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
ACTIVITY UNCHANGED FROM FY 2008.
This activity is linked to activities in Chest Diseases Laboratory (CDL) (#15510), Centers for Disease
Control and Prevention - Technical Assistance (CDC-TA #9022), American Society of Microbiology (ASM #
9794)), Comforce (#8996), and Supply Chain Management System (SCMS # 9524) within the Laboratory
section.
Since 2004, the Tropical Diseases Research Centre (TDRC) Regional Tuberculosis (TB) reference
laboratory has provided acid fast bacilli (AFB) smear microscopy services for the Ndola area. In fiscal year
FY 2004 and 2005, the United States Government (USG) provided funding to upgrade the laboratory to a
"state-of-the-art" facility which completed in May 2005, to support the scale-up of HIV/TB activities. It now
provides TB fluorescent microscopy and expanded TB culture services for people living with HIV/AIDS
(PLWHA) in the Northern region of the country.
TDRC supports TB culturing of samples from the Northern region of Zambia. Transportation of specimens
from facilities to TDRC for culture has proven difficult. In FY 2008 the Ministry of Health (MOH) established
a courier system for the TB drug resistance survey to help with transportation of TB specimens from
selected laboratories in the country.
In FY 2008 training for TB laboratory support, equipment, reagents and supplies for liquid TB culture, DNA
probe identification of TB isolates, and drug susceptibility testing (DST) was performed. Training was
provided to ten laboratory staff on the use of the bio-safety cabinets, reagents preparation, and culture
media. Equipment provided included a BACTEC MGIT TB culture and GenProbe DNA Mycobacteria
identification system, in addition to a water tank and generator for a backup power supply.
In FY 2009 TDRC aims to receive referral samples from 77 TB diagnostic centers to increase uptake of
referred diagnostic and follow-up TB specimens from Copperbelt, North-Western, Luapula, and Northern
Provinces. In addition the TDRC Laboratory staff will be focused on further expanding and improving
detection of TB and testing of drug resistant TB cases using liquid culture technology in support of the
TB/HIV program. The regional laboratory works in collaboration with the national TB reference laboratory,
the Chest Diseases Laboratory, (CDL) to improve rapid culture and drug susceptibility diagnostic services
and to provide support to the Arthur Davison's Children's Hospital, which is the national pediatric hospital
located a few kilometers from TDRC.
In addition TDRC will continue to improve TB diagnosis by implementing direct molecular testing (DMT) for
rapid detection of multi-drug resistant (MDR) TB and extensive drug resistant (XDR) TB (line-probe assay).
This test will improve the turn around time of results for DMT to 24-48hrs. The test will be used for rapid
screening of smear positive TB patients at risk for infection with MDR-TB.
In FY 2009, TDRC will provide support renovation to maintain its laboratory infrastructure. Maintenance
services for laboratory and essential equipment will be acquired. Shelves and storage cabinets will be
procured and installed. TDRC will procure audio visual facilities for conference calls and continuing
education links with CDC as well as procuring supplies, furniture, and audiovisual facilities to equip the
continued education center at Ndola biomedical school. This facility shall be used as a conference training
center. TDRC will continue to support its staff. The available TDRC TB laboratory staff in FY 2008 will
remain the same in FY 2009 -2010.
Furthermore, in FY 2009 the TDRC regional TB reference laboratory will continue to support external quality
assurance services for AFB smear microscopy to the provincial laboratories on the Copperbelt, North-
Western, and Luapula Provinces. These services will include training, on-site evaluation, proficiency
testing, AFB smear microscopy blind rechecking, and feedback to the laboratories. TDRC will respond to
the feedback reports for local and rural settings to provide on-site capacity for corrective actions. Training in
smear Microscopy and EQA will be provided to two technologists from each of the provinces in the Northern
Region to expand capacity for supervision and monitoring of TB/HIV support in the districts. Those to be
trained at the provincial level are currently government staff and will share skills with district TB laboratory
staff during supervisory visits to ensure laboratory skills are expanded and sustained at all levels of health
facilities.
TDRC will co-ordinate with MOH, CDL, and other donors such as the Global Funds, and TBCAP to
strengthen EQA for TB AFB smear microscopy in five Northern provinces. Through the PEPFAR co-
operative agreement, TDRC provides staff and transport assistance to TBCAP activities.
In addition, in FY 2009, TDRC will build local staff capacity by supporting continuous professional
development of laboratory personnel in TB lab related activities in the form of trainings conferences and
meetings associated with TB.
New/Continuing Activity: Continuing Activity
Continuing Activity: 15564
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
15564 3702.08 HHS/Centers for Tropical Diseases 7184 3009.08 TDRC - $400,000
Disease Control & Research Centre U62/CCU02315
Prevention 1
9027 3702.07 HHS/Centers for Tropical Diseases 5017 3009.07 TDRC - $190,000
3702 3702.06 HHS/Centers for Tropical Diseases 3009 3009.06 TDRC $187,324
Disease Control & Research Centre
Prevention
Emphasis Areas
Construction/Renovation
Workplace Programs
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $50,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.16:
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAY:
Commencement of capacity building for basic internet infrastructure for sentinel and TB sites in Northern
Zambia will be the major new activity.
This activity relates to Ministry of Health (MOH) (#3713.08), and Centers for Disease Control and
Prevention (CDC) (#3714.08).
This cooperative agreement with the Tropical Diseases Research Centre (TDRC) was established with the
following objectives: (1) to expand the use of quality program data for policy development and program
management; (2) to support and increase TDRC expertise in the surveillance of HIV/AIDS/STI/TB; (3) to
improve information and communication technology (ICT) infrastructure; (4) to improve human resource
capacity for monitoring and evaluation (M&E); and (5) to strengthen capacity in scientific research methods,
data management and statistical analysis, and reporting. CDC-Zambia will continue to provide technical
assistance and other support to strengthen the TDRC and its infrastructure as a key partner in
HIV/AIDS/STI/TB surveillance, laboratory and strategic information quality control and assurance, and
strategic information. In FY 2009, CDC-Zambia will place special emphasis on training in ICT and data
management analysis in order to strengthen TDRC expertise in these areas for sustainability of all above
activities.
This activity will continue to maintain support of a local area network (LAN) established during FY 2004. FY
2009 funding will allow increased bandwidth utilization from previous upgrade and the expansion of
structured LAN and wireless technology coverage to the new tuberculosis (TB) laboratory supported by
CDC-Zambia, for efficient operations. FY 2009 funding will also help to procure ICT equipment, deploy
offsite data backup, enable TDRC to continue the employment of personnel skilled in ICT to maintain the
infrastructure, to provide in-house ICT expertise and training capability, and to train TDRC staff in data
management. Commencement of capacity building for basic internet infrastructure for sentinel and TB sites
in the Northern Zambia will be a new activity.
TDRC will support the Government of the Republic of Zambia (GRZ) in HIV/AIDS, sexually transmitted
infections, and TB surveillance activities, including the Zambia Antenatal Clinic Sentinel Surveillance (SS)
survey and the Zambia Demographic and Health Survey (ZDHS). While the MOH is the authorizing
institution for national surveys and other surveillance activities, TDRC and the University Teaching Hospital
(UTH) Virology Laboratory serve as the implementing institutions the national surveys, laboratories. FY
2009 funding will support the TDRC and UTH in implementing the national surveys, laboratory testing,
supervision of sentinel sites, and data analysis and reporting. Additional laboratory testing using existing
bio-specimens are planned. Activities related to final testing for the Nakambala Health Worker Study are
planned, including specimen shipping. TDRC laboratory and data processing personnel have participated
in multiple CDC-Zambia-sponsored trainings in SI and laboratory methods, and worked closely with CDC-
Zambia staff in data management, analysis, and reporting. TDRC laboratory staff were trained to perform
the BED-CEA assay and testing is currently ongoing to identify recent HIV infections to estimate HIV
incidence. Laboratory staff will perform HIV incidence testing, confirm HIV and syphilis testing, and perform
testing for other important viruses, including Hepatitis testing.
Funding to the TDRC will cover travel and transportation needs for national surveillance activities,
procurement of consumables in the immunology and data processing units, procurement of -70 freezers for
storage of samples from national surveys and expenses to cover the coordination, implementation, and
dissemination of survey results.
In addition, the TDRC will continue the expansion and upgrading of the central electronic specimen tracking
and repository system. Numerous research projects, including large national surveys, that involve collection
and storage of biological samples, are conducted each year at the TDRC. A much more efficient process is
required, not only to enable scientists to track their specimens as they work, but also enable them to
retrieve samples that have been stored for a period of time. Novel techniques for the detection of different
diseases are being developed continuously; the existence of an efficient repository system will ensure easy
retrieval of samples, and safe archival of biologic specimens. Because Zambia has had a well-developed
sentinel surveillance system since the early 1990's there is a wealth of historic data and biologic specimens
that require careful archiving.
In FY 2009, TDRC intends to continue with all ongoing surveillance activities in HIV/AIDS/STI/TB. Timely
implementation of the National Sentinel Surveillance of HIV/Syphilis in ANC attendees will be key. Apart
from existing laboratory analysis for HIV and syphilis from this population, other laboratory analyses will be
conducted, included BED testing to estimate HIV incidence and testing for prevalence of other viruses that
cause significant mortality and morbidity among HIV infected persons. Additional training will be given to
sentinel site staff to collect dried blood spots (DBS) in the same population for estimation of the prevalence
of transmitted HIV drug resistance in the ANC population. TDRC proposes to conduct a separate survey in
the same sites to determine HIV prevalence and incidence in children in these sentinel sites. TDRC will
also participate in the surveillance of HIV/AIDS in prison populations in Zambia.
M&E activities for TDRC will focus on: (1) continued operation of the LAN and extension of LAN coverage to
the newly-completed TB laboratory; (2) the number of TDRC, UTH, and district health center staff trained in
SI; (3) the successful design and implementation of the Sentinel Surveillance (SS) survey, and successful
analysis, reporting and dissemination of the 2008 SS; (4) the successful collection, storage, and
management of demographic information and biologic specimens; (5) additional laboratory testing required
of surveillance activities and focused studies such as the HIV Surveillance in Prisons Study; (6) the
appropriate analysis and reporting of HIV prevalence and incidence data in relation to socio-demographic
data; and (7) the dissemination of surveillance information for GRZ planning, making of policy decisions,
and design of community-level interventions.
This activity relates to activities in counseling and testing activity, laboratory infrastructure, palliative care,
basic health support activity, and HVTB activities.
Targets set for this activity cover a period ending September 30, 2010.
Continuing Activity: 15565
15565 3718.08 HHS/Centers for Tropical Diseases 7184 3009.08 TDRC - $1,100,000
9028 3718.07 HHS/Centers for Tropical Diseases 5017 3009.07 TDRC - $450,000
3718 3718.06 HHS/Centers for Tropical Diseases 3009 3009.06 TDRC $150,000
Estimated amount of funding that is planned for Human Capacity Development $30,000
Table 3.3.17:
