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: 2007 2008 2009
This program will support the provision of comprehensive HIV/AIDS prevention, care, treatment, and related
services to HIV positive adults, children and their family members. Services will include antiretroviral
therapy (ART); adherence counseling; TB screening and treatment; diagnosis and treatment of
opportunistic infections (OI); the basic preventive care package (BCP); prevention with positives (PWP)
interventions; family-based and individual confidential HIV counseling and testing; and psycho-social
support. In order not to interrupt critical services and to ensure the continuation of care and treatment, the
previous implementing partner was extended for 6 months through September '07. During this time, the
partner provided ART for 15,000 adults and children. The applicant for the FY'08 program will provide
comprehensive services through an established country-wide network of urban and rural health facilities
with the goal of continuing ART to the existing client base of 15,000, as well as provide comprehensive HIV
support, prevention, care and treatment (as needed) to an additional 70,000 HIV positive individuals. A
family-centered approach will be established, using the index HIV+ client to identify family members, who
will receive confidential HIV counseling and testing and HIV care for those identified as seropositive. All
seropositive clients and HIV+ family members will receive a Basic Preventive Care package that includes:
cotrimoxazole prophylaxis; a safe water vessel and chlorine solution; insecticide treated bed nets; condoms
as appropriate; educational materials; plus PWP counseling. Following national ART treatment guidelines
and services criteria, each health center supported by the applicant will be staffed with trained HIV clinical
and ancillary health care professionals, and will establish systems to monitor patients for ART eligibility and
initiation. Those on ART will receive continuous adherence counseling and support services. PWP
interventions will be an integral part of services to reduce HIV transmission to sexual partners and unborn
children, including specific interventions for discordant couples. Methods to integrate prevention messages
into all care and treatment services will be developed, and will be implemented by all staff. HCT services will
also be offered to sexual partners who are not family members. Depending on the location of each health
center, various service delivery models will be developed to facilitate access and ensure coverage of the
target population; these will include facility-, community-, and home-based approaches, as well as outreach
activities. The applicant will also develop a more robust program to provide services to conflict and post-
conflict areas of Northern and North-eastern Uganda; these will include HCT at facility-based and mobile
out-reach clinics.
The implementing partner will focus on improving 2-way referrals and integration with PMTCT services. This
will include ensuring that HIV+ female clients who are pregnant, are referred to PMTCT and ANC services,
and that they receive appropriate HAART or prophylaxis according to national guidelines. The applicant will
ensure that both CD4 testing and ARV treatment slots are available for pregnant women identified as
seropositive at ANC. Training and support supervision will improve the level of awareness of health care
providers to needs of HIV positive pregnant women, and implementation of national treatment guidelines.
Efforts will be made to reduce biases of health care personnel towards HIV+ women who are pregnant, and
which prevent them from seeking appropriate services. Linkages with the community through PHA and
support groups will facilitate follow up of HIV+ women post-natally, and ensure that infants are appropriately
managed and HIV tested, and that women make informed decisions about infant feeding. The IP will work
towards integration with wrap-around family planning services for HIV+ women who wish to avoid
pregnancy, and for discordant couples.
target population; these will include facility, community, and home-based approaches, as well as outreach
Palliative care (PC) involves the provision of a wide range of services, counseling, and commodities,
including the Basic Care Package, PWP interventions, the Client Kit, and other types of support. FY08 goals
for the applicant will include expanding PC coverage to a greater number of HIV+ clients and their
seropositive family members. All components of palliative care will be available, directly or through referral.
Because many components of PC need not be facility based, increased efforts will be made to provide
services at the community level, and to use PHA networks. Logistics, commodity procurement and human
resources will be emphasized. Procurement logistics will be enhanced, as described in the "ARV Drug"
area activity narrative, by working within the National System for commodity procurement and distribution.
Commodities that are relevant to PC include those needed for the prophylaxis, management, and screening
of OIs; and components of the Basic Client Kit. The applicant will work to ensure that these commodities,
drugs and diagnostics are available to meet increased needs. Health care workers will be given refresher
training to improve and update their knowledge of and skills in providing palliative care. This will include
training of health care providers to enhance their capacity to also provide PWP counseling. To ensure
quality assurance, standardized and up-to-date guidelines of palliative care will be provided and service
centers will be supported to ensure quality of service provision. Data collection and monitoring systems will
be maintained and enhanced with the goal of improving patient care, meeting reporting requirements, and
evaluating data to improve program planning.
The program will support the provision of comprehensive HIV/AIDS prevention, care, treatment, and related
-support services to HIV positive adults, children and their family members. These services will include
antiretroviral therapy (ART); adherence counseling, TB screening and treatment; diagnosis and treatment of
opportunistic infections (OI); basic preventive care package (BCP); prevention with positives (PWP)
interventions; confidential HIV counseling and testing and psycho-social support.
Initiatives in FY07 will support clinical and related support services through an established network of urban
and rural health facilities located throughout the country to ensure equitable access for treatment to an
existing pool of 7,000 adults and pediatric patients. Comprehensive HIV support services will also be
expanded to reach an additional 60,000 HIV positive individuals with prevention, care and treatment
services as appropriate. A family-centered approach will be established, using the index HIV person to
reach family members with confidential HIV counseling and testing, and care for those identified as HIV
positive. All clients testing positive will receive a Basic Preventive Care package that includes:
cotrimoxazole prophylaxis information; a safe water vessel and chlorine solution; long-lasting insecticide
treated bednets; condoms as appropriate; educational materials; and prevention with positives counseling.
Following national ART treatment guidelines and services criteria, each health center will be staffed with
fully trained HIV clinical and ancillary health care professionals and establish systems to monitor patients in
care for ART eligibility and initiation. Those on ART will receive continuous adherence counseling and
support services. Prevention with positive interventions will be an integral part of the services to reduce HIV
transmission to sexual partners and unborn children, including specific interventions for discordant couples.
Activities to integrate prevention messages into all care and treatment services will be developed for
implementation by all staff. Depending on the location of each health center, service delivery models will be
developed to provide easy access to all in need of services, including facility-based, community-based, and
home-based approaches, as well as outreach activities to ensure full coverage for the targeted population.
partner provided ART for 15,000 adults and children. The applicant for the FY08 program will provide
The implementing partner will establish a comprehensive counseling service and build human capacity in
the delivery of counseling services. Counseling will be provided to clients and their family members at
facilities, in the community, homes and other venues. It will be provided through one-to-one sessions,
couple sessions and group sessions to address individual and couple concerns, as well as provision of
general information to clients. Counselors will provide information on HIV prevention, STI, family planning,
and PMTCT with special focus on sexually active clients; nutrition, basic care package, and OI including
tuberculosis. Counseling sessions will also support clients to disclose their sero- status to family members
and particularly sexual partners.
Strategies for establishing Positive Prevention services will include staff training in Positive Prevention;
training PHA networks and peer support groups in HIV prevention; sensitizing leaders in HIV prevention;
sensitizing HIV discordant couples on Positive Prevention; educating partners of clients on discordance and
Positive Prevention; promoting safer sex, including condom use among discordant couples; establishing
discordant couple clubs; establishing peer support mechanism for sexually active PHAs; providing condoms
to sexually active discordant couples; and supporting sexually active clients to disclose sero-status to their
sexual partners. Out of and in school youth will be given abstinence messages.
Regarding gender issues, couples counseling will provide information on risk assessment, risk reduction
and aim to promote an environment for stigma reduction. Clients, women in particular will be supported to
address negative outcomes of disclosure by linking them to appropriate support systems. Particular
emphasis is taken to address high risk sexual behavior, including multiple partners, wife inheritance. Clients
will also be linked to income generating activities in order to reduce economic dependency that may result
in failure to choose safer sex options.
Overall program description: This program will support the provision of comprehensive HIV/AIDS
prevention, care, treatment, and related services to HIV positive adults, children and their family members.
Services will include antiretroviral therapy (ART); adherence counseling; TB screening and treatment;
diagnosis and treatment of opportunistic infections (OI); the basic preventive care package (BCP);
prevention with positives (PWP) interventions; family-based and individual confidential HIV counseling and
testing; and psycho-social support. In order not to interrupt critical services and to ensure the continuation of
care and treatment, the previous implementing partner was extended for 6 months through September '07.
During this time, the partner provided ART for 15,000 adults and children. The applicant for the FY'08
program will provide comprehensive services through an established country-wide network of urban and
rural health facilities with the goal of continuing ART to the existing client base of 15,000, as well as provide
comprehensive HIV support, prevention, care and treatment (as needed) to an additional 70,000 HIV
positive individuals. A family-centered approach will be established, using the index HIV+ client to identify
family members, who will receive confidential HIV counseling and testing and HIV care for those identified
as seropositive. All seropositive clients and HIV+ family members will receive a Basic Preventive Care
package that includes: cotrimoxazole prophylaxis; a safe water vessel and chlorine solution; insecticide
treated bed nets; condoms as appropriate; educational materials; plus PWP counseling. Following national
ART treatment guidelines and services criteria, each health center supported by the applicant will be staffed
with trained HIV clinical and ancillary health care professionals, and will establish systems to monitor
patients for ART eligibility and initiation. Those on ART will receive continuous adherence counseling and
support services. PWP interventions will be an integral part of services to reduce HIV transmission to sexual
partners and unborn children, including specific interventions for discordant couples. Methods to integrate
prevention messages into all care and treatment services will be developed, and will be implemented by all
staff. HCT services will also be offered to sexual partners who are not family members. Depending on the
location of each health center, various service delivery models will be developed to facilitate access and
ensure coverage of the target population; these will include facility, community, and home-based
approaches, as well as outreach activities. The applicant will also develop a more robust program to provide
services to conflict and post-conflict areas of Northern and North-eastern Uganda; these will include HCT at
facility-based and mobile out-reach clinics.
Drug procurement and distribution: In Uganda, the USG supports procurement and distribution of
commodities through the National Medical Stores (NMS) for government facilities, and the Joint Medical
Stores (JMS) for NGOs and FBOs, assisted by the Program for Supply Chain Management (PSCM). The
latter provides technical and forecasting support. The applicant will work within the "Ugandan National 3-
year rolling procurement Plan," JMS and PSCM to ensure proper forecasting, storage, dispensing, and
recording of drugs received and used, and to avoid stock outs. The applicant will make sure that data
systems are in place to monitor adherence and timely uptake of drugs by clients. The implementing partner
will work actively with and collaborate with other stakeholders providing ART to curb clients from accessing
drugs from multiple providers, and to facilitate and keep track of appropriate referrals to other facilities. The
overall goal is to support adherence.
Monitoring and QA: The applicant will document, regularly evaluate and audit its procurement and
distribution systems for drugs and commodities. The IP will ensure a functional pharmacy information
management system including patient management information system both at its central and peripheral
facilities. To ensure quality drug supply chain management, the applicant will employ qualified staff and
provide ongoing training to existing personnel.
Overall program description. This program will support the provision of comprehensive HIV/AIDS
family members, who will receive confidential HIV counseling and testing, and HIV care for those identified
as seropositive. All seropositive clients and HIV+ family members?) will receive a Basic Preventive Care
treated bednets; condoms as appropriate; educational materials; plus PWP counseling. Following national
ensure coverage of the target population; these will include facility-, community-, and home-based
In addition to the services described above, the applicant will also focus on the following. Efforts will be
made to increase coverage to children: by training and supporting health care providers to extend services
to pediatric clients rather than refer them; by improving referrals with OVC services; and by encouraging
community networks to help identify children in need. Linkages with PMTCT services need to be improved
and extended. These will require 2-way referrals of HIV+ pregnant women to PMTCT clinics, as well as
ensure that women who are identified as HIV+ through testing at ANC, are screened for ART eligibility and
treated appropriately. This requires that testing CD4 testing and treatment slots are made available to
women in a timely manner, and improved planning takes place so that CD4 cytometry is available
regionally. Planning for expansion of services will be required, if national guidelines for initiation of ART are
changed from 200 CD4 cells/ml to 350 CD4 cells/ml. Linkages with TB services need to be enhanced, and
screening and management should become a routine component of HIV care. To address shortages in
health care personnel, ongoing training will take place, and greater use of PHA networks will be used.
Various types of training will take place so that staff, health care workers, PHA, and community liasons are
available to address the expanded services described above. Support supervision will be provided.
Quality Laboratory diagnosis is a key element in providing palliative care, TB care as well as initiation and
monitoring of antiretroviral therapy as all these other areas benefit from the investments made in laboratory
infrastructure. The implementing partner will put in place laboratory capability to conduct HIV testing and
related ART monitoring, OI screening and diagnosis. These laboratory services will support the delivery of
drugs; client monitoring and follow up; delivery of care and treatment at facilities, communities and in
homes. Home-based HIV counseling and testing service will be provided to sexual partners and family
members of clients by trained personnel with quality control in place. Routine support supervision, quality
assurance, laboratory information system will be established and the relevant trainings offered to lab
personnel.
