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.
Funds for FY 2010 are proposed to be allocated to a TBD to fund the construction of a new fully integrated National Public Health Reference Laboratory (NPHRL).
In general, the role of a NPHRL is to provide leadership and coordination for public health laboratory and surveillance systems at the national level and to support evidence-based decision and policy making. In Mozambique, this role is severely hampered by the fact that the existing National Reference Laboratories and surveillance units are spread across multiple departments of the MOH), with no common strategy, management and oversight structure. Furthermore, Reference Laboratories, including bacteriology and parasitology, are housed within the MOH administrative building which lacks appropriate biosafety features and barriers to protect laboratorians and non-laboratorians alike. A recent assessment of Mozambique's public health system found that lack of appropriate physical infrastructure was a significant impediment to the countries ability to implement, manage, and maintain essential public health activities in the country.
To address these deficiencies, the MOH invited the International Association of National Public Health Institutes (IANPHI), FIOCRUZ (Brazil's national public health agency), and USG to assist the MOH to develop a National Public Health Strategic Plan which describes the organizational structure and function for the country's NPHRL. In this plan, the #1 priority identified was the construction of a new, fully integrated NPHRL facility.
In previous years, separate infrastructure investments into individual Reference Laboratories (HIV, bacteriology, parasitology) were made as an "emergency fix" so that these Laboratories could remain functional, in even a limited capacity. With FY 2009 Partnership Framework funds and FY 2010 funds the USG proposes to partner with IANPHI, FIOCRUZ, Global Fund, and the architectural firm, Design for Others, to make a consolidated investment in the country's public health infrastructure by supporting the construction of a new, integrated, state of the art NPHRL which will co-locate the country's National Reference Laboratories and serve as the headquarters for public health surveillance and research, laboratory quality assurance, and public health training. In this way, USG investments in HIV-related health systems strengthening will be leveraged with those of other partners as well as across diseases to achieve greater public health system strengthening impact then smaller investments into individual labs or systems.
The process to establish a NPHRL was initiated in 2008 when IANPHI sought the assistance of archtectural firm, Design for Others, and the USG to work with the GOM National Health Institute to develop a laboratory design which meets all of the requirements of a NPHRL as set forth in the Strategic Plan. The Design for Others architectural design work was done pro bono through a public private partnership with IANPHI. The MOH-approved design was then costed by a local architect and results
were used to plan for FY 2009 and FY 2010 funding to support the construction of the new facility. IANPHI will support human resource development, FIOCRUZ and the USG will continue to provide technical assistance in implementation of the Strategic Plan, and Global Fund will buy furniture and equipment.
Through this unique partnership of multiple donors/partners, the proposed USG infrastructure investment will be leveraged to achieve significant impact in creating and strengthening Mozambique's ability to manage the HIV epidemic and provide quality care and treatment services in a sustainable way. This IM is in alignment with the PF Objective to "Improve and expand the public health infrastructure".
Laboratory systems strengthening to improve quality of diagnostic testing and increase collection of surveillance data to guide policy and decision making has been hampered by the lack of a National Public Health Reference Laboratory (NPHRL). A NPHRL serves as the head of the National Laboratory Network and public health surveillance capacities, houses the country's National Reference Laboratories, manages the country's Quality Assurance Programs, and serves as a center of excellence for reference testing and specialized training. Each of these capacities intersects with the USG's programmatic priorities and is critical for Mozambique to prevent new HIV infections and provide quality care and treatment services for those infected and affected by HIV. To achieve this goal, the USG is partnering
with other organizations (IANPHI and FIOCRUZ) to support the construction and operationalization of a NPHRL in Mozambique. PEPFAR's parallel FY 2010 investments in lab strengthening, quality assurance, technical training, field epidemiology and surveillance for diseases of public health importance, will be complimented and maximized by the investment in an integrated NPHRL. Furthermore, consolidated investment into an integrated NPHRL instead of separate investments into existing weak and decentralized reference labs is more cost effective and sustainable over time. FY 2009 funding for the architecture and engineering phase and FY 2010 funding for construction of an integrated NPHRL will address the need to build sustainable lab capacity and develop local expertise to continue strengthening health systems in the country once the USG has phased out its support to build laboratory capacity.
Funding from IANPHI and FIOCRUZ along with technical assistance from the USG will be used to strengthen public health leadership and management, establish systems for surveillance and support human resources to staff the NPHRL, while USG investments will support the construction of the NPHRL itself. This project also supports the Partnership Framework which calls for USG and GOM partnership to strengthen the public health infrastructure and expand laboratory diagnostic testing capacity, including early infant diagnosis.
