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.
ACTIVITY UNCHANGED AND ENDING IN SEPTEMBER 2009. NO FY 2009 FUNDS ARE PLANNED FOR
THIS ACTIVITY.
In FY2008, this activity will focus on training health workers, strengthening and mentoring regional hospitals,
districts, private sector including faith-based institutions and other anti-retroviral therapy (ART) providers to
scale-up ART services district-wide, and infrastructure development for increased clinical space for ART in
rural health centers and improved laboratory infrastructure and services for diagnosis and monitoring of
treatment for tuberculosis(TB) and HIV
In an effort to integrate delivery of interventions for Prevention of Mother to child Transmission (PMTCT)
within maternal and child health services(MCH), the TREAT program will scale-up the use of highly active
anti-retroviral (ARVs) for treating pregnant women and preventing HIV-infection in infants in 60 supported
sites. The program will provide HIV/AIDS Counseling and Testing (HCT) and CD4+ cell measurement
services to at least 10, 000 HIV-positive pregnant women in 60 sites to determine anti-retroviral therapy
(ART) eligibility and provide ART to those eligible. It is estimated that 30 percent of these women will
receive ART services.
The program will provide support and training to other USG-supported program to integrate CD4+ cell
measurement in the essential package for pregnant women and setup referral networks to ensure that
health facilities without CD4+ cell measurement facilities send samples to referral laboratories.
In addition to training staff in MCH services to provide ART, the program will procure and provide ARVs to
antenatal clinics in 60 sites. The program will also ensure that AZT and Nevirapine for infants is available in
the 60 MCH sites.
It is estimated that 3,000 HIV-positive pregnant women with CD4 cell count below 350cells/mm³ will receive
ART while 7,000 not yet eligible for ART will receive a course of highly effective ARVs for prevention of HIV
infection in infants. All the 10,000 HIV-exposed infants will receive a 7-day course of zidovudine (AZT) and
nevirapine. The program will follow the revised Ministry of Health protocol for PMTCT and the WHO
recommendations for ARV drugs for treating pregnant women and preventing HIV-infection in infants in
Resource-limited setting.
It is anticipated that through this activity, PMTCT using single dose Nevirapine will be reduced to an
absolute minimum in the supported sites.
The program will link with the President's Malaria Initiative (PMI) to provide Intermittent Preventive Therapy
for malaria in pregnancy using either daily cotrimoxazole or 3-doses of sulfadoxine-pyrimethamine and the
distribution of Insecticide Treated Mosquito nets to pregnant mothers. All women diagnosed to be HIV-
positive will be screened for tuberculosis (TB) and receive nutritional counseling and education including
support for infant feeding. All women eligible will receive cotrimoxazole prophylaxis.
New/Continuing Activity: Continuing Activity
Continuing Activity: 15894
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
15894 15894.08 U.S. Agency for Joint Clinical 7207 7207.08 TREAT $300,000
International Research Center, (Timetable for
Development Uganda Regional
Expansion of
ART)
Table 3.3.01:
In FY 2008, this activity will focus on training health workers, strengthening and mentoring regional
hospitals, districts, private sector including faith-based institutions and other anti-retroviral therapy (ART)
providers to scale-up ART services district-wide, and infrastructure development for increased clinical space
for ART in rural health centers and improved laboratory infrastructure and services for diagnosis and
monitoring of treatment for tuberculosis(TB) and HIV.
In the selected 25 focus districts and over 60 sites, the program will provide palliative care services to
15,000 clients not yet eligible for ART. This brings the total number of patients under care including those
on ART to over 45,000. The program will provide clinical care services including diagnosis and treatment of
opportunistic infections(OIs), nutritional assessment and counseling, psychosocial support and screening
for ART eligibility. Patients under palliative care will be screened for tuberculosis and those diagnosed with
TB will receive treatment. The program will provide a comprehensive preventive basic care package to the
10,000 clients under care.
The program will train and support 120 expert clients from 60 groups of People Living with HIV/AIDS to
facilitate referrals and linkages between facility-based and community based care. The groups will facilitate
referrals to warp around services available in the communities. 900 health workers will be trained to provide
palliative care services.
The program will scale-up TB/HIV integration activities including setting facility infection control procedures
in facilities supported, provider-initiated counseling and testing for TB-registered clients and ensuring
referral and retrieval referrals between TB and HIV clinics and services.
Continuing Activity: 16008
16008 16008.08 U.S. Agency for Joint Clinical 7207 7207.08 TREAT $340,000
Table 3.3.08:
The program will train physicians and non-physicians to provide ART services. The program will also
support groups of People Living with HIV/AIDS (PHAs) to provide services as expert clients in the health
facilities and in the community. PHAs will facilitate referrals and linkages between facility-based and
community-based care, ART literacy, food and nutrition support, support for adherence to anti-retrovirals
(ARVs), counseling for prevention with positives and linkages to basic preventive package and wrap-around
services.
In the selected 25 focus districts and over 90 sites, the program will support infrastructure development for
ART services and build capacity of the Directorate of Health Services to manage ART services in the
district. The program will provide technical and financial support for districts to carry out quarterly support
supervision activities. It is estimated that a total of 6,000 new patients will be initiated on treatment bringing
the total number of patients supported to over 24,000.
Critical emerging issues like adherence, surveillance for resistance, Infant Diagnosis using DNA-PCR and
screening of patients under palliative care for ART eligibility will be supported. The program will provide
financial support in form of grants to Civil society organizations and Networks of PHAs to carry out activities
that support improved ART literacy, adherence, patient tracking, prevention with positives and linkages to
wrap around services.
A key area of focus for this program will be support for the scale-up of access to ART for pregnant women
by ensuring that ARVs are available in the ante-natal clinics and that staff in the antenatal clinics are trained
to counsel, initiate and manage ART in pregnant women. The program will also work closely with the
maternity ward and pediatrics unit to identify HIV-exposed and infected children, provide infant-diagnostic
services and provide care and ARVs for those that are eligible.
The program will scale-up TB/HIV integration activities including setting up facility infection control
procedures in facilities supported, provider-initiated counseling and testing for TB-registered clients and
ensuring referral and retrieval referrals between TB and HIV clinics and services.
In FY2008, the program will continue to support the Department of Defense (DOD) ART programs through
Walter Reed in Kayunga district and Uganda People Defense Forces (UPDF) in Gulu, providing ART to
2,000 additional clients.
In conjunction with Supply Chain Management Systems (SCMS), the program will continue to explore the
introduction of the Smart Card and an ART Dispensing Tool in all public health ART sites. This will improve
patient tracking.
To complement these efforts, this new activity will also focus on integrating family planning and HIV/AIDS
services. Such integration has the potential to create synergistic relationships between programs, reduce
missed opportunities, and ultimately maximize the effectiveness and impact of services by providing
comprehensive reproductive health care that holistically addresses clients' dual risks of HIV infection and
unintended pregnancy. With increased access to HIV/AIDS treatment, more people living with HIV/AIDS are
regaining their sexual activity. Among HIV-infected women, the prevented of unintended pregnancies is
essential and highly cost-effective for prevention mother-to-child transmission of HIV and reducing the
number of children orphaned when parents die of AIDS-related illnesses.
The program will develop programmatic strategies for strengthening linkages between family planning and
HIV/AIDS services such as voluntary counseling and testing (VCT), prevention of mother-to-child
transmission (PMTCT), and antiretroviral treatment (ART). This activity will leverage USAID funding for
family planning and ensure that linkages between HIV/AIDS and family planning are established and
institutionalized.
The program will disseminate the recently developed tools and materials that contain guidance for providers
who offer contraceptive counseling to clients with HIV, including those on ARV therapy. The information will
be designed to be used in a variety of settings by providers who regularly offer family planning services and
by those who want to begin integrating contraceptive services with HIV treatment and care services.
300 health workers will be trained to integrate family planning in HIV/AIDS care and treatment services.
Continuing Activity: 15791
15791 15791.08 U.S. Agency for Joint Clinical 7207 7207.08 TREAT $4,800,000
Table 3.3.09:
In the selected 25 focus districts and over 60 sites, the program will train 300 health workers to diagnosis
and manage TB/HIV co-infection.
5,000 TB/HIV co-infected patients will be identified, treated for TB and given cotrimoxazole prophylaxis. The
program will implement infection control procedures at all the 60 service outlets.
facilitate referrals and linkages between facility-based and community based TB and HIV management. The
groups will facilitate referrals to wrap around services available in the communities. 900 health workers will
be trained to provide TB/HIV services. It is estimated that in FY2008, the program will provide anti-retroviral
therapy to 1,000 TB/HIV co-infected clients.
Continuing Activity: 16007
16007 16007.08 U.S. Agency for Joint Clinical 7207 7207.08 TREAT $225,000
Program Budget Code: 13 - HKID Care: OVC
Total Planned Funding for Program Budget Code: $26,053,620
Total Planned Funding for Program Budget Code: $0
Program Area Narrative:
Uganda is one of the countries in sub-Sahara Africa that has been devastated by the HIV/AIDS epidemic, malaria and
tuberculosis. The impact of the three major diseases has led to a huge population of orphans and other vulnerable children.
According to Uganda Demographic and Health Survey (UDHS) 2006, the Uganda National Household Survey (UNHS) 2005/6,
and Uganda Population and Housing Census (UPHC) 2002, more than 3 million children in Uganda live below the poverty line.
Approximately 7.5 million children are either orphaned or vulnerable children, making up 46% of the total number of children. An
estimated 7% (2.3 million) of the country's total population are orphans, 46% of these are orphaned by AIDS. Approximately
130,000 children aged 0-14 are HIV-positive with about 7% receiving care and treatment services. Other children have been
orphaned due to conflict. Of four million children living in conflict, approximately 850,000 continue to live in Internally Displaced
Persons camps (2007 UNICEF).
Most U.S. Government support in this area goes to the Ministry of Gender, Labor, and Social Development (MGLSD) to build its
capacity to provide strategic direction, coordination and monitoring of Uganda's response to OVC, from the national to the
household level. USG, through its CORE Initiative project, undertook a detailed assessment of MGLSD and of the Community
Based Services Departments (CBSD) at district level, developed and is currently implementing an extensive capacity building
interventions in seven areas of coordination between sectors and levels; planning; leadership; staffing; communications and
advocacy; granting; and monitoring and evaluation. The MGLSD works directly with districts to implement its OVC program. With
82 districts nationwide, and very limited resources, the USG, through its CORE Initiative, established eight OVC technical and
management support services (TSOs) to effectively roll out national OVC policies, guidelines and standards to districts and lower
levels. The MGLSD developed a quality and service standards tool, national, district and household indicators, and is in process
of developing a national OVC management information system, including primary and secondary data and linked via tested
indicators to a national OVC framework that guides the overall response. In partnership with other donors, it has established a
sustainable civil society funding and granting mechanism through which the donors (USAID, DANIDA, Irish Aid, and DFID) fund
Civil Society Organizations for implementation and provision of OVC services.
Despite the progress, the response to date does not match the magnitude of the need. There is still limited progress in coverage,
reach and impact of services to the most vulnerable children and their households. For example, according to the 2006 UDHS, an
estimated nine out of ten OVC households were not receiving any type of external support, leaving the traditional social net of
extended families picking up the majority of the OVC burden in the country. The 2004-5 HIV/AIDS Sero-Behavioral Survey found
similar results with only 23 percent receiving any kind of external support. Persistent high levels of child abuse, school drop-outs,
poor nutrition and health, psychosocial deficiencies and poor livelihoods continue to disproportionately affect specific categories of
vulnerable risky groups of children and their households defined in the national OVC policy. The national OVC policy and plan
developed in 2004 to address the above situation needs review. In FY08, with USG support, twenty-four implementing partners
reached 205,735 OVC nationwide with various services including but not limited to education (primary, secondary and vocational
skills), health (immunization, sanitation and basic care for HIV-positive children), psychosocial support, food and nutrition,
protection against abuse and neglect, economic and livelihood support to caregivers, emotional and mental rehabilitation of
children involved in war in northern Uganda.
In FY09, USG support will be focused on: conducting an OVC situational analysis with the view of establishing the current
magnitude of the OVC problem and use the evidence obtained to revise the national OVC strategic plan to effectively inform
programming for the next five years 2009-2014; facilitating linkages between facility and community based OVC service providers;
replicating block grant models for education support to scale up access to education services and scholarships. USG support will
also be linked to networks of people living with HIV/AIDS to increase access to care for HIV-positive children and leverage private
sector resources through Corporate Social Responsibility (CSR) to support OVC programs. USG further intends to strengthen the
socio-economic security of the OVC households through market access models (Micro-enterprise), strengthen grants system to
CSOs for OVC service delivery and build capacity of CSOs, CBOs and FBOs to expand quality OVC service delivery and
integrate HIV prevention for OVC. A national OVC management information system to monitor and measure quality improvement
will be established. USG further plans to strengthen the Peace Corps volunteer network to support and serve OVC through
strengthening community based organization systems.
Table 3.3.13:
In FY 2008, this activity will focus on strengthening and mentoring regional hospitals, districts, private sector
including faith-based institutions and other anti-retroviral therapy (ART) providers to scale-up ART services
district-wide.
The program will provide training of over 1,000 health workers in 30 districts in ARV logistics and
procurement focusing on forecasting, warehouse management and distribution of ARVs. The program will
strengthen the Directorate of District Health Services in the 30 focus districts in ARV drugs procurement and
distribution and reporting to Ministry of Health.
The program will procure ARVs to cater for over 20,000 patients on first line treatment and 5,000 on second
line. The program will also procure a buffer stock to respond to emergency stock-outs of ARV in the public
health sites. The program will introduce a pharmacy dispensing tool to capture and report on clients
accessing ARVs, track patients and report on treatment outcomes. Opportunities of introducing a Smart
Card will be looked at during this financial year.
Continuing Activity: 15623
15623 15623.08 U.S. Agency for Joint Clinical 7207 7207.08 TREAT $7,800,000
Table 3.3.15:
monitoring of treatment for tuberculosis (TB) and HIV.
In the 25 focus districts, the program will provide support to the Directorates of District Health Services
(DDHS), six regional hospital laboratories and
over 60 primary health centers to provide laboratory services for improved laboratory testing for diagnosis of
HIV infection and other opportunistic infections and for monitoring patients during care and treatment.
Through the DDHS office, the program will support the establishment of effective laboratory networks in the
focus districts. The program will build the capacity of the district hospitals to provide laboratory support to
lower health centers (HCIVs, HCIII and HCII) through referral testing and support supervision. The program
will build capacity of the district hospital to provide quality assurance and train laboratory personnel.
At least 10 of the 60 health facilities will be designated as regional referral hubs for CD4+ testing and infant
diagnosis and two centers for viral load
and TB culture. In addition the program will support at least six regional centers to a status of a Regional
center of Excellence to provide highly specialized HIV and TB diagnostic testing and support supervision. In
FY2008, the program will train over 100 non-laboratory technicians to carry out microscopy work in the
laboratories and also provide in-service training for 100 laboratory technicians.
Through support to the districts the program will generate support from the local government structures and
provide an environment for a sustainable long-term impact. The program will provide financial and technical
support to the District Directorate of Health Services (DDHS) to provide support supervision to health
workers in the district and monitor establishment of a tiered-quality-assured laboratory networks in the focus
districts.
Continuing Activity: 15914
15914 15914.08 U.S. Agency for Joint Clinical 7207 7207.08 TREAT $1,400,000
Table 3.3.16:
