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
BMA Implementing Mechanism Narrative
HHS/CDC funds the Bangkok Metropolitan Administration (BMA) through a five-year cooperative agreement (CoAg). Currently, CDC's Global AIDS Program (GAP) is entering the fourth year of the second five-year CoAg with BMA. The goals of the award are to provide technical support for HIV prevention, care, and treatment programs as determined by BMA leadership and GAP/Thailand and in accordance with the national HIV/AIDS strategy. The specific objectives of the GAP-BMA CoAg are: 1) supporting replicable models for prevention and care; 2) improving the quality of prevention and care programs; 3) increasing the collection and use of strategic information; and 4) sharing successful models and providing TA to other PEPFAR countries. Models may include service delivery models, surveillance methodologies, or laboratory systems. Support for model development typically proceeds through phases: 1) model development, implementation, and evaluation; 2) scale-up through leveraging of other donor or government funds; 3) integration to routine services; and 4) technical support to ensure quality of national programs and for national-level program M&E.
Support through this implementing mechanism covers the city of Bangkok and hospitals and health clinics (public and private) under BMA governorship. Of note, some hospitals in Bangkok fall under MOPH, not BMA. Technical areas and target populations include HIV prevention for IDU, quality of HIV care, positive prevention for general PLHA, surveillance for MSM and IDU, ARV threshold surveys, and early warning indicators.
Contributions to health systems strengthening are made through all aspects of support to BMA. Health information systems and human resources for health are areas of emphasis in USG support to BMA. The USG team provides technical support for the development of new surveillance methodologies that are subsequently integrated into routine systems, and for M&E of prevention, care, and treatment programs administered by BMA, NHSO, or GFATM. USG also supports human resources for health through in-service training in specific technical areas, adoption of new concepts or programs as part of national curricula and guidelines, and task-shifting of key services from government clinic staff to peer and community workers. USG provides training of trainers so that national curricula can be used by government staff to provide trainings at all levels, thereby ensuring that programs and technical capacity are integrated into routine BMA government programs.
All GAP/Thailand technical support to BMA is for programs that are, or have a plan to be, fully integrated into routine public health programs. Technical support and capacity building are provided to BMA staff for development, implementation, evaluation, and expansion of programs that are funded by the Bangkok city government. If a new program, method, or service delivery strategy is developed, it is developed jointly with BMA, and training and technical capacity building support are provided at all stages of the process, including for fully expanded programs in the form of M&E and support for quality systems. M&E is conducted for new program models of service delivery and new quality systems, as well as for national programs or systems to identify gaps or areas that need strengthening. M&E serves to identify the effectiveness or success of a program, and builds the M&E capacity of BMA counterparts. USG health systems strengthening support to BMA includes development of M&E and database systems, increased technical knowledge and capacity, policy change, and development and evaluation of quality systems and programs.
As a TA-based program, costs are low as part of this implementing mechanism, and will continue to be low. Model development and evaluation are supported for a limited time, and then other donor or government funding is leveraged for program expansion and integration. However, new programmatic gaps or technical support needs may be identified as some programs are integrated.
08-HBHC Care:
Adult Care and Support
Budget Code Narrative for BMA
With USG assistance, BMA will continue to provide support for integration of the HIVQUAL-T model through the Department of Medical Services, which is responsible for nine ARV clinics in BMA hospitals.
BMA supports QI activities through sharing of performance measurement results and discussion among BMA stakeholders as to how the quality of services can be improved. Furthermore, the QI activities themselves are conducted with BMA financial support. Performance measurement results are sent directly to MOPH and combined at the national level.
Following the development and implementation of clinic-based positive prevention tools with short messages, BMA will support implementation and evaluation of advanced counseling materials including risk reduction, HIV disclosure, and partner testing counseling. The counseling modules will be tested at two BMA hospitals. Tools and materials and results from the evaluation will be presented to BMA stakeholders for use in other settings. BMA will also support a TOT for all nine BMA hospitals and some health centers on the positive prevention short messages.
17-HVSI Strategic Information
With USG assistance, BMA has implemented HIV/AIDS information, monitoring, and surveillance systems. Key activities in FY 2010-FY 2011 include piloting models for program monitoring and surveillance, building human resource capacity within local governments to integrate and expand these models, and using the results for program planning and improvement. Specifically, BMA will undertake:
1) a pilot HIV drug resistance (HIVDR) threshold survey to estimate the prevalence of HIVDR among recently HIV infected pregnant women in Bangkok. USG will provide technical support to develop standardized operational procedures, build capacity in survey implementation among key resource persons, and fund field data collection and laboratory supplies; and,
2) consultative and training workshops to conduct in-depth analysis of SI on ART monitoring, HIVDR early warning indicators, HIVDR resistance surveillance, HIVDR threshold survey data, and HIVQUAL-T. Results will be used to support policy planning and action by health and non-health government organizations and the private sector for program improvement. Lessons learned will be shared for scaling-up the national program.
06-IDUP Biomedical Prevention:
Injecting and Non-Injecting Drug Use
With USG assistance, BMA will support the IDU peer outreach prevention program, including capacity building for peers and clinic staff to enhance their outreach interventions for HIV-positive IDU. BMA will develop Positive Prevention activities at the methadone clinics in Bangkok, such as support of HIV status disclosure, counseling and testing for partners, pre-ART services (e.g., CD4 monitoring and supportive counseling), referral to HIV care, ARV adherence counseling, injecting and sexual risk reduction counseling, STI self screening, and referral for treatment. BMA will strengthen and expand the services provided at methadone clinics, including STI self-screening and referral to treatment services at BMA public health centers and hospitals. In addition, BMA will increase access to HIV testing and counseling services by extending them to IDU who are non-methadone patients, and supporting mobile VCT services from an IDU drop-in-center operated by PSI in Bangkok. BMA will develop an integrated M&E system to assess the success of these services, including the development of service record forms, a data base program, and a reporting system.
10-HVTB Care:
TB/HIV
With USG assistance, BMA has enhanced laboratory capacity for TB diagnosis and drug susceptibility testing (DST). The BMA central laboratory conducts mycobacterial culture (liquid and solid media), and DST when indicated, for all specimens referred from BMA clinics and hospitals. In FY 2009, the USG team supported the laboratory to validate its performance using a new rapid molecular test (Hain MTBDR+) for DST. Routine implementation of this new test by BMA, in parallel with conventional DST methods, is being supported for one full calendar year. The public health impact of the new assay will be evaluated. This process began mid-FY 2009, and will continue to be supported during FY 2010. The USG team will support the cost of reagents and technician time, and the refresher training of clinicians in MDR TB management.
