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: 2007 2008 2009
UNAIDS MARPS COORDINATION AND CAPACITY BUILDING: $200,000
This is a continuation of FY07 and FY08 activities to: 1) strengthen coordination and advocacy for Most At
Risk Populations (MARPs); and 2) build capacity for the response to HIV among men who have sex with
men (MSM), commercial sex workers (CSW), and injecting drug users (IDU).
While the Vietnamese HIV epidemic remains concentrated among MARPs, the national focus on IDU
programs may overshadow the needs of other groups such as MSM and CSW. Given the significant
interaction between drug and sexual risks revealed by the 2006 IBBS, it is imperative to strengthen
coordination between all MARPs interventions by standardizing approaches and strengthening advocacy for
IDU, sex workers and MSM. UNAIDS will continue to lead coordination of these activities and will build
capacity of stakeholders to address HIV on a larger scale. This activity consists of two objectives:
1. Increased Coordination and Advocacy for MARPs
UNAIDS remains responsible for coordination and advocacy of national and provincial MSM working groups
and for strengthening links with the regional MSM Purple Sky Network. Due to the observed interaction of
drug use and sexual risk, in FY08 UNAIDS expanded its advocacy role to address recovering IDU and sex
work in addition to MSM. FY09 funds will support continued advocacy for all high risk groups through
standardization and consolidation of peer educator manuals for IDU, sex workers and MSM. At the
provincial level UNAIDS will support operation of six current MSM working groups and advocate
establishment of at least 4 more. Through collaboration with local and international IDU and CSW
advocates, UNAIDS will develop strategies to reduce stigmatization of drug users and sex workers and to
encourage peer participation in decisions that affect their health and welfare, including HIV/AIDS
prevention, care and treatment. Strategies focus on: a) coordination of MARP working groups and
interventions, and; 2) generation of strategic information to inform service development and implementation
for these high risk populations (e.g. size estimation and development of a research agenda on MARPs and
HIV).
UNAIDS will continue to increase MARP access to HIV prevention information by translating, printing and
disseminating MSM material; using existing web access, mailing lists, electronic or printed bulletins and the
UNAIDS website; and joining forces with experienced IDU and CSW advocates to ensure prevention
information is readily on hand. Advocacy for inclusion of MARPs in policy and programming decisions at the
national level will continue.
New in FY09, UNAIDS will work to coordinate a unified approach to MARP interventions with international
agencies such as (but not limited to) WHO, UNODC, PEPFAR and Vietnamese government partners
including the Vietnam Administration of AIDS Control (VAAC); the Ministry of Labor, Invalids and Social
Affairs (MOLISA); and the Ministry of Public Security (MOPS). This includes work with MOPS to advocate
services in prisons (including prevention addressing male-to-male sex) and with MOLISA on (male) sex
workers to address service overlap and gaps.
2. Improved Capacity for MSM Access to HIV Services
In FY07, UNAIDS conducted a needs assessment on MSM and HIV issues, which led to development of a
capacity-building plan for 2008-2010. Implementation of the plan commenced in FY08. In FY09, UNAIDS
will continue training sessions to strengthen MSM interventions using the previously developed materials.
UNAIDS will also support establishment of MSM community-based organizations through leadership
training and institutional development for self-help groups and MSM CBOs, seed funds for self-help groups
and support for their legal registration. Since previous MSM interventions have increased media attention—
some reflecting a stigma towards this group—UNAIDS will continue media work to improve the image of
MSM. Research on social perceptions of homosexuality and work with mass media to address stereotypes
will support efforts to combat discrimination against MSM.
Number of targeted condom service outlets: N/A
Number of individuals reached through community outreach that promotes HIV/AIDS prevention through
behavior change other than abstinence and/or being faithful: 1,000
Number of Individuals trained to promote HIV/AIDS prevention through behavior change other than
Abstinence and/or being faithful: 200
UNODC HIV PREVENTION AND SERVICES IN CLOSED SETTINGS: $250,000
The Vietnamese custodial system includes more than 800 correctional facilities and associated clinics with
over 20,000 security and health staff. Of an estimated 150,000 detainees, more than 35,000 are
incarcerated drug users. Current HIV services in custodial settings remain weak, and while the Ministry of
Public Security (MOPS) offers basic health care and small-scale prevention campaigns, a significant
response to the epidemic is lacking.
While no public data quantify HIV prevalence across Vietnamese prison facilities, informal discussions
suggest infection rates are high, sparking concerns for the health and safety of prison staff and those in
custody. As such, addressing health needs of confined persons living with HIV, reducing transmission risk
to detainees and custodial staff, and ensuring a detention-to-community continuum of care are needed to
integrate the Vietnamese correctional structure with the national strategy on HIV/AIDS.
As lead UN agency for HIV programs in closed settings, the UN Office on Drugs and Crime (UNODC), in
collaboration with UNAIDS, partners with MOPS to develop guiding principles and programs related to HIV
service in prisons. This includes provision of UN technical advice and assistance for: (a) HIV/AIDS and TB
services for custodial populations (detainees, security and support staff) equivalent to that in the community;
(b) Preventing transmission of HIV and other infections among detainees, staff, and the community; and (c)
Promoting a continuum of care between custodial facilities and the community to address the needs of
PLHIV.
UNODC will receive FY09 assistance to complete four concrete activities, increasing knowledge, skills and
resources to combat HIV in custodial settings. UNODC will:
Activity Narrative: 1. Translate, publish and distribute UN technical ‘best practice' guidelines for prisons and closed settings.
Central and provincial MOPS and prison agencies will receive the following translated ‘best practice'
documents: (a) HIV Prevention, Care, Treatment and Support in Prison Settings: A Framework for an
Effective National Response; (b) Effectiveness of Interventions to Address HIV in Prisons; (c) Interventions
to Address HIV in Prisons: HIV Care, Treatment and Support; and (d) Interventions to Address HIV in
Prisons: Drug Dependence Treatments.
2. A national seminar on ‘HIV in Prisons and Closed Settings', and two regional technical workshops will
take place - one in Hanoi and one in HCMC.
3. UNODC will facilitate development a draft national strategy on HIV prevention, care and treatment in
prisons. A series of policy meetings will garner support from senior MOPS leaders on the need for, and
contents of, a national framework for HIV service in prisons. UNDOC will coordinate assistance from other
international stakeholders in order to assist MOPS to begin drafting the framework.
4. UNODC will lead in-service training of central MOPS Department of Prisons and Department of
Healthcare officials and officers, and officials and officers from up to four pilot prison locations, on UN ‘best
practice' guidelines. An initial assessment will determine technical, human resource, and financial needs to
adopt the program framework in pilot prisons, including continuum of care links between prison and the
community. Support will include technical and policy-related training, including in-service mentoring with a
UNODC global expert dedicated to the facility for 4-6 weeks. This prison-based support could be
coordinated with prison-oriented assistance provided by Nordic Assistance to Vietnam, with possibilities for
additional service support through in-reach models of care and treatment from community-based programs
supported by PEPFAR though Family Health International and others.
By the end of FY09 200 prison staff will be trained, 2,000 prisoners will receive HIV prevention training, and
a total of 20,000 prison staff and prisoners will receive HIV prevention messaging and other HIV prevention-
related communication.
behavior change other than abstinence and/or being faithful: 20,000
Abstinence and/or being faithful: 2,000
UNODC HIV PREVENTION SUPPORT FOR POLICE: $200,000
Building on previous MOPS initiatives supported by UNODC and UNAIDS, this FY09 activity will provide
information and training for new police recruits to make informed behavioral decisions, and increase
HIV/AIDS knowledge among other MOPS staff. Training will improve police understanding and attitudes
towards HIV prevention and sensitize officers to address correlated issues of drug addiction and HIV. This
improved understanding would enhance police officers' approaches towards vulnerable at-risk populations,
including IDU and sex workers, in the execution of their duties. This will be accomplished through: training
for trainers and peer educators; peer education courses; modification of training materials; provision of
training and support for MOPS departments at central and provincial level; and support for the use of
existing MOPS media to disseminate HIV prevention messaging and related information.
UNODC, in close cooperation with UNAIDS and in partnership with the MOPS Department of Healthcare,
will conduct training for trainers (TOT) courses for 400 peer educators who will deliver HIV/AIDS courses for
8,000 MOPS members in provinces to be determined in consultation with UNODC, MOPS, and PEPFAR.
Peer educators from the MOPS healthcare system, including prisons and detention centers, and other
MOPS staff, will be trained on peer education and HIV/AIDS/STI prevention, referral to HIV testing, care
and treatment services, and national HIV policy. UNODC also will provide technical assistance to MOPS to
set up clubs to support prevention outreach and as condom access points for officers.
Peer educators will be equipped with HIV prevention training kits to support their outreach. They will also
employ communication kits based on the UN Peer Education Kit for Uniformed Services to assist them in
their prevention interventions. Peer educator messages will be reinforced through IEC campaigns via
domestic media channels including the MOPS weekly television program and daily newspaper.
By the end of FY09, 400 police peer education trainers will be trained, 30 outreach support clubs supplying
condoms and other prevention materials to police will be established, and an additional 8,000 police will be
provided HIV/AIDS prevention training.
Number of targeted condom service outlets: 30
behavior change other than abstinence and/or being faithful: 8,000
Abstinence and/or being faithful: 400
New/Continuing Activity: Continuing Activity
Continuing Activity: 15282
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
15282 12261.08 U.S. Agency for United Nations 7111 6132.08 $200,000
International Resident
Development Coordinator
12261 12261.07 U.S. Agency for Joint United 6132 6132.07 UNAIDS $130,000
International Nations
Development Programme on
HIV/AIDS
Emphasis Areas
Gender
* Addressing male norms and behaviors
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $450,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.03:
UNODC HIV PREVENTION AND SUBSTANCE ABUSE TREATMENT AMONG HIGHLAND DRUG
USERS: $500,000
Consistent with PEPFAR Vietnam's efforts to refine its focus on the role of drug use in the HIV epidemic,
this UNODC initiative provides evidence-based community support for HIV prevention in northwestern Son
La, Dien Bien and Lao Cai provinces, marked by high rates of drug use and HIV infection with few available
HIV services. The program relies on peer education and referral of drug users to voluntary substance
abuse treatment and aftercare without assignment to 06 drug rehabilitation centers.
FY09 assistance will expand access to prevention services developed through FY07 and FY08 PEPFAR
support, and expand geographic coverage in the three target provinces. The program will also advance
coordination and implementation with World Bank projects, the AusAID/Dutch-funded HAARP program, and
PEPFAR LIFE-Gap programs in Dien Bien and Son La. Coordination with UNAIDS and other PEPFAR
partner projects in these provinces will also be advanced.
Through FY09 funding, 500 community drug abuse recovery support and peer outreach workers will be
trained to provide HIV prevention education, and referral to HIV testing, care and treatment, and to
community based substance abuse treatment options for 4,000 drug users. Outreach and support staff will
improve links between community-based HIV prevention, substance abuse treatment, and PEPFAR or
other donor-sponsored HIV testing and service. Substance abuse treatment options include medically-
supervised detoxification, recovery management and support, and relapse prevention support neglected by
mainstream HIV initiatives. These substance abuse treatment and HIV prevention services will be offered in
clients' home districts and communes, avoiding the stigma, fear and family difficulties associated with
compulsory government detoxification centers.
Building upon the foundations established in FY08, the peer education model will be tailored in FY09 to
highland ethnic minority drug users and their families through service development that fits unique close-knit
communities, including use of minority languages and support from drug users' relatives and neighbors.
This will enable these provinces to expand the scale, accessibility, and geographic coverage including
development of culturally-appropriate HIV prevention education materials distributed to approximately
14,000 households.
FY09 assistance outputs will include:
1. A report on baseline HIV risk behavior for project sites, focused on qualitative data, will be completed
largely by existing peer workers recruited and trained in FY07 and FY08. The report will address prevention,
care and treatment needs, accessibility, and barriers among IDU and other MARPs. These data will be
collected in new FY09 geographic areas, and will complement existing quantitative data collected through
the Integrated Biological and Behavioral Surveillance (IBBS). Services will expand thematically,
geographically, and by risk population groups based on qualitative data collected through the FY08 UNODC
program.
2. Provincial and district Department of Public Security and Department of Labor, Invalids and Social Affairs
personnel will be trained to support provincial HIV prevention and referral service.
3. Community based HIV and injecting drug use prevention and education materials will be developed and
distributed.
4. Community based HIV prevention and services referral programs, including substance abuse treatment,
will be developed and implemented.
prevention of drug use: 4,000
Number of individuals trained to promote HIV/AIDS prevention through prevention of drug use: 500
In accordance with the PEPFAR Vietnam five year strategy and a refined focus on the role of drug use in
the HIV epidemic, this UNODC initiative provides evidence based community support for HIV prevention in
northwestern Son La, Dien Bien and Lao Cai provinces marked by high rates of drug use and HIV infection
with scarce HIV services. The program relies on peer education and referral of drug users to voluntary
substance abuse treatment and aftercare without assignment to 06 drug rehabilitation centers.
FY09 assistance will expand access to prevention services developed through FY07 and FY08 PEPFAR,
and expand geographic coverage in the three target provinces. The program will also advance coordination
and implementation with World Bank projects, the AusAID/Dutch-funded HAARP program, and CDC/Life-
Gap programs in Dien Bien and Son La. Coordination with UNAIDS and other PEPFAR partner projects in
these provinces, will also be advanced.
Through FY09, 500 community drug abuse recovery support and peer outreach workers will be trained to
provide HIV prevention education, and referral to HIV testing, care and treatment, and to community based
substance abuse treatment options for 4,000 drug users. Outreach and support staff will improve links
between community-based HIV prevention, substance abuse treatment, and PEPFAR or other donor-
sponsored HIV testing and service. Substance abuse treatment options include medically-supervised
detoxification, recovery management and support, and relapse prevention support neglected by mainstream
HIV initiatives. These substance abuse treatment and HIV prevention services will be offered in clients'
home districts and communes, avoiding the stigma, fear, and family difficulties associated with compulsory
government compulsory detoxification centers.
In continuation of FY08 activities the peer education model will be tailored to highland ethnic minority drug
users and their families through service development that fits unique close-knit communities, including use
of minority languages and support from drug users' relatives and neighbors. This will enable these
provinces to expand the scale, accessibility, and geographic coverage including development of culturally-
appropriate HIV prevention education materials distributed to approximately 14,000 households.
Activity Narrative: FY09 assistance outputs include:
1. A surveillance report on baseline HIV risk behavior for project sites, focused on qualitative data will be a
peer-driven intervention completed largely by existing peer workers recruited and trained in FY07 and FY08.
The report will address prevention, treatment, and care needs, accessibility, and barriers among IDU and
other MARPs. These data will be collected in new FY09 geographic areas, and will complement existing
quantitative data collected through the FY07 IBBS survey. They will expand thematically, geographically,
and by risk population groups based on qualitative data collected through the FY08 UNODC program.
2. Provincial and district Department of Public Security and Department of Labor, Invalids, and Social Affairs
3. Community-based HIV and injecting drug use prevention and education materials will be developed and
4. Community-based HIV prevention and services referral programs, including substance abuse treatment,
Condom Service Outlets: N/A
Number Reached: 4,000
Number Trained: 500
Estimated amount of funding that is planned for Human Capacity Development $200,000
Table 3.3.06:
SUMMARY AND BACKGROUND:
WHO will provide technical support to the National HIV drug resistance (HIV DR) working group to
implement the Country Plan on HIV DR and to facilitate National HIV DR laboratories to obtain WHO's
accreditation. WHO will also provide technical assistance in data collection of HIV DR early warning
indicators (HIV DR EWIs).
In the rapid scale-up of ART, concern has been raised for the potential emergence of HIV DR, as monitoring
of approximately 200 ART sites in the country has become increasing challenging. WHO has played critical
roles in facilitating development and implementation of the National HIV DR strategies in close collaboration
with PEPFAR and other members of HIV DR working group. The National HIV DR Working Group was
officially established in the middle of 2008 and the Country Plan on HIV DR is expected to be approved
within 2008.
ACTIVITES AND EXPECTED RESULTS:
ACTIVITY 1 (Funding - $20,000; Sub-Partner - WHO): WHO will provide technical and coordination support
to the National HIV DR working group to plan, monitor and address the issues in implementing the Country
Plan on HIV DR, consisting of HIV DR prevention and HIV DR surveillance activities, designation of
National HIV DR laboratory(ies), and development of National HIV DR database. It is expected that the
working group will focus its discussion in planning and analyzing the HIV DR surveillance activities (i.e. HIV
DR threshold survey, HIV DR monitoring survey, and HIV DR EWIs) to inform National Program on care
and treatment to prioritize its support and supervision functions, to optimize HIV DR prevention activities
and to revise National policies, guidelines and patient monitoring system. WHO will also facilitate the
designated National HIV DR laboratories to obtain the WHO accreditation.
ACTIVITY 2 (Funding - $10,000; Sub-Partner - WHO): WHO's advisor will provide technical assistance to
VAAC and relevant institutes in collecting and analyzing data on HIV DR EWIs, which has been adapted
and piloted in Vietnam in 2007 with WHO's support. HIV DR EWI is designed to monitor potential HIV DR
risks at each ART sites, including drug supply continuity, appropriate initial prescribing practices,
appointment keeping, lost-to-follow-up and first-line retention. In fiscal year 2009, the Country Plan suggests
further data collection for HIV EWI will be expanded to fifty ART sites. Actual data collection will be funded
by other sources.
ACTIVITY 3 (Funding - $300,000; Sub-Partner - Vietnam Women's Union)
The Women, AIDS and Reproductive Health Center of the Vietnam Women's Union (VWU-WARC) and
United Nations Volunteer (UNV), implement a microfinance scheme for members of people living with HIV
(PLHIV) support groups, called "Empathy Clubs" in two provinces in Northern Vietnam. The program has
been very successful and enjoys a 100% payback rate.
Reports of inflation at rates of around 25% this past year have made food security more difficult for HIV
infected women and OVC. Because ART is not available in all provinces in the country, HIV infected
mothers and their children have to travel long and costly distances to access ART and other needed
services. However, the Vietnamese have traditionally maintained an entrepreneurial spirit and are very
industrious at finding jobs that can support their families. With small loans, they will be able to start a small
business that can prosper in their neighborhoods.
In 2008, USG/Vietnam received plus-up funds to catalyze a self-sustaining food security and livelihood
program for Empathy Clubs in the seven PEPFAR-supported provinces. The target group is HIV infected
and affected individuals,
with preference to (1) those persons identified through the clinical nutrition program in out-patient clinics
(OPCs) who are assessed to be in need of supplemental or therapeutic foods; and (2) HIV infected women
and caregivers supporting OVC.
Approximately 1050 direct beneficiaries in 7 provinces will have access to an average loan of USD 500
(VND 8.3M) and a three-day training courses on small business management. Program beneficiaries and
additional Empathy Club members will also receive training on community-based nutrition screening,
assessment, and counseling and home based care.
In COP09, USG/Vietnam will expand this support to an additional 700 direct beneficiaries (in two rounds at
an average of 25 scheme participants per club - 4 clubs per 7 provinces). For each direct beneficiary there
would be at least 5 indirect beneficiaries (family members). Each participant will undergo three-day training
courses on small business management and related skills, and have access to an average loan of USD 500
(VND 8.3M). Capacity building on small business management skills will complement this effort and ensure
a higher rate of success among its members.
An additional 50 per participants per club will also receive trainings nutrition screening, assessment, and
counseling and home-based car Links with nutrition counseling will ensure that additional household funds
spent on food are spent on the most nutritious choices. A total of 800 individuals will be trained in the
COP09 program. It is anticipated that at least 85% of the loan activities will succeed beyond 12 months,
and that funds from re-paid
loans in FY09 will circulate back to the community and can be rotated for new loans which may benefit
directly 700 people. Community members will follow up with the people identified to see if they meet the
qualifications for small loans for the purpose of food security once they exit the feeding scheme. Central
and Provincial VWU staff will regularly monitor and evaluate the recipients' activities and provide support
and supervision.
Continuing Activity: 17300
17300 17300.08 U.S. Agency for United Nations 7111 6132.08 $100,000
Table 3.3.08:
COP09 narrative
This is a new activity in FY09
The idea of increasing the capacity of the Stop TB Unit of the Country Office of Hanoi had been already
raised towards the end of 2007 and the process had gone as forward as the creation of a position of
National Professional Officer (NPO) by the Personnel Office in WPRO at the beginning of 2008.
The need to have a second professional staff to assist the Medical Officer for TB Control (MO/STB) came
from the recognition of the increasing demand for technical assistance from the National TB Program (NTP)
for the implementation of the many activities entailed by the Stop TB Strategy launched by WHO in 2006,
duly included in the Mid-term Development Plan 2007-11 of NTP endorsed by the Ministry of Health (MOH)
and funded by various donors, including the Government of Viet Nam, The Royal Netherlands Embassy and
the Global Fund.
STB-VN has to perform more and more various and complicated activities required to scale up Stop TB
Strategy. In order to assist NTP in making these activities happen at the right time, in the right place and in
the right way, solid technical assistance by professional staff with competence in TB (including its peculiar
interaction with the HIV infection) is required. In addition to help managing the expected increased workload
produced by the expansion of NTP's scope of work, it is also the quality of WHO support to NTP that would
benefit from the recruitment of a national professional officer.
In terms of outcomes, the recruitment of an NPO will help reinforce and make more efficient the
collaboration of WHO with VAAC in the field of TB/HIV and will contribute to provide WHO technical
leadership to the different partners that are expected to join the NTP in the implementation of TB control
activities in case Viet Nam succeeds in its application to Round 9 of the Global Fund. This, in turn, will
indirectly impact on PEPFAR indicators, though hard to quantify in details given the very "up-stream" nature
of the proposed activity.
New/Continuing Activity: New Activity
Continuing Activity:
Health-related Wraparound Programs
* TB
Table 3.3.12:
This is a continuation of FY 07 and FY 08 activities to strengthen coordination and technical assistance to
Vietnam Ministry of Health on improving its HIV counseling and testing (CT) program.
Following a technical consultation on HIV Testing, jointly organized by WHO/Western Pacific Regional
Office (WPRO) and PEPFAR/CDC, "Guidance for HIV testing in Western Pacific Region" is being finalized
by WHO/WPRO and PEPFAR. This publication is expected to provide guidance on HIV testing strategies
and algorithm, and quality management elements for HIV testing sites in low and concentrated epidemic.
Discussion during the technical consultation and the subsequent situation analysis of HIV testing in Viet
Nam highlighted some major programmatic issues. There are more than thirty test-kits listed on the national
list of approved HIV test kits, none of which have been properly evaluated in Vietnamese testing conditions.
Further, these test kits are being used with no or little consideration for the order in which they are being
used in algorithm. Cross-reactivity between assays used in algorithm can lead to compromised testing
outcomes as falsely reactive specimens can be incorrectly reported as positive. The evaluation of six rapid
test kits to be conducted in FY08 at National Institute of Hygiene and Epidemiology (NIHE) with support
from PEPFAR/CDC will provide a critical first step in regulating the use of evaluated HIV test kits and their
use in a validated testing algorithm.
In FY09, WHO will provide intensive technical support in close collaboration with PEPFAR/CDC to the MOH
in establishing the National HIV testing algorithm (s). Based upon the phase I evaluation of HIV test kits
expected in FY08 and aforementioned new Guidance, phase II evaluation will be carried out to validate the
HIV testing algorithm to ensure high positive predictive value and no or limited cross-reactivity between the
assays in the field conditions. Then, the monitoring system for the newly developed algorithm will be
established.
In establishing the testing algorithm, special attention will be paid to reduce the turn-around time, and to
possibly enable same-day results and HIV testing in the outreach settings. Furthermore, WHO will facilitate
review of in-country pilot of mobile and outreach HIV testing and counseling services to strengthen relevant
policy and programmatic guidance. Combined with the efforts to strengthen quality management at HIV
testing site, these activities are expected to significantly contribute in scaling-up HIV testing and counseling
to reach most-at-risk populations to much greater extent, who are most affected in the Viet Nam's
concentrated epidemic.
Number of service outlets providing counseling and testing according to national and international
standards: N/A
Number of individuals who received counseling and testing for HIV and received their test results (excluding
TB): N/A
Continuing Activity: 15357
15357 5332.08 U.S. Agency for United Nations 7111 6132.08 $50,000
9516 5332.07 U.S. Agency for United Nations 5165 3111.07 UNDP $50,000
International Development
Development Programme
5332 5332.06 U.S. Agency for United Nations 3111 3111.06 $30,000
Table 3.3.14:
This is a new activity in COP 2009.
HIV diagnostic testing in Vietnam is currently not standardized or systematic; a variety of different rapid
tests and ELISA tests are used for screening and confirmatory testing across the country. The Vietnam
Ministry of Health is concerned about this situation and has turned to PEPFAR-Vietnam to support the
evaluate HIV rapid tests. In FY08 an HIV rapid test kit evaluation protocol (based on using internationally
accepted guidelines) was developed and approved by the Government of Vietnam and CDC-IRB. This
evaluation is structured to allow for participation from all relevant stakeholders both inside and outside the
government of Vietnam and will serve as a tool for building trust for the use of HIV rapid tests. Ideally it will
also lead to consensus for a single national algorithm.
The Government of Vietnam is also interested in evaluating HIV confirmatory diagnostic test kits, enzyme-
linked immunosorbant assays (ELISA). In the current testing environment in Vietnam it is appropriate to
evaluation which tests perform best in the Vietnam environment and limit the number of ELISA tests used
nationally. This is an easy add-on to the current rapid test evaluation; the same well-characterized sample
set can be used and will allow for comparison of rapid and ELISA test results.
This funding will support TA (through WHO) from National Reference Lab (NRL) Australia. Over the past
year consultants from NRL-Australia have had an ongoing role in Vietnam in the evaluation of test kits and
development of a strong quality assurance program.
Table 3.3.16:
Sub-Partner: UNAIDS
Total funding: $210,000
This is a continuing activity from FY08.
Data Triangulation and Use: $110,000
Major changes to this activity since FY08 approval are:
Objective: Strengthen the national AIDS response through development of a national costed strategic plan
from 2010.
The globally agreed deadline for reaching Universal Access is only two years away; we have already
reached the midpoint of the Millennium Development Goals. Vietnam is still lagging behind in achieving the
progress promised. Key to an effective national response is; an excellent understanding of the epidemic and
its features; the prioritization of activities that make the most impact; and, the development of costed
intervention packages. Components that need to be integrated in the next phase of the national response,
through creation of the costed National Strategic plan from 2010 on include:
Activity 1: Adaptation of the training materials from the first Regional Training on Designing and costing HIV
programs in Asia, and the organization of four regional trainings for policy makers, practitioners and civil
society organization (CSO) representatives.
HSS, National Activity, Cross cutting, Strategy
Activity 2: Based on the mid-term evaluation findings, the size estimation exercise, the latest rounds of
Integrated Biological and Behavioral Surveillance (IBBS) and the estimates and projections project (EPP),
and the UNGASS 2010 report, support the Vietnam Administration for HIV/AIDS Control (VAAC) and all
other national and international partners in the development of a costed strategic plan, following the
essential criteria suggested by the Commission on AIDS in Asia (clear goals and measurable objectives,
prioritization by sub -population and geographic region; size estimation of population in need of services,
standardized costed response packages; annual operation plan; human resources and management plan;
coordination plan; M&E plan; estimation of total need).
HSS?, National Activity, National M&E Framework, Strategy
Activity 3: Data triangulation TA & application of results at provincial level
Support the provincial leaders and practitioners in use of data for strategic planning and programme
monitoring at the provincial level, which will complement the work that other partners are doing in this area.
Data Synthesis and Use, Triangulation
HCD - Support national capacity building on use of strategic information: $110,000
Building on the efforts undertaken in FY07 and FY08, UNAIDS will further support VAAC and the M&E
department in building the capacity of the provincial AIDS centers (PACs). This will focus on the use of
strategic information and the coordination of overall efforts of different national and international partners in
the SI arena.
Activity 1: National HIV/AIDS SI related training coordination: Support VAAC in development of an annual
costed capacity building plan; organization of workshops for the team of national trainers ( "refresher
training", development of new modules) -planning with MOH, keeping partners informed, listserv, etc.
HSS, HCD, National M&E Framework, TA
Activity 2: Support the work of the M&E TWG; Mapping of national and international partners' efforts in
implementation of the national AIDS response (collection of data, development of reader friendly reports
and maps) and promotion of use of newly established AIDS data hub. In addition, UNAIDS will continue the
coordination role for GIS TWG to develop a visualized database of HIV programs in Vietnam.
Data synthesis and use, Activity mapping, Cross-cutting, Harmonization/Standardization.
Sub-Partner: UNODC
Total funding: $40,000
This is new activity in FY09.
Funds will be used to contract 1 Vietnamese national full time to provide direct strategic information
technical assistance to UNODC activities. This position will become an active member of the National M&E
technical working group and an extension of the national PEPFAR supported SI Team. Since UNODC
partners closely with the Ministry of Labor, Invalids and Social Affairs; The Ministry of Public Security, other
UN Agencies, bi-lateral donors and the GVN, this person will work directly will provide direct assistance to
improving strategic information available on those programs. Being an IDU-driven epidemic, a focus on
services and programs targeting IDUs is the cornerstone of the SI strategy. By providing direct HCD
support to partners engaged in PEPFAR supported programs, PEPFAR Vietnam will continue to build a
culture of data use where partners and their associated programs continue to be evidence-based, focused
and sustainable.
Sub-Partner: World Health Organisation
This is continuing activity from FY08.
HMIS - To establish integral health information system for health sector responses: $150,000
In the past few years, VAAC developed M&E tools for the HIV program, such as the National M&E
Framework, revised routine reporting (Decision 28) and sentinel surveillance systems with joint support from
international community (e.g. PEPFAR, UNICEF, UNAIDS and WHO). VAAC also updated estimation and
Activity Narrative: projection, piloted HIV drug resistance early warning indicators, and developed a prototype for electronic
information system. However, data from those various systems have not been designed or used in an
integral manner. WHO considers that it is critical that information generated from various systems should
be synthesized and used effectively for planning and continuous improvement of the service delivery.
Activity 1: To facilitate program departments of VAAC (e.g. care and treatment department, HIV prevention
department) to work closely with VAAC's M&E department to maximize data use integrating those from
different sources.
Data synthesis and use, triangulation
Activity 2: To advocate for and provide TA to establish data exchange standards and the Central data
warehouse and to strengthen data quality assurance procedures, which will provide foundation for the
proposed integral health information systems. The attention will also be paid to develop linkage between the
VAAC's and MoH's health information management systems.
HMIS, Management IS, National IS, Strategy/TA
Surveillance - To map MARPs Activities: $30,000
WHO has been working with VAAC to develop National Guidelines on Mapping of MARPs, building upon
WHO's deep involvement in implementing large harm reduction projects in the past several years as well as
its normative work at regional and global level. To complement PEPFAR's initiative in size estimation of
MARPs, WHO will support VAAC in the development of national guidance.
Activity 1: Support to VAAC for the development of the national guidance document on population size
estimate of MARPs.
Program monitoring, Activity mapping, Policy Guidelines, TA
Data Use - To identify national operational research agenda for health sector response: $30,000
In line with the WHO's support to the various departments of VAAC and concerned institutions in data
analysis and use for effective planning and continuous improvement of service delivery (care and treatment,
harm reduction etc.), WHO will support identification of the national operational research agenda for health
sector response based on the review of existing and planned researches and programmatic priorities of
VAAC.
Activity 1: Support VAAC and relevant institutions to review the existing and planned operational researches
and to identify programmatic priorities of VAAC
Data Synthesis and Use, National Activity, Cross-cutting, TA
Activity 2: Support VAAC and relevant institutions to agree on the National Operational Research Agenda
for accelerating health sector response
Data Synthesis and Use, National Activity, Cross-cutting, Harmonization/Standardization
Continuing Activity: 15358
15358 5698.08 U.S. Agency for United Nations 7111 6132.08 $460,000
9371 5698.07 U.S. Agency for United Nations 5165 3111.07 UNDP $75,000
5698 5698.06 U.S. Agency for United Nations 3111 3111.06 $75,000
Table 3.3.17:
SUMMARY and BACKGROUND:
In support of the One UN Initiative all PEPFAR support to UN Agencies is channeled through a grant
agreement between USAID and the United Nations Resident Coordinator.
UNAIDS will continue vital coordination and advocacy work to ensure Vietnam's response to HIV is
strengthened and targeted in COP09. Through coordination of international organizations and support to the
Government of Vietnam, the Communist Party, mass organizations and other partners, UNAIDS has a very
important role at this stage of the response. Work to strengthen multisectoral coordination mechanisms,
particularly through the Office of the Government and provincial People's Committees, is a special focus for
activities in COP09.
WHO will implement two system strengthening activities one of which is to work in coordination with the
SCMS to strengthen the procurement system for HIV prevention commodities and to accelerate
coordination of ARV procurement and supply management systems. The second is to support the Health
Partnership Group and the Joint Annual Health Review.
It was observed that key commodities for HIV prevention such as condoms and lubricants were in shortage
causing major difficulties in implementing and expanding HIV prevention for most-at-risk populations
(MARPs). Currently, major efforts are underway to improve the situation in particular to procurement
capacity and procedures specific to certain donor funded projects.
Besides problems caused by complexities of procurement at national level, in many cases, lack of capacity
and clear procedures at province level appears to be a major barrier for efficient procurement and
distribution of these commodities. Given the declining trend of donor resources, it is imperative provincial
procurement system are strengthen to ensure future sustainability.
Based upon intensive collaborative support from SCMS and WHO, basic elements and procedures of
procurement and supply management of ARV were incorporated in the HIV Decree enacted in 2007. This
decree has been serving to strengthen VAAC's ability to coordinate procurement and supply management
procedures of ARVs from major funding sources including PEPFAR, Global Fund, Clinton Foundation and
National Budget.
There remains substantive challenges in operationalizing the common ARV procurement and supply
procedures across the boundaries of the three funding sources. In the context of integration of donor
support into national health system with a view to establishment of a single sustainable ARV procurement
and supply management system in Vietnam, WHO will support MOH, in close collaboration with SCMS, to
conduct assessment of current systems and operations and to come up with strategic options.
The second focus for WHO will be to support the Health Partnership Group (HPG) whose purpose is to
improve the overall effectiveness of external support to the health sector, as it is recognized as the over-
arching co-ordination forum for the health sector, primarily dealing with strategic and policy issues. It is a
joint forum, between development partners, the Ministry of Health (MOH) and other government ministries.
The HPG is recognized as the primary forum for developing trust, building common understanding and
facilitating progress towards common systems and ways of working in the health sector, as a priority sector
for government and development partners. The proposed funding will strengthen the Secretariat function of
the HPG and support 6 to 8 meetings of the HPG.
The Joint Annual Health Review is the process through which the Ministry of Health and Partners jointly
assess progress in the health sector on an annual basis. As such it is, along with the Health Partnership
Group, a forum for dialogue on key issues in sector development. Each review provides an overview of
progress in the sector, including up-to-date data on an agreed set of indicators, and looks in-depth at a
particular theme of concern. Once the next 5-year Health Plan is developed, the indicators monitored in the
JAHR will be coherent with those in the results framework of the Plan.
The JAHR is a relatively new process: the first review was undertaken in 2007, which was a general review
of the progress and issues of the health sector, and the review for 2008 focuses on health financing.
Funding will be used to support the JAHR in the medium-term (3 years) and the Ministry of Health to further
institutionalizes the process and create a predictable and sustainable source of financing.
UNRC will carry out activities in this program area.
ACTIVITY 1: Development of HIV prevention commodity procurement manuals for provincial level (Funding:
$37,813, Sub-partner: WHO)
WHO will work with VAAC and other concerned departments of MOH to conduct the review of provincial
systems of procurement of HIV prevention and other health commodities. Experiences of donor supported
procurement will also be compiled. The review is expected to identify key barriers concerning procedures
and capacity, diversity of local practices, and good practices to be shared and promoted. It will also explore
the possibility of maximally utilizing the experiences of procurement of other health commodities for that of
HIV prevention commodities. Based on the review, HIV prevention commodity procurement manuals for
provincial level will be drafted to guide local implementation.
ACTIVITY 2: Development of strategic options with a view to establishment of a single sustainable ARV
procurement and supply management system (Funding $37,813, Sub partner: WHO)
In close collaboration with SCMS, WHO will work with VAAC and other concerned departments of MOH to
conduct assessment of ARV procurement and supply management systems. Possible advantages and
constraints of systems established for PEPFAR, Global Fund HIV Project, Clinton Foundation and national
funded ART program will be reviewed. Special attention will be paid to the strengths of the procurement
Activity Narrative: and supply management system supported by SCMS. Based on the assessment, strategic options will be
drafted for the national level discussions with a view to establishment of a single sustainable ARV
procurement and supply management system in Vietnam.
ACTIVITY 3: HEALTH PARTNERSHIP GROUP (Funding - $47,812, sub partner: WHO):
The first activity is to strengthen the HPG secretariat and ensure the smooth functioning of HPG meetings.
A work plan of activities will need to be developed with MOH, but may include: (i) holding 6-8 HPG
meetings; (ii) support to strengthen civil society participation in HPG discussions; (iii) options for
establishing an HPG secretariat; (iv) on-line database of partner activities in the health sector; (v) support
to HPG sub-groups.
ACTIVITY 4: JOINT ANNUAL HEALTH REVIEW (Funding - $47,812; Sub-Partner - WHO):
assess progress in the health sector on an annual basis, both through review of previous indicators and
areas of priority action identified in earlier JAHRs, and to review in some depth a particular aspect/area of
focus - for 2008 the focus is on health financing; the focus for future JAHRs has not yet been determined.
In order to undertake the JAHRs, the Ministry of Health has requested support from partners to undertake
the significant work involved in the review (for 2007 and 2008, the JAHR budget has been approximately
US$150,000 per year). The MOH has requested WHO to assist by serving as a vehicle through which
funding from multiple donors can be pooled and provided for the JAHR as needed. The contribution of
multiple partners is an important aspect of the JAHR exercise, and helps to maintain its independence - so
single donors should fund the entire review.
After agreeing with partners on the topic for the JAHR for the coming year, the MOH prepares a budget for
consideration of partners and requests contributions. Depending on the issues being examined, funding
may then be needed by the MOH directly, or to engage local consultants and a coordinator to undertake the
analysis, specific studies, and report writing. Some international expertise may be engaged to provide peer
review of various chapters, coordinate with international partners and edit the English version of the report.
In addition, there is an intensive consultation process around the JAHR: meetings are held with health
professionals, academics, international partners, and other ministries as draft sections of the report are
developed, and once the entire report is compiled, to provide comment and peer review.
The JAHR is only in its second year. PEPFAR funds will provide a foundation for the JAHR over the next
three years, thus supporting the institutionalization of the process within MOH and helping to establish a
sustainable and predictable source of financing in the medium term, which other partners can then
contribute to. Over time it is hoped that it will be possible for funding to be directly contributed to and
managed by the MOH. For now, WHO is serving as the mechanism that can enable contributions from
different donors to be pooled and used in a timely manner. The responsible department within the MOH is
the Department of Planning and Finance.
ACTIVITY 5: Strengthen national coordination, harmonization and alignment within the response to HIV
(Funding $73,906 Sub partner UNAIDS).
With the Law on HIV/AIDS Prevention and Control, the National Strategy on HIV/AIDS Prevention and
Control in Vietnam till 2010 with a Vision to 2020 and the Coordination Action Plan in place, UNAIDS will
continue to work with Government to strengthen national coordination and harmonize laws and policies in
the Vietnam's response to HIV. In 2009, UNAIDS has identified activities to support the National Committee
on AIDS, Drugs and Prostitution Prevention and Control in its role as the National AIDS Coordinating
Authority. Working closely with the National Committee chair, Deputy Prime Minister Trong Vinh Trong,
UNAIDS aims to support the Office of Government's initiative to coordinate a truly multisectoral response
and establish systems to oversee the implementation and harmonization of the drug law, the law on HIV
(including the decree) and the ordinance on sex work.
UNAIDS will help the National Committee to facilitate open dialogue with donors and other partners and
establish a national advisory group of experts to provide high-quality, advice on HIV. As Vietnam advances
towards middle-income status, the National Committee is keen to develop strategies to sustain existing
budget levels and phase out current donor contributions. In the context of Vietnam's wider economic
development agenda, members of the National Committee will also work in 2009 to integrate of HIV in the
Poverty Reduction Strategy.
It has been recognized - by international partners and government representatives alike - that a wealth of
knowledge and expertise on responding to HIV already exists in Vietnam. In order to share this knowledge
more effectively, leaders from both national and provincial levels are interested to take part in domestic
study exchanges and bi-annual workshops.
ACTIVITY 6: Strengthen Provincial coordination, harmonization and alignment within the response to HIV.
($48,906 Sub partner UNAIDS)
Building on work which began in FY06, UNAIDS will continue to strengthen the capacities of provincial
coordinating mechanisms. Multisectoral mechanisms in Ho Chi Minh City and Hanoi will continue to be an
important focus of work, while Hai Phong, Khanh Hoa, Thai Binh (where assistance began in FY07) will
enter a second phase. In cooperation with UNODC, UNAIDS will also support high-prevalence provinces
Dien Bien and An Giang (or Can Tho, TBD) and look to expand assistance to new provinces, such as Binh
Dinh and Thai Nguyen. Specifically, UNAIDS will support Provincial People's Committees to establish
systems to oversee the implementation of relevant laws, and to clarify and interpret these laws at the
provincial level.
With a clear example set at the central level, Provincial People's Committees will be provided with the
capacity and tools to engage a wide mix of government departments, donors and mass organizations in a
more multisectoral response to HIV.
Activity Narrative: UNAIDS will advocate to encourage provincial authorities to integrate HIV into local poverty reduction
strategies and plans, and support Provincial Committees in work to develop sustainability strategies for the
withdrawal of donor funding in the future.
ACTIVITY 7: Advocate for the active participation and meaningful involvement of civil society and PLHIV in
the response to HIV. ($48,906 Sub partner UNAIDS)
In bringing together other stakeholders and leveraging stronger partnerships with civil society, UNAIDS will
continue to provide support to the HIV Technical Working Group, its subgroups and regular lunchtime
seminars. UNAIDS will continue to promote GIPA principles and support the development of the new
National Network of PLHIV (VNP+).
UNAIDS will concentrate on activities to assist VNP+ to build its own capacity (in terms of operation,
organization, resource mobilization and so on) and expand its reach into the provinces. Work will be
complemented by the work of HPI, UNV and other partners.
UNAIDS will advocate to the Communist Party and the Government in to include most-at-risk population
groups decision-making mechanisms and processes. In FY09, UNAIDS will scale-up activities to ensure the
greater involvement of people living with HIV through technical assistance to the Fatherland Front, the
Communist Party website and new projects with the Women's Union to expand promotion of GIPA
principles.
ACTIVITY 8: Work with key partners to strengthen their involvement in the response to HIV. ($48,907 Sub
partner UNAIDS)
UNAIDS has worked with the Ministry of Public Security (MOPS) since 2004, and more recently Ministry of
Labor, Invalids and Social Affairs (MOLISA), to strengthen the response to HIV through the application of
the Law on HIV and Decision 54. Additional activities planned for FY09 include advocacy to senior leaders
within MOPS and MOLISA to scale up HIV prevention in closed settings (comprising 05/06 centers, prisons
and juvenile detention centers) in collaboration with UNODC. Work with MOPS, MOLISA, UNODC and the
National Committee to support the development of a ‘Video Textbook' series for closed settings that will
comprise information on ‘Safe Living' and ‘HIV'. For a long time, UNAIDS has worked to strengthen the
capacity of Vietnam's print and electronic media to raise awareness of HIV. By providing technical support,
capacity-building and advocacy (such as through campaigning during World AIDS Month), UNAIDS will
continue this work in COP09.
Continuing Activity: 15359
15359 5789.08 U.S. Agency for United Nations 7111 6132.08 $175,000
9536 5789.07 U.S. Agency for United Nations 5165 3111.07 UNDP $170,000
5789 5789.06 U.S. Agency for United Nations 3111 3111.06 $60,000
* Increasing gender equity in HIV/AIDS programs
* Increasing women's legal rights
Table 3.3.18:
