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: 2010 2011 2012 2013 2014 2015
SCMS supports the Medical Procurement and Distribution Division (MPD), Pharmacy Task Force (PTF), National Reference Labs (NRL), and others. In COP12 SCMS goal is to assist the Coordinated Procurement and Distribution System (CPDS) in forecasting and procurement planning for HIV/AIDS products, strengthen MPDs procurement processes, and capacity to procure commodities and contribute to the establishment of the Logistics Management Office (LMO). Key objectives are: quantification of national HIV/AIDS commodities needs, improvement of LMOs capacities and capabilities to collect and ensure data quality for guiding logistics decisions, identify and pursue opportunities to strengthen procurement of commodities to meet scale-up requirements; and procure essential laboratory equipment and supplies.
In COP12 SCMS will provide first and second-line ARV drugs for 61,331 adults and 6,058 pediatric patients in 191 USG supported ART sites. This is 55% of all Rwandans currently on ARVs; the Global Fund covers the remaining 45%. During COP12 SCMS will continue to act as the procurement agent for a limited amount of commodity categories including ARVs until MPD is ready to procure USG funded products. SCMS will also provide TA to MPD and CPDS in procurement and quantification. Through SCMS support, MPD is preparing to receive direct USG funding. SCMS has assisted MOH in the establishment of a LMO to take over logistics activities currently managed by SCMS. In addition to the monitoring and supervision activities, during COP12 SCMS will closeout and there will be a final supply chain assessment to evaluate the availability of HIV/AIDS commodities, and identify any transitioned areas of critical need.
3 vehicles were purchased under previous COPs; no vehicles planned in COP12.
The recently rolled out logistics management information system (LMIS) now collects consumption data at the facility level for many HIV related products, including opportunistic infections (OI) drugs. The CPDS will be able to use this data to make more accurate quantifications. SCMS will procure products related to adult care.
SCMS will continue to provide technical assistance to MPD to assist them in storage and distribution of OI drugs for all PLHIV at USG-supported sites.
In COP11 SCMS procured laboratory equipment, consumables, reagents, teaching materials and containers to transport histopathology samples from district hospitals to referral laboratories. In COP12 SCMS will continue to support laboratory diagnosis of extra pulmonary TB through procurement of histopathology reagents and consumables for two teaching hospitals (CHUK and CHUB) and 42 district hospitals. It is expected that histopathology laboratories of CHUK and CHUB will analyze 7,200 samples from patients at district hospitals and teaching hospitals.
During COP12 the procurement of TB testing reagents and consumables will also be funded. Funds will also be used to procure $100,000 in Isoniazid for treatment.
The GOR has made early detection of HIV-positive infants a priority in its plan to provide optimal care and treatment for children. The National HIV and AIDS Strategic Plan has set a target for 90% of children eligible for ART will be provided ART by 2012. Funds will be used for the procurement of pediatric ARV drugs. These drugs will help provide treatment for a targeted 6,058 pediatric patients through 191 USG supported ART sites.
An assessment of the laboratory network was completed in 2011. In COP12 SCMS along with the CPDS, NRL and implementing partners will analyze the laboratory equipment gaps among USG supported sites. During COP12 PMTCT/lab equipment will be procured to support the expansion of USG supported PMTCT sites. SCMS will ensure continuity in lab supplies and reagents through consolidated forecasting, quantification, supply planning and continuing to build MPDs and CPDS advocacy to increase resource mobilization for procurement. SCMS will procure all the biochemistry, hematology, and CD4 supplies for an estimated 76,493 patients needed in COP12. The revised National ART Guidelines call for viral load testing in cases of suspected treatment failure. To meet the need for viral load testing, SCMS will quantify (jointly with MPD) and procure viral load reagents sufficient to cover the estimated needs of all USG-supported patients. SCMS may procure supplies and reagents for specific central-level activities and functions, including: 1) kits and supplies for PCR tests for the national EID program; 2) additional viral load kits and associated supplies for the laboratory component of the national ART program impact evaluation; 3) test kits and supplies for continuing HIV serology and CD4 testing Quality Assurance (QA) and training systems; 4) PCR supplies and reagents for expansion of PCR capacity to CHUB and as backup for the National Reference Laboratory (NRL); 5) supplies and reagents for opportunistic infections diagnostics for regional and district-level laboratories, as well as supplies for ongoing microbiology.
Since 2007, SCMS has been supporting the GOR in strengthening the national supply chain for HIV/AIDS commodities (ARVs, OIs, and laboratory commodities). SCMS works closely with MPD, HIV-Division, NRL-Division, PTF, and District Pharmacies to establish the Coordinated Procurement and Distribution System (CPDS), the Logistics Management Office (LMO), and Active Distribution (AD). SCMS technical support to MPD will scale down in COP12 as previous support has significantly improved the operations of MPD. During COP12, limited support to MPD will focus primarily on building capacity of the procurement unit in preparation for it to eventually take on the procurement of USG funded commodities. In COP12 there will no longer be support to district pharmacies through SCMS, as this work will transition to the LMO in COP11. During COP 12, support for HIV & AIDS quantification will be limited to the participation of one or two technical advisors participating in the quantification and minor logistical support for the workshop. During COP12 SCMS will reduce external technical assistance, trainings, workshops, conferences and related costs to allocate funds with an emphasis on efficient, effective programming.
Through the Coordinated Procurement and Distribution System (CPDS) and jointly with MPD, SCMS will continue to ensure the quantification and procurement of rapid test kits (RTKs). As part of the plan to build national capacity to quantify laboratory supplies at all levels of the system and ensure smooth functioning of the CPDS system, SCMS will continue to work closely with the CPDS and MPD to ensure the integration of rapid test kits into the system, including development of a supply plan incorporating RTKs, that will be updated on a quarterly basis. As Rwanda continues to strengthen its counseling and testing strategy and implementation, MPD will use the logistics management information system (LMIS) data to analyze and report on district pharmacy and health facility stock levels on a regular basis to monitor consumption trends, potential stock outs, and make any revisions to procurement plans and projections. In COP12, the projected number for routine VCT will be 1.6 million.
During 2009, MOH revised the ART Guidelines to progressively begin moving away from D4T and AZT-based regimens because of their long-term irreversible side effects, towards tenofovir (TDF) or ABC-containing regimens. During COP12 the gradual transfer of patients from D4T and AZT-based regimens to the TDF and ABC-based regimens will continue. Current levels of use of first-line regimens show that 28% of adults are on D4T-based regimens, 37% on AZT-based regimens and 34% on TDF-based regimens. It is anticipated that by the end of COP12, the level of use of D4T-based regimens will go down to 17%, AZT-based regimens will go down to 26%, and the level of use of TDF will rise to 52%.
During COP12, SCMS will purchase ARV drugs to continue and increase the provision of ART therapy for eligible adult and pediatric patients. SCMS will continue to provide first-line and second-line ARV drugs for approximately 61,331 adults and 6,058 pediatric patients in 191 USG supported ART sites. In addition to the existing patients, SCMS will provide first-line ARVs to an estimated 6,043 anticipated new patients initiating ART during COP12.
Improvements to the Rwanda supply chain have led to a significant one-time savings in commodities needs as the supply chain becomes leaner. These savings were passed on to other activities for COP 12. Patients supported by USG will still receive the care afforded them in previous years. Savings realized for COP12 are a one-time savings; COP13 HIV and AIDS drugs and commodities funding needs are expected to return to previous amounts.
During COP12 SCMS will work closely with MPD to support coordinated ARV drug procurement for USG supported sites. A consolidated approach for quantification and supply planning with the Rwandas Global Fund support will increase cost savings, improve the efficiency of current procurements, and allow for building MPDs capacity through limited mentoring.
