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
This is a continuing activity from FY08.
In keeping with Vietnam's National HIV/AIDS Strategy and PEPFAR's 5-year Strategy, FY09 funds and will
be provided to the National Institute of Hygiene and Epidemiology (NIHE) for numerous laboratory activities.
These include HIV rapid test field evaluation (phase II); dissemination of a national HIV diagnostic algorithm
(using rapid tests); coordination of the national external quality assurance (EQA) program for HIV serology,
estimation of a local HIV-incidence (BED assay) misclassification rate, patient monitoring for HIV drug
resistance in outpatient clinics in high prevalence provinces and expansion of HIV early infant diagnosis to
all provinces offering prevention of mother-to-child transmission (PMTCT) services. NIHE and the Pasteur
Institute are developing similar, reference laboratory-like roles related to HIV; each covers different ends of
the country. NIHE is a resource for Vietnam's Ministry of Health (MOH) in setting policy and developing
national testing guidelines.
The evaluation by NIHE and the Pasteur Institute of Ho Chi Minh City of HIV rapid tests is one part of a plan
to help MOH develop a single HIV diagnostic algorithm based on simple, rapid testing technologies.
PEPFAR funding from previous years has been provided for this activity, but only recently has there been
such a high level of interest and urgency within the MOH's Vietnam Administration for HIV/AIDS Control for
the completion of this activity. In mid-2008 Vietnam, hosted a World Health Organization (WHO)-sponsored
regional HIV testing meeting (with CDC support). The protocol for the initial laboratory based evaluation
(phase I) has been completed (using the internationally accepted WHO/CDC guidelines) and approved by
both the government of Vietnam and CDC (Internal Review Board). Sample collection, characterization,
testing, and data analysis will occur in early 2009. Based on the results of this initial evaluation, tests will be
selected for field evaluation (phases II) at selected testing sites in late 2009. NIHE and PI will provide
training and supervision to testing sites and will characterize study specimens. Resulting data will be used
by the Ministry of Health (and stakeholders) to make recommendations for testing algorithms that will be
implemented with education and training programs. An HIV diagnostic quality assurance program will be
developed around the new algorithm (phase III) and will be based at NIHE to support the northern provinces
(the Pasteur Institute will support the southern provinces). This will include a combination of training,
internal QA, external QA, retesting, and site monitoring.
PEPFAR continues to support the development of NIHE's HIV molecular testing laboratory, which is
responsible for HIV drug resistance monitoring for antiretroviral therapy clients and threshold surveys. To
date, support has included staff training, limited infrastructure improvements, and reagent procurement. For
FY09 PEPFAR will provide long-term (three month) technical assistance (TA) through its laboratory coalition
partner, the Association of Public Health Labs (APHL). A former molecular laboratory director will serve as a
mentor to the current director (see APHL activity narrative for additional detail).
Development of an efficient early infant diagnosis (EID) program for HIV-exposed infants, linked to PMTCT
services, continues to be a goal of Vietnam's Ministry of Health. NIHE, with PEPFAR support, is seeking
approval from the government of Vietnam for use of Roche Amplicor DNA PCR 1.5 kits. A protocol has
been developed and approved for EID implementation; NIHE and the Pasteur Institute are jointly designated
as technical leads. Dried blood spots (DBS) will be used for specimen collection. PEPFAR will collaborate
with the Clinton HIV/AIDS Initiative, which is providing sample collection materials and test kits. TA will be
provided by PEPFAR for collection and testing site training and development of a comprehensive quality
assurance (QA) program for EID. In FY09, EID services will be expanded to more provinces.
In the past, PEPFAR supported NIHE in the implementation of various laboratory QA-strengthening
activities. Laboratory technicians from 55 provinces have been provided vendor-supported EIA training on
equipment use and preventive maintenance. Service contracts were put in place for biological safety hoods
and pipettes. Two new laboratory technicians were hired to conduct site visits and data analyses. NIHE will
develop standard operating procedures for laboratories at the national, regional, and provincial levels for
quality assurance and laboratory safety. In FY09, PEPFAR will provide support to NIHE for the continuation
of these activities.
NIHE currently supports a national HIV EQA program. In FY08, PEPFAR assisted in the procurement of
equipment necessary for the production of the serology panels. In collaboration with the Thai Ministry of
Public Health (TMOPH) and PEPFAR, NIHE has validated and calibrated this equipment and characterized
EQA panels. The Hanoi School of Public Health (HSPH) is working with NIHE to adapt the EQA software
provided by Thailand to Vietnam. Staff at NIHE received additional training from TMOPH and WHO
regarding production of EQA panels and data analyses to generate reports. Three proficiency rounds have
been completed. PEPFAR will continue to fund the expansion of this EQA program as a component of the
national quality management system.
New/Continuing Activity: Continuing Activity
Continuing Activity: 15301
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
15301 5709.08 HHS/Centers for National Institute 7115 3106.08 $315,500
Disease Control & for Hygiene and
Prevention Epidemiology
9506 5709.07 HHS/Centers for National Institute 5102 3106.07 NIHE $319,474
Disease Control & for Hygiene and Cooperative
Prevention Epidemiology agreement
5709 5709.06 HHS/Centers for National Institute 3106 3106.06 Cooperative $220,000
Disease Control & for Hygiene and agreement
Table 3.3.16:
HCD - Training and TA: $40,000
Data Triangulation: $40,000
GIS: $20,000
HMIS: $20,000
Incidence Surveillance: $70,000
Sentinel Surveillance: $70,000
As the leading disease surveillance institute in Vietnam, the National Institute of Hygiene and Epidemiology
(NIHE) will continue gathering and analyzing epidemiological data to inform policy and programs and
contribute to human capacity development in epidemiology. NIHE is currently collaborating with the
HHS/CDC Global AIDS Program (GAP) Surveillance and Laboratory Branches to obtain the correction
factor for the BED HIV-1 incidence assay for Vietnam. With COP FY 2009 funds, NIHE will apply BED to
stored and new specimen from sentinel surveillance and integrated biological and behavioral surveillance
(IBBS) to track incidence among most at risk populations. Incidence data are key data currently unavailable
for prevention program planning in Vietnam; this activity will provide baseline data for future PEPFAR and
national strategy planning. Funds will be used for laboratory supplies and transportation; PEPFAR will
procure BED kits.
To address low field surveillance capacity, NIHE will continue to strengthen the capacities of regional
epidemiology institutes and provincial implementing partners in ensuring quality sentinel surveillance data.
Funds will be used for regional refresher trainings, quality assurance systems establishment, field QA
activities, and dissemination workshop.
By 2009, in addition to incidence surveillance, the second round of IBBS, MARP size estimation, and
behavioral survey among male client of sex workers will have been completed. Along with the Vietnam
Administration for HIV/AIDS control, NIHE will co-chair a technical working group to triangulate these data
with program data and disseminate findings to stakeholders.
NIHE will also collaborate with local public health and medical universities to develop epidemiology
concentrations at these universities and scholarship programs to encourage greater enrollment in
epidemiology programs. NIHE will also engage in curriculum development and lectures of short-course in-
service epidemiology training, which will be coordinated by and funded through the Hanoi School of Public
Health.
NIHE will also participate on the GIS technical working group, supporting training and data collection and
contributing epidemiological data to the project.
Furthermore, NIHE will improve information systems around surveillance, size estimation, and other
epidemiological data for data management and sharing among GVN and other stakeholders.
Continuing Activity: 15302
15302 5694.08 HHS/Centers for National Institute 7115 3106.08 $610,000
9244 5694.07 HHS/Centers for National Institute 5102 3106.07 NIHE $165,314
5694 5694.06 HHS/Centers for National Institute 3106 3106.06 Cooperative $225,000
Emphasis Areas
Military Populations
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $40,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.17:
