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: 2013 2014 2015 2016 2017 2018
The second phase of the Tanzanian AIDS Prevention Project (TAPP 2) aims strengthen existing program by developing an integrated user-friendly system of HIV prevention and treatment services for key populations (KPs) in Dar es Salaam (then Tanga and Arusha thereafter), including people who use drugs (PWUD) and men who have sex with men (MSM). The program will provide MSM and PWUD with easily accessible HIV prevention, HIV care and drug treatment services in a safe and friendly manner. This aligns with the second goal of the Partnership Framework, to prioritize accessible HIV prevention programming targeting drivers of the epidemic. MUHAS will continue to collaborate with local indigenous organizations for this activity.
The TAPP 2 consortium will expand HIV testing and counseling (HTC), prevention, care, and HIV and drug treatment services for KP throughout the three municipalities of Dar es Salaam. Violence and alcohol interventions will be integrated to existing programs and couples will be targeted for HTC and other interventions. Quality assurance (QA) measures will be applied to ensure the program functions according to clearly defined standards of excellence. The partner will also develop the leadership capabilities of the community-based organizations to maximize facilitation of KP outreach. Treatment navigators will be established to help MSM access HIV prevention, care and treatment. The PWUD HIV prevention outreach and methadone treatment activities will be strengthened by implementing women-centered strategies to link more female PWUD into services. The partner will provide technical expertise in supporting national initiatives to scaling up KP interventions. Quarterly reports in line with the MOHSW standard M & E documents will be provided.
TAPP will continue to focus on supporting PITC services with the aim to increase identification of HIV infected patients in need of care and treatment. The program will also continue to support HTC services targeting the general population, couples, children, and key populations through mobile and static facility based services. PITC will be offered in health settings, including to those persons accessing medically assisted therapy (MAT) services, while client initiated services will be offered both at the static Muhimbili Health Information Centre and mobile caravans services.
20% of the clinic population come as couples for client-initiated testing both at facility and mobile services. Training and service provision targeting couples will continue to be offered at PITC services. Promotional activities around HTC for demand creation will be offered to the general population, key populations and couples.
The project will strengthen and integrate alcohol screening and brief motivational intervention in HTC services. TAPP will ensure that all of its staff and PITC trainees receive training and supportive supervision to address the issue of alcohol use among their clients.
Funds will be used to support and track referrals and linkages from HTC services to appropriate care and treatment support and strengthen the escorted referral system in the services offered to key populations to tracking of service outcome.
MUHAS will continue to support training for health care providers, to update them on new guidelines for HTC services, Standard Operating Procedures and QI for HTC. In collaboration with implementing partners in Dar Es Salaam , MUHAS will attend district/regional partnership meetings aimed at strengthening coordination, collaboration and sustainability and monitoring of the implementation of joint strategies to achieve World AIDS Day targets. MUHAS will continue to document the best practices in M&E and disseminate the reports locally and international. Funding will also be used to maintain the electronic data base for HTC clients.
This mechanism implements the Tanzanian AIDS Prevention Program (TAPP), with the aim of reducing HIV transmission and providing HIV care and treatment for key populations, especially people who inject drugs (PWID) and MSM, in Dar Es Salaam. Building upon experience gained in providing outreach services to persons who use drugs, TAPP works with non-governmental organizations and community-based peer support networks of men who have sex with men (MSM) to provide outreach services and comprehensive HIV prevention and care interventions to MSM in Dar es Salaam. TAPP works closely with these local NGOs to provide training and supportive supervision to ensure the quality of outreach services is maintained. Preliminary data estimates HIV prevalence among MSM in Dar es Salaam to be 30%, with evidence of very low access to HIV testing and counseling.
The project will target key populations and their sexual or injecting partners, through community outreach by facilitating access to HIV testing, care and treatment, substance abuse therapy, and STI and TB treatment. The program targets MSM in Dar es Salaam through direct service provision. Specific interventions include:
- community-based outreach to promote HIV testing and harm reduction, including distribution of condoms and water-based lubricant for HIV prevention and sexual risk reduction and bleach kits for injecting risk reduction;
- HIV testing and counseling; targeted prevention information, education and communication;
- screening and treatment for STIs;
- screening and treatment for TB;
- screening, prevention and management of viral hepatitis; and
- linkage to HIV care and antiretroviral treatment. The program will facilitate strengthening linkages to, and supporting retention in, HIV care and treatment.
The program also focuses on training of various cadres of health service providers and providing technical support to the scale-up of comprehensive services to MSM in other parts of the country. TAPP will continue to work in Dar es Salaam, with expectations of expanding interventions for key populations in Tanga and Arusha.
It is estimated that there are at least 25,000 persons who inject drugs (PWID) in mainland Tanzania and many more persons who use drugs (PWUD) through other routes. Available data from Dar es Salaam, the commercial capital, indicate HIV prevalence of 42% among PWID compared to 11% among the general population in the city. Risky injection practices such as sharing needles have been documented among PWID, coupled with risky sexual practices. HIV prevalence has been consistently higher among female PWUD and PWID coupled with trading sex for money and drugs, high numbers of sexual partners, inconsistent condom use, intimate partner violence, rape and alcohol abuse. This program targets PWUD and PWID where there are concentrated populations, in Dar es Salaam and other parts of mainland Tanzania, with specific initiatives to strategically reach those at highest risk, such as female sex workers and those without a social support network.
TAPP contributes to the recommended comprehensive package of interventions for HIV prevention, care and treatment among PWUD, by providing direct services in Dar es Salaam. Specific interventions include
- community-based outreach;
- HIV testing and counseling;
- targeted prevention information, education and communication;
- condom promotion and distribution;
- screening, prevention and management of viral hepatitis;
- medication-assisted treatment for opioid addiction;
- and antiretroviral treatment.
Other services such as alcohol screening and screening for other blood borne diseases such as HBV and HCV, will be provided to all methadone clients at the clinics. More emphasis will be placed on linkage to and supporting retention in HIV care and treatment services.
The program also focuses on training various cadres of health service providers and providing technical support to the scale-up of comprehensive services to PWUD throughout the country. Technical assistance to other medication-assisted treatment facilities will be provided. Other services such as psychosocial sessions with clients and family meetings will be emphasized to ensure reintegration of methadone clients into their family. During this year, MUHAS will be required to put special focus on strengthening linkages of people who use drugs to continuum of care and treatment services in their respective localities.
Being a parastatal academic institution, MUHAS is strategically placed to provide necessary technical input to Tanzanian government entities having the public health mandate over PWUD, such that policy and programs are technically sound and informed by scientific evidence. In close collaboration with the Ministry of Health and Social Welfare and the Drug Control Commission, TAPP is able to demonstrate effective use of a secure database for monitoring and tracking services to persons who use drugs. TAPP works closely with local non-governmental organizations, providing training and supportive supervision to ensure the quality of outreach services is maintained.
