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 2010 2011 2012 2013
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
The funding for this activity has changed from clinical services (HTXS) to Health Systems Strengthening
(OHSS), and as a result the targets have also changed to reflect their contribution to OHSS targets. In FY
2008, this activity did not contribute to HTXS targets.
*END ACTIVITY MODIFICATION*
TITLE: Strengthening Skills of Health Workers in HIV/AIDS
NEED and COMPARATIVE ADVANTAGE:
The tremendous shortfall of skilled health workers to address the needs of HIV/AIDS patients requires
focused training above and beyond the normal pre-service training in Tanzania. The Fogarty International
Center (FIC) of the U.S. National Institutes of Health has funded 23 AIDS International Training and
Research Program (AITRP) Centers for more than ten years, including several African countries and can
make an important contribution to addressing the clinical training needs in HIV/AIDS care in Tanzania.
ACCOMPLISHMENTS:
This has not previously been funded by PEPFAR/Tanzania.
MAJOR ACTIVITIES:
The primary goal of this program is to build multi-disciplinary biomedical, behavioral, and social science
capacity for the care and treatment of HIV/AIDS and HIV-related conditions HIV/AIDS-affected adults and
children in Tanzania. AITRP makes provisions for training in the United States, in other countries, as well as
the home country itself. Though the primary focus of the AITRP grants has been on research capacity, the
Fogarty International Center has expressed interest in broadening the human capacity focus to clinical
service delivery.
The AITRP supports long-term (two to three years) MPH, PhD, and postdoctoral training in HIV/AIDS
research at Duke University and Baylor College of Medicine for health-professionals from Tanzania.
Shortterm
U.S. based-training of health professionals also is conducted.
In the case of Baylor, FY 2008 funding would support professionals who might benefit from focused training,
primarily in pediatric HIV/AIDS care and treatment. Baylor can host trainees with nursing degrees and
medical degrees. Another training model Baylor is set up to use is shorter term "attachments" to one of the
Baylor Pediatric AIDS Centers of Excellence (COE). For example, two to four week training programs can
be done with groups of physicians or nurses to a Center of Excellence in Botswana, Swaziland, or Malawi.
This model has been successful with trainees from other African countries because a) the learners do not
have to travel so far, b) they can do whatever length of attachment works for them based on how long they
can be away from their primary job, and c) the clinical training and guidance they receive is likely to be more
relevant to their home context than if they traveled to the US for short-term training.
In an attachment training experience, Tanzanian trainees (doctors, nurses, pharmacists, social workers, and
others) would have the opportunity to observe and work within an Africa-based care and treatment program
that is successful and thriving. They will learn about Antiretroviral therapy: when to start, when to stop,
when to switch, what to do about known or suspected resistance, etc. They will have the opportunity to talk
through difficult cases, and observe a multi-disciplinary team in action. This has been a very valuable
experience for those who have been through it.
The Duke University AITRP can also provide training opportunities in the care of persons living with HIV
infection. The Duke University AITRP has trained over 50 Tanzanians in the past four years in
HIV/AIDSrelated
disciplines, including physicians, researchers, nurses, pharmacists, laboratory technologists, social
workers and community members. With FY 2008 funds, programs can be created with an individualized
teaching focus to meet their specific training needs. The Duke University AITRP would offer additional
training for key personnel involved in supporting care, especially nursing leadership and laboratory
technologists. Duke University's principal collaborator in Tanzania is the Kilimanjaro Christian Medical
Centre (KCMC). Together they have established a state of the art Microbiology Laboratory at KCMC which
is used for training and the support of clinical research. The Duke-KCMC collaboration has studied or is in
the process of intensively studying the relationship of HIV and co-pathogens, especially Mycobacterium
tuberculosis. The focus of these studies has included defining the prevalence and incidence of HIV/TB
codiagnosis,
enhancing screening for both diseases among newly diagnosed persons, optimal strategies of
TB diagnosis, molecular diagnostics, TB susceptibility patterns, predictors of disseminated tuberculosis,
drug interactions between Nevirapine and Rifampicin, and the immediate versus delayed initiation of
antiretroviral treatment in patients newly diagnosed with TB and HIV. This ongoing work with Duke would
offer other excellent clinical training opportunities.
LINKAGES:
This training would be linked with other activities ongoing at KCMC through the Elizabeth Glaser Pediatric
AIDS Foundation.
CHECK BOXES:
Training; pre-service.
M&E:
A comprehensive monitoring and evaluation plan will be developed once the program begins. This plan will
capture information on who receives training, what they have been trained on, and how their skills have
improved
Activity Narrative: SUSTAINAIBLITY:
The training will help to develop a strengthened platform of trained health workers with very specific clinical
experience.
New/Continuing Activity: Continuing Activity
Continuing Activity: 17036
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
17036 17036.08 HHS/National US National 7629 7629.08 $450,000
Institutes of Health Institutes of Health
Emphasis Areas
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $450,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.18:
