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
In FY 2009 the university technical assistance (UTA) mechanism will be competed to continue provision of
high quality expert technical support for PEPFAR programs in Uganda. The focus of this assistance will be
in three key program areas.
Treatment services technical assistance will be concentrated on enhancing comprehensive care and
treatment interventions to strengthened partners' clinical programs. In FY08 the primary focus will be to
review patient management and record keeping systems at treatment sites and identify areas and
implement improvements in the clinic operations to substantially improve patient outcomes.
The strategic information component of UTA will be to assist the PEPFAR program in using the substantial
amounts of program area data collected over the past five years in combination with country surveillance
data to provide a better understanding of PEPFAR outcomes and contributions to the national portfolio.
Examining the data from multiple sources will provide the country team will a more comprehensive analysis
to assist with future programming directions.
For systems strengthening/policy development the UTA technical expertise will be transferred to local
partners through a series of in-country workshops for advanced data analysis and triangulation and training
on how to interrupt the results for policy guidance and program direction; and, training on how to prepare
technical presentations and manuscripts.
New/Continuing Activity: Continuing Activity
Continuing Activity: 13325
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
13325 4423.08 HHS/Centers for University of 8655 8655.08 UCSF $120,000
Disease Control & California at San
Prevention Francisco
8371 4423.07 HHS/Centers for University of 4818 1273.07 University of $120,000
Disease Control & California at San California San
Prevention Francisco Francisco -
UTAP
4423 4423.06 HHS/Centers for University of 3345 1273.06 University of $120,000
Table 3.3.09:
In addition, this component of the follow-on will focus on—1) To assist in providing training and technical
assistance to develop the capacity of Implementing Partners (IP) to perform meaningful quantitative
program monitoring and evaluations, and 2) to assist Implementing Partners to perform HIV care and ART
outcome evaluations.
The need for this technical assistance is based on the uneven skill level of PEPFAR supported IPs to
perform M&E particularly program impact evaluations, the range of data collection and management
systems being used from paper-based to highly sophisticated web-based platforms, and the large number
of IPs and sites that require assistance. In addition, the ability to determine the impact of PEPFAR
programming requires moving beyond aggregate indicator reporting, to more detailed evaluations of
individual program outcomes. This is particularly true for care and treatment programs, in which the loss to
follow-up, mortality rate, morbidity, and adherence to medications are not known for the vast majority of
partners. These outcomes are critical for individual programs to assess how well they are meeting the
clinical and treatment needs of their clients, to determine the extent of loss to follow-up and how to address
it, and to determine whether the choice of treatment regimens being used are appropriate for their context.
Measures of adherence are inconsistently applied and difficult to interpret. Finally, there are currently
numerous reporting requirements of IPs including the CDC quarterly report, PEPFAR aggregate indicator
reporting, the MOH HMIS reports and ART cards, HIVQUAL assessments for those facilities being
evaluated, and early warning indicators (EWI) for drug resistance, surveys of which are being performed by
the MOH HIV Drug Resistance Working Group. All these reporting requirements and most indicators are
overlapping but are currently assessed individually, resulting in inefficient use of IP data management
capacity, incomplete reporting of indicators across sites, and variable data that is difficult to compare.
Ideally, almost all indicators could easily be collected with routine data collection instruments, and reports
and outputs programmed in advance so that data are generated routinely and without undue and costly time
inputs.
The selected partner providing this technical assistance will work closely with and under the guidance and
supervision of both the CDC Program Unit and the Informatics Unit. The partner will have technical
experience and capacity in data management, systems and statistical analysis; M&E; epidemiology;
providing training, workshops and support supervision; be familiar with the country context; understand the
components of program evaluations and relevant HIV clinical outcomes; be familiar with IRB and NRD
protocol requirements and reviews.
Specifically, the partner will provide technical assistance to CDC Uganda in the following. 1) Review and
evaluation of current data management capacity of IPs with recommendations for needed staffing, training,
and support supervision. 2) Assist in the review of all indicators across reporting formats; assist in the
harmonization of those indicators to reduce reporting burden, and improve consistency and data quality. 3)
Provide workshops, training, and hands-on support supervision to IPs on data collection, management and
analysis; routine M&E; and program evaluations, including protocol development and ethical issues. 4)
Develop and implement a method of assessing the utility and impact of these trainings, revising them based
on these assessments. 5) Assist CDC-Uganda and selected IPs with adequate capacity to develop and
implement protocols for HIV care and treatment (ART) outcome evaluations, including submission for
clearance to appropriate review boards.
Continuing Activity: 13326
13326 4424.08 HHS/Centers for University of 8655 8655.08 UCSF $600,000
8372 4424.07 HHS/Centers for University of 4818 1273.07 University of $490,000
4424 4424.06 HHS/Centers for University of 3345 1273.06 University of $490,000
Table 3.3.17:
Continuing Activity: 13327
13327 4421.08 HHS/Centers for University of 8655 8655.08 UCSF $200,000
8369 4421.07 HHS/Centers for University of 4818 1273.07 University of $160,000
4421 4421.06 HHS/Centers for University of 3345 1273.06 University of $140,000
Program Budget Code: 19 - HVMS Management and Staffing
Total Planned Funding for Program Budget Code: $18,992,034
Total Planned Funding for Program Budget Code: $0
Program Area Narrative:
The US Ambassador, as the head of the US Mission in Kampala, has been charged with managing the overall PEPFAR country
program. Working through the Executive Committee and the PEPFAR Coordinator, the Ambassador provides leadership for USG
interagency coordination, and gives policy, strategic, and budgetary guidance for achieving the overall PEPFAR goals.
Five PEPFAR implementing agencies are represented in Uganda, the Department of State, Department of Defense (DOD),
Department of Health and Human Services (HHS), Peace Corps, and U.S. Agency for International Development (USAID). HHS
works through its Centers for Disease Control and Prevention (CDC) and National Institutes of Health (NIH). DOD works through
its Office of Security Cooperation in the Embassy and the Walter Reed Army Medical Center.
The PEPFAR Executive Committee is responsible for making policy and strategy decisions. It is made up of the Ambassador, the
Deputy Chief of Mission, the CDC Country Director, the DOD Security Cooperation Chief, the Peace Corps Country Director, the
USAID Country Director, and the PEPFAR Country Coordinator who is an ex-officio member. At the program level, the Executive
Committee is responsible for the final review and approval of the annual Country Operational Plan (COP) activities and resource
allocation decisions, and semi-annual and annual reports prior to submission. The Executive Committee will address and make
decisions on operational matters that cannot be resolved by the PEPFAR Interagency Country Team or the PEPFAR Coordinator,
with the Ambassador holding authority to make final decisions.
The Government of Uganda established a PEPFAR Advisory Committee that includes representatives from Government and the
private sector. It is chaired by a former Prime Minister of Uganda; the Uganda AIDS Commission acts as the secretariat. The
purpose of the Committee is to advise the USG to ensure that the PEPFAR Program is complementary to other HIV/AIDS
programs, operates under the National Strategic Plan for HIV/AIDS, and is supportive of Uganda policies.
The PEPFAR Coordinator's Office consists of the Coordinator, Deputy Coordinator, Communications Officer, Strategic Information
Liaison, and a Program Assistant. The PEPFAR Coordinator is empowered by the Ambassador to carry out day-to-day leadership
and management of the USG PEPFAR program, and is therefore responsible for ensuring that the interventions and approaches
of the various USG agencies are harmonized to provide maximize synergy and that they support the Ugandan national HIV/AIDS
Strategic Plan.
The PEPFAR program in Uganda is implemented by the Department of State, DOD's Office of Security Cooperation and the
Walter Reed Army Medical Center, HHS's Centers for Disease Control and Prevention, Peace Corps, and U.S. Agency for
International Development. HHS's National Institutes of Health does not receive PEPFAR funding in Uganda but coordinates its
activities with the PEPFAR team.
PEPFAR Technical Workgroups (PWGs) conduct joint partner and program area reviews, outline strategies and interventions
specific to their respective program area, help determine the appropriate implementing partner mix for programs and services,
ensure linkages and synergies between program areas, and make recommendations to the Country Team when developing the
Country Operational Plan and Annual and Semi-annual Reports. There are currently eight PWGs in prevention, care, OVC,
counseling and testing, treatment, laboratory, strategic information, and policy and systems strengthening. Agencies assign
appropriate staff members with the requisite knowledge, expertise or experience in the specific technical area to each of the
workgroups. Work group members, particularly the Co-chairs, are accountable to the PEPFAR Coordinator, not their agency
supervisor.
The PEPFAR Interagency Country Team (PICT) has the responsibility to guide the U.S. Mission's development and
implementation of a comprehensive HIV/AIDS prevention, care and treatment program that supports the national GOU program.
The PICT leads strategic planning and ensures that sound programmatic and resource allocation decisions are made to
implement PEPFAR plans and contribute to the GOU priorities. Team members will support collaboration with other development
partners by participating in meetings, planning sessions, and national fora to share information on PEPFAR Uganda activities. The
PICT is made up of the PEPFAR Coordinator (chair); two representatives from each USG Agency, who represent their respective
agency; and the co-chairs of the PEPFAR Workgroups, who will represent the consensus opinion of their respective workgroup. If
PWGs cannot reach a consensus decision or a working compromise on an issue, the issue will be brought forward to the PICT for
resolution. PICT decisions will be made through consensus or an agreed upon alternative by the group.
PEPFAR Uganda first implemented Staffing for Results in 2006, assisted by a visit from OGAC Deputy Principals. At that time the
team established inter-agency Technical Working Groups and outlined the terms of reference for the governance structures that
would facilitate country operations. This interagency approach was fully endorsed and supported by the new Ambassador. With
the support of an organizational development facilitator and Core Team visits, PEPFAR Uganda has made great strides in joint
planning, budgeting, and program review, using an interagency approach with the key principles being consensus, collaboration,
and at times compromise. The team acknowledges that this is an evolving process. The facilitator made two visits in 2008 to build
PWG strengths, assist the PICT with staffing decisions, and start the COP development process. These joint team meetings, in
coordination with agency management, determined the staffing mix and size proposed for FY09.
The PEPFAR Uganda team's SFR vision is aligned with the FY09 COP guidance. We envision having in place a fully staffed and
functional interagency team that effectively plans, implements, and evaluates its programs together with appropriate technical
leadership and management oversight. While we work through the SFR process to make this vision a reality, we are striving to
create an enabling environment where team members are empowered and their contributions are valued, where the diversity of
the various USG agencies is appreciated, and where teamwork, trust, transparency, and collaboration are core values.
A key accomplishment to date is the delegation of planning, decision making and monitoring to the interagency PEPFAR
Workgroups. During PEPFAR Uganda Team's continuous assessment of the processes and lessons learned, the Team will also
look at how best to address some of the challenges that include the need to bolster intra- and inter- agency communication as
responsibilities devolve to working groups, and ensure the PWGs have the requisite skills in leadership, management, budgeting,
and conflict resolution. We plan to continue with the current management structure and make minor modifications based on
evolving administrative and programmatic needs. For example, with the realignment of OGAC program areas and with pediatric
care "outgrowing" PMTCT we may need to realign the PWGs. With an enlarged PEPFAR Coordinator's office, functions such as
communications may move to that office. The basic management structure, built on inter-agency collaboration, will continue.
We will work with the Staffing for Results framework and plan throughout the year. As noted below and in agency activity
narratives, we are requesting more staff for FY09 and may do so in the future. As we discussed staffing issues in team meetings,
we realized that during the first phase of PEPFAR, funding grew much more rapidly than staffing. We will use the staffing analysis
tools throughout the year (and not just as we develop the COP) to determine which technical areas are understaffed (or possibly
overstaffed), given funding and workload. As we reach a steady-state environment, with stable funding and fewer new contracts
and grants to award, we will work with non-program offices to match their staffing to our workload.
The PEPFAR Uganda team is requesting 24 new positions in FY09. These are: 1 Applications Development Coordinator; 3
Behavioral Scientists; 2 Care and Treatment Specialists; 1 Deputy Chief (Behavioral); 2 Drivers ; 1 Epidemiology Services
Coordinator; 2 Health Systems Support Specialists; 1 Prevention Specialist; 1 Program Management Specialist, Civil Society; 1
Program Management Specialist, Decentralization ; 1 Program Management Specialist, Decentralization; 1 Program Management
Specialist, DLI Program; 1 Program Management Specialist, Health Systems; 1 Program Management Specialist, Nutrition; 1
Program Management Specialist, OVC; 1 Program Management Specialist, Planning Program Manager; 1 Property Clerk; 1
Quality Assurance Technician; and 1 Secretary. These positions will provide the technical and administrative assistance needed
to implement PEPFAR activities in Uganda, including strengthening indigenous partners' capacity and thus sustainability. As
noted above, these positions were discussed and decided upon by the PEPFAR team, and agency management, operating within
the staffing for results framework.
Twenty-eight previously approved positions were vacant on September 30, 2008. These were: 1 Administrative Clerk; 1
Behavioral Advisor; 1 Chief, Informatics; 1 Communication Specialist; 1 Computer Management Assistant; 2 Data Clerks; Deputy
Team Leader (HIV/AIDS); 2 Drivers; 1 Epidemiologist (DHAP); 2 HIV/AIDS Specialists (Fellows); 1 IT Advisor; 1 Lab Systems
Specialist; 1 Medical Epidemiologist; 2 Medical Officers; 1 PEPFAR Administrative Assistant; 1 PEPFAR DOD Program Assistant;
1 Program Management Assistant; 1 Program Management Specialist, Care and Treatment; 1 Program Management Specialist,
Conflict Gulu Office; 1 Program Management Specialist, Pediatrician; 1 Public Health Advisor; 1 Roving Secretary; 1 SAS
consultant; and 1 Senior Data Analyst. These were vacant due to resignations, delays in arrival of new staff, or due to a
sometimes-lengthy hiring process. Some positions (e.g., the Team Leader (HIV/AIDS)) have been filled since the cut-off date. All
positions were considered during staffing for results discussions and were deemed still necessary.
Table 3.3.19:
