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.
This activity links directly to the support provided by CDC (# 7974), ITECH (# 7353), Potentia (#7342), and NIP (# 7971) to improve TB/HIV implementation. This activity leverages $1.5 Million in USAID TB Resources to strengthen implementation of community based DOTS, MDR-TB mgmt, infection control, and also mobilizes $19.3 Million in resources from the GFATM (R2 and R5) to support overall implementation of the objectives outlined in the MTP-1 for TB.
Despite resources in basic TB control and prevention (and HIV control), the burden of TB and TB/HIV co-infection remains one of the highest in the world in Namibia. WHO estimates that 61% of all TB cases are HIV+. Greater efforts are needed to improve coordination and implementation of TB and TB/HIV collaborative programs at the national, regional, and district levels. HIV testing and counseling of TB patients is reported in 2005 (NTCP) at only 16% of registered patients, with a range of 0%-80% in districts - still falling short of the 90% target. The NTCP aims to offer CT to all TB patients (and test 90% of them) and provide access to CPT and ART for all eligible patients. The main problem has been lack of counselors in the TB clinics and wards, and the failure of health workers to offer HIV testing to TB patients under their care, or ask them about their HIV status. To date, there has been no established forum to discuss TB/HIV collaborative activities within the Directorate of Special Programs and other partners (in public and private sector) As a result implementation of activities is uncoordinated, fragmented and M&E systems are operating in isolation.
TBCAP activities will intensify TB/HIV collaboration at all levels, securing critical planning, coordination, and technical assistance through MSH and KNCV, two of the partners in the TB CAP coalition. This activity will create effective management and coordination between HIV/AIDS and TB Control, through implementation of district level TB/HIV coordination meetings across the country. These routine meetings will provide a platform for in-service training on the newly revised NTCP guidelines focusing on TB/HIV activities needing to be implemented. NTCP national officers will assess TB/HIV needs in 34 districts across the country, and sensitize and train health care personnel in districts to organize and implement TB/HIV services. These services will include improving the coverage of CT and HIV tests for TB patients or suspects, screening PLWHA for TB, improving coverage and follow-up of IPT and CPT for HIV patients, and increasing quality of care for TB/HIV patients (through early detection, diagnosis, and treatment, and stronger coordination between facility and community home based care partners). Three regions (Kavango, Khomas, and Karas) with high TB CNR and HIV prevalence will be the focus of intensified TB CAP TBHIV support in this first year.
These regions will improve community and facility level care for TB/HIV patients through stronger bi-directional referrals and linkages between facility-based health care providers, community based health care promoters, and palliative/home-based care volunteers in Kavango, Lüderitz, and Windhoek. TB/HIV resources will be used to train existing community care partners, ensure clinical supervision and support to 1400 volunteers, and alleviate critical human resource constraints at the national and district level by filling 2 key TB/HIV nursing positions in the TBHIV referral hospital, Katutura, and hiring 3 TB/HIV sr health program administrators in Karas, Omaheke and Kavango regions. These regional posts are part of the Ministry approved staffing structure, will be supported under the Emergency Plan at Ministry approved salary levels, and will be transitioned to the Ministry for future absorption.
TBCAP will also support application of a Management and Organizational Sustainability Tool for TB/HIV Collaboration (MOST TB/HIV) for 30 TB-HIV health workers to support comprehensive TB/HIV care for the dually infected patient. The MOST TB/HIV tool is a participatory process that will involve 30 senior TB/HIV program mgrs in assessment, action planning and follow-up to improve collaboration between TB and HIV/AIDS programs, which have to date not been well coordinated. The process focuses on strengthening management systems to support the mechanisms for collaboration, and interventions needed at different levels of the health system to support the diagnosis, care and treatment of dually infected individuals. The action plan will minimize the burden on patients faced in accessing free services through better coordination, planning, implementation, and M&E at different levels of the system.
TBCAP will work in collaboration with CDC to improve recording and reporting systems for
TB/HIV, through basic training of nurses in computer applications that will reinforce their ability to use the ETR NET. TB/CAP resources will also support printing of TB/HIV forms and registers for nationwide use. Simple infection control measures will be reinforced through districts, and further IPT will be scaled-up to PLWHA and eligible patients in CDCs and contacts of infectious TB patients -- especially children under 5 years and HIV+ adults.
Since 2002, The Royal Netherlands Tuberculosis Foundation (KNCV) has supported the National TB Control Program (NTCP) in the Ministry of Health and Social Services. External and resident technical KNCV assistance to NTCP has led to: a) Successful Global Fund proposals (2nd & 5th Rounds), b) Formulation of the 5 year National TB Strategy (TB-MTP I) with TB/HIV as one of the Strategic Outcomes, c) Formulation of the HIV/AIDS strategic plan mainstreaming TB (HIV/AIDS-MTP III); d) Publication of the revised TB Guidelines (2nd ed), emphasizing TB/HIV implementation & MDR-TB management, and nosocomial infection prevention. e) Adaptation of the TB reporting system to include information on TB/HIV (counseling and testing, CPT and ART); and e) Successful leveraging of USAID DA funds for strengthening community based DOTS expansion and overall NTCP management and coordination capacity.
In FY07, USG resources will continue to support long-term TA through a physician with TB/HIV expertise from within the Africa region in TB/HIV and NTCP planning and management issues at the national level, as well as provide full-time support for TB-HIV integration activities. Through this TA support will be given to training of approximately 120 health care providers throughout the country (doctors and nurses) on TB/HIV co-management (clinical prophylaxis and treatment for TB to HIV infected individuals, in collaboration with I-TECH with funding from another COP grant. Health care providers will be supervised to provide care and treatment in a non-discriminatory and patient supporting environment (See I-TECH activity #7353).
An additional $948,000 will be leveraged from USAID Development Assistance (DA) funds to support expansion of community based DOTS (Directly Observed Treatment Short-Course) in Erongo region, the region with the highest burden of multi-drug resistant (MDR)-TB in Namibia.
In addition support will be given USG resources will continue to strengthen Katutura Hospital as the national TB referral unit, particularly regarding the management of patients with complications of TB/HIV and will develop orientation programs for new staff involved in TB/HIV.
In addition, part-time external TA will provide technical support, as required - for hands on policy implementation, supervision and M&E, planning and budgeting, and capacity building for integrated HIV/TB activities.
COP 07 plus up funds will build capacity to implement, sustain, and monitor effective TB infection control practices.
