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.
Implementing Mechanism narrative
Makerere University Faculty of Medicine was awarded a 5- year Cooperative Agreement "Provision of routine HIV testing, counseling, basic care and antiretroviral therapy at Ugandan teaching hospitals" in 2004. The implementing program was code-named "Mulago-Mbarara Teaching Hospitals' Joint AIDS Program" (MJAP). In June 2006, MJAP received supplemental funding to build capacity of Kampala City Council (KCC) clinics to provide HIV care and treatment.
In August 2006, MJAP was awarded a second grant "Expanding Tuberculosis/HIV Integration Activities" to support the Uganda Ministry of health (MOH) to expand integrated Provider Initiated Counseling Testing (PICT) and TB screening and care to 11 regional referral hospitals (RRHs).
MJAP received funding in February 2008 to strengthen capacity of Mulago STD unit in prevention and control of HIV/STI with particular focus on Most at Risk populations (MARPS) and vulnerable groups.
And recently, July 2008, MJAP received central funds to pilot provision of medical and psychosocial services to survivors of sexual and gender-based violence (SGBV).
The goals of the program were as follows:
1. To develop a national model for providing the full continuum of HIV/ AIDS care
2. To prevent HIV infection and HIV related illness through a continuum of prevention and care
3. To enhance capacity of health providers to deliver comprehensive HIV services
Service coverage: MJAP supports comprehensive HIV prevention, care and treatment services in 9 districts and 19 facilities (2 national referral hospitals of Mulago and Mbarara, 7 RRHs of Kabale, Fortportal, Jinja, Mbale, Soroti, Hoima and Masaka, and 10 HCIVs namely Kawempe, Naguru, Kiswa, Kiruddu, Kisenyi, Kawaala, Kitebi Komamboga, Bwizibwera, Mbarara Municipal Council). MARPI activities are supported in Kampala district. RCT is offered in 63 units including all high HIV prevalence units in Mulago hospital and Mbarara Hospital units.
Services: The RCT program targets adults and children attending out-patient clinics, in-patient wards of facilities for routine medical care. Spouses of RCT recipients are targeted to promote couple testing and identify discordant couples. VCT is extended to household members of clients to promote a family approach to care. HIV care is provided to HIV positive clients identified in RCT. All TB patients are screened for HIV, and all HIV clients screened for TB, and co-infected patients managed for both conditions. Antiretroviral therapy (ART) is provided to eligible clients as per MOH guidelines. Clients in care are provided OI treatment and prophylaxis using cotrimoxazole in addition to positive prevention messages and supplies like condoms. HIV-negative persons are also encouraged to remain negative through behavioral change messages. Children identified to be vulnerable are provided with health care and referred to OVC programs for additional services. MARPI program targets STD clinic clients, commercial sex workers and students in tertiary institutions and provides HIV testing, referral, and prevention interventions. The SGBV program targets survivors of rape and sexual violence, provides testing, counseling, and post exposure prophylaxis. Training is both for pre and in-service medical and allied workers.
Health systems strengthening supported areas include:
Human resources for health: MJAP provides training for providers in HIV prevention and care and salary support for some additional staff in the supported facilities. MJAP with MOH conduct regular technical support supervision.
Laboratory strengthening: This is supported through training, procurement of equipment, ensuring supplies availability, and quality assurance.
Infrastructure: MJAP has remodeled some facilities to improve waiting space and power solutions.
Capacity building for HIV care: MJAP supports HC IVs in Kampala and Mbarara to provide care and treatment
Strengthening Logistics and data management systems: Through training of data staff, support supervision, provision of computers.
National level contributions: MJAP pioneered PITC and TB/HIV integrated care. MJAP staffs are members of national committees for HCT, ART, and TB/HIV providing guidance on policy development.
Cross-cutting programs/ key issues: Gender: MJAP provides services to survivors of SGBV in Mulago hospital with referrals to police, legal, spiritual services.
MJAP has implemented use of drugs and other supplies from other sources when available e.g. NTLP for TB drugs, CHAI for pediatric and 2nd line ARVs, Pfizer for Fluconazole, and ARVs through MOH/GF. The program has moved from brand to generic FDA approved drugs, use of fixed dose combinations (FDC), and piloted clinic models to reduce on staffing requirements e.g. family model, task shifting.
Monitoring and evaluation: MJAP plans to utilize MOH data collection tools in facilities. This is ongoing and any challenges will be shared with MOH and CDC. Monitoring/ technical support visits to facilities will continue and reports will be submitted as required.
Major program achievements
Since inception MJAP has provided HIV testing to more than 570,000 individuals, identified over 79,800 HIV-infected individuals, and linked them to care. Over 43,799 HIV-infected have received basic HIV care, over 63,000 screened for TB and 12,734 managed for TB /HIV co-infection. MJAP has over 22,055 patients enrolled on ART and has served more than 9,232 OVCs, trained over 8,545 health care providers in areas of HIV/AIDS and TB.
