCMS Mozambique staff will collaborate with CMAM, CHAI, and any other sources of
financing and procurement of commodities to the Mozambique HIV/AIDS program by providing technical
assistance in the monitoring and management of the incoming pipelines and distribution of commodities in
country. SCMS will facilitate quarterly updates to the national forecast and supply plan, enabling timely
identification and response to any inbound supply constraints that may arise. SCMS will help CMAM to
facilitate the communication of commodity availability between the MOH and PEPFAR.
Importation: Because SCMS will procure and transport commodities for use in Mozambique, it will need to
provide CMAM/Medimoc with all of the necessary documentation for importation of the commodities.
SCMS will prepare a process map of the importation process to become fully aware of the applicable
Mozambican regulations and requirements affecting drug importation, in order to be able to provide a high
level of customer service to MISAU, evidenced by shipments of PEPFAR funded commodities arriving on
time.
Distribution and Storage: Given the increasing volume and value of ARVs and other commodities procured
by MISAU and to be donated under PEPFAR, SCMS will work with CMAM to improve the quality and
security of storage facilities at central, provincial, and district warehouses, as well as at individual sites.
Logistics Information System Implementation: SIGM is an information management tool which greatly
increases the quality of management data available to CMAM and provinces in managing MOH´s integrated
logistics system for all commodities, including ARVs. The SIGM software has been developed with
previous USAID funding, and has been implemented at the Central level sites of CMAM and Medimoc
Headquarters the three Central Warehouses and Provincial Warehouses. During COP08, SCMS will assist
CMAM in implementing the SIGM at 3 central hospitals and 3 general hospitals, fund a service-level
agreement (SLA) including help desk support and Support CMAM´s ability to use information produced by
SIGM for monitoring, management and evaluation.
SCMS will procure laboratory equipment, reagents, and consumable supplies ($2,000,000) in support of
existing APHL supported sites and in support of the laboratory capacity scale up plan. SCMS will provide
Technical Assistance ($200,000) to support the systems strengthening goals set out in the national
laboratory strategic plan.
SCMS will procure purchase specimen collection kits and commodities for HIV DNA PCR for infant
diagnosis of HIV ($80,000).
SCMS will purchase equipment and reagents to support the implementation of automated blood culture in 3
central hospital labs, by the American Society for Microbiology (ASM), to improve pathogen isolation in the
diagnosis of OI's. This activity will also include the purchase of other materials required to strengthen OI
diagnosis at central level. ($250,000)
This activity is related to activities HVCT 9156, HTXD 9117,HBHC 9136, and MTCT 9142.
DAM (the MOH Department that supervises hospitals). National Institute of Health Lab, the Lab Section and
CMAM (MOH Central Medical Stores) have repeatedly stated the need for assistance in resolving various
logistics challenges they face with regard to the logistics management of rapid HIV test kits as well as other
laboratory reagents and consumables needed for managing patients on ART. The Lab Section at DAM is in
the process of drafting a new Laboratories Strategic Plan for 2007-2011. The technical assistance activities
proposed will support the systems strengthening goals set out in the strategic plan. The SCMS activities
will focus on the national laboratory system which will complement the activities being planned by DAM and
American Public Health Labs (APHL), which is receiving funding from CDC to specifically support the
HIV/AIDS rental equipment supply system in place at 10 sites.
SCMS will facilitate a participatory process to support MOH in developing Standard Operating Procedures
for the inventory control, information system, and storage procedures necessary for improved logistics
management of laboratory reagents and supplies. SCMS will define the scope for capacity building
activities by developing a list of essential equipment, reagents, and consumables needed for a list of key
tests. While tests required for HIV/AIDS prevention, care and treatment services such as PMTCT and to
enroll and manage patients on ART will be a priority, the scope may be comprehensive given the integrated
Activity Narrative: nature of laboratory services in Mozambique. SCMS will conduct a laboratory logistics system assessment
that focuses on the items on the list defined above. SCMS will facilitate a design workshop for staff from
CMAM, the Laboratory Sector, Provinces, GATV (VCT) sites and Day Hospitals, to decide on the operating
parameters for a decentralized logistics management system for labs, outline the logistics procedures,
design a logistics reporting and ordering form. A steering committee will be established with broad
representation of all levels of the Laboratory supply chain for the approval of all new SOPs and reporting
forms resulting from the design workshop. SCMS will create SOP Manual for management of Laboratory
logistics, with a review by the steering committee, create training curriculum and produce materials
including printing of training manuals, SOPs, and logistics reporting and ordering forms. SCMS will facilitate
a training of trainers workshop for training in the use of SOPs and the logistics reporting and ordering form
and in logistics management of Laboratory supplies in general. SCMS will organize training of staff from
laboratories, including refresher training as needed to assure compliance with standard operating
procedures and to ensure that all new staff is trained and train provincial-level supervisors.
A designated staff from the Lab Section to be seconded to CMAM will be the primary counterpart for
leadership and implementation of the various activities as well as coordinating the nominations of
candidates to be trained as trainers and person to be trained. Design and approval activities will have
broad representation in support of decentralized decision making. At the end of the activities described
above, all staff involved in logistics management of rapid HIV Test Kits and other laboratory reagents and
consumables throughout the MISAU supply chain will have the tools, knowledge and skills required to make
informed logistics management decisions.
Given the nature of laboratory reagents-short shelf--lives, heavy and bulky packaging, complicated
definition of units--MISAU faces repeated challenges in creating accurate forecasts and in developing
procurement plans that take into account the special nature of these items. SCMS proposes to assist
MISAU in improving the Forecasting and Procurement Planning of HIV/Test Kits and other laboratory
reagents and consumables required for supporting HIV/AIDS services by providing training in the use of
ProQ (software package designed specifically for forecasting HIV tests for VCT, PMTCT, sentinel
surveillance, and clinical diagnosis purposes) and in PipeLine software (scheduling procurement shipments
to maintain appropriate inventory levels) and by facilitating annual HIV tests forecast and procurement
planning process and at least one 6-month update
SCMS will Support the integration of management of laboratory reagents and consumable supplies into the
SIGM system and will train the Staff from Laboratory Sector, CMAM, Provincial Warehouses and Hospitals
to manage laboratory reagents and consumable supplies using the SIGM system.
