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
Approximate CSCS fees are $20,500 which cover support for desk and non-desk positions overseas for
New/Continuing Activity: New Activity
Program Budget Code: 18 - OHSS Health Systems Strengthening
Total Planned Funding for Program Budget Code: $800,000
Total Planned Funding for Program Budget Code: $0
Program Area Narrative:
Program Area: Health Systems Strengthening
Health systems strengthening and policy is a key area of focus for the USG/Russia program, particularly in this phase-down
period as the USG program transitions to a program that emphasizes technical assistance and dissemination of effective
approaches in HIV prevention and care. USG implementing partners will continue to contribute to Russia's implementation of the
United Nations' "Three Ones" principles and to support Russia in reaching its Universal Access targets. Following the conclusion
of Presidential and Parliamentary elections last year, Russia's National Commission on HIV resumed its work in April 2008. In
May 2008, Russia held the second national consultation to assess Russia's progress to date towards reaching 2010 Universal
Access targets. While noting significant progress towards targets set for the prevention of mother-to-child transmission, HIV
testing and counseling, and anti-retroviral treatment, participants from the Government of Russia (GOR) and Russian civil society
recognized the need to boost prevention activities for most at-risk populations, as current programs only reach 24% of injecting
drug users (IDUs), 36% of commercial sex workers (CSWs), and 16% of men having sex with men (MSM). Contributions of civil
society and external partners were central to the completion of Russia's second UNGASS report for 2006/2007. The foundation
for the UNGASS progress report is the national strategic information (SI) system supported in part by USG partners, UNAIDS and
WHO for routine and sentinel surveillance data as well as special studies.
The GOR is demonstrating a growing commitment to address the weaknesses in programming as identified in the UNGASS
report and by stakeholders such as NGOs and external partners (USG, Global Fund (GF) and UN groups). One example is the
doubling of the prevention budget under the National Priority project up to $17 million in 2008. This includes continued support,
albeit limited for federal tenders for prevention programs through the NGO community such as last year's three year, $2M award
made to a local NGO consortium to develop outreach programs. However, this is not enough, given the continued concentration
of the epidemic in Russia among MARPs and in light of the GOR commitment to repaying its HIV grants from the GF in the
cumulative amount of $217M. The continued engagement of external partners such as the USG will help catalyze GOR
resources to better target priority areas in order to contain the epidemic.
Last year, with World Bank, USG and UNAIDS support, the Ministry of Health and Social Development (MOHSD) organized the
review and adoption of 50 new normative guidelines on HIV prevention, treatment and care, an essential step forward to solidify
effective implementation of new policies and programmatic approaches. Although there has been progress in strengthening
HIV/AIDS policy, programming and system development, many challenges remain. The doubling of the GOR prevention budget
represents less than four percent of the total funds allocated for HIV-related programs in Russia. GOR authorities recognize the
existence of gaps in its implementation of the "Three Ones": there is still no official national HIV strategy; although a National
Governmental HIV Commission has been established, it does not have a sufficiently high level of multi-sector representation to
enable interagency coordination within the GOR; coordination with NGOs and international agencies needs to be improved, and
stigma and discrimination towards HIV-positive people continues to be problem in Russia, including among the medical
professions and employers.
With FY 2009 funding, UNAIDS partners will continue their collaboration with the GOR and will develop a plan to assist the
MOHSD and the Federal AIDS Center in dissemination and monitoring of the use of the recently completed and approved
normative guidelines on HIV prevention, treatment and care. Shoring up full implementation of the "Three Ones" will continue to
be a priority area for USG support to UNAIDS in FY09. USG will also continue to support UNAIDS in facilitating the development
of a unified HIV strategy by the GOR. Continued support for the capacity building and involvement of civil society in policy making
forums at national and regional levels will further efforts to both de-stigmatize attitudes towards the most at-risk populations
(MARPs) and to ensure that policy decisions are well-informed and meet the needs of target groups.
In FY 2009, the USG will develop an overall dissemination strategy, based on successes of the past few years of the USG HIV
program. The goal of this effort will be to establish a sustainable approach to dissemination of key practices endorsed by the
USG. These practices and approaches are tools that can help the Russian health care system adapt to meet the needs of the
growing epidemic and number of people living with HIV/AIDS (PLWHA) who will be coming for treatment and care in the next few
years. Each innovative activity will have an appropriate pathway for dissemination at additional regional levels and federal level.
For example, UNAIDS support will include institutionalization of a unified HIV M&E program in collaboration with the Federal AIDS
Service and other government organizations. Together with the Federal Service, USG plans to support UNAIDS for providing
technical advice through the seven Federal Okrugs (districts) to improve their collaboration within the unified system on data
collection, submission, and analysis. At the second consultation on Universal Access, participants recommended the further
institutionalization of the SI framework (see SI section). This will include, importantly, the National AIDS Spending Assessment
and its use not only at the national level but also in the regions. As the methodology for systematic monitoring of HIV/AIDS
financial flows at national and sub-national levels are refined, a training curriculum will be finalized and disseminated. Continued
investment of small amounts of USG funding will help catalyze not just major increases in Russian funding, but ensure that these
resources are targeted in the most effective way.
Another example will be the development of a plan for dissemination of the decentralized approach to HIV health systems as
promoted in St. Petersburg and Togliatti, with 2008 funding (see success story). USG partners will develop a strategic approach
for disseminating this model to other parts of Russia. This may include the creation of a dissemination team to develop the
package of documents, training modules, technical assistance plans, and a strategy for dissemination in coordination with the
GOR. It is envisioned that USG partners will provide targeted technical expertise for training of trainers to supplement the
regional MOH experts or institutes who would lead the process. There may be opportunities to secure regional government
commitment to this effort once the package of services and approaches is prepared and shared with the regions. FY09 funds will
be used to implement the dissemination and transition the model to GOR.
USG implementing partners will capitalize on Russia's commitment to Universal Access processes and targets to promote needed
policies and adequate funding for effective programs, especially for MARPs. To assist the GOR in formulating sound policies and
plans to reach their ambitious target for universal access by 2010, USG implementing partners will support the dissemination of
best practices from USG-supported regions, regions supported by the Global Fund (GF) and other external donors, and regions
participating in the National Priority Project on Health. One potential venue for sharing this will be Federal level HIV conferences
and roundtables. This year, the US National Institutes of Health (NIH) will contribute to the Russian HIV meeting planned for May
2009. The dissemination of best practices in HIV prevention, treatment and care developed with USG support will help the GOR
build its programs based on the experiences of governmental institutions, NGOs, faith-based organizations (FBOs), community-
based organizations (CBOs), and businesses.
Central to the continued involvement of NGO and civil society in HIV programming in Russia is the need to strengthen
partnerships with the GOR and to develop mechanisms to formalize relationships. There are over 200 NGOs working in the area
of HIV/AIDS in Russia (UNAIDS database), and although the external partners such as USG and Global Fund have increased
support to them in recent years, GOR funding and collaborative systems for partnering with governmental service providers
remain insufficient. USG implementing partners will continue to support a dialogue with the GOR on developing contractual or
other mechanisms to fund NGOs to provide HIV/AIDS prevention and care services. In 2009, the USG will explore ways to
incorporate best practices of USG and other NGO partners and outline an effective strategy for informing government of the
successes the NGO interventions in order to aid GOR representatives in planning for future collaboration, including support for
additional government tenders and financial support. This effort may include links with national NGO networks working on
HIV/AIDS to facilitate their participation with the GOR in the development of a joint platform for action.
Similar to the GOR, the faith-based community has demonstrated an ongoing and broadened commitment to the fight against
HIV/AIDS. Five denominations (Baptist, Lutheran of Ingria, Lutheran, Catholic and Evangelic) have either developed or adopted a
strategic framework on HIV/AIDS, building on the first such framework developed by the Russian Orthodox Church with USG
support. The Inter-Church Committee on HIV/AIDS has expanded to include the Jewish community as observers, and in co-
operation with the Islamic community, the Committee is currently organizing the Second Inter-Religious Conference on HIV/AIDS,
which is expected to result in the establishment of the Inter-Religious Committee on HIV/AIDS. Regional Inter-Church
Committees on HIV/AIDS have been formed in St. Petersburg, Orenburg and Kaliningrad, meeting quarterly to co-ordinate efforts.
Importantly, the issue of faith based organizations' (FBO) involvement in the Russian response to HIV/AIDS was recently included
in the agenda of the Council of PLWHA. This PLWHA Council has developed concrete proposals on cooperation with churches in
the South and Far East regions of Russia and has nominated a focal point to develop a strategy of co-operation with churches
and maintain working relationships with them.
The faith-based community plays a significant role in policy advocacy and has the potential to contribute more to HIV/AIDS
programs in Russia. With FY 2009 funds, UNDP partners will continue their successful work with faith-based leaders at the
national level to strengthen the policy environment to reduce stigma and discrimination within the religious community and to
develop sustainable and measurable systems for continued and expanded FBO involvement. Efforts towards the development of
a multi-religion HIV strategic framework will continue to be supported. UNDP will expand their HIV policy development activities
with the Russian Orthodox Church to include other religions. Beginning with a conference in November 2008, the existing Inter-
Church Council currently supported by the USG will be expanded to become an Inter-Religious Council as a way to improve
collaboration on HIV/AIDS between different sects at national and local levels. The conference will be the first step to secure the
commitment of other senior religious leaders and to disseminate best practices in HIV prevention and care piloted by FBOs in
Russia. Continued USG assistance for faith-based policy dialogue will further support efforts to share best practices, possibly
through exchange visits between the different regions, as well as providing for technical advice and training for new faith-based
partners engaging in Russia's response to HIV/AIDS.
In FY09, the USG will continue to develop alliances with the private sector in Russia. Leveraging private sector resources and
involving the private sector in social program development and implementation will be one of the key directions in the upcoming
years. Building on the existing strong collaboration of TransAtlantic Partners Against AIDS and the Global Business Coalition
(TPAA/GBC) with the private sector, including the Business Against AIDS Coalition and other business alliances, the USG will
support the development of the Public-Private Partnership (PPP) model for HIV/AIDS. TPAA/GBC has strong partnerships with
the private sector, government, and legislators (through the Parliamentary Working group on HIV/AIDS and TB), and is well
positioned to advance PPP policy development. Policy briefs, round-table discussions with partners, and PPP best practices
dissemination activities will facilitate the establishment of the PPP as a model of government and private sector collaboration on
HIV/AIDS. This model and approach can then be applied to build alliances to confront other socially significant problems.
?Facilitate NGO and civil society participation with the GOR in the development of a joint platform for action to address MARPs.
?Increased GOR funding for NGOs to provide HIV outreach and care to MARPs.
?National Aids Spending Assessment institutionalized.
?Strengthened support of religious leadership of the faith-based response for HIV/AIDS issues and programs.
?Stigma and discrimination associated with HIV and substance abuse decreased.
?Official national HIV strategy developed and/or quarterly meetings of the National HIV Governmental Commission held.