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.
The long-term United States government (USG) goal is to enable South African government (SAG) ownership of PEPFAR-supported programs. To this end, the USG and the SAG are working together on a major program rationalization effort in order to enhance sustainability and to increase effectiveness and impact of the program on maternal and child health.
A comprehensive submission defining specific activities will be prepared for the November review and final submission in January. This realignment will provide the basis for the Partnership Framework. It is anticipated that there will be significant reprogramming during the coming year since this is an ongoing process.
REDACTED. These funds will be used to support the South African government's Accelerated Plan for PMTCT (A-Plan). The A-Plan focuses on the 18 priority health districts where the need to intensify PMTCT support is greatest. These districts were identified based on a selection of maternal and child health and socio-economic indicators such as poverty, unemployment, and access to water and sanitation. The goal of the A-Plan is to reduce mother to child transmission to rates between 12%- 20%. These targets are less aggressive than the targets defined in the National Strategic Plan for HIV and AIDS and STI, 2007-2011 (NSP), which provides a target of less than 5% by 2011.
The interventions defined in the A-Plan focus on expanding access to PMTCT services and increasing demand, as well as to improving the quality of these services. The A-Plan has eleven specific objectives, linked to the general objectives of the national PMTCT program. These objectives are listed below:
1) Increase the proportion of early antenatal care bookings (under 20 weeks), 2) Increase the proportion of pregnant women tested for HIV, 3) Increase the proportion of HIV-positive women who are tested for CD4 count, 4) Increase the proportion of HIV-positive women receiving dual ARV prophylaxis, 5) Increase the proportion of eligible HIV-positive pregnant women initiated on HAART, 6) Increase the proportion of HIV-exposed infants receiving dual ARV prophylaxis, 7) Increase the proportion of HIV-exposed infants receiving a PCR test around 6 weeks, 8) Increase the proportion of HIV-exposed infants initiated on Cotrimoxazole, 9) Increase the proportion of HIV-positive mothers who receive counseling in infant feeding options,
10) Decrease the proportion of infants with a positive PCR, among those HIV-exposed infants who are tested, 11) Increase the proportion of HIV-positive infants who are initiated on HAART and receive continuum of care and support.
In September 2009, USAID convened a working group, composed of USAID PMTCT and Pediatric Care and Treatment partners who provide PMTCT services, tasked to define activities which currently and directly support the A-Plan, as well as a South African National Department of Health request to further strengthen these activities and bring them to scale. The working group meeting was guided by the National Department of Health leadership and there was Provincial Department participation.
Select partners were also requested to support the Accelerated Plan for Maternal Health, linking it to the Accelerated plan for PMTCT. The Accelerated Plan for Maternal Health will support the ten health districts with the highest number of avoidable maternal deaths per total deliveries. This objective is to link the A-Plan for PMTCT with the Accelerated Plan for Maternal Health. This will result in a program of action enhancing both plans.
The supplemental funding will be utilized to further define efficient activities in support of the A-plan and bring them to scale. Activities identified for scale-up have been clustered into three categories: 1) Creating an enabling environment; 2) Comprehensive approaches to PMTCT improvement; and 3) Specific interventions addressing one area of the PMTCT cascade.
One of the better practices described in the A-Plan is the work of one of the PEPFAR partners, the Perinatal HIV Research Unit (now known as ANOVA), in Soweto which provides 100% coverage and has resulted in a transmission rate of less than 4%. The A-Plan intends to replicate "gold standards" of this type in order to achieve 80% coverage throughout the program and the additional PMTCT funds will be used to support activities of this type.
Coordination and monitoring of these additional PMTCT funds will be achieved through our close partnership with CDC.
See Overview Narrative
