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
The USG has been supporting provision of ART services in Uganda through the Joint Clinical research
Center (JCRC) since 2003. Today, JCRC is the leading provider of ART in Uganda with over 40,000
patients, providing ART in 51 static and 25 outreach sites across the country. The static and outreach sites
are supported through six regional centers of excellence (RCE) located in Jinja, Mbale, Gulu, Mbarara,
Kabale and Fort Portal.
In FY 2008, JCRC initiated treatment to over 10,000 new clients bringing the total number of clients on ART
to over 40,000. Currently JCRC is the largest single provider of pediatric ART with over 7,600 children
accessing treatment. In FY 2008, over 4,000 health workers were trained in clinical care, laboratory
services, logistics, community mobilization and pediatric HIV/AIDS care.
The USAID cooperative agreement with JCRC has been extended to September 2009. USAID/PEPFAR will
continue to support HIV/AIDS prevention, care and support activities through indigenous partnerships,
which demonstrate competency and leadership in respective technical areas. These partnerships are
envisaged to continue as mechanisms for building local partnership, response, ownership and sustainability.
While doing so, USAID envisions moving from sole sourcing to open competition among indigenous
partners. Competition will prompt local partners on the need to be competitive, and on the requirement to
develop their own capacity in designing and developing high quality and competitive proposals and
programs. USAID will award the new agreement by March 2009. This will ensure smooth transition
between the current JCRC program and the TBD mechanism.
In FY 2009 the major focus of the activity will be to ensure the continuity of life saving services, a smooth
transition and capacity building of 11 regional referral hospitals and expansion of district wide HIV/AIDS
care and treatment services in 40 facilities located in the 11 districts hosting the regional referral hospitals.
Specific activities will include: 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. 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 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 55 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 55 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 and Early Infant Diagnosis using DNA-PCR 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 55 sites. The program will also ensure that AZT and Nevirapine for infants is available in
the 55 MCH sites.
It is estimated that 400 HIV-positive pregnant women with CD4 cell count below 350cells/mm³ will receive
ART while 700 not yet eligible for ART will receive a course of highly effective ARVs for prevention of HIV
infection in infants. All the 400 HIV-exposed infants will receive a seven-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 three-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)
Emphasis Areas
Health-related Wraparound Programs
* Family Planning
* Malaria (PMI)
* TB
Military Populations
Refugees/Internally Displaced Persons
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.01:
The USG has been supporting the provision of ART services in Uganda through the Joint Clinical research
continue to support HIV/AIDS prevention, care and support activities through indigenous partnerships which
demonstrated competency and leadership in respective technical areas. These partnerships are envisaged
to continue as mechanisms for building local partnership, response, ownership and sustainability. While
doing so USAID envisions moving from sole sourcing to open competition among indigenous partners.
Competition will prompt local partners on the need to be competitive and the requirement to develop their
own capacity in designing and developing high quality and competitive proposals and programs. USAID will
award the new agreement by March 2009. This will ensure smooth transition between the current JCRC
program and the follow-on mechanism.
In FY 2009 the major focus of the activity will be to ensure continuity of life saving services, smooth
transition and capacity building of the 11 regional referral hospital and expansion of district wide HIV/AIDS
In the selected 11 focus districts, 11 regional referral hospitals and over 40 sites (district hospitals and
HCIVs), the program will support infrastructure development for ART services and build the 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. The program will
ensure consistent availability of care and treatment services of patients currently under JCRC mechanism.
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 the 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.
In the selected 11 focus districts, 11 regional referral hospitals and over 40 sites, the program will provide
care and support services to 40,000 clients not yet eligible for ART. This brings the total number of patients
under care, including those on ART, to over 85,000. 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 40,000 clients under care.
The program will train and support 120 expert clients and community volunteers 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 wrap around services available in the communities. 350 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
Estimated amount of funding that is planned for Food and Nutrition: Policy, Tools
and Service Delivery
Table 3.3.08:
Continuing Activity: 15791
15791 15791.08 U.S. Agency for Joint Clinical 7207 7207.08 TREAT $4,800,000
Table 3.3.09:
Competition will prompt local partners on the need to be competitive, and on the requirement to develop
their own capacity in designing and developing high quality and competitive proposals and programs.
USAID will award the new Cooperative Agreement by March 2009. This will ensure smooth transition
In FY 2009 the major focus of the activity will be to ensure continuity of life saving care and treatment
services, smooth transition and capacity building in the 11 regional referral hospitals and expansion of
district wide HIV/AIDS care and treatment services in 40 facilities located in the 11 districts hosting the
regional referral hospitals.
Pediatric care and treatment 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, utilization of pediatric care and
treatment services, growth monitoring, food and nutrition support, support for adherence to anti-retrovirals
(ARVs), counseling for pediatric HIV-positive patients and linkages to basic preventive package and wrap-
around services.
In the selected 11 focus districts, 11 regional referral hospitals and over 40 sites, the program will support
infrastructure development for pediatric care and treatment services and build capacity of the Directorate of
Health Services to scale-up linkages between PMTCT and pediatric care and treatment in the district. It is
estimated that a total of 11,000 children will receive care and 5,000 will be initiated on treatment.
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.
to counsel, initiate and manage ART in pregnant women and, linkages between pregnant women and
pediatric care are strengthened. 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.
Table 3.3.10:
regional referral hospitals. Specific activities will include: 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. The program will train physicians
and non-physicians to provide Pediatric care and treatment 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,
utilization of pediatric care and treatment services, growth monitoring, food and nutrition support, support for
adherence to anti-retrovirals (ARVs), counseling for pediatric HIV-positive patients and linkages to basic
preventive package and wrap-around services.
Table 3.3.11:
services, logistics, community mobilization and pediatric HIV/AIDS care. It has also identified and treated
700 TB/HIV co-infected patients and trained 150 health workers on TB/HIV collaborative activities. The
program is also expected to have provided anti-retroviral therapy to 500 TB/HIV co-infected clients by the
end of the FY 2008.
programs. During the extension phase JCRC will transition the majority of the sites beyond the nine
regional referral hospitals to the new USAID district based mechanisms, other PEPFAR partners who
overlap in the same facilities, and to the Ministry of Health (MOH). To ensure continuity of services, USAID
will award the new agreement by March 2009.
In FY 2009 the major focus of the activity is to ensure continuity of life saving services, smooth transition
and building capacity of nine regional referral hospitals. 1,000 new 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 nine regional referral hospitals.
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 TB and HIV management. The
groups will facilitate referrals to wrap around services available in the communities. 100 health workers will
be trained to provide TB/HIV 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. The activity will closely work with the MOH national TB reference laboratory and the National
Tuberculosis Control Program for diagnosis and referral of Multi-Drug Resistant Tuberculosis.
Continuing Activity: 16007
16007 16007.08 U.S. Agency for Joint Clinical 7207 7207.08 TREAT $225,000
Table 3.3.12:
demonstrated competency and leadership in respective technical areas. During the extension phase JCRC
will transition majority of the sites beyond the nine regional referral hospitals, to the new USAID district
based mechanisms, other PEPFAR partners who overlap in the same facilities, and to the Ministry of Health
(MOH). To ensure continuity of services USAID will award the TBD new mechanism by March 2009, this will
ensure smooth transition between the current JCRC program and the TBD mechanism.
and building capacity of nine regional referral hospitals. The program will provide training of over 200 health
workers in ARV logistics and procurement focusing on forecasting, warehouse management and distribution
of ARVs.
The program will procure ARVs to cater for over 30,000 patients on first line treatment and 1500 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.
In FY 2009, 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 supported ART sites to improve patient
tracking.
Table 3.3.15:
Kabale and Fort Portal. In FY 2008, JCRC initiated treatment to over 10,000 new clients bringing the total
number of clients on ART to over 40,000. Currently JCRC is the largest single provider of pediatric ART with
over 7,600 children accessing treatment. In FY 2008, over 4,000 health workers were trained in clinical
care, laboratory services, logistics, community mobilization and pediatric HIV/AIDS care.
Between October 2007 and June 2008, JCRC conducted 216,837 CD4 tests, 15000 DNA PCR tests, and
204,946 chemistry tests through six regional centers of excellences and JCRC centers in Kampala. JCRC is
the lead partner in providing laboratory support for the Ministry of Health (MOH) EID program; in providing
viral load and CD4 tests for monitoring treatment response and drug failure; and DNA sequencing for HIV
Drug resistance testing. The JCRC advanced laboratory is being used as major referral center for Uganda
and several African countries in the Great Lakes Region and reports to the national HIVDR Coordinating
Center at UVRI.
The cooperative agreement with JCRC has been extended to September 2009 and PEPFAR will continue
to support HIV/AIDS prevention, care and support activities through indigenous partnerships which have
demonstrated competency and leadership in respective technical areas. During the extension phase, JCRC
will transition the majority of the sites beyond the eleven regional referral hospitals to the new district-based
mechanism, other PEPFAR partners who overlap in the same facilities and to MOH. To ensure continuity of
services, the new mechanism will be awarded by June 2009 to ensure a smooth transition between the
current JCRC program and the TBD mechanism.
With more that 140,000 Ugandans on ART and as PEPFAR transitions from an emergency phase to a
sustainable program, it is imperative to address quality issues through regular CD4+ monitoring of patient
pre-ART and ART phase, annual viral load tests for patients on ART to monitor treatment responses; there
is also a need to rapidly increase access to DNA-PCR for early infant diagnosis. Through the TBD
mechanism USG will continue to support access to early infant diagnosis. In FY 2009, the program will
provide support to nine regional hospital laboratories to provide services for improved laboratory testing for
diagnosis of HIV infection and other opportunistic infections and for monitoring patients during care and
treatment. The program will support the establishment of effective laboratory networks in districts hosting
regional referral hospitals. The program will build the capacity of the district hospitals to provide level
appropriate laboratory support to lower health centers (HCIV and HCIII) through referral testing and support
supervision; in this JCRC will work closely with the MOH Central Public Health Laboratory. The program will
build capacity of regional referral hospitals to provide advanced HIV diseases monitoring services in a
consistent manner. The program receives reagents for EID from the Clinton Foundation, a donation to
MOH.
Additional resources are required in the subsequent fiscal years for this activity to achieve the objectives
highlighted above and to continue to provide the services that are being provided by JCRC including
supporting MOH, PEPFAR and non-PEPFAR partners in CD4+ counting, serum chemistries and
hematology, DNA and RNA PCR. The need for such lab services will increase exponentially with the rapid
scale up of ART services and as the MOH plans to link more service outlets to the EID network which is
mainly serviced through JCRC laboratories.
Continuing Activity: 15914
15914 15914.08 U.S. Agency for Joint Clinical 7207 7207.08 TREAT $1,400,000
Table 3.3.16:
