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.
Subdivisions of Program Areas, these track general higher level sub-classifications of expenditure.
Subdivisions of Major categories, these are the most detailed expenditure data.
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
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
Procurement and Distribution of ARV Drugs and Related Commodities
The main focus of this activity is to support the quantification, supply planning, procurement and distribution
of ARV drugs for opportunistic infections (OI), sexually transmitted infections (STI), and other commodities
for HIV/AIDS programs. This will ensure sufficient supply and availability of these at service delivery points,
providing support to Prevention for Positives and other critical programs. Major support in the development
and implementation of national Pharmaceutical Logistics Master Plan (PLMP), which will provide a reliable
system for all health commodities, is another major focus.
Collaboration in commodity provision between the various partners is another major focus. This was
continued in FY07, with the Global Fund To Fight AIDS, Tuberculosis and Malaria (Global Fund) continuing
to provide funds for the supply of first-line adult ARVs. In FY07, an agreement was reached whereby supply
of pediatric first- and second-line ARV formulations and adult second-line formulations, previously provided
by PEPFAR, was transferred to the Clinton HIV/AIDS Initiative (CHAI). PEPFAR Ethiopia continues to
support ARV commodity procurement through contingency funding for a reserve stock of first-line adult ARV
drugs, and will also plan for emergency stocks of first-and second-line pediatric ARV, second-line adult
ARV, and rapid test kits (RTK), in case planned supplies from other donors are not available, as well as for
commodities used by other PEPFAR partners.
Commodities will be procured per Government of Ethiopia's (GOE) national ART and other program
protocols, and USG rules and regulations. PEPFAR funds the Partnership for Supply Chain
Management/Supply Chain Management Systems (PFSCM/SCMS).
Ethiopia's national target of universal access to ART and primary healthcare by 2010 has translated into a
rapid scale-up of ART service. The challenge presented under this scale-up is two-fold: 1) the need to
ensure systematic quantification, forecasting, and procurement planning so that adequate quantities of
commodities of appropriate quality are available; and 2) the need to have a reliable logistics system capable
of responding to the geographic and programmatic conditions of Ethiopia. The latter also includes the need
to consider the limited capacity of health facility stores to handle the volume of drugs needed for the
growing number of patients and to begin to ensure the development of a sustainable logistics system
aligned with the PLMP. SCMS is coordinating with diverse partners to support this effort, and is one of the
primary technical assistance (TA) providers for the Master Plan, including personnel support at both
national and regional levels, and planned support in improving regional warehouses.
In FY07, in conjunction with the Ministry of Health's HIV/AIDS Prevention and Control Office
(MOH/HAPCO), SCMS facilitated a National HIV/AIDS Commodity Quantification Exercise. The results
provided input into the Global Fund's Round 7 proposal and included requirements for ARV, RTK for
counseling and testing (CT), OI and STI drugs, male and female condoms, laboratory supplies, PMTCT,
and infection-prevention materials, as well as ready-to-use therapeutic food (RUTF). SCMS spearheaded
the exercise, using it to begin an open-ended supply-planning process. This will be institutionalized through
HAPCO's HIV Commodity Supply Management Committee, with technical support from SCMS and a
commodity security advisor seconded to HAPCO. The quantification and costing results, updated in June
2007, showed a total of $272 million needed to cover all HIV commodities for Calendar Year 2008, in
support of the MOH's Road Map II: Accelerated Access to HIV/AIDS Prevention, Care, and Treatment in
Ethiopia. This plan for universal access has a $159 million gap in funding to cover commodities for the
country, more than PEPFAR can cover in FY08. Prioritization of commodities will be important, as many
services cannot be effectively implemented without key products.
In FY07, SCMS provided support to the procurement process by developing quarterly forecasts of
requirements and updating supply plans. In FY07, SCMS procured drugs for the treatment of OI, infection-
prevention materials, and PMTCT supplies to address the continued shortage of these commodities—which
are key to the provision of quality services for PLWH and HIV-positive pregnant mothers.
In FY07, SCMS provided support for strengthening logistics systems. In FY08, in close collaboration with
MOH, HAPCO, and other partners, SCMS will continue to provide TA and support to PHARMID, the
national central medical stores, and the Ethiopian Health and Nutrition Research Institute (EHNRI) for
developing an integrated, logistics-management system for HIV/AIDS commodities. SCMS worked with
PHARMID to support the clearing, warehousing, and distribution planning of ARV drugs and related
commodities purchased by PEPFAR Ethiopia and other sources. SCMS began to play a major role in
procurement of commodities with Global Fund support, procuring approximately $8 million, mainly in RTK,
in FY07. Also in FY07, SCMS recruited and seconded ten logistics associates to regional PHARMID hubs,
and completed transitioning the distribution of commodities to sites from Rational Pharmaceutical
Management Plus (RPM+) to SCMS. In collaboration with RPM+, SCMS established a system for compiling
and transmitting facility-level patient and stock data to facilitate distribution planning as well as systematic
quantification and procurement. SCMS also provided support to central PHARMID to establish state-of-the-
art warehouse and distribution operations to manage HIV/AIDS commodities. Responding to emergency
shortages of commodities, SCMS collaborated with MOH and other partners to begin implementation of an
emergency, transitional inventory-control system for HIV commodities, to alleviate these problems until the
PLMP is fully implemented.
In FY08, SCMS will continue its efforts to strengthen the supply-chain management system for HIV/AIDS
commodities. Attention will be focused on support to regional PHARMID hubs in developing effective
warehouse and distribution operations, and integrating information and planning functions with the central
headquarters. Assuming a waiver for new construction can be obtained, SCMS will support PHARMID's
need to expand capacity to meet the growing demand, as well as the need for organizational development
to ensure sustainable institutionalization of logistics practices. SCMS will also support investment in
inventory control and warehouse management to support flexible and quality logistics operations. In
addition, SCMS will work in conjunction with the MOH's PLMP implementation to support development of
PHARMID's procurement capacity. In FY08, SCMS will make substantial investments in procurement and
logistics, with the aim of supporting national ART targets for numbers of patients, and hospital and health-
center sites providing ART services. In FY08, PEPFAR Ethiopia will procure up to $25,000,000 in HIV
commodities through SCMS, and will spend up to $14,000,000 to strengthen the capacity of PHARMID and
support PLMP implementation from national to site level. Capacity building may include substantial
provision of information-technology resources at appropriate sites, as well as support for adequate storage
space for commodities. Commodity procurement will be defined in conjunction with the MOH's HIV
Commodity Supply Management Committee, as the lack of funds to cover all commodity needs for universal
access goals requires prioritization to ensure optimum use of existing resources. The exact mix of
commodities to be procured will not be known until this analysis is complete, and will shift depending on
availability of funds from other sources, actual usage levels in MOH facilities, etc. To ensure sustainability,
SCMS will build the capacity of MOH and PHARMID staff through TA, training, and skills transfer to
effectively forecast, procure, and deliver essential commodities, and to collect, use, and share supply chain
information. SCMS will second staff at national and regional level to further those processes.This activity will
Activity Narrative: contribute to the upstream achievement of essentially all PEPFAR program indicators that depend on
commodities for success. This activity will ensure that health commodities for HIV programming, including
ARVs, are cost-effectively procured and effectively managed. HIV commodity requirements will be
appropriately quantified, projected, and costed. In-country systems for procurement, distribution and
monitoring of HIV commodity needs will be developed and supported.This activity is linked to other donor
and partner resources through an accountability matrix designed to coordinate the implementation of the
PLMP. Close integration with John Snow, Inc./DELIVER activities supported by USAID population funding
will be continued and strengthened. Partners include the Global Fund, the United Nations Children's Fund
(UNICEF), the United Nations Population Fund (UNFPA), the Global Alliance for Vaccines and
Immunization (GAVI), CHAI, and the World Health Organization. To ensure reliable and sustainable
logistics systems, PFSCM/SCMS will focus on building the capacity of PHARMID to carry out supply-chain
Based on COP08 approval, SCMS levels under HTXD are restored to the original level by adding back in
the $13,686,592 that was put into unallocated. At the same time, there are a number of reductions that bring
the total amount of funding proposed to $38,724,200. These changes include moving 1) $622,972 from
SCMS to USAID M&S to account for the OE guidance from OGAC, 2) 960,000 from SCMS to cover the
HMIS support to the Federal Ministry of Health as a continuation of support offered in COP07, and finally 3)
$1,167,349 from SCMS to CDC to cover costs for Nastad.
Laboratory Reagents, Supplies, Equipment and Logistics Management
This is a continuing activity from FY07. In FY08, it is expected that the demand and cost of laboratory
monitoring will continue to increase. This is due both to the scale-up of Ethiopia's prevention, care, and
treatment (including ART) programs as it strives to reach universal access goals, as well as the PEPFAR
Ethiopia focus on increasing the quality of services in FY08. To meet the demand and provide quality
laboratory services to all sites, substantial investments will be necessary.
The main focus of this activity is to ensure that laboratory supplies procured by the USG and the
Government of Ethiopia (GOE) with Global Fund for AIDS, Tuberculosis and Malaria (Global Fund) and
PEPFAR monies are in sufficient supply, of superior quality, and are moving efficiently through a supply
chain that will support the scale-up of ART. The PEPFAR Partnership for Supply Chain
Management/Supply Chain Management Systems (PFSCM/SCMS) will procure laboratory supplies,
including reagents, consumables, and limited equipment, and develop the capacity of personnel at the
national, regional, and local levels to implement an efficient supply-chain management system for laboratory
commodities. These commodities, in conjunction with the supplies procured by the Ethiopian Ministry of
Health (MOH) and complemented by SCMS technical assistance in supply-chain management, will improve
the capacity of laboratories nationally to support ART services. SCMS will procure reagents at optimal
prices, and will collaborate with PHARMID, Ethiopia's public-sector, central medical store, on storage,
inventory, monitoring, and support distribution of reagents for CD4, hematology, and chemistry testing.
SCMS technical assistance and supplies procured with SCMS support will reach at least 131 hospital
networks, including national, regional, hospital, and health center laboratories throughout Ethiopia.
In FY07, SCMS supported the Ethiopian Health and Nutrition Research Institute (EHNRI), the national
reference laboratory, in designing and beginning implementation of a laboratory logistics-management
system. This work was carried out in close collaboration with PHARMID, as well as with the Management
Sciences for Health/Rational Pharmaceutical Management Plus (MSH/RPM+) team (ID 10534), the Clinton
HIV/AIDS Initiative (CHAI), and USG and other relevant partners. SCMS supported a senior laboratory
logistics advisor seconded to EHNRI and five regional laboratory associates (RLA) seconded to regional
laboratories. All activities were done in close collaboration with all relevant stakeholders, to ensure that the
laboratory logistics-management system functions smoothly. During FY07, SCMS worked with PHARMID to
strengthen its capacity to handle the special logistics needs for laboratory supplies, including cold chain
requirements, at the central and regional hubs. In FY08, SCMS will continue to support PHARMID in the
integration of cutting-edge logistics for lab commodities and distribution-management practices and
technologies in its standard logistics system.
In FY07, PEPFAR Ethiopia supported the national ART program by purchasing large quantities of
laboratory equipment and test reagents for diagnosis and treatment monitoring of HIV/AIDS patients. A total
of $9,403,323 million in lab monitoring supplies (CD4, hematology, and chemistry profiles) was procured
and distributed by SCMS. In addition, funds were allocated to support the expansion of the hospital
networks to cover 131 hospital networks (131 hospitals and 240 health centers); this included budgeting for
related equipment and semi-durable supplies and consumables. PEPFAR Ethiopia in FY08 has allocated
$9,500,000 to procure the following laboratory reagents, test kits and supplies through SCMS: (1) Chemistry
test reagents for monitoring patients on treatment: alanine aminotransferase/glutamate pyruvate
transaminase (ALT/GPT), creatinine, cholesterol, blood urea nitrogen (BUN), and glucose; (2) Hematology
test reagents for monitoring patients on treatment; (3) CD4 (cluster of differentiation-4) test reagents for
monitoring patients on ART treatment and pre-ART patients, including pregnant women; (4) Pregnancy test
kits; (5) Syphilis tests; (6) Deoxyribonucleic acid (DNA) polymerase chain reaction (PCR) test kits for
diagnosis of pediatric patients less than 18 months of age; (7) HIV rapid-test kits, as an emergency stock;
(8) Reagents and staining solutions of microscopic diagnosis of opportunistic infections (Acid-fast bacillus
smear, culture, and sensitivity, malaria, stool parasites); (9) Other supplies, including gloves, tubes, pipette
tips, and disinfectants.
SCMS will continue to support an integrated approach to procurement and distribution of laboratory
commodities in FY08, working with appropriate national, regional, and sub-regional counterparts and
partners. SCMS will work with laboratory and GOE stakeholders to support the implementation of the
national laboratory logistics systems, under the auspices of PHARMID and with technical input as
appropriate from EHNRI. SCMS will work closely to support the system for distribution of supplies direct to
testing and other service-delivery sites, in line with a national standardized system for supply-chain
management. Supportive supervision will be provided to ensure reporting through a robust, laboratory-
logistics management-information system (LMIS), which will be substantially strengthened. A system for
reporting and using the laboratory LMIS to support appropriate inventory control systems, proper
quantification, forecasting, and timely procurement, as well as responsive distribution of supplies, will be
developed. RLA will continue to contribute to capacity development at the site-level to carry out laboratory
LMIS functions, and to ensure sustainability of services. In these ways, SCMS will assist in strengthening of
the national and local supply-chain management system.
To ensure long-term sustainability of interventions, SCMS will assist in improving national capacity through
training and skills transfer to EHNRI, the Federal MOH, PHARMID and nongovernmental organization
(NGO) partner staff, and will ensure that the interventions are consistent with the vision and capacity of the
MOH and the Pharmaceutical Logistics Master Plan (PLMP). SCMS will continue to use training as an
important means of achieving the above objectives.
This activity will support a unified approach to procurement and distribution of laboratory commodities,
coordinating with its support for availability of other critical HIV/AIDS commodities to support the prevention,
care, and treatment program. Sustainable lab-commodity management systems will be developed through
integration into, and strengthening of, in-country systems for managing these commodities.
This activity is linked to other donor and partner resources to coordinate the implementation of a national
PLMP. Close integration with the SCMS and RPM+ ART drugs activities (ID 10532, ID 10534) as well as
other PEPFAR laboratory-support partners will be continued and strengthened. Other linkages include the
Global Fund, CHAI, and the World Health Organization (WHO).
PFSCM/SCMS will ensure consistent and timely delivery of laboratory commodities to public-sector sites
Activity Narrative: providing prevention, care, and treatment services to patients who need them throughout Ethiopia. PLWH
will be among the beneficiaries.
The primary emphasis of this activity will be to ensure robust logistics for lab commodities. Capacity of sites
and Ethiopian organizations such as PHARMID will be strengthened to ensure the sustainability of a
national supply-chain system for lab commodities. EHNRI's ability to provide the necessary technical input
to inform planning for the procurement of laboratory commodities will also be strengthened.
Based on COP08 approval SCMS levels are restored to $14,437,102 as originally submitted in COP08.