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.
Reprogrammed in May 2009 as the cost extension was shorter than had been planned. Support for cost
extension of current agreement as a bridge before the new CDC FOA.
New/Continuing Activity: Continuing Activity
Continuing Activity: 17592
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
17592 11412.08 HHS/Centers for IntraHealth 7817 5632.08 CA $230,000
Disease Control & International, Inc
Prevention
11412 11412.07 HHS/Centers for IntraHealth 5632 5632.07 $146,216
Program Budget Code: 02 - HVAB Sexual Prevention: AB
Total Planned Funding for Program Budget Code: $1,010,000
Total Planned Funding for Program Budget Code: $0
Program Area Narrative:
Overview
Sexual prevention, including promoting abstinence, fidelity including partner reduction, and other prevention interventions
including correct and consistent use of condoms (ABC), is the highest USG program priority. Southern Sudan is an archetype
post-conflict society. The conflict era isolation has rapidly eroded since signing of the Comprehensive Peace Agreement (CPA).
All elements are present for the rapid spread of HIV in a country ill-prepared to handle even routine medical care. Refugees in
large numbers are returning from neighboring higher prevalence countries such as Ethiopia, Kenya, Uganda and the Democratic
Republic of the Congo (DRC), often carrying the virus with them. Trade and transport are increasing exponentially with hundreds
of truckers, a high risk group, arriving daily and often staying for days to weeks in major transport corridor hubs. A large
population of Sudanese People's Liberation Army (SPLA) is garrisoned in these hubs, as are large numbers of jobless,
demobilized SPLA. Mobile populations often have extended periods of time away from their families and are thus prone to risky
sexual behavior. Vulnerable women and youth also flock to these transport hubs due to the promise of economic opportunity.
While the prevalence of HIV in Southern Sudan is estimated to be 2.6% and the epidemic mimics the regional one, it is probable
that HIV is spreading rapidly in "hotspot" towns or hubs along transport corridors. Regionally, prevalence is often at least twice as
high in such hubs as compared to national estimates. The combination of poverty, concentration of truckers and other transient
workers, sexual networking including polygamy and concurrent relationships, gender based violence often as result of widespread
alcohol abuse, lack of recreational facilities, and dearth of services create an environment of elevated risk. These hubs are, in
effect, incubators of HIV, driving transmission in areas well beyond their geographic location. Without strong sexual prevention
efforts linked to other services, this rate is likely to further increase in a post-conflict environment.
Preliminary results of a Behavior Monitoring Survey in three transport corridor towns suggest the depth of the challenge.
Knowledge levels of sexual transmission of HIV and of AIDS as a disease are among the lowest in Africa. Only 63% of women
surveyed knew that HIV can be transmitted through sexual intercourse, 18% had never heard of AIDS, and 25% responded "no"
or "don't know" respectively to the question "can people protect themselves from HIV?" Furthermore, only 15% of women
surveyed reported "ever use" of condoms, and 43% or nearly half reported some form of gender based violence (GBV) or
coercion. Studies from other countries suggest that since the delicate issue of GBV is often seriously underreported in surveys,
the real percentage probably far exceeds this. There is also a need to improve strategic communications skills, as expertise in
state-of- the-art communications is restricted to several USG implementing partners. Many implementing partner staff, for
instance, have difficulty discussing means of sexual prevention other than abstinence.
Current USG Efforts
USG implementing partners focus on geographical areas with higher risk of HIV transmission, including border areas with high
rates of returnees, large numbers of transient groups, the military, and vulnerable resident populations. All implementing partners
promote comprehensive ABC interventions, and sexual prevention efforts are generally linked to other USG services including
counseling and testing (C&T), prevention of mother to child transmission (PMTCT) and home based care (HBC). In FY08,
492,105 individuals were reached with abstinence and being faithful (AB) messages; 163,134 with abstinence only messages;
and 484,906 with other prevention interventions, including the establishment of 488 condom outlets. Other achievements
included support to 35 community based organizations (CBOs) and to a national network of people living with HIV/AIDS (PLHA) to
implement ABC programming.
ABC prevention interventions are available to both the mobile and the less transient populations in select truck stop towns under
the banner of "SafeTStop". The target beneficiaries are truck drivers, low-income women and other women's groups, PLHA, out of
school youth, religious leaders, demobilized soldiers, community members, orphans and other at-risk populations. Also included in
the SafeTStop prevention menu are trucker recreation and resource centers that provide a basis for organizing education,
services, and entertainment alternatives for transport workers and community men; the cluster model of community mobilization;
and interventions to address root causes of risk behaviors. These include substance abuse and gender based violence
interventions. The first "SafeTStop Recreation and HIV Resource Center" was implemented in Juba and received over 16,000
visitors in the first two months; 156 local pharmacies and other buildings were branded with the distinctive SafeTStop logo to
develop a link between the recreation center services and the rest of the SafeTStop community. As elsewhere in the region, the
two approaches contributed significantly to the increase in number of people reached and uptake of services. For example, over
600 people accessed C&T in the first two months of the Resource Center's operation. However, although ABC targets were
mainly achieved by the SafeTStop partners, difficulties in resolving problems due to the differing development approaches of the
various partners hampered building a stronger basis for future efforts.
The ABC behavior change program with the Sudan Peoples Liberation Army (SPLA) covered two out of eight divisions nationally.
Activities included support to a PLHA support group of enlisted men, the training of 86 peer educators in ABC interventions, and
the production of BCC materials appropriate to the SPLA. Notable program achievements included the production of a Juba-
based radio program that carried ABC messages to the military and surrounding communities, a stigma reduction mass media
campaign, the creation of 76 condom outlets, and a series of posters targeting risk behaviors including multiple partners. In all,
more than 150,000 SPLA, their families and community members were reached with ABC interventions. However, as mentioned
above, there remain problems with the degree of SPLA command buy-in, including SPLA support to USG trained peer educators.
For instance, the SPLA command has not mandated 100% of the peer educators' time to this work and peer educators once
trained are often moved to non-program divisions where they are not empowered to continue their activities.
FY09 Funds
Given the assumed nature of the HIV epidemic in Southern Sudan, the focus of ABC programming will remain largely the same.
However, given even more limited resources in FY09, programming will focus more attention on known high risk groups and the
towns and surrounding areas with suspected highest prevalence based on available data from antenatal clinic (ANC) surveillance
and counseling and testing centers. For example, certain towns now targeted for services may be eliminated, or their level of
support decreased, due to estimated lower prevalence (e.g. Kaya) whereas other towns with estimated high prevalence and with
opportunities to link with other donors may be added or receive increased attention (e.g. Wau which has GFATM funded ART
services). Efforts initiated in FY08 to increase linkages between USG implementing partners working in the same areas and
avoiding duplication of efforts will be given greater attention in FY09. Facility and community based partners will continue to offer
comprehensive ABC interventions integrated into other services and a pilot project will test bringing services under the SafeTStop
banner for its recognition factor and as a branded quality service. To ensure greater sustainability, increased effort will also focus
on building capacity of Community Based Organizations (CBOs) and even smaller local groups (e.g. church groups, savings
groups, etc.) to support services. However, despite changes to improve efficiency and synergy, targets will have to be reduced.
SPLA will continue to provide comprehensive HIV prevention programming, including stigma reduction and anti-discrimination
activities. However, based on the strategies identified during the assessment planned early in the fiscal year, there will be more
emphasis on strategies that more actively incorporate military PLHA, particularly those that motivate officers to disclose their
status and become PLHA advocates. Likewise, it is anticipated that the program assessment will identify potential interventions
targeting SPLA top leadership that will increase their buy-in and ensure greater program sustainability. CDC will procure a new
mechanism which, in addition to supporting other ABC activities, will integrate its SPLA work into a seamless program that avoids
duplication of efforts.
To minimize the USG team management burden, the newly awarded five year ROADS II mechanism and the planned CDC
procurement will each incorporate several implementing partners under their umbrellas. Some of these partners were previously
managed under individual agreements, which due to field staff shortages, resulted in an excessive management burden and
insufficient oversight. All USG partners will continue to use community outreach/mobilization to promote awareness, faithfulness
and partner reduction specifically among men, including long-distance transport workers, community men and vulnerable youth,
including those in internally displaced camps scattered around Juba and other towns. The nascent national PLHA network will
receive increased support to promote ABC, address gender concerns and combat stigma and discrimination. All USG partners
will increasingly incorporate interventions addressing the gender issues that inhibit women from accessing services. For instance,
implementing partners will work with communities to identify and address community norms that allow domestic and other forms
of violence against women and girls.
The USG Health Team will integrate AB interventions at its health sites where PMCT is being offered by providing AB funding to
partners providing such services.
The USG team will work with the GoSS and other donors to address the supply chain logistics issue through a combination of
technical assistance and advocacy. However, given the critical immediate need, the USG team will also in the short term support
implementing partners with the appropriate expertise to support condom procurement and distribution for all USG partners.
Linkages
All community and SPLA outreach efforts (peer education, community theatre, sporting events, etc.) will promote HIV testing-and
care-seeking, linking individuals, couples and family members to facility-and non-facility-based C&T and care and support.
Likewise, facility services offering such services as C&T and PMTCT will also promote ABC interventions. Substance abuse
interventions as a prevention measure are also effective means to promote better ART adherence and positively impact on care
and support interventions.
Expected Results
More sustainable approaches to the range of sexual prevention interventions
Increase in the number of individuals who can correctly perceive their degree of risk leading to changed behaviors such as
condom use or getting tested.
Development of community-created solutions to address gender based violence
Decrease in stigma and discrimination against PLHA
Table 3.3.02:
Reprogrammed all funding in May2009 as the cost extension needed as for a shorter time period than had
been planned. Support for cost extension of current agreement as a bridge before the new CDC FOA.
Continuing Activity: 17593
17593 11333.08 HHS/Centers for IntraHealth 7817 5632.08 CA $81,000
11333 11333.07 HHS/Centers for IntraHealth 5632 5632.07 $279,877
All funds reprogrammed from this parnter in May 2009 as the cost extension was needed for a shorter
period of time than had been planned. Support for cost extension of current agreement as a bridge before
the new CDC FOA.
Continuing Activity: 17594
17594 11344.08 HHS/Centers for IntraHealth 7817 5632.08 CA $226,000
11344 11344.07 HHS/Centers for IntraHealth 5632 5632.07 $399,494
Program Budget Code: 04 - HMBL Biomedical Prevention: Blood Safety
N/A
Program Budget Code: 05 - HMIN Biomedical Prevention: Injection Safety
Program Budget Code: 06 - IDUP Biomedical Prevention: Injecting and non-Injecting Drug Use
Program Budget Code: 07 - CIRC Biomedical Prevention: Male Circumcision
Program Budget Code: 08 - HBHC Care: Adult Care and Support
Total Planned Funding for Program Budget Code: $1,473,425
OVERVIEW
Southern Sudan has numerous competing health needs. This is compounded by poor infrastructure and limited human capacity
occasioned by the prolonged civil war. Since the signing of the peace agreement, there are enormous population movements,
with the return of internally displaced people, professionals, and other individuals in search of career and economic ventures.
Many of these individuals come from neighboring high prevalence countries. No population based survey has been done in Sudan
to determine HIV prevalence. These circumstances make it difficult to determine the number of people in need of ART in Southern
Sudan. However, based on an estimated population of 10 million, with a 2.6% prevalence rate of HIV, the expected number of
individuals in need of care and potential ART is approximately 25,000, with a larger estimate in need of care and support services.
ART provision is currently available in 7 locations that provide treatment to approximately 800 HIV-infected individuals. All these
sites are under the management of the Global Fund. Over the past year, ART guidelines have been established with support from
World Health Organization (WHO).With the development of STI guidelines by SSAC, training on screening and treatment of STIs
will begin in FY 08.
Counseling and testing services are on the increase, and a significant amount of uptake is seen in mobile services. This poses a
challenge for referrals, follow up and linkages to care and support for those found to be HIV positive. PMTCT services have also
been functioning in a few sites and is another entry into care and support. An additional challenge is the coordination with non-
USG funded ART programs which lack significant care components or community linkages.
At least one established home-based care (HBC) program exists, and a number of new HBC programs are planned. The concept
of basic preventive care for people living with HIV/AIDS (PLWHA) and their families is being introduced to Southern Sudan by the
PEPFAR program, and is integrated as a core part of the country strategy. TB screening is encouraged, and in PEPFAR
supported centers, a simple TB evaluation tool has been designed but not uniformly implemented.
The USG believes that care and support is an essential component of an integrated prevention-focused HIV program. Simple,
basic care interventions, focused on the prevention and treatment of opportunistic infections (OIs), can prolong life and decrease
morbidity. Beyond the immediate clinical benefits to those affected, the provision of HIV care has an important prevention potential
due to the effect of decreased stigma created by the availability of care. Supporting systems to provide care and support sends
the message that HIV-related illnesses can be prevented or treated, and that people infected with HIV deserve care and support.
Although many basic care interventions can be effectively delivered outside health facilities, the USG strategy encourages a
central healthcare worker role. Access to clinics for prevention, care and support services, through strengthening health facilities
in the community, improves the quality of all health related services and builds on the foundational goals of establishing
comprehensive care programs.
CURRENT STATUS
PEPFAR Sudan, through its work and collaboration with the Southern Sudan HIV/AIDS Commission (SSAC), the Government of
Southern Sudan Ministry of Health (MOH) and USG implementing partners, has introduced a model for preventive care based on
the successful basic package of preventive/palliative care (PC) delivered in Uganda. With PEPFAR and GOSS leadership,
PEPFAR partners have adapted training materials from Uganda for lay people and community groups for use in Southern Sudan.
USG is supporting the delivery of basic HIV care, including education of patients and family members on issues related to care
and efforts to reduce stigma and promote an open and supportive environment. One partner, PSI, is responsible for the
procurement of supplies, development of communication materials, and training. Other USG partners in the field are responsible
for the implementation and design of a locally-appropriate distribution strategy, utilizing health facilities, community groups and
individuals. People living with HIV/AIDS are encouraged to participate, and in turn this has encouraged them to become openly
involved.
Over the past year, over 811 kits have been distributed, and over 201 service providers and lay persons have been trained in
palliative care. Basic care kit contents are comprised of a water vessel, 90 water treatment tablets, 72 condoms, 2 treated
mosquito nets, a filter cloth, and information materials on HIV/AIDS. Cotrimoxazole prophylaxis is given in health facilities where
the client's health status is evaluated. Due to supply purchase delays, a delay in the delivery and program activities has occurred.
The current USG strategy is to have all PEPFAR supported facilities, including military sites, offer counseling and testing and
encourage clients to continue with care. Support groups have been formed and strategies to retain patients in care continue to be
sought and require ongoing strengthening to include adequate staff capacity.
Care and support interventions are provided at no cost to families infected and affected by HIV. Program wrap-arounds promote
synergy between PC and existing partner activities, and include social marketing of bed nets, safe water interventions, and
provision of condoms to the general population. Communication strategies built around these interventions incorporate the
benefits for people living with HIV, but marketing strategies emphasize the benefits for other key population groups. Children are a
focus of safe water campaigns and pregnant women, a targeted population for bed net distribution. It is expected that broadly
promoting these proven public health interventions will prevent perceived associations between their use and HIV status.
FY 2009 PLANS
Service delivery is expected to significantly increase in FY2009, as growing CT and PMTCT program activities identify more
people in need of care. Concomitantly, geographic coverage will also increase to include areas covered under the Sudan Health
Transformation Project (SHTP) funded by USAID whose goals seek to revamp primary health care in Southern Sudan. In addition,
there is envisaged expansion of the SPLA prevention and CT program to other divisions, which if successful, will create added
demands on care and support needs. Health facilities are a major priority in need of strengthening. PEPFAR will work with
facilities to establish and strengthen care and support activities. Better and strong referral strategies will be designed to capture
those tested at outreach services
PEPFAR Sudan will strengthen the existing program by training and retraining service providers and lay people in the provision of
care and support. Additional peer educators will be trained in the utilization of basic care packages as well as other basic
preventive strategies to help PLWHA live healthy lives. In addition to education and the distribution of basic package kits, family
members and volunteers will be trained as home based care givers to foster the continuity of care. Emphasis on a
multidisciplinary approach to care, to include spiritual, psychological and economic support, as feasible, will also be placed.
Community resources such as pastors, among others, will be mobilized for these activities. Collaboration with the ROADS project
for possible economic empowerment activities such as the establishment of small community farms for good nutrition will be
fostered. Linkages will be made with World Food Program (WFP) in very needy cases, but self reliance will be encouraged. The
USG will facilitate the development of national standards for HIV care that include a set of basic care interventions offered to all
people living with HIV, regardless of the stage of illness
LEVERAGING AND COORDINATION
With the expected finalization of the M &E framework, the creation of standardized data collection and reporting tools between
PEPFAR stakeholders, SSAC, MOH and others will be encouraged and supported. Other policy documents, such as the strategic
plan for TB developed by the TB program with PEPFAR participation will soon be finalized. Global Fund for AIDS, TB and Malaria
(GFATM) will help establish strong linkages and synergy between HIV and TB care screening and treatment. With PEPFAR
support for the development of care guidelines and training curricula, consistent with global best practices, we hope that evidence-
based preventive care services will be rapidly adopted by HIV programs that are supported by other donors, such as the GFATM
and the Multi-Donor Trust Fund (MDTF).
The palliative care program will continue to benefit from coordination and synergy with other donors for provision of bed nets, safe
water distribution programs, and small scale condom social marketing activities.
EXPECTED OUTCOMES
The following are the expected outcomes:
1. Strengthened and expanded number of HIV-specific care and support outlets in Southern Sudan
2. Improved data collection systems and data capture, and utilization of the number of people currently in need of care and/or
treatment, among other measures of care.
3. Increased number of components of care and community linkages.
4. Increased number of home-based care programs.
5. Improved basic preventive care for people living with HIV and their families.
6. Development of national guidelines for HIV care and support inclusive of a basic care. for HIV-infected people irrespective of
stage of infection.
Program Area Downstream Targets:
6.4 Total number of service outlets providing HIV-related palliative care (excluding TB/HIV): 33
6.5 Total number of individuals provided with HIV-related palliative care (excluding TB/HIV): 2498
6.6 Total number of individuals trained to provide HIV-related palliative care (excluding TB/HIV): 350
Table 3.3.08:
Continuing Activity: 17595
17595 11351.08 HHS/Centers for IntraHealth 7817 5632.08 CA $120,000
11351 11351.07 HHS/Centers for IntraHealth 5632 5632.07 $198,216
Continuing Activity: 17596
17596 11322.08 HHS/Centers for IntraHealth 7817 5632.08 CA $430,000
11322 11322.07 HHS/Centers for IntraHealth 5632 5632.07 $438,016
Table 3.3.14:
Continuing Activity: 17597
17597 11329.08 HHS/Centers for IntraHealth 7817 5632.08 CA $80,000
11329 11329.07 HHS/Centers for IntraHealth 5632 5632.07 $116,000
Program Budget Code: 19 - HVMS Management and Staffing
Total Planned Funding for Program Budget Code: $1,483,400
BACKGROUND
Sudan is considered a low-prevalence country for HIV. Although the true prevalence rate is unknown, it is estimated to be
approximately 2.1% for all of Sudan. The rate varies widely among the north and the south, ranging from a low of 0.5%
prevalence in certain parts of Northern Sudan to about 15% in parts of Southern Sudan. The overall prevalence of HIV in
Southern Sudan is estimated to be 2.6%.
Southern Sudan is bordered by high prevalence countries like Ethiopia, Kenya, Uganda, and the Central African Republic.
Relative peace returned to Sudan with the signing of the Comprehensive Peace Agreement (CPA) in 2006, resulting in mass
population movements along the porous borders of Southern Sudan. Thousands of Southern Sudanese who took refuge at
neighboring countries during the civil war are returning or have returned to Sudan. Internally displaced people have also started to
return home. Trade and commerce has resumed with the neighboring countries, the main pipeline being the transport corridor in
the south. With peace and stability has come development and relative prosperity. All these above factors are relevant and could
contribute to rapid spread of HIV, especially in Southern Sudan. With those in consideration, Sudan was brought under the
President's Emergency Plan for AIDS Relief (PEPFAR) as a bilateral mini-COP country in 2006.
Since its inception, the PEPFAR Sudan Team has primarily been based in Nairobi due to inadequate infrastructure and insecurity
in Southern Sudan. FSN staff based in Nairobi has to travel to Sudan to conduct activities, and each time they have to obtain
Sudanese visa and Country Clearance to get into Sudan. The latter is also dependent on several factors, including the availability
and presence of a Point of Contact (POC), a space in the very limited living quarters for temporary duty employee (TDYers), and
the overall security situation at the time in Sudan. All these contribute to great challenges for functioning smoothly as a PEPFAR
team in Sudan.
CURRENT STAFFING SITUATION
The Sudan PEPFAR team currently consists of members from the US Centers for Disease Control and Prevention (CDC) and the
United States Agency for International Development (USAID). The US Department of State (DoS) and the Department of Defense
(DoD) also participate in advisory roles.
The CDC Global AIDS Program (GAP) staff include five fully funded country positions: the GAP Director (the only full-time
PEPFAR team member in Juba until recently), and four Nairobi based positions (1 Senior Technical Advisor, 1 Administrative
Assistant, 1 Counseling and Testing Advisor, and 1 Laboratory Technical Advisor). The first three positions are FSNs, while the
Laboratory Technical Advisor is on contract through the Kenya Medical Research Institute (KEMRI). In August 2008, CDC placed
a Deputy Director for Operations for GAP Sudan at its headquarters in Atlanta to support the country team. A Country Officer is
also assigned at CDC GAP headquarters to support GAP Sudan. These last two positions are funded and supported by CDC
headquarters. The current half-time Administrative Assistant position at GAP Sudan has recently (October 2008) fallen vacant.
The USAID staff include the HIV/AIDS Program Manager (resumed position in Juba starting October 2008), the Health Team
Leader and a Health Advisor, all based in Juba, and three advisors from the USAID East Africa Regional Office based in Nairobi
(which includes an HIV/AIDS Senior Advisor for Prevention, Care, and Support, an M&E Advisor and a Care and Treatment
Specialist). The HIV/AIDS Program Manager is the only fully funded USAID position for PEPFAR. The other USAID positions are
not currently funded by PEPFAR.
As stability increases in Southern Sudan, the Government of Southern Sudan (GoSS) expects that donors and implementing
partners transition operations to Juba. Without a presence in Sudan, serious opportunities are missed for the USG to develop and
implement a unified and cohesive program. It is critical that the USG PEPFAR team engages with government counterparts as
well as implementing partners on a regular basis. It continues to be difficult to find required TDY space on the USAID compound
in Juba for Nairobi-based technical staff for regular visits to Juba. Travel and other expenses also add up to the total cost of doing
business in Sudan when staff travels from Kenya to Sudan. All considered, it is imperative that PEPFAR Sudan makes a transition
to Sudan at its earliest. All positions that had been planned to be filled and transitioned to Sudan in previous Country Operational
Plans (COP) still need to be filled for greater efficiency and delivery of services in Sudan.
Due to the improved security situation and completion of renovation of the USG office compound and additional residential units at
the residential compound in Juba, all USAID FSNs have started relocating to Juba. CDC is working with the US
Embassy/Khartoum and USAID/Juba to put in place the necessary administrative structures and to identify approved office space
in order to move the Nairobi based Sudan positions to Juba. It is expected that one or more of the positions will be relocated
during FY 2009.
CDC continues to work with the Ministry of Health and the US Embassy in Khartoum for final approval for co-locating technical
staff within the Ministry of Health in Juba. Highest level GAP leadership in CDC Atlanta, high officials in the GoSS Ministry of
Health, and senior US embassy officials in Sudan support the concept, but final approval involves clearance from the Regional
Security Officer (RSO) at the US Embassy. The Ministry of Health has indicated that space would be made available at the
National Reference Laboratory in Juba, currently under renovation, but has yet to identify the specific space for the co-location.
Once the MOH identifies the space, the RSO will be able to make an assessment and process the co-location request.
CDC GAP Director and the entire USAID Health Team, including its PEPFAR staff, had been assigned spaces at the newly
renovated USG Office Compound. CDC has recently been allocated an additional space in that compound. With the
Administrative Assistant position falling vacant recently and this additional office space becoming available, GAP Sudan plans to
transfer the current Nairobi-based Program Assistant position to Juba. This position will be converted to an Administrative Officer
serving as the office manager and providing administrative support to GAP Sudan.
Due to the limitation of resources and a review of program priorities, the FY 2008 proposed position of a Technical Advisor based
in Khartoum has been revisited, and this position has been eliminated. Instead GAP Sudan proposes to provide short term
technical support for surveillance and other activities in Northern Sudan utilizing CDC/GAP headquarter technical support and set
aside some funding for travel and incidental expenses related to travel of these personnel.
FY 2009 STAFFING AND MANAGEMENT PLAN
Three new positions, to be hired by USAID, include an M&E Advisor, a Prevention Advisor, and a Program Assistant.
The M&E Advisor will be responsible for supporting development of PEPFAR planning and reporting documents (including future
Sudan PEPFAR Country Operational Plans); mentoring GOSS and PEPFAR partners in the collection and use of HIV strategic
information; coordinating the development and management of necessary databases, and leading the responsibility for the
collection, collation, and submission of PEPFAR program data.
The PEPFAR Sudan team is planning to staff for results and thus a Prevention Advisor is needed to serve as a technical advisor
to USG partners in furthering their HIV/AIDS prevention programs, with a focus on ensuring non-duplication of services. The
advisor will work closely with the government and other collaborative organizations involved in HIV/AIDS prevention programs to
adopt appropriate strategies for their program activities. Prevention programs include but are not limited to, education, outreach,
youth directed programs, voluntary counseling and testing (VCT), and prevention of mother to child transmission (PMTCT).
Initially, the advisor will concentrate on sexual prevention activities.
Due to a high workload and a need to ensure adequate administrative support to the PEPFAR team as well as adequately
address specific agency needs, two Program/Administrative Assistants will be hired (includes the one recently vacated at CDC).
The Program/Administrative Assistants will ensure the smooth running of technical and administrative operations and other
related activities through program coordination and provision of logistics support. This includes being responsible for day to day
coordination of project activities, overseeing the day-to-day management, administrative, financial and program coordination
functions and supporting a broad range of administrative functions. The work portfolio includes finance, human resources,
procurement, information management, and logistics.
In lieu of hiring additional FSNs, which is currently not feasible due to space limitations in Juba, USAD will use a contract with
Management Systems International (MSI) to provide support services to the PEPFAR team such as administrative program
support, monitoring and evaluation expertise, and HIV prevention expertise.
The time line for transferring the Nairobi-based CDC FSN and contract positions to Juba is dependent on identification of office
space. In addition to the Program Assistant who will serve as an office manager and provide administrative support to PEPFAR
GAP Sudan activities, the planned CDC positions in Juba include a physician Care and Treatment Technical Advisor, a
Laboratory Officer/Technologist, and a Counseling and Testing Advisor.
The physician Care and Treatment Technical Advisor will provide technical guidance to partners on predominantly clinical issues
such as care, treatment, and PMTCT. This advisor would participate in guideline and curriculum development, conducting training,
and mentoring partners in care and treatment.
The Laboratory Officer/Technologist will work in tandem with the existing Nairobi-based Laboratory Technologist to support
surveillance and counseling and testing in southern Sudan in addition to providing technical support and leadership in HIV
laboratory methods to the National Reference Laboratory in Juba.
The Counseling and Testing Advisor will continue to provide training and technical support to partners and the GoSS on HIV
counseling and testing.
PEPFAR Sudan team has been receiving technical support from the USAID East Africa Regional Office since its inception.
Estimates for staff time (up to 30 days each) has been made and some FY 2009 funds will be set aside from the Sudan PEPFAR
budget to contribute towards the partial funding for specific technical assistance and program support of three critical staff (the
HIV/AIDS Senior Advisor for Prevention, Care, and Support, the M&E Advisor and the Care and Treatment Specialist). USAID'S
Health Advisor will provide about 25% of his time to PEPFAR which will be funded with FY 2009 funds.
The Sudan PEPFAR team continues to work between agencies. The FY 2009 revised staffing pattern, including all contract
mechanisms for needed support, was discussed between the agencies and agreed upon. All PEPFAR positions for Sudan,
whether hired through USAID or CDC or one of the agency's contract mechanisms, are to support any PEPFAR need or partner
regardless of the source of funding for the position or the partner. Almost all areas cross-cut and the technical support of an M&E
Advisor or one for Prevention or Care and Treatment will be available to PEPFAR Sudan.
The PEPFAR team has also held discussions on the need for inter-agency site visits, including joint site visits and the ability for
either agency to visit and report back on any partner activities during a site visit. The team plans to work collaboratively in all
aspects to implement PEPFAR Sudan goals and objectives and to attain the targets, while reducing the burden of HIV in Sudan.
In FY 2009 the combined cost of doing business is projected to be over one million dollars at $1,058,000, or 11% of the total
budget. This has been proportioned to the appropriate program areas. The Management and Staffing budget also includes the
one-time cost of either obtaining space within the MOH and the remodeling costs of procuring a pre-fabricated or other structure
for space on MOH property. Travel costs for M&S staff are included in the M&S budget.
Table 3.3.19:
