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: 2008 2009
THIS IS AN ONGOING ACTIVITY FROM FY 2008. ACTIVITIES LISTED HAVE BEEN INITIATED AND
WILL PROCEED DURING FY 2009 AS IN THE PREVIOUS YEAR. ACCOMPLISHMENTS WILL BE
REPORTED IN THE FY 2008 APR. PLEASE NOTE THAT THE ACTIVITY NARRATIVE REMAINS
UNCHANGED FROM FY 2008.
TITLE: PMTCT Activities, Management and Staffing (Base)
ACTIVITIES: Management and staffing funds are split between Base and GHAI to ensure continuity of
activities and no interruption in staff funding.
FY 2008 funds will support a total of two full-time staff. One senior PMTCT advisor to oversee the PMTCT
program and provide guidance on implementation of regionalization, and one program specialist to manage
cooperative agreements.
HHS/CDC will continue close collaboration with the Government of Tanzania, Ministry of Health and Social
Welfare (MOHSW), and other key partners to further strengthen technical and program capacity to ensure
appropriate Emergency Plan implementation. This will include the establishment and expansion of
qualityassured
national systems in prevention of mother to child transmission (PMTCT).
In FY 2008, this funding will support the PMTCT in-country program staff to provide technical assistance
and support to PMTCT implementing partners as they operationalize the new district approach model and
regionalization of PMTCT services. The in-country staff will work with implementing partners to expand
PMTCT services to lower-level facilities and empower districts in order to serve the targeted population.
Incountry
staff will provide technical assistance to MOHSW and implementing partners to strengthen linkages
between ART, PMTCT, TB, malaria, family planning, and nutrition services at the national, district and site
level. An integrated approach to care and treatment will be emphasized.
Early infant diagnosis and enrollment into pediatric care and treatment is a main focus in FY 2008. Incountry
staff will provide technical assistance for all early infant diagnosis activities and will ensure that all
PMTCT services are in line with the USG technical strategy and national guidelines. Field visits and
attendance at regional authority meetings will be necessary for continued program monitoring.
PMTCT staff will provide technical assistance for the Ministry of Health and Social Welfare (MOHSW) to
finalize and operationalize the recently revised national guidelines and move into a predominant role of
national coordination and program planning. Increased technical assistance will be provided in the area of
monitoring and evaluation to ensure quality of data and that data is used for decision-making.
In addition, the HHS/CDC in-country team will work with implementing partners to develop annual work
plans, conduct training and ensure overall program monitoring. Staff will also ensure that all HHS/CDC
programs adhere to the national and USG PMTCT strategies and protocols.
New/Continuing Activity: Continuing Activity
Continuing Activity: 13620
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
13620 9433.08 HHS/Centers for US Centers for 6567 1470.08 Base $37,635
Disease Control & Disease Control
Prevention and Prevention
9433 9433.07 HHS/Centers for US Centers for 4602 1470.07 Base $37,635
Table 3.3.01:
ACTIVITY UNCHANGED FROM FY 2008.
TITLE: Management and Staffing (Base)
ACTIVITIES: In FY 2008, HHS/CDC will continue to work closely with the government of Tanzania (GOT)
through the relevant Ministries of Health and Social Welfare (MOHSW)/National AIDS Control Program
(NACP), Ministry of Education and Vocational training (MOEVT), and other key actors in the areas of
abstinence and faithful programs to strengthen technical and program capacity for implementing the
PEPFAR. The proposed funding will support the salaries of in-country youth program staff for FY 2008 and
site visits to provide direct capacity building among partners.
Emphasis will be placed on building the capacity of the organizations to develop appropriate behavior
change communication strategies and IEC materials for AB. Staff will collaborate with the NACP/TAYOA,
MOEVT/TIE, Balm In Gilead and other key USG funded AB partners. Staff expertise with behavior change
and behavioral theory will enhance the effectiveness of the HIV/AIDS programs that promote abstinence
messages for in and out of school youth.
The staff will work with MOEVT/TIE to scale up the LPS training in more schools in the selected regions.
Youth program staff will provide guidance on ways in which the life planning skills guidelines can be used to
reinforce and simultaneously address AB prevention while linking with other HIV prevention strategies.
The in country staff will conduct site visits to other countries to learn HIV/AIDS prevention programming to
sites managed by government, NGO, and FBO partners. They will also conduct field visits for monitoring
the implementation of the programs through supportive supervision with partners. More time will be spent
mentoring the NACP/TAYOA and the MOEVT/TIE on the development of quality BCC materials and
curriculums tailored to different target groups. A particular focus will be placed on assisting the key
implementers to adopt the Modeling and Reinforcement to Combat HIV (MARCH) and Families Matter
Program (FMP) strategies and approaches.
Continuing Activity: 13623
13623 9423.08 HHS/Centers for US Centers for 6567 1470.08 Base $289,961
9423 9423.07 HHS/Centers for US Centers for 4602 1470.07 Base $231,341
Table 3.3.02:
NEED and COMPARATIVE ADVANTAGE: Management and staffing funds are split between Base and
GHCS to ensure continuity of activities and no interruption in staff funding. This activity relates to 8724.
Continuing Activity: 16374
16374 16374.08 HHS/Centers for US Centers for 6567 1470.08 Base $7,800
Table 3.3.03:
ACTIVITY NARRATIVE HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
With FY09, CDC will work with AABB to assist NBTS to develop strategies to increase blood collection and
distribution, implement an effective and well coordinated automated blood testing and grouping systems,
reorganize staff placement across the zones, improve its coordination between different systems put in
place in FY08 (PDAs, SMS phones for Health) so as to link with the blood computer software to be procured
and installed in FY09. Technical Assistance will also be jointly provided for a more comprehensive
monitoring and evaluation system to include all the critical processes and systems thereby continuously
improving the quality services and safety of blood and blood products provided by the NBTS. END OF
MODIFICATION
TITLE: Blood Safety-Management and Staffing
NEED and COMPARATIVE ADVANTAGE:
In FY 2004, the National Blood Transfusion Service (NBTS) in
The Ministry of Health and Social Welfare (MOHSW) established a cooperative agreement with the CDC for
Rapid strengthening of blood safety services in Tanzania. The USG strategically focused on establishing a
nationally sustainable and coordinated body, developing infrastructure, and acquiring necessary capacity,
building for collection, processing, storage, and distribution of safe blood. Health and Human Services,
through CDC provides technical assistance and financial support to the mainland NBTS and Zanzibar Blood
Transfusion Services (ZBTS) through a central funding mechanism to NBTS and the Association of
American Blood Banks provides (AABB) consulting services. This technical assistance (TA) involves visits
from the project officer in Atlanta as well as in-country site visits to central, zonal, and regional centers,
operated by NBTS, the Tanzania Red Cross Society, and military hospitals under Tanzania People ‘s
Defense Forces.
ACCOMPLISHMENTS: Due to the expansion and development of the NBTS scope of services, FY 2006-
2007 funds supported the recruitment of an in-country CDC blood safety program officer who provided TA
to NBTS toward renovating, equipping , and operationalizing zonal centers. Collaboration between NBTS,
AABB, and CDC resulted in the development of policy, guidelines, quality systems and processes, a
monitoring and evaluation (M&E) framework, as well as M&E tools. With FY 2007 funds, HHS/CDC is
providing TA to NBTS to formulate, promote, and strengthen existing blood donor clubs. This has
strengthened the capacity of the NBTS to effectively and efficiently manage its programs through training,
mentoring, advocacy for the implementation of the NBTS as an executive agency, and ensuring
sustainability through a cost recovery process.
ACTIVITIES:
With FY 2008 funds, CDC collaborated with the AABB to provide TA in M&E, quality, management, and
the efficient use of the database system to monitor, record, and account for different blood related variables.
In addition CDC will collaborate with NBTS to provide capacity building for staff, and effective management
of donor clubs in order to ensure repeat donations. This will result in an increase in the supply of
sustainable, safe, and adequate blood supply. CDC will also provide TA to the Abbott foundation, which is
renovating regional hospitals and will incorporate blood banks in their blueprints to ensure adequate supply
and proper storage procedures. CDC will also provide TA and assist with equipment procurement for the
regional blood banks. In order to achieve this CDC will obtain expertise through contractual mechanisms
and collaboration with AABB.
The CDC and the AABB will combine their resources to provide essential TA to NBTS to facilitate formation
of regional blood committees, training of individuals within those committees, and feedback from physicians
on rational blood uses at different levels. Working collectively, CDC, supply chain management systems
(SCMS), NBTS, and other partners will ensure a sufficient backup supply for test kits and reagents.
Additionally, CDC will assist NBTS to integrate PMI and prevention activities in their work plan and will
subsequently assist in reviewing their completed work plan, budget, and reports in addition to linking with
private public partnership toward implementing Phones for Health and the use of Personal Digital Assistants
(PDAs) to enhance data transmission and communication . Collaboration between the CDC and the
Counseling and Testing and the Presidential malaria initiative (PMI) programs incorporate malaria
prevention messages and sexual abstinence and be-faithful messages in blood safety activities. CDC will
work with the counseling and testing programs to include messages that promote donor recruitment
targeting to the general public.
LINKAGES: The Blood Safety Program will work with PMI, malaria, injection safety and counseling and
testing programs to develop preventive messages, and promote donor recruitment across these PEPFAR
programs.
SUSTAINAIBLITY: TA provided by HHS/CDC and USG partners is geared toward developing sustainable
blood systems.
Continuing Activity: 13624
13624 9473.08 HHS/Centers for US Centers for 6567 1470.08 Base $56,400
9473 9473.07 HHS/Centers for US Centers for 4602 1470.07 Base $61,680
Table 3.3.04:
THIS IS A NEW ACTIVITY.
TITLE: Management and Staffing (GHCS)
ACTIVITIES: USG staff will place an emphasis on building the capacity of the relevant organizations to
develop appropriate injection safety strategies. The USG staff will work directly with implementing partners,
both governmental and non-governmental, to improve the quality and reach of the IDU activities. Technical
assistance will be provided through site visits, capacity assessments, mentoring, and skills building, as well
as monitoring the progress of the programs. The staff will work directly with USG partners to develop
effective interventions and disseminate lessons learnt to the others. The staff will also collaborate with GOT
on defining national priorities and strategies to achieve sustainability of the programs.
New/Continuing Activity: New Activity
Continuing Activity:
Table 3.3.05:
ACTIVITIES: As identified in the USG five-year strategy, targeted behavior change and condom distribution
to reduce transmission in MARPs, including injecting drug users (IDU), is a priority.
Emphasis will be placed on building the capacity of the relevant organizations to develop appropriate HIV
prevention strategies, risk reduction activities and IEC materials for IDU. Staff will collaborate with key USG
partners and staff expertise with behavior change and behavioral theory will enhance the effectiveness of
the HIV/AIDS programs that target IDU and other substance users.
The USG staff will work directly with implementing partners, both governmental and non-governmental, to
improve the quality and reach of the IDU activities. Technical assistance will be provided through site visits,
capacity assessments, mentoring, and skills building, as well as monitoring the progress of the programs.
The staff will work directly with USG partners to develop effective interventions and disseminate lessons
learnt to the others. The staff will also collaborate with GOT on defining national priorities and strategies to
achieve sustainability of the programs.
Table 3.3.06:
ACTIVITIES: USG staff will work with male circumcision partners to build the capacity of the relevant
organizations to develop appropriate services and IEC materials for men interested in circumcision services.
Staff will collaborate with key USG partners and staff expertise with behavior change and behavioral theory
will enhance the effectiveness of the HIV/AIDS programs that target men for male circumcision.
improve the quality and reach of the male circumcision activities. Technical assistance will be provided
through site visits, capacity assessments, mentoring, and skills building, as well as monitoring the progress
of the programs. The staff will work directly with USG partners to develop effective interventions and
disseminate lessons learnt to the others. The staff will also collaborate with GOT on defining national
priorities and strategies to achieve sustainability of the programs.
Table 3.3.07:
TITLE: Palliative Care: Basic Health Care Management and Staffing
NEED and COMPARATIVE ADVANTAGE: USG agencies provide direct technical support for all of its
HIV/AIDS programs through US and Tanzania based organizations, which manage and implement
incountry activities. These activities are funded through cooperative agreements and contracts that are
performed at the field level in direct partnership and collaboration with Tanzanian governmental and
nongovernmental organizations. The non-governmental implementing partners have considerable
experience in the field of HIV/AIDS and have established offices in Tanzania to carry out these activities.
ACCOMPLISHMENTS: FY 2006 funds supported the in-country Palliative Home-based Care program staff
to assist the Ministry of Health and Social Welfare (MOHSW) Home-based Care Unit to initiate the Basic
Care preventive package program and Home-based Care counseling and testing. Technical support was
provided in the zonal Home-based Care meeting and at the sub committee meetings. The staff worked with
MOHSW through the Counseling and Social Services Unit (CSSU) in conducting supportive supervision and
preparing scale up and expansion plans for Palliative Home-based Care activities in Tanzania.
In FY 2007 the USG will continue to collaborate closely with the Government of Tanzania, Ministry of Health
(MOHSW), and other key partners to further strengthen technical and program capacity for implementing
the Presidents Emergency Plan for AIDS Relief (PEPFAR). This will include the establishment and
expansion of quality-assured national systems in the areas of surveillance, prevention of mother-to-child
transmission (PMTCT), laboratory services, blood safety and blood transfusion, antiretroviral treatment,
care and TB/HIV programs. In FY 2007, this funding will support the in-country Palliative Care: Basic Health
Care/Support program staff at the US Centers for Disease Control (CDC). The staff will: 1) support the
National AIDS Control Programme (NACP) - Counseling and Social Services Unit in their coordination role;
2) assist with the provision of integrated, high quality care and support for people living with HIV/AIDS; 3)
provide guidance for the strengthening of referrals between community and facility based care; 4) assist in
the preparation for implementation of the preventive care package; 5) provide guidance on improving the
monitoring and information system; 6) assist with enhancement of national guilelines for palliative care; 7)
conduct field visits and supportive supervision to USG sites that are implementing Home-Based Care(HBC);
8) review and compile quarterly and annual reports and oversee the HBC program mid- term review.
SUSTAINAIBLITY: The technical assistance (TA) and support provided by the USG through cooperative
agreements and contracts will ensure a long-term sustainable system for providing HIV/AIDS services to
Tanzanians.
Continuing Activity: 13626
13626 9419.08 HHS/Centers for US Centers for 6567 1470.08 Base $74,300
9419 9419.07 HHS/Centers for US Centers for 4602 1470.07 Base $100,620
Table 3.3.08:
TITLE:ARV Services, Management and Staffing, Base funding
Management and staffing funds are split between Base and GHAI to ensure continuity of activities and no
interruption in staff funding. This acrtivity relates to activity # 5506.08
FY 2008 funds will support a total of five full-time staff. Three technical staff will assist in coordinating
activities within this program area as well as serve as technical leads for aspects of the work. The specific
composition of the staffing is three full-time specialists given the scope and magnitude of the treatment
rollout
in Tanzania, and the evolving responsibility of the USG in the coordination of the various ARV treatment
partners.
In addition, one aministrative specialist will assist the team with all logistical and communication work. With
the enormous growth of the program during the last fiscal year, this position has become a critical addition
to the team.
Finally, a public health advisor will be integral part of the team by providing data analysis for program
planning and evaluation.
In FY 2008, USG/Tanzania ART-implementing partners will assist the GOT in scaling up ARV services to
additional sites throughout the country, especiallly to lower level health care facilities. USG partners will
continue providing some level of support, and will be integrated within the regional and district annual health
budget and plans.
In support of this, the technical full-time staff members will work directly with implementing partners, both
governmental and non-governmental partners, specifically providing technical assistance to the National
AIDS Control Program (NACP) and USG ART partners. Field visits and attendance at regional authority
meetings will be a necessary. One staff member, in addition to the focus on ARV Services, will help oversee
the ongoing integration of non-ARV services such as PMTCT, TB/HIV and Care. One specialist will mainly
focus on the multi-dimensional strategic approach to pediatric HIV/AIDS.
ACTIVITIES:.
1. Assist in coordinating activities within this program area as well as serve as technical leads for aspects of
the work.
2. One administrative specialist will assist the team with all logistical and communication work.
3. A public health advisor will be integral part of the team by providing data analysis for program planning
and evaluation.
4. Work directly with implementing partners, both governmental and non-governmental partners, specifically
providing technical assistance to the National AIDS Control Program (NACP) and USG ART partners and
conducting field visits
5. Oversee the ongoing integration of non-ARV services such as PMTCT, TB/HIV and Care. One specialist
will mainly focus on the multi-dimensional strategic approach to pediatric HIV/AIDS.
Continuing Activity: 13631
13631 9399.08 HHS/Centers for US Centers for 6567 1470.08 Base $150,829
9399 9399.07 HHS/Centers for US Centers for 4602 1470.07 Base $329,092
Table 3.3.09:
THIS IS A NEW ACTIVITY
TITLE: Pediatric Care: Basic Health Care Management and Staffing
HIV/AIDS programs through US- and Tanzania-based organizations, which manage and implement in-
country activities. These activities are funded through cooperative agreements and contracts that are
performed at the field level in direct partnership and collaboration with Tanzanian governmental and non-
governmental organizations. The non-governmental implementing partners have considerable experience
in the field of HIV/AIDS and have established offices in Tanzania to carry out these activities.
ACTIVITIES: In FY 2009 the USG will collaborate closely with the Government of Tanzania, Ministry of
Health and Social Welfare, and other key partners to strengthen technical and program capacity for
implementing PEPFAR. This will include the establishment and expansion of quality-assured national
systems in the areas of surveillance, prevention of mother-to-child transmission, laboratory services, blood
safety and blood transfusion, antiretroviral treatment, care and TB/HIV programs. In FY 2009, this funding
will support the in-country Pediatric Care: Basic Health Care/Support program staff at the US Centers for
Disease Control. The staff will travel to various sites for supportive supervision and basic program
evaluation of pediatric care activities, and travel to provide technical assistance in various technical meeting
in enhancement of national pediatric care guidelines and its implementation.
SUSTAINAIBLITY: The technical assistance and support provided by the USG through cooperative
Table 3.3.10:
TITLE: Pediatric Treatment: Management and Staffing
HIV/AIDS programs through US and Tanzania based organizations, which manage and implement in-
In FY 2009 the USG will collaborate closely with the Government of Tanzania, Ministry of Health (MOHSW),
and other key partners to further strengthen technical and program capacity for implementing the Presidents
Emergency Plan for AIDS Relief (PEPFAR). This will include the establishment and expansion of quality-
assured national systems in the areas of surveillance, prevention of mother-to-child transmission (PMTCT),
laboratory services, blood safety and blood transfusion, antiretroviral treatment, care and TB/HIV programs.
In FY 2009, this funding will support the in-country Pediatric Treatment program staff at the US Centers for
Disease Control (CDC). The staff will: 1) Travel to various sites for supportive supervision and basic
program evaluation of pediatric treatment activities. 2) Travel to provide technical assistance in various
technical meeting in enhancement of national pediatric treatment guidelines and its implementation.
Emphasis Areas
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $600
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.11:
ACTIVITY NARRATIVE REMAINS UNCHANGED FROM FY 2008
TITLE:HIV/TB Collaborative Activities, Management and Staffing (GAP)
NEED and COMPARATIVE ADVANTAGE: Tanzania established TB/HIV program in 2001. In 2005, the
Ministry of Health through NTLP signed a Cooperative Agreements with CDC for implementation of the
TB/HIV collaborative activities in Tanzania. HHS/CDC provides direct technical support for all HIV/HIDS
programs through US and Tanzania based organizations, which manage and implement in-country
activities. Cooperative Agreements fund these activities which are performed at the field level in direct
partnership and collaboration with Tanzanian governmental and non-governmental organizations. The
responsibilities of the TB/HIV staff include working with the Ministry of Health (MOH) through the National
Tuberculosis and Leprosy Program (NTLP) and other partners, to oversee the overall activities within the
program, guide the partners on the PEPFAR goals and ensure quality services.
ACCOMPLISHMENTS: FY 2006 funds supported the in-country TB/HIV program staff and technical
assistance (TA) from Headquarters who aided the MOH with the development of TB/HIV policy, training
curriculums and manuals for TB/HIV collaborative services. The staff provided technical support for the
development of needs assessment tools, TB screening tools for PLHA and modification of TB data
collection to incorporate HIV information. The staff worked with MOH through NTLP to conduct needs
assessment, training, supportive supervision and preparing scale-up and expansion plans for TB/HIV
activities in Tanzania.
ACTIVITIES: The core activities for the TB/HIV program staff in FY 2008 will include: providing technical
assistance to MOH though NTLP, The National AIDS Control Program (NACP) and other partners
implementing TB/HIV collaborative activities in the scaling-up of TB/HIV activities in Tanzania; guiding the
partners on the PEPAR goals and required indicators; working with NTLP and other partners in conducting
needs assessment and supportive supervision activities; participating in, and providing technical support for
the training of health care providers and sensitization of regional, district and community leaders on TB/HIV
collaborative services; following up, in collaboration with NTLP, on the renovation of TB clinics (to done by
the Regional Procurement Support Office [RPSO]) ensuring that they are able to provide TB/HIV
collaborative services including provision of Anti-Retroviral Treatment (ART); providing assistance to
partners in reviewing their work plan and budgets, report writing and timely submission; providing
assistance to the Senior Program Manager for Care in overall program planning, establishment of new
strategies, resource allocation, and expansion of the Government of Tanzania (GOT) supported TB/HIV
Program to achieve the overall goals of program; assisting the Senior Program Manager with collaborations
involving MOT through NTLP and insuring that the CDC TB/HIV program embodies its needs and
objectives; closely monitoring and supervising TB/HIV collaborative activities allocated by the Senior
Program Manager for Care and serving as a consultant to TB/HIV national and district coordinators in
addressing and resolving TB/HIV implementation issues; evaluating TB/HIV collaborative implementation
activities and making modifications based on protocols and available data; performing other duties as
assigned by immediate supervisor or other Senior CDC/Tanzania management.
SUSTAINAIBLITY: The technical assistance and support provided by HHS/CDC through Cooperative
Agreement will ensure a long term sustainable system for providing TB/HIV collaborative services in
Tanzania.
Continuing Activity: 13627
13627 9250.08 HHS/Centers for US Centers for 6567 1470.08 Base $89,000
9250 9250.07 HHS/Centers for US Centers for 4602 1470.07 Base $59,340
Health-related Wraparound Programs
* TB
Table 3.3.12:
ACTIVITY REMAINS UNCHANGED FROM FY 2008.
TITLE: HIV CT Activities, Management and Staffing (Base)
NEED and COMPARATIVE ADVANTAGE: Tanzania established a Counseling and Testing (CT) program in
1987. In 2004 the Ministry of Health through the National AIDS Control Program (NACP) signed a
cooperative agreement with CDC for implementation of the CT activities in Tanzania. HHS/CDC provides
direct technical support for all HIV/HIDS programs through US and Tanzania-based organizations, which
manage and implement in country activities. These activities are funded through cooperative agreements,
and are performed at the field level in direct partnership and collaboration with Tanzanian governmental and
non governmental organizations. The responsibility of CT staff include working with the Ministry of Health
and Social Welfare (MOHSW) through NACP and other partners to oversee the overall activities with in the
program, guide the partners on the PEPFAR goals, and ensure quality services.
ACCOMPLISHMENTS: PEPFAR funds supported the in-country CT program staff to assist the MOHSW
and partners with the development of CT policy, training curriculum and manuals. The staff provided
technical support for development of guidelines, training materials, and other relevant materials. The staff
also worked with MOHSW/NACP in conducting supportive supervision, training, and preparing scale-up and
expansion plans for CT activities in Tanzania.
The core activities for the CT program staff in FY 2008 include the following:
1) Providing technical assistance and oversight to the MOHSW, NACP, Zanzibar AIDS Control Program
(ZACP) and other partners in the implementation of HIV counselling and testing. This includes the
development of policy, guidelines, protocols, tools, reporting instruments, and systems to effectively monitor
and evaluate counselling and testing program activities.
2) Identifying and correcting problems, barriers, and issues that impede the effective implementation of
counselling and testing program activities.
3) Developing and maintaining effective liaisons with partner organizations to ensure that timelines and
quality standards for implementation of program activities are met. Staff will identify training needs in
implementing partner organizations, facilitates, and participates in the planning and development of training
programs, teaching modules, manuals, and educational materials to address identified needs. Staff will
also build capacity through mentoring while keeping up to date with scientific developments, innovations,
best practices, and new approaches in CT.
4) Participating in the design and development of program guidelines and activities, including protocols for
HIV counselling and testing, strategies for expanding and improving the quality of counselling and testing
services and strategies.
5) Conducting site visits to provide technical assistance and oversight to partners in program
implementation.
6) Ensuring adherence to established work plans and CDC and PEPFAR guidelines, policies and priorities.
SUSTAINAIBLITY: The technical assistance and support provided by HHS/CDC will ensure a long term
sustainable system for CT services in Tanzania.
Continuing Activity: 13629
13629 9608.08 HHS/Centers for US Centers for 6567 1470.08 Base $42,600
9608 9608.07 HHS/Centers for US Centers for 4602 1470.07 Base $34,718
Table 3.3.14:
TITLE: Laboratory Infrastructure and Capacity Building Management and Staffing
NEED and COMPARATIVE ADVANTAGE: This activity is funded through country held funds and
complements the centrally funded activities.
HHS/CDC laboratory infrastructure program has the necessary expertise to support care and treatment
partners and the MOHSW in the provision of well-equipped laboratories staffed by qualified personnel
applying goodl laboratory practices which are essential in the fight against HIV/AIDS. The Ministry of
Health and Social Welfare (MOHSW) with support from USG in FY 2004 developed a plan to strengthen
HIV/AIDS laboratory capacity. Emergency Plan funds were allocated to support the network of zonal,
regional, and district laboratories and provide capacity to diagnose HIV infection, disease staging of
HIV/AIDS, and treatment monitoring.The HHS/CDC laboratory infrastructure program draws resources and
support from the Global AIDS Program International Laboratory branch which has a wealth of expertise and
human resources, and International Laboratory partners. HHS/ CDC is a renouned institution for its
laboratory expertise and is therefore best placed to support the laboratory Infrastructure Program
ACHIEVEMENTS: HHS/CDC provided technical assistance to the MOHSW and coordinated technical
assistance by international and in country laboratory partners in order to meet the needs for HIV diagnosis,
and monitoring of care and treatment. HHS/CDC has provided technical assistance at all levels of the
National Laboratory Network to ensure a comprehensive infrastructure and capacity building.
HHS/CDC provided technical assistance in the revision of the national rapid testing algorithm and the
subsequent training and roll out. Technical assistance and coordination was provided in the training for
CD4, Chemistry and Hematology undertaken by Association of Clinical Pathologists (ASCP) and the African
Medical Research Foundation ( AMREF), technical assistance in the development of standard operational
procedures and quality systems implementation by the Clinical and Laboratory Standards Instituted and in
the revision of data collection and reporting tools and further implementation of Laboratory Information
Systems by The Association of Public Health Laboratories (APHL). HHS/CDC also coordinates the
laboratory support provided by the USG care and treatment partners in order to ensure a cohesive
implementation without duplication of efforts but also to meet the increasing demand for laboratory support
to care and treatment sites.
HHS/CDC works to build laboratory capacity in the country. This has been achieved through its
participation in national laboratory activities and attending coordination meetings. The training of trainers
with teach back methodology has been adapted from CDC and is now the modus operandi for all in-service
training. This has ensured that training capacity is left in the country.
HHS CDC undertook renovation and equipping of the National Quality Assurance Laboratory and Training
Center which is now complete. This center will be responsible for the quality assurance activities of the
country through the implementation of the National Quality Framework as well as training to achieve the
quality.
HHS/ CDC has provided leadership and guidance to the implementation of the Early Infant Diagnosis
Program and has been involved in the preparation policies and guidelines.,
HHS/CDC has procured high through put equipment for three zonal hospitals and one military referral
hospital. This effort was complementary to the global fund which procured medium and low through put
Equipment for the regional and district laboratories while the AXIOS procured equipment for the fourth
Zonal Hospital.
The HHS/CDC Laboratory Infrastructure Program works in collaboration with MOHSW and partners to
impliment National Laboratory Plan in support of HIV/AIDS Care and Treatment Plan. The program
supports the laboratory network at all levels in infrastructure and capacity building.
FY09 funds wil be used to maintain the existing staff consisting of a senior laboratory advisor and a senior
laboratory technologist and hire additional two members of staff approved in FY 2007. These will be the
Infant Diagnosis Program officer and an additional senior laboratory technologist whose positions are
currently vacant.
HHS CDC will financially support the procurement of reagents, equipment and supplies in the first year of
operations of the NHQALTC as the MOHSW plans to take over not only the building but also works on
making the NHQALTC into an executive agency which will make it autonomous. This process is anticipated
to take a year. In FY 08 HHS/ CDC will assist MOHSW to coordinate Technical Assistance to the National
HIV Quality Assurance Laboratory and Training Centre from USG partners. The NHQALTC will provide
leadership and serve as a focal point for HIV/AIDS-related laboratory training, quality systems
implementation and will support and promote operational research into various aspects of HIV including its,
treatment, control and prevention and related opportunistic infections. The NHQALTC will serve as a
referral laboratory for specimens that present unusual or unique testing problems and facilitate referral for
specialized testing not available in the country, such as genetic sub-typing, HIV drug resistance testing, HIV
-1 incidence, and other specialized microbiological assays. In the long term the NHQALTC will undertake
greater Public Health Laboratory Functions such as the surveillance of new and emerging infections such
as Avian Influenza.
HHS/CDC will continue to coordinate and provide technical Assistance to the Track 1.0 ART awardees
(Columbia University, Harvard University, EGPAF, Family Health International, AIDSRelief) , who provide
support to the laboratory network at the regional level, provide support and Technical assistance to the
MOHSW and coordinate the implementation of the Infant diagnosis program in the country by the care and
treatment partners. The target is to build early infant diagnosis capability at KCMC Moshi, Muhimbili
National Hospital, Mbeya referral hospital and develop capacity to manage speciment transportation and
results back to the patients .This activity will be undertaken in collaboration with the , PMTCT, RCHP, HBC,
OVC and other community based intervention programs. The activities will include the finalisation of the
national infant diagnosis guidelines, customisation of training modules for Tanzania from existing national
and international documents, training on Dried blood Spot (DBS) collection transportation system; provide
Activity Narrative: technical assistance for the renovation of three referral laboratiry facilities to implement DNA PCR; support
the training of three technologist per site on DNA PCR
HHS/CDC will support MOHSW efforts to establish a national HIV laboratory quality assurance system to
meet international standards of Good Laboratory Practices (GLP) and will provide and coordinate technical
assistance to MOHSW and US based partners CLSI, APHL, ASCP and in country based partners NIMR,
AMREF Bugando Medical center Track 1 and non-USG organizations that support the national laboratory
plan such as WHO, AXIOS, JICA and the Clinton HIV/AIDS foundation.. The areas of technical assistance
include laboratory infrastructure renovation, equipment specification and procurement, laboratory
information systems, training, quality assurance framework development and implimentation, assessment
for provision of services for infant diagnosis, policy formulations and guidelines in various areas of
laboratory based and affiliated services
LINKAGES: The HHS/CDC staff work with all USG partners in collabotion with MOHSW and its non -USG
partners such as German technical assistance (GTZ) Clinton Foundation (CHAI), WHO in the planning and
implementation of the HIV/AIDS laboratory activities. The activities are in line with the National HIV/AIDS
multisectorial Framework, the National Laboratory Operational Plan in support of HIV/AIDS care and
treatment for Tanzania and PEPFAR goals. The activities are undertaken in consultation with the National
AIDS Control Program and the PMTCT,VCT, PITC programs
CHECK BOXES: N/A
M&E: N/A
SUSTAINAIBLITY: HHS/CDC works to build capacity nationally for the sustainability of quality laboratory
services. This is in the areas or training trainers, standardization of information and data collection in line
with country requirements, implementation of quality systems with a long term goal towards accreditation
and establishment of implementation, oversight and management structures within the network in line with
the MOHSW operational framework.
Continuing Activity: 13633
13633 9475.08 HHS/Centers for US Centers for 6567 1470.08 Base $164,398
9475 9475.07 HHS/Centers for US Centers for 4602 1470.07 Base $167,501
Table 3.3.16:
THIS NARRATIVE HAS BEEN MODIFIED IN THE FOLLOWING WAY:
This is an ongoing activity from FY 2008. Activities listed have been initiated and will proceed during FY
2009 as in the previous year. Accomplishments will be reported in the FY 2008 APR. Please note that the
activity narrative remains unchanged from FY 2008, however in FY2009 funds will support three additional
positions: 1) SI Liaison, a contractor previously funded under a different budget to support USG/PEPFAR-
wide SI activities; 2) Chief of SI and HCD, which was previously funded under CDC general management
and staffing; and 3) Program Analyst for Systems Strengthening, an ASPH fellow to support activities in the
systems strengthening strategic results unit.
** END - UPDATE**
TITLE: Management & Staffing - SI CDC (GHAI)
ACTIVITIES: CDC Management and Staffing in strategic information (SI) will be used to support CDC
agency-specific staffing needs in Tanzania as they relate to ensuring that the goals and objectives of
PEPFAR are met.
The FY 2008 funds will support seven full-time equivalent staff that will coordinate activities in strategic
information. The composition of the staffing includes the following: 1) Senior Surveillance Advisor, a
contractor, who will oversee all CDC specific activities related to surveillance/surveys and provide
biostatistical support for public health evaluations; 2) Health Management Information System (HMIS)
Advisor, a contractor, who will provide support and technical expertise in developing, implementing, and
maintaining information systems for the Government of Tanzania, and within CDC and USG ; 3) Monitoring
and Evaluation Team Lead, a local hire, who will coordinate all CDC specific activities related to internal and
external M&E and oversee target-setting for OGAC indicators for CDC partners. This advisor will work
closely with the Ministry of Health and Social Welfare (MOHSW), Zanzibar AIDS Control Program (ZACP),
and other CDC partners to standardize and strengthen M&E capacity to ensure sustainability; 4)
Surveillance Advisor, a contractor, to replace the exiting Surveillance ASPH (Association of Schools of
Public Health) fellow, who will provide technical assistance for the development and implementation of HIV
surveillance activities related to PEPFAR, including antenatal clinic surveillance, drug resistance surveys
and monitoring, and behavioral and biological surveys among most at-risk populations. S/he will also
conduct trainings and participate in technical working groups to build capacity within the ministries of health;
5) M&E Advisor, a contractor, to replace the exiting M&E ASPH fellow. The M&E Advisor will support the
M&E senior advisor in implementing M&E activities for CDC and its partners. S/he will work closely with
CDC program officers to build their capacity in program monitoring; 6) M&E Officer, a local hire or ASPH
fellow, to implement M&E related activities for CDC and its partners; and 7) a Database Administrator, a
local hire, who will oversee the planning, maintenance and development of databases, including
implementation of a program monitoring system for PEPFAR Tanzania, and who will also coordinate on the
US Government side, the implementation and use of data from the Phone for Health Initiative.
All CDC SI personnel will be members of the USG Strategic Information Inter-Agency Technical Team (ITT)
and serve as the SI focal person on at least one of the programmatic ITTs.
All of the CDC SI staff described will work directly with the MOHSW on the Mainland and the ZACP on
Zanzibar to provide ongoing technical assistance and building capacity in SI among the respective
Epidemiology Units. They will work with CDC's implementing partners to establish and maintain health
information systems, and monitor and evaluate the activities of CDC's partners. This includes the
development and implementation of national and USG databases for HIV/AIDS, specifically ART
monitoring, counseling and testing, home-based care, PMTCT, and TB/HIV linkages where feasible and
appropriate. It also includes building capacity in monitoring and evaluation and managing and analyzing
surveillance data. In FY 2008, additional emphasis will be placed on building capacity among local research
institutions, including the National Institute of Medical Research and the Muhimbili School of Public Health,
for public health evaluations and surveys. With the implementation of the Phones for Health Initiative in
Tanzania, building interfaces among existing information systems and ensuring the use of data at local
levels will be a major focus. Trainings for Epi Info, data use and activity planning and monitoring will be
conducted for both CDC program officers and CDC's partners.
The FY 2008 funds will support travel, both international (trainings, meetings, and conferences), and
domestic (USG strategic planning meetings, partner meetings, workshops, and partner site visits).
This activity will contribute to developing the human and institutional capacity building within CDC-Tanzania
and its partners, USG agencies, and the Ministries of Health in the United Republic of Tanzania.
LINKAGES: CDC Tanzania's SI Team links with other USG agencies SI professional staff to provide overall
support to the PEPFAR Tanzania team. All SI staff serve on inter-agency technical teams (ITTs). There is
also a linkage with the Measure Resident Advisor in SI through the SI ITT.
CHECK BOXES: Activities will include training and capacity building of local organizations and Government
of Tanzania public health professionals in strategic information, with a primary focus on CDC's partners.
CDC SI staff will provide technical support to public health evaluations through PEPFAR Tanzania. Training
and capacity building in M&E, HMIS, and surveys/surveillance are the objectives of the SI team in CDC
SUSTAINAIBLITY: CDC Tanzania's approach for sustainability in SI is to ensure that capacity is built in
M&E, HMIS, and surveillance/surveys among local organizations and GoT (Ministry of Health and other line
ministries). Capacity building includes both pre-service and in-service approaches. In addition to the above
-mentioned areas, a particular focus will be placed on work plan development and monitoring of activities.
There will be an increased focused on building capacity of local research institutions in public health
evaluations in FY 2008.
Continuing Activity: 13635
13635 9576.08 HHS/Centers for US Centers for 6567 1470.08 Base $167,910
9576 9576.07 HHS/Centers for US Centers for 4602 1470.07 Base $572,376
Table 3.3.17:
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
The FY09 budget now includes one new staff member to support the growing OHSS portfolio. In addition,
the budget will include the Infrastructure Support Specialist who was previously covered under the CDC
management and staffing budget. One additional short term fellow, who will support the program
strengthening strategic unit for three months, is also included.
*end activity modification*
TITLE: Management and Staffing CDC OPSS (GHAI) funding
NEED and COMPARATIVE ADVANTAGE: As the CDC portfolio has grown over the last five years there
has been a need for adequate personnel to manage the PEPFAR activities.
ACTIVITIES: This is a split with activity #7831
FY 2008 funds will support one full time equivalent, locally employed staff (LES) who will assist in
coordinating activities for the OPSS program area at CDC Tanzania. The employee will also serve as the
technical lead for aspects of the work, including provision of direct technical assistance in systems
strengthening to the Ministry of Health and Social Welfare, National AIDS Control Programme, and other
CDC partners. Primary implementing counterparts include the National Institute for Medical Research
(NIMR), the International Training and Education Center for HIV/AIDS (I-TECH), and the American
International Health Alliance Twinning Center (AIHA). The LES will oversee AIHA and I-TECH activities
across program areas, as well as manage other human capacity development activities within CDC across
program areas. She/he will also serve as the Inter-Agency Technical Team Lead for OPSS.
Funds will also be used to support a program health analyst for the program strengthening strategic unit and
to support technical assistance for a three-month period by a fellow. Funds also include local and
international travel for these two positions.
In addition, funds will also be used to access technical assistance from Atlanta for the establishment of a
Field Epidemiology and Laboratory Training Program in Tanzania. Assistance will be provided from Atlanta
and the Kenya program based on the specific needs identified by CDC.
The persons funded with these monies will provide technical assistance to implementing partners, including
the MOHSW to ensure capacity is built.
SUSTAINAIBLITY:Through working with local organizations, capacity in human resources for health will be
built.
Continuing Activity: 13637
13637 9575.08 HHS/Centers for US Centers for 6567 1470.08 Base $88,000
9575 9575.07 HHS/Centers for US Centers for 4602 1470.07 Base $12,000
Estimated amount of funding that is planned for Human Capacity Development $88,000
Table 3.3.18:
UNCHANGED FROM FY 2008
TITLE: Management and Staffing GAP
ACTIVITIES: HHS/CDC Tanzania estimates the cost to manage and support the HIV program in Tanzania
to total $4,327,141 (GAP=$1,769,047; GHAI = $2,558,094) exclusive of ITSO support.
This activity narrative describes the CDC Tanzania M&S needs for both GAP and GHAI funds. The budget
for all funds has been vetted through the interagency decision-making process and agreed upon as
presented in the FY2009 submission. Included are costs associated with the management, administration,
information and communication services, and operations of the HHS CDC HIV program for the
establishment and expansion of quality-assured national systems in the areas of strategic information,
prevention of mother to child transmission of HIV, human capacity development, laboratory services, blood
safety and blood transfusion, antiretroviral therapy, patient care and prevention programs.
Activities supported by CDC are funded through 31 cooperative agreements and are performed at the
national and field level. Strong partnership and collaboration exists between CDC management and
program staff, USG, Government of Tanzania and many non-governmental organizations.
By June 2007, PEPFAR country team had completed a Staffing for Results (SFR) analysis. This
comprehensive analysis was endorsed by the U.S. Ambassador and yielded a "footprint" that, although
started in 2007 and 2008 will continue to be implemented throughout FY2009. HHS/CDC Tanzania is
currently working in compliance with the SFR footprint.
Current Staffing Pattern: There are currently a total of 57 positions approved for HHS/CDC Tanzania.
While this staff mix currently includes seven US Direct Hire (USDH) staff, 41 locally engaged staff (LES),
three Personal Service Contract (PSC) and six Non-Personal Service Contract (NPSC) staff, the mix will
change over FY2009 as CDC continues to make progress converting contract staff to LES.
Twenty three (23) of the 57 current positions support the management, administration and operations of the
CDC HIV program and include: a) one Country Director, one Deputy Director who together provide
technical leadership and overall management and a USDH hired for the cooperative agreement
management; b) four staff (IT chief, systems manager, assistant systems manager and computer
management assistant) supporting the information and communications needs of the program; c) six staff,
including a team lead, to support the administrative and management support functions (e.g., travel,
procurement, human resources support, etc.); d) three staff, including a Budget and Finance Chief,
assisting with budget and fiscal management and tracking; e) two staff assisting with cooperative
agreement management* and infrastructure development, respectively, and f) one Public Health Evaluation
Specialist providing technical expertise on scientific and evaluation activities across all CDC programs.
Also included in the management and staffing activity section are two program area staff that have
significant management responsibility; these are the Chief, SI and Capacity Building Program, Chief,
HIV/AIDS Care and Treatment.
The other 34 currently approved staff positions are technical advisors (non-management staff) that are
located in the respective program areas (2 PMTCT, 2 ABY, 1 HVOP, 1 Blood Safety, 1 IDUP, 1 Palliative
Care, 2 TB/HIV, 2CT, 5 ARV Services, 4 Laboratory, 10 SI, and 3 OPSS.
Nineteen of the 57 approved positions are currently vacant and processes are underway to fill these
positions as quickly as possible. CDC requests early funding to continue support for on-going management
and staffing needs.
FY2009 Staff: two new positions are proposed for 2009 as being needed to provide fiduciary, technical and
programmatic oversight; these positions have been jointly developed across PEPFAR agencies and are not
duplicative of efforts across these agencies. These include US Direct Hire (USDH) - Associate Director for
Programs and FSN with signing authority (pilot only) -Medical Epidemiologist (MD or MBBS) who will link to
Government of Tanzania and ability to serve as Advisor.
Management and staffing needs identified for FY2009 include short term technical assistance and training
needs (i.e., 3-6 month consultations and non-PEPFAR technical assistance needs) of CDC and partner
staff. Specifically, the technical assistance needs include assistance with property management, document
control processes, and human resources management. Training needs include procurement and grants
training for internal staff and external partners, training on human subjects review process, and team
building/leadership training.
Concerns and issues include the following: challenges to recruitment and retention and the inability to
attract the caliber of persons needed for grades/salaries offered; disparate salaries and benefits packages
that exist across types of persons engaged (USDH, LES, contractors); differing interpretations of job
analysis documents across USG agencies (e.g., results of CAJEing often differ between Department of
State and USAID); and lag times and steps needed to complete a recruitment action. One additional issue
of note is that CDC is moving to standardizing ICT processes across its international offices. The impact of
this action is not immediately known but will be monitored throughout FY2009.
Continuing Activity: 13638
13638 3521.08 HHS/Centers for US Centers for 6567 1470.08 Base $2,614,167
7830 3521.07 HHS/Centers for US Centers for 4602 1470.07 Base $1,567,525
3521 3521.06 HHS/Centers for US Centers for 2907 1470.06 Base $3,063,481
Table 3.3.19:
