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
Supply Chain Management Systems (SCMS) is to procure HIV testing and counseling and HIV Quality assurance program supplies for the PEPFAR South Sudan program. These supplies include HIV rapid test kits (RTKs) and reagents and materials for the laboratory quality assurance.
The management, storage and distribution of HIV RTKs were done from CDC Nairobi until FY2011. In FY2011 SCMS started delivering supplies directly to Juba, South Sudan. In early FY2012, SCMS identified Freight in time (FIT), a local agent in Juba, to handle shipments, clearance, storage and distribution of commodities. In FY 2012, SCMS through FIT will be able deliver supplies directly to the PEPFAR partners offices in Juba efficiently and within the shortest time possible. SCMS will streamline the delivery process by ensuring that FIT communicates with partners prior to delivery in order to have site personnel receive, inspect and validate commodities for discrepancies in quality or quantity. FIT will also ensure that the partners are notified of the status of all upcoming deliveries, and submit proof of delivery to PEPFAR point of contact. The PEPFAR partners will then be able to distribute commodities to their field sites in the states in a timely fashion.
In order to avoid incidences of stock-outs, PEPFAR South Sudan will be monitoring consumption of HIV commodities through collection of quarterly consumption data from implementing partners and sub-partners and cross-checking record at the field sites during support supervisory visits.
In order to strengthen the Care program in South Sudan that is being implemented by the PEPFAR Partners, procurement of cotrimoxazole will be done centrally through SCMS. In an environment where it is unknown when or if ARVs will be available for those HIV positive individuals who are eligible for treatment, it is critical that cotrimoxazole is available and a part of care programs. Based on the PEPFAR FY12 target for number of persons testing for HIV, it is estimated that 7,633 clients will test positive for HIV and all will receive cotrimoxazole for prophylaxis.
The funding for HIV Rapid Test Kits (RTK) for TB clinics as well as many near-by VCT sites to TB clinics was thorough the Global Fund. This funding is no longer available. No donor has come forward to provide HIV test kits for the TB clinics or for the health facilities that are near TB clinics. This funding is to assist the MOH in sustaining the gains made over the previous five years in having TB patients tested for HIV by procuring the HIV RTKs to be used to test TB patients for HIV. It is expected that about 6,000 TB patients will be tested for HIV.
The MOHs blood transfusion safety program has relied on HIV RTKs procured through the HIV Round 4 Global Fund resources. The Round 4 ended on 30 November 2011; the Round 10 HIV Global Fund was not successful. At this time the MOH has not identified resources or another donor to support HIV testing of blood that will be transfused. In order to fill this critical gap in public health safety and ensure that blood transfusion is safe, PEPFAR South Sudan will include procurement of RTKs for the blood transfusion centers located at hospitals in FY2012.
The procurement will provide HIV test kits to enable screening of 18,000 donors in FY12. About half of the blood donation in South Sudan takes place in Juba at the Juba Teaching Hospital; both the Al-Sabaha Childrens Hospital and the Juba Military Hospital send the majority of their transfusion patients to the Juba Teaching Hospital.
PEPFAR South Sudan, through a different Implementing Mechanism, will be providing technical assistance to the MOH in the area of blood transfusion safety. The availability of RTKs in the current settings will support the other planned TA.
Through SCMS, PEPFAR South Sudan will provide to Implementing Partners the necessary RTKs for the HTC program. PEPFAR South Sudan is supporting 43 static HIV testing and counseling sites and regular outreach and mobile services. Details of the HVCT program are found in the Implementing Mechanism budget narrative. The national algorithm is followed and this is the same as the recently adopted WHO two-test algorithm where Determine HIV 1/2 will be used as a first line test and Unigold HIV 1/2 as a confirmatory test. In FY 12, PEPFAR target for persons testing for HIV is approximately 90,000 clients.
The estimated number of RTKs needed for HTC is based on a) target for FY12 that is 20% higher than the FY11 achievement of 87,512 clients; b) expected increase in clients/sites from sites that had been funded under the Global Fund Round 4 and for which no donor or funds are currently identified; and c) support to the MOH for the 2012 World AIDS Day National Testing Campaign of up to 50,000 people.
In FY11, PEPFAR supported the MoH to start performing quality assurance for its HIV program from the Juba Teaching Hospital laboratory as the National Public Health Laboratory (NPHL) has not yet been completed. PEPFAR will continue to provide reagents and related commodities for performing quality assurance for the HIV program. The QA activities to be conducted will include:
Kit-to-kit validation of HIV test kits when they reach in-country and before distribution to partners.
Provision of internal quality control panels to sites for checking kit performance and ensure reliability of results obtained from the field. These panels will be prepared by the Serology laboratory at the CDC International laboratory branch in Atlanta, shipped to CDC South Sudan and then distributed to HIV testing sites to be used for internal quality control.
Dry blood spot (DBS) collection and testing. DBS specimen will be collected from 10% of those tested for HIV using the rapid test strips at the HTC and PMTCT sites, and sent to the NPHL for testing using 4th generation HIV assays. The counselors at the field locations will be trained to properly collect and store DBS cards and have them transported to the NPHL in a timely manner. The laboratory technician at NPHL will be trained periodically on the testing protocols and trouble-shooting to ensure that results are reliable.
PEPFAR will also support Proficiency testing (PT) at 50 sites in FY 12 and later expand to cover all testing sites in subsequent years through use of Dry tube specimen (DTS). PEPFAR South Sudan will make arrangements to obtain DTS panels from the HIV reference laboratory in Kenya until at a time when the NPHL in South Sudan is in position to prepare DTS in country. At the testing sites counselors will run the test and send results back to Kenya for counselor performance analysis. SCMS will provide test kits to be used for conducting the PT at the site and for associated trainings on the use of DTS.
External quality assurance program for serology. PEPFAR will support the participation of the NPHL in a serology external quality assurance program through the provision of supplies and technical assistance. Panels will be prepared by the International Laboratory Branch at Atlanta, and sent to the NPHL in Juba- South Sudan for testing. Results of these tests will be sent back to ILB serology laboratory in Atlanta for performance assessment.
