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
Reprogramming funds to HXTD for ARV Gap (SCMS)
New/Continuing Activity: New Activity
Continuing Activity:
Program Budget Code: 06 - IDUP Biomedical Prevention: Injecting and non-Injecting Drug Use
Total Planned Funding for Program Budget Code: $0
Program Budget Code: 07 - CIRC Biomedical Prevention: Male Circumcision
Total Planned Funding for Program Budget Code: $4,727,738
Table 3.3.07:
ACTIVITY UNCHANGED FROM FY 2008.
Activity Narrative:
This activity links directly with Johns Hopkins Program for International Education in Gynecology and
Obstetrics (JHPIEGO), Population Services International/Society for Family Health (PSI/SFH), and indirectly
with USAID | DELIVER PROJECT's ARV Drug activity, the Partnership for Supply Chain Management
Systems' (SCMS) activities in Laboratory Infrastructure, and Health Systems Strengthening.
FY 2008 funds were used in the area of supply chain support for the implementation of a national program
to support male circumcision (MC) as part of the prevention of HIV/AIDS. Through SCMS, these funds
assisted United States Government (USG) projects and the Ministry of Health (MOH) to ensure that a
national forecast and quantification was completed and corresponding procurement plans developed.
Key activities included sending staff to the different national meetings focused on MC to ensure that supply
chain issues were addressed as the program expanded. A national quantification exercise was conducted
to determine the commodity quantity needs and costs. SCMS staff monitored the supply situation of MC kit
products at the Ministry of Health's central medical stores, Medical Stores Limited (MSL), and reported back
to the different partners on product availability.
Quantification of both the MC needs for these products and the general health needs will continue to be a
challenge. It will be important to ensure there are ample supplies of MC kits to supply health facilities and
new mobile units on a timely basis, using the existing MSL-managed distribution system. It is anticipated
that MC kits will be procured nationally as complete kits, and will be ordered from Medical Stores Limited as
part of the essential drug order. However, as with essential drugs, the system in place suffers from a lack of
sufficient funding and the lack of effective information and inventory control systems to manage the actual
needs of the health sites.
With FY 2009 funding, SCMS will review the pricing of the different products in a kit and determine if
procuring complete kits is the most cost efficient manner, as the scale-up of the national program warrants
larger USG support for commodity purchases. There will also be a need to determine if MC kits should be
managed within the new ED logistics system, or kept separately to address the specific needs of the MC
program. SCMS will also conduct more field visits to ascertain the stock situation as more health facilities
initiate MC activities. Another key activity will be to review the national logistics strategic plan for the
support of MC activities. This plan will become increasingly important as more organizations begin
supporting MC activities throughout the nation.
New/Continuing Activity: Continuing Activity
Continuing Activity: 14415
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
14415 12523.08 U.S. Agency for Partnership for 6827 4139.08 Supply Chain $1,700,000
International Supply Chain Management
Development Management System
12523 12523.07 U.S. Agency for Partnership for 5072 4139.07 Supply Chain $150,000
This activity links directly with USAID | DELIVER PROJECT's ARV Drug activity, the Partnership for Supply
Chain Management Systems' (SCMS) activities in Counseling and Testing (CT), Laboratory Infrastructure,
and Health Systems Strengthening, Center for Infectious Diseases Research in Zambia, Catholic Relief
Services/AIDS Relief, Churches Health Association of Zambia (CHAZ), University Teaching Hospital (UTH),
Zambia Prevention, Care, and Treatment Partnership (ZPCT), Global Fund for AIDS, Tuberculosis and
Malaria (GFATM), the Clinton Foundation HIV/AIDS Initiative, and UNITAID.
The purpose of this activity is to procure opportunistic infection (OI) and sexually transmitted infection (STI)
drugs (with a special emphasis on cotrimoxazole) in support of the Government of the Republic of Zambia's
(GRZ) national ART program. Cotrimoxazole is used both as a prophylaxis and as a treatment for
opportunistic infections. Following WHO recommended guidelines, Zambia has adopted the policy of
adding cotrimoxazole to the new national ART guidelines which have been disseminated by the National
HIV/AIDS/STI/TB Council (NAC). This commodity has been added to the national ARV ordering and
reporting system to better ensure its availability for ART patients. With approximately 35% of FY 2009
funding, roughly 225,000 HIV-positive adults will receive cotrimoxazole (pediatric cotrimoxazole is being
provided by the Clinton Foundation with UNITAID funding).
Also included in this activity is the procurement of STI drugs to treat herpes, syphilis, gonorrhea, and
chlamydia, which are the most common STIs in Zambia, and the most critical to treat for HIV/AIDS
prevention. Possible drugs to be procured include: Ciprofloxacin, Acyclovir, Erythromycin, Doxycycline,
Benzathine penicillin, and others, pending final discussion with partners and the MOH.
Finally, it should be noted that as with USG-funded ARV drugs, the OI and STI drugs will be placed in the
GRZ's central warehouse, Medical Stores Limited (MSL), where all public sector and accredited
NGO/FBO/CBO/work-place/private sector ART programs will have access to these critical supplies. All
PEPFAR partners are connected to the national ARV logistics system.
Continuing Activity: 14416
14416 12527.08 U.S. Agency for Partnership for 6827 4139.08 Supply Chain $1,500,000
12527 12527.07 U.S. Agency for Partnership for 5072 4139.07 Supply Chain $1,300,000
Table 3.3.08:
This activity links directly with all other Partnership for Supply Chain Management System activities; as well
as: The USAID | DELIVER PROJECT; Center for Infectious Disease Research in Zambia (CIDRZ); Catholic
Relief Services/AIDS Relief; Churches Health Association of Zambia; University Teaching Hospital; Zambia
Prevention, Care and Treatment Partnership (ZPCT); Population Services International/Society for Family
Health (SFH); Catholic Relief Services/SUCCESS; Zambia VCT Services; Global Fund for AIDS,
Tuberculosis and Malaria (GFATM); UNITAID; and the Clinton Foundation HIV/AIDS Initiative.
The purpose of this activity is to procure HIV test kits in support of the Government of the Republic of
Zambia's (GRZ) counseling and testing (CT), prevention of mother to child transmission (PMTCT), and
diagnostic testing programs. With FY 2008 funding, the USAID | DELIVER Project provided support in
strengthening the national HIV test kit forecasting, quantification, and procurement systems, while the U.S.
Government (USG) through SCMS purchased $2 million worth of HIV test kits for the national program in
accordance with GRZ and USG rules and regulations.
With FY 2009 funding, USG will continue its strong collaboration with GRZ, GFATM, Japan International
Cooperative Agency (JICA), and the Clinton Foundation/UNITAID to assist the national HIV testing
programs in fulfilling demand for these products. On behalf of the USG, SCMS will purchase three types of
test kits for various testing procedures based on the GRZ's 2006 revised HIV testing algorithm: screening
(Determine), confirmatory (Unigold), and tie-breaker (Bioline). All three tests are non-cold chain HIV rapid
tests that enhance the overall accessibility and availability of HIV testing in Zambia.
Furthermore, USG-funded HIV test kits will be placed in the GRZ's central warehouse, Medical Stores
Limited (MSL), where all the public sector and accredited NGO/FBO/CBO HIV testing programs will have
access to these critical supplies. It is anticipated that over 1,200 testing sites will be accessing these
donated supplies. Assuming that the number of annual tests stabilizes at 2009 figures, the USG's HIV test
kit contribution will meet an estimated 92% of the projected national need, allowing for approximately
1,825,000 HIV tests to be conducted, testing approximately 1,220,000 persons.
Continuing Activity: 14417
14417 3750.08 U.S. Agency for Partnership for 6827 4139.08 Supply Chain $2,000,000
9523 3750.07 U.S. Agency for Partnership for 5072 4139.07 Supply Chain $4,000,000
3750 3750.06 U.S. Agency for Partnership for 4141 4141.06 $1,000,000
International Supply Chain
Development Management
Table 3.3.14:
This activity links directly with the USAID | DELIVER PROJECT's Health Systems Strengthening activity,
the Partnership for Supply Chain Management Systems' (SCMS) activities in Counseling and Testing (CT),
Laboratory Infrastructure, and Health Systems Strengthening, Center for Infectious Diseases Research in
Zambia (CIDRZ), Catholic Relief Services(CRS)/AIDS Relief, Churches Health Association of Zambia
(CHAZ), University Teaching Hospital (UTH), Zambia Prevention, Care and Treatment Partnership (ZPCT),
Global Fund for AIDS, Tuberculosis and Malaria (GFATM), UNITAID and the Clinton Foundation HIV/AIDS
Initiative.
The purpose of this activity is to procure ARV drugs in support of the Government of the Republic of
Zambia's (GRZ) national ART program. In FY 2008, USAID | DELIVER PROJECT provided assistance in
strengthening the national ARV drug forecasting, quantification, and procurement systems. With their
support, the US Government (USG) purchased over $30 million worth of ARV drugs for the national
program in accordance with GRZ and USG rules and regulations.
In 2009 the USG will continue its strong collaboration with GRZ, GFATM, UNITAID and the Clinton
Foundation to assist the national ART programs in fulfilling demand for ART services. On behalf of the
USG, SCMS will purchase the following drugs: zidovudine (AZT) 300mg, zidovudine/lamivudine 300/150mg,
didanosine (ddI) 100mg, efavirenz (EFV) 200mg, EFV 600mg, lopinavir/ritonavir (LPV/r) 200/50 mg,
nevirapine (NVP) 200mg, tenofovir/emtricitabine (TDF/FTC) 300/200mg. The cost per patient is estimated
at $30-40/month depending on regimen, based on the new national treatment protocols enacted at the end
of 2007.
To ensure an uninterrupted supply of ARVs, it is estimated that 75% ($18 million) of the FY 2009 funds will
be needed for procurement before April 2009 in order to meet the 2009 ARV procurement gap.
Furthermore, the remaining 25% ($6 million) of FY 2009 funding, combined with the estimated GRZ,
GFATM and UNITAID funding, will only enable Zambia to meet approximately 65% of the targeted 313,000
patients expected to be on ART by the end of 2010. The estimated funding gap for ARV procurement for
2010 is between $40-50 million.
Purchases may change as: 1) additional ARV drugs are approved by the Food and Drug Administration
(FDA) and registered in Zambia; 2) the GFATM and Clinton Foundation ARV drug donations change; and,
3) the GRZ increases its purchases of ARVs. USG-funded ARV drugs will be placed in the GRZ's central
warehouse, Medical Stores Limited (MSL), where all public sector and accredited NGO/FBO/CBO/work-
place/private sector ART programs will have access to these critical supplies.
Continuing Activity: 14418
14418 3751.08 U.S. Agency for Partnership for 6827 4139.08 Supply Chain $24,000,000
9196 3751.07 U.S. Agency for Partnership for 5072 4139.07 Supply Chain $20,000,000
3751 3751.06 U.S. Agency for Partnership for 4139 4139.06 $14,000,000
Table 3.3.15:
This activity links with the Partnership for Supply Chain Management System's (SCMS) activities in ARV
Drugs, Counseling and Testing (CT), and Health Systems Strengthening; USAID | DELIVER PROJECT
activities in ARV Drugs and CT; the Centers for Disease Control and Prevention (CDC); Center for
Infectious Diseases Research in Zambia (CIDRZ); Catholic Relief Services(CRS)/AIDS Relief; Churches
Health Association of Zambia (CHAZ); Zambia Prevention, Care and Treatment Partnership (ZPCT); the
Government of the Republic of Zambia (GRZ); the Global Fund for AIDS, Tuberculosis and Malaria
(GFATM); UNITAID; and the Clinton Foundation (CF).
The purpose of this activity is to procure essential HIV/AIDS laboratory commodities in support of the
national ART program and to ensure that US Government (USG), GFATM, GRZ, and other partners'
HIV/AIDS laboratory commodity procurements are in sufficient supply and available at service delivery sites
through an efficient and accountable HIV/AIDS laboratory logistics and supply chain system.
With FY 2008 funding, the USG, the World Bank, UNITAID, and GRZ provided funding for the procurement
of laboratory reagents to support the rapid scale-up of treatment and care for persons living with HIV/AIDS
in Zambia. Beginning with FY 2007 funding and continuing into FY 2008, the USG through SCMS,
procured the following items: CD4 reagents (Becton Dickinson FACSCalibur, Becton Dickinson
FACSCount); hematology reagents (ABX Pentra 60C+, ABX Micros 60, Sysmex pocH-100i); chemistry
reagents (Cobas Integra 400, Ortho Vitros DT60, Olympus AU400, Human Humalyzer 2000); and various
consumables (e.g., EDTA vacutainer tubes, needles, disposable gloves and pipette tips).
To better ensure that these valuable commodities will be available in the correct condition, quantity, location
and time; SCMS has been working to improve the national HIV/AIDS laboratory logistics system through
technical assistance. A key component of this assistance was the design of the new lab logistics system,
which was implemented through nationwide training. The new system includes a computerized central
management information system that was installed at the Ministry of Health (MOH) Logistics Management
Unit. Implementation of a computer software logistics management information system for service delivery
sites was also begun with FY 2008 funding.
In 2009, SCMS will continue to procure laboratory commodities in bulk. SCMS will procure at least 50% of
the national quantification for laboratory commodities; which will support the ART target of 313,000 patients.
SCMS will also continue to strengthen and expand the national HIV/AIDS laboratory logistics system
through the following activities:
1) SCMS will quantify and procure USG-funded HIV/AIDS laboratory commodities consistent with
resources and policies for rapidly scaling-up HIV/AIDS clinical services;
2) SCMS will coordinate HIV/AIDS laboratory commodity forecasting efforts and will develop procurement
planning capacity within the MOH and with other key national stakeholders;
3) SCMS will continue to implement a computerized HIV/AIDS laboratory logistics management information
system (LMIS) in at least 50 service delivery sites. The software development will be in conjunction with
ZPCT, the Centers for Disease Control (CDC), and the USAID | DELIVER PROJECT, and its related
mandate to improve the HIV test kit logistics system;
4) With the completion of the nationwide laboratory logistics system, SCMS will work closely with DELIVER
to support the MOH's efforts to network all service delivery sites in the country;
5) SCMS will continue to provide technical assistance and funding support for the creation of service and
maintenance contracts for laboratory equipment; which has been identified as a vital need by all
stakeholders;
6) SCMS will continue to maintain a system for monitoring the function and condition of laboratory
equipment, providing an early warning system for the MOH when repairs or replacements are needed;
7) SCMS will significantly increase the monitoring and evaluation of the HIV/AIDS laboratory supply chain
as a whole, and will make improvements and recommendations as needed, taking full advantage of the
recently established seven provincial offices.
To complete these activities, SCMS will collaborate with GRZ, GFATM Principal Recipients, and other
partners, to train up to 120 key personnel in the newly computerized national HIV/AIDS laboratory logistics
management system. Moreover, at the central level, SCMS will coordinate multi-year national HIV/AIDS
laboratory commodity forecasts and procurement plans with all key partners, including GRZ and donors.
SCMS will also be a key member of related national technical working groups, such as the Ministry of
Health's Procurement Technical Working Group and the HIV/AIDS Laboratory Committee.
Finally, in order to create a more sustainable HIV/AIDS laboratory commodity logistics system, SCMS will
continue to improve national capacity through training and skills transfer programming that is consistent with
the GRZ's vision of a fully-functioning national HIV/AIDS laboratory system.
Continuing Activity: 14419
14419 9524.08 U.S. Agency for Partnership for 6827 4139.08 Supply Chain $10,300,000
9524 9524.07 U.S. Agency for Partnership for 5072 4139.07 Supply Chain $8,000,000
Emphasis Areas
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $700,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.16:
ACTIVITY UNCHANGED FROM FY 2008:
This activity links with the USAID | DELIVER PROJECT's activities in Counseling and Testing (CT) and
ARV Drugs; the Partnership for Supply Chain Management Systems' (SCMS) activities in CT, ARV Drugs,
and Laboratory Infrastructure; the Centre for Infectious Disease Research in Zambia (CIDRZ); Catholic
Relief Services/AIDS Relief; Churches Health Association of Zambia (CHAZ); University Teaching Hospital
(UTH); Zambia Prevention, Care and Treatment Partnership (ZPCT); Government of the Republic of
Zambia (GRZ); Global Fund of AIDS, Tuberculosis and Malaria (GFATM); and the Clinton Foundation.
The purpose of this activity is to provide support to GRZ policy makers, the National HIV/AIDS/STI/TB
Council (NAC), the Ministry of Health (MOH), the Ministry of Finance and National Planning (MOFNP), and
other relevant stakeholders to implement the HIV/AIDS Commodity Security Strategy which was developed
with assistance from SCMS and the USAID | DELIVER PROJECT.
The development and initial implementation of a national HIV/AIDS Commodity Security Strategy was
based on a comprehensive HIV/AIDS Commodity Security (HACS) needs assessment conducted in
consultation with key MOH managers, policy makers, and cooperating partners. The process has provided
GRZ policy makers, NAC, donors, and other partners with a strategic plan detailing priority interventions to
better ensure a sustained, appropriate supply of essential HIV/AIDS commodities required for the
continuation of the national HIV/AIDS program following intensive PEPFAR support.
In FY 2007, the US Government (USG) authorized SCMS project core funds for the needs assessment and
the development of a national HIV/AIDS Commodity Security Strategic Plan. This strategy was developed
in close collaboration with GRZ, NAC, MOH, and other key stakeholders, such as CHAZ and the Clinton
Foundation. The first step in the process was to conduct an analysis of existing policies, procedures,
guidelines, and programs to identify commodity security issues that must be addressed in order to better
ensure the availability of key HIV/AIDS commodities (e.g., HIV test kits, ARV drugs, and laboratory
reagents), and a series of stakeholder meetings were held to seek support for the way forward. In FY 2008,
an implementation plan for the HIV/AIDS Commodity Security Strategic Plan was developed to foster local
ownership and to provide monitoring and evaluation of progress towards commodity security. Furthermore,
the newly formed national HIV/AIDS Commodity Security Working Group, representing 20 organizations,
was formed to ensure that activities are institutionalized and in accordance with the GRZ policies and
procedures.
With FY 2009 funding, SCMS will continue working with the HIV/AIDS Commodity Security Working Group
and the 20 member organizations. In order to support the national HIV/AIDS Commodity Security Working
Group, formed under the MOH's leadership, and its implementation of the national strategy, SCMS will
provide the following assistance with FY 2009 funding: 1) full-time support to the working group to ensure
that the group remains a viable entity; 2) continuous review, monitoring, and updating of the implementation
of the HIV/AIDS Commodity Security Strategy; 3) advocacy for HIV/AIDS Commodity Security at all levels
of the health care system (e.g., national, provincial, district, and community); 4) facilitate GRZ and donor
coordination to analyze and make recommendations to harmonize various inputs into the national HIV/AIDS
procurement systems; 5) enhance GRZ's commitment to provision of these essential commodities through
increased budgetary support; and 6) conduct a supplementary analysis identified in the strategy such as
market segmentation, ability to pay, and diversifying the funding base which would inform a longer term
national sustainability strategy that could be less dependent on donors for vital HIV/AIDS commodities.
The USG, GRZ, GFATM, Clinton Foundation, and other partners are committed to creating an environment
that will allow for the sustained availability of these critical supplies; long-term implementation of the
HIV/AIDS Commodity Security Strategic Plan will greatly assist in achieving this goal.
All FY 2009 targets will be reached by September 30, 2010.
Continuing Activity: 14420
14420 9525.08 U.S. Agency for Partnership for 6827 4139.08 Supply Chain $150,000
9525 9525.07 U.S. Agency for Partnership for 5072 4139.07 Supply Chain $150,000
Table 3.3.18:
