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.
B1. Contextual information:
Tuberculosis (TB) is one of the leading causes of death in the DRC. Each year, 73 people out of every 1,000 die from TB. The DRC is currently scaling up and expanding TB control activities. Provisional data from WHO indicates that the country had met the target for case detection and treatment by the end of 2005. However, DOTS coverage has not expanded beyond 70%.
To date, only a few TB diagnostic units have integrated HIV testing. According to district health teams, the key issues are lack of staff training, unavailability of testing kits for TB/HIV co-infection and for CD4 count, difficult access to ARVs. In 2007, 14% (14.484 patients out of 99.547 of all notified TB patients knew their HIV status, among whom 15% (2129 patients) were HIV positive (WHO report 2009). EPP Spectrum analysis estimates that there will be 132,210 individuals in DRC co-infected with TB and HIV in 2009.
Currently, USAID provides support for TB through three separate mechanisms: Tuberculosis Control Assistance Program (TBCAP), Project AXxes and the Leadership Management and Sustainability project (LMS). TBCAP is a global five-year Cooperative Agreement which started in September 2005 and will end in September 2010. TB CAP is a coalition led by KNCV Tuberculosis Foundation with other sub- partners including the American Thoracic Society (ATS), Family Health International (FHI), The International Union Against Tuberculosis and Lung Disease (The Union), the Japan Anti-Tuberculosis Association (JATA), Management Sciences for Health (MSH), the World Health Organization (WHO) and the United States (US) Centers for Disease Prevention and Control (CDC). The focus of TBCAP is to
decrease TB morbidity and mortality in USAID-priority TB countries, including the DRC, through improved case detection and treatment success.
Goal and global objective
To expand services by integrating TB/HIV activities in 4 TB CPLTs: (1) South Kivu, (2 and 3) West Kasai (eastern and western) and (4) East Kasai (South coordination). During this period, 22,367 individuals will be screened for HIV and 3,355 out of them are expected to be HIV(+)..and 17% of them positive TB patients
Strategies: To work in Axxes health zones (referral link and complementary actions) To work with club des Amis Damien To support supervision for the national level of nation programs and coordination meeting. To strength institutional capacity by supporting national and regional level of NTP and CPLTs by providing computer kits to ameliorate data collection CPLT
The intermediate results of the program are:
(1) Increased and strengthened TB and HIV/AIDS coordinated activities; and, (2) Improved human and institutional capacity for sustainable programs.
In the DRC, USAID has supported TBCAP to successfully strengthen the overall National TB Program, to expand the Stop TB Strategy, to establish the referral laboratory system in order to ensure quality control measures are in place, and to strengthen the national and provincial level capacity in South Kivu, Maniema, Equator East, Kasai Occidental East and West provinces. TBCAP has also helped to develop new guidelines to improve TB/HIV co-infection and MDR TB. The control of the TB infection has also been added on the list of the expected results.
USAID TB/HIV efforts initially included provision of counseling and testing to all TB patients and referral to care, support and treatment services. This scope has been expanded to include initiation of diagnosis of TB among HIV patients, and implementation of collaborative activities at the national level to improve service delivery. These activities are implemented through FHI.
Recently, USAID supported the national AIDS program to develop Provider Initiated Counseling and
Testing guidelines that will contribute to increasing the HIV testing opportunities for TB patients.
Organize monitoring and supervision site visits at various levels schedule In order to carry out monitoring and supervision for each TB site every quarter, different visits will be performed at various levels, including national, provincial, and health districts in four TB CPLT and their partners. The NTP national and provincial and the Health District will be supported by The UNION and AXxes, respectively. FHI will support the PNLS supervision visits (national and provincial). These activities will be conducted monthly for the health districts. For the others levels, visits will be performed quarterly and jointly between the two programs (NTP and PNLS) at the national and provincial levels. The Union and FHI will coordinate their site visits in terms of travel, accommodation and trip reports.
Monitoring and evaluation and Coordination across partners:
Activities listed below help the partner to review and report high quality data using the national TB and HIV M&E framework and tools and to report on the revised TB/HIV indicators
1. Hold quarterly and annual coordination meetings between TB and HIV programs and their partners at
the national and provincial levels 2. Print and disseminate TB/HIV guidelines and monitoring tools 3. Organize monitoring and supervision site visits at various levels schedule
Human Resources Capacity and Sustainability
Activities listed below help to reinforce human resources capacity and sustainability of the project
4. Strengthen a TB/HIV unit at the PNLS, national and provincial levels 5. Train health providers on the application of TB infection control measures. 6. Create and ensure HIV post test clubs activities 7. Reinforce the referral system between TB/HIV integrated sites, OI/ARV and others services
Alignment with country policy and strategic plan
According to alignment with the country policy and strategic plan, FHI organize the below activities:
8. Organize transport of HIV tests to PNLS National Referral Laboratory for quality assurance of testing 9. Conduct an advocacy to the responsible of the MoH and partners 10. Create a TB infection control committee 11. Elaborate and disseminate the national guideline and posters relative to TB Infection Control 12. Organize counseling quality assurance sessions 13. Supply the TB/HIV sites with Lab reagents and HIV tests kits 14. Ensure TB/HIV services, counseling and testing at TB sites 15. Increase TB Screening of HIV(+) clients 16. Ensure the management of TB/HIV activities at the sites levels 17. Provide two MDR facilities with environmental and personal preventive measures
