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
April09 Reprogramming Change: Increased $150,000.
April08 Reprogramming Change: Reduced $100,000.
This is a new activity under COP08 in this program area although WFP has received PEPFAR funding for
palliative care, OVC and treatment in FY2006 and FY2007.
WFP will provide support to pregnant and lactating women on an as needed basis. Two provinces will be
covered by the PL 480/Title II program, namely Zambezia and Nampula. Food assistance will be channeled
and coordinated with PMTCT and treatment partners to ensure a focused intervention (as opposed to HBC
distribution points). WFP assistance is a valuable contribution while the USG in Mozambique can ensure
that longer term solutions are available, viable, and possible according to OGAC guidance.
It is anticipated that over 6,000 will be reached with emergency individual food rations with COP08 funding.
New/Continuing Activity: Continuing Activity
Continuing Activity: 16305
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
16305 16305.08 U.S. Agency for World Food 6858 3628.08 USAID-World $400,000
International Program Food Program-
Development GHAI-Local
Table 3.3.01:
In keeping with current guidance from (OGAC) Emergency Plan funds for this activity will target food
support to the following priority groups: Orphans and vulnerable children born to an HIV infected parent
(regardless of the child's HIV and nutritional status); HIV-positive pregnant and lactating women in
programs to prevent the transmission of HIV to their children (PMTCT); and Adult patients in anti-retroviral
therapy (ART) and care programs who have evidence of severe malnutrition, as defined by The World
Health Organization (BMI less than 16).
The activity will support a Request for Proposals to procure commodities and provide logistics support
required to implement a nutrition/HIV program modeled after Kenya's Food by Prescription program. It is
important to note that USG does not yet have full buy-in of the Ministry of Health for a food by prescription
program model. PEPFAR/Mozambique will sponsor a study tour to Kenya in early 2009 (led by FANTA) for
Ministry of Health, National AIDS Council, and the Social Welfare Ministry to observe and understand
implementation of the AMPATH and FBP programs.
This activity will involve (1) competitive procurement of one or more fortified, blended flour products for
clinically malnourished PLWHA, PMTCT women during pregnancy and lactation, and early weaned infants
born to HIV-positive women (specifications based on foods presently used in the Mozambique (2) regular
delivery of the product(s) implementation sites (supported by PEFFAR partners); and (3) support to the
clinic sites on inventory control, storage, and record keeping (working with FANTA and the hospital and
health center clinical care partners).
A 30-day supply of food will be provided to patients who have undergone clinical nutrition assessment and
counseling, and who meet specific entry criteria, specifically: clinically malnourished patients with body
mass index (BMI) or mid-upper arm circumference (MUAC) defined by Ministry of Health. Patients will
return on a monthly basis for reassessment and an additional month's food supply until their weight
stabilizes above an established exit cutoff (to be defined with MOH). Typically, patients are provided with 3-
6 months of supplementary food before exceeding the BMI/MUAC exit cutoff. In addition, supplementary
food will be provided on a monthly basis for women in select PMTCT programs during pregnancy and until
the infant is weaned (~4-6 mo of age), at which time food will continue to be provided on a monthly basis for
the infant until 2 years of age. FANTA will assist in establishing the product specifications and production
standards (e.g. GMP and safety) for the low-cost, nutrient-dense supplementary food(s) to be procured
under this activity.
In a later phase, contractor will supply food baskets in line with MOH food and nutrition guidelines and the
food by prescription program for all USG-supported clinical sites not within WFPs geographic focus areas.
The contractor will develop a food distribution strategy that ensures that all beneficiary sites receive the
recommended food commodities. The contractor will support the following activities: 1) Forecasting of food
commodities in close collaboration with AED/FANTA project, MOH, UNICEF, World Food Programme
(WFP), and Clinton Foundation/CHAI. 2) Development of a distribution strategy based on different
scenarios, including distribution within existing distribution system as well as outsourcing distribution of food
commodities to point of service, in cases where the existing system is not functioning. 3) Develop SOPs
and tools for USG clinical partner-supported sites, districts, and provinces to adequately manage food
commodities, including LMIS tools for reporting on food consumption, FIFO, storage at sites, and
distribution 4) Conduct assessments of provincial warehouses and district warehouses in collaboration with
the DPS/DDS and USG clinical partners supporting the provinces and districts to identify needs for
adequate storage and distribution of food stuffs 5) Provide assessment tools and SOPs to DDS/DPS and
USG partners for assessing storage space and conditions
New/Continuing Activity: New Activity
Continuing Activity:
Table 3.3.08:
April09 Reprogramming Change: Increased $375,000.
Reprogramming August08: Funding decrease $153,000. Funds were originally allocated to SCMS to cover
pediatric formulations in COP 08 charged under the OVC. Further guidance from OGAC has indicated that
drug commodities can't use this budget code. As pediatric treatment is a priority activity and given a recent
no-cost extension to WFP, it was decided that the funds allocated to WFP would be better utilized to cover
expenses related to pediatric treatment.
April08 Reporgramming Change: Reduced $140,000.
This is a continuing activity under COP08.
WFP will continue to provide support to people living with HIV/AIDS who are currently on ART and meet
PEPFAR criteria. Nutritional supplementation is critical as it is number one complaint amongst those on
ART who have either defaulted or are experiencing reprecussions from sub-optimal nutrition while on ART.
Two provinces will be covered by the PL 480/Title II program, namely Zambezia and Nampula. Food
assistance will be channeled and coordinated with treatment partners to ensure a focused intervention (as
opposed to HBC distribution points). WFP assistance is a valuable contribution while the USG in
Mozambique can ensure that longer term solutions are available, viable, and possible according to OGAC
guidance.
It is anticipated that over 20,000 ART clients will be reached with emergency individual food rations witih
COP08 funding.
The FY2007 narrative below has not been updated.
This is a follow-on to the FY06 activity and is related to HKID 9124 and HBHC 9138. This activity duplicates
other activities because food subsities will be provided to currents clients of OVC and ART services.
Therefore, no separate targets are provided.
With the rapid roll out of ART in the country, the ever increasing number of OVC, and the unreliable food
supply in Mozambique due to droughts and floods, the interest in associated food support is growing. Most
recently this has been given impetus by a request from the Minister of Health for urgent clarity on the design
and implementation approach of appropriate food based interventions in the context of ART both at the
clinical setting and within the household. WFP along with USAID is working closely with colleagues in the
Ministry of Health, Ministry of Women and Social Action and other stakeholders in the development of a
programmatic model for the provision of food in conjunction with clinical and home-based ART services.
The goal of this activity is to improve the health and nutritional status of PLWHA receiving ART at USG-
supported sites in order to improve treatment adherence and reduce any potentially negative effects of the
drugs. WFP will continue to work closely with PEPFAR partners (HAI, Columbia University and EGPAF and
any other new treatment partners) to determine if clients meet WFP guidelines for vulnerability and
nutritional need. Guidelines were set with assistance from WHO, SETSAN*, MOH, and other multi-lateral
organizations and bi-lateral missions. PEPFAR-funded NGO partners will contract with WFP to provide a
specific number of supplemental packages for no longer than 6 months for PLWHA on ART and their
families. Patients will be assessed clinically on a regular basis and taken off the supplemental foods earlier
than 6 months if warranted. WFP will provide a supplementary food ration to PLWHA on ART living in
vulnerable, food-insecure households, distributed through the PEPFAR-supported Day Hospitals where
patients go for initial assessment, CD4 counts and ART follow-up. This activity will provide PLWHA
receiving ART and their families (an average family size of 5) with family food rations consisting of 1200g
cereals, 200g pulses, 100ml Vitamin A-enriched oil, and 600g corn-soya blend per person daily for one
meal per day. PEPFAR partners will ensure that clients on food supplements will have available wrap-
around services including nutrition information (which is part of the curriculum for home-based care
providers) and opportunities to be involved in food sustainability practices (home gardens) or livelihood
activities to provide longer term food security. If studies are published that suggest a different combination
of supplemental foods, any new guidelines will be incorporated into the food rations. Monitoring of clients
that receive food supplements will be carried out by WFP to determine the effectiveness of the supplements
and related assistance on ARV treatment reactions and treatment adherence.
With COP07 funding support it is anticipated that WFP, along with treatment partners in Mozambique, will
assist all PLWHA initiating treatment and deemed to need nutritional support based on clinical criteria with
food and nutritional support. It is estimated that ½ of people starting ART will need food supplements to
ensure proper uptake and adherence.
*SETSAN is Mozambique's Technical Secretariat for Food and Nutrition Security. The multisectoral
Vulnerability Analysis Group (GAV) monitors food security and vulnerability within the country. Indicators
used include: i) availability - agriculture production, livestock, seeds, food aid and rainfall; ii) access -
prices, markets terms of trade, income sources; iii) utilization - nutrition, health, water, sanitation and
consumption; and iv) social protection and survival strategies.
Continuing Activity: 14535
14535 6441.08 U.S. Agency for World Food 6858 3628.08 USAID-World $707,000
9167 6441.07 U.S. Agency for World Food 5052 3628.07 USAID-World $800,000
6441 6441.06 U.S. Agency for World Food 3628 3628.06 $800,000
International Program
Development
Table 3.3.09:
April09 Reprogramming Change: Increased $400,000.
This is a continuing activity under COP09. ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
This is a continuing activity under COP08 with an increase in funding over FY2007 of $200,000. Targets
have also been increased to reach an additional 2,400 OVC, brining the total to approximately 17,400, with
supplemental direct services consisting of short term food supplements.
In an effort to ensure that linkages are strengthened among partners and WFP in FY08, the USG program
will work directly with the FANTA follow-on to provide technical assistance and establish monitoring tools
which can improve provision of food and nutrition as one of the essential OVC services. This effort will be
undertaken in consultation with WFP to ensure that the money awarded to WFP for emergency food relief
for OVC is targeting the neediest with appropriate food supplements and that both WFP and USG can
accurately track those efforts.
This activity is related to HBHC 9138 and HXTS 9167.
The World Food Program has worked closely with WHO efforts to develop approaches, based on the latest
available scientific evidence, to identify the macronutrient and micronutrient needs of HIV-infected peoples,
the specific nutritional needs of children infected and affected by HIV/AIDS and the nutritional needs of HIV-
infected adults and children receiving ART. It is recognized that HIV infected adults and children in general
have greater energy needs, greater presence of micronutrient deficiencies and that growth in children can
be severely impaired if infected with HIV or if they do not have access to a properly balanced diet. To
achieve the full benefits of ARV and proper growth of a vulnerable child, adequate food intake is important
and dietary and nutritional assessments are essential parts of comprehensive care.
The interest in associated food support is growing due to the rapid roll-out of ART in the country, the ever
increasing number of OVC, and the unreliable food supply in Mozambique due to droughts and floods.
Most recently, the Ministry of Health has convened several meetings to gain better clarity on program
designs and implementation approaches for clinics and households for food interventions in the context of
ART. WFP, along with USAID, is working closely with colleagues in the Ministry of Health, Ministry of
Women and Social Action and other stakeholders in the development of a programmatic model for the
provision of food in conjunction with clinical and home-based ART services.
The goal of this activity is to improve the health and nutritional status of the neediest OVC and their
caregivers at USG-supported service sites. WFP will continue to work closely with PEPFAR partners
(World Relief, World Vision, ADPP, FDC, Africare, Save the Children, Project Hope, Care, HACI and any
other new OVC partners) to determine if clients meet WFP guidelines for vulnerability and nutritional need.
Guidelines were set in collaboration with MOH, SETSAN* (Mozambique's Technical Secretariat for Food
and Nutrition Security), WHO, and other multi-lateral organizations.
The USG will fund WFP to provide logistical support to PEPFAR-funded partners to receive a specific
number of supplemental food packages for no longer than 6 months for OVC and their caregivers. The cost
of these food packages have been leveraged by the WFP through private-sector funds. The supplementary
food ration will then be distributed to OVC living in vulnerable, food-insecure households, distributed
through the PEPFAR implementing partners. This activity will provide OVC and caregivers with food rations
equivalent to one meal a day. PEPFAR partners will ensure that OVC and their caregivers on food
supplements will have available wrap-around services including nutrition information and opportunities to be
involved in food sustainability practices (home gardens) or livelihood activities to provide longer term food
security.
It is anticipated that over 15,000 OVC will be reached with emergency individual food rations and 1,000
individuals will be trained for this wrap-around activity with COP07 funding.
*SETSAN is Mozambique's Technical Secretariat for Food and Nutrition Security. The multi-secotor
Vulnerability Analysis Group (GAV) monitors food security and vulnerability with the country. Indicators
used include: i) availability - agriculture production, livestock, seeds, food aid and rainfall; ii) access - prices,
markets terms of trade, income sources; iii) utilization - nutrition, health, water, sanitation and consumption;
and iv) social protection and survival strategies.
Continuing Activity: 14534
14534 5143.08 U.S. Agency for World Food 6858 3628.08 USAID-World $1,200,000
9124 5143.07 U.S. Agency for World Food 5052 3628.07 USAID-World $1,000,000
5143 5143.06 U.S. Agency for World Food 3628 3628.06 $800,000
Table 3.3.13:
