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 HAS BEEN MODIFIED IN THE FOLLOWING WAYS FROM COP 2008:
+COP08 funding for this activity was captured only under HVMS. In COP 09 the funding is distributed
across the program areas.
COP 2008
CDC-Kenya, including GAP-Kenya, is co-located with the Kenya Medical Research Institute (KEMRI) in
Nairobi and Kisumu, with most PEPFAR-supported staff based in Nairobi, Kenya. Due to the dramatic
scaling up of PEPFAR activities in Kenya, and the resulting expansion of staff since the inception of
PEPFAR, the capacity of the existing offices has been exceeded. CDC proposes to renovate the existing
structure, however, due to site and structural constraints, this will avail only limited additional space. CDC
therefore proposes to build a second building to house the expanded CDC-KEMRI HIV program. The
proposed building, on the campus of KEMRI, will become part of the KEMRI complex; CDC will not hold title
to the building.
A total of $1,2000,000 in FY08 funds was programmed to RPSO for this purpose; however, these funds
were allocated in the absence of a fully developed staffing plan, and without consultation with an
architectural & engineering services contractor. Funds were also allocated without considering the cost of
an A&E contractor. Construction costs in Kenya have also increased dramatically due to increased costs
for materials, labor and fuel. Additional FY09 funds are sought to meet the funding shortfall resulting from
the unplanned-for A& E services contract, as well as the under-estimated cost of construction.
Costs for the total CDC-KEMRI project have been allocated across GAP program areas, based on projected
space utilization.
New/Continuing Activity: New Activity
Continuing Activity:
Emphasis Areas
Construction/Renovation
Human Capacity Development
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.01:
+COP 08 funding for this activity was captured only under HVMS. In COP 09 the funding is distributed
A total of $1,2000,000 in FY 08 funds was programmed to RPSO for this purpose; however, these funds
for materials, labor and fuel. Additional FY 09 funds are sought to meet the funding shortfall resulting from
Program Budget Code: 04 - HMBL Biomedical Prevention: Blood Safety
Total Planned Funding for Program Budget Code: $7,337,716
Total Planned Funding for Program Budget Code: $0
Program Area Narrative:
1) Blood Safety
Key Result 1: Increase collection of blood units from low-risk volunteer donors to 180,000.
Key Result 2: Increase repeat donations to 40% of all volunteer donations.
Key Result 3: Notify 80,000 blood donors of their HIV test results.
CURRENT PROGRAM CONTEXT
The National Blood Transfusion Service (NBTS) collected 124,000 units in 2007 from low-risk volunteer blood donors, which
represented about 80% of the national blood supply. Significant successes include an increase of regular donors from 10% to
25%, and of the proportion of volunteer donors from 20% to 80% since 2004. The NBTS consists of six Regional Blood
Transfusion Centers (RBTC), which collect, process, test, and distribute blood, and nine satellite centers, which distribute blood to
surrounding health facilities. Over 200 NBTS health care workers were trained through the support of the American Association of
Blood Banks (AABB). All blood is screened for HIV, syphilis, hepatitis B and hepatitis C. HIV prevalence among donors declined
from about 6% in 2000 to 1.2% in 2007. Safe blood units collected increased from 22,000 in 2003 to 124,000 in 2007.
SERVICES
The NBTS collaborates with the Kenya Red Cross Society (KRCS), Bloodlink Foundation (BLF), and Hope Worldwide for
mobilization and retention of volunteer blood donors among high school and college students, community- and faith-based
organizations, and adults in the work place. In 2009, the Africa Society for Blood Transfusion will continue support for 20 hospital
transfusion committees; blood donor recruiters will deliver messages for HIV prevention to over 600,000 potential blood donors
during pre-donation health talks; and two-thirds of all blood donations will be processed for pediatric use. At least 80,000 blood
donors will learn their HIV test results. The National Center for Health Marketing's Global Communication and Marketing Team will
collaborate with CDC, NBTS, and BLF to increase the number of repeat blood donors by using mobile phone SMS technology to
support targeted messaging, particularly when blood stores are critically low.
POLICY
Blood safety receives limited financial support from the Government of Kenya (GoK). Frequent staff transfers and overall staff
shortages hamper quality improvements. Many hospitals still collect blood in emergencies from high-risk family members and
testing of these units is sub-optimal. Track 1 funding is enabling NBTS to develop as an independently functioning unit within the
MOH through improved infrastructure, communications, and management and staffing. Centralized blood testing, facilitated by
RPSO extension of the Nairobi RBTC, will further enhance quality and cost-efficiency.
Additional partnerships with community groups are being strengthened through KRCS and Hope Worldwide under their Track 1
cooperative agreement. BLF uses public-private partnerships to identify low-risk repeat donors in the workplace and increase the
funding base for NBTS, which has resulted in up to $100,000 raised annually from local corporations in support of volunteer blood
donor recruitment. BLF will collaborate with APHIA II HCM and NBTS to mobilize university students for voluntary, regular blood
donation. Policy and plans to inform and counsel blood donors who test HIV-positive will be refined. Procurement hurdles have
been addressed by engaging the Supply Chain Management Systems as a partner to NBTS.
While the GoK policy on blood transfusion has outlined the structure of the NBTS, there is a lack of legislative authority for NBTS
to become a semi-autonomous agency of the Ministry of Health. The Permanent Secretary has been requested to appoint a
Transfusion Service Advisory Committee in the interim. Other development partners contributing to a safe blood supply include
the Japan International Cooperation Agency, which is supporting hospital transfusion practice at three hospitals in Rift Valley
Province, and the Kenya Red Cross Society, which has supported the creation of a regional blood transfusion center at Garissa
Provincial Hospital. Overall, there is excellent development partner coordination through a national committee chaired by the
NBTS.
2) Injection Safety
Key Result 1: Scale up injection safety initiatives to Nairobi and Rift Valley provinces.
Key Result 2: Promote documentation of needle-stick injuries and uptake of PEP amongst health care workers.
Key Result 3: Rehabilitate and secure waste management sites at 40 health facilities.
A 2003 study conducted in Kenya by the World Health Organization (WHO) and the Expanded Program for Immunization (EPI)
revealed that medical transmission of HIV and other blood borne infections primarily occur through unsafe medical injections
resulting from unnecessary therapeutic injections, use of non-sterile injection equipment, needle-stick injuries, and poor disposal
of used needles and other medical waste. Inappropriate injection use arises from client demand, prescriber preference, deficient
national treatment and procurement policies. Failure to systematically provide sufficient injection supplies is a key contributor to
widespread re-use of syringes and needles. A majority of health care facilities previously reported stock-outs of disposable
injection supplies, a situation that favored re-use of injection devices. The GoK's syringe procurement in its 2006-07 budget
included 60% non-reuse injection devices. The Kenya EPI program, with support from GAVI, has been the leader in injection
safety, with 100% procurement of auto-disable, single-use injection equipment.
Basic approaches to achieve national safe injection practices include support for development, dissemination, and implementation
of national policies on injection safety and post-exposure prophylaxis (PEP); training of health workers on safe injection practices;
proper use of auto-disable or protective injection devices; infection control and medical waste disposal procedures; advocacy to
decrease demand for injections; improved logistics management to eliminate stock-out of injection devices; strengthening of
facility-level infection prevention committees for monitoring and supervision; and provision of sharps waste containers for
appropriate waste management. In 2009, through a private-public partnership with Becton-Dickinson, sharp injuries surveillance
will be strengthened to identify practices and procedures that pose risks to health workers and patients. Uptake of PEP by health
care workers will be assessed and linkages to care and treatment services established.
National policies on injection safety and medical waste management and National Standards and Guidelines for Safe Injection
Practice have been recently published. Health workers in six of seven provincial hospitals have been trained on safe injection
practices. Rollout of national policies and training health workers throughout the country will benefit from 2009 EP funding and
result in improved practices at over 1,000 health facilities in six provinces. A post-exposure policy will be developed. Linkages to
the counseling and testing program to encourage health workers to know their status and to the ART program for PEP will be
strengthened to reduce HIV transmission in medical settings. Medical waste management will be emphasized through
rehabilitation and securing of waste disposal sites.
Advocacy with the GoK aims to secure the required budget for adequate injection/infusion supplies and review of both the
essential drug list and various treatment guidelines. To achieve sustainability, local training institutions have been assisted by to
review teaching curricula to include safe injection practices. The MOH supports the injection safety initiative but lacks a system to
monitor adherence to policies at the facility level. This will be overcome through support of Infection Control Committees at health
facilities and the creation of databases to monitor needle-stick injuries and uptake of PEP amongst health care workers. In 2009,
focus will be given to improve phlebotomy practice and reduce the risk of needle-stick injuries and exposure to blood for health
care workers. Poor medical waste management has been identified as a major weakness in ensuring injection safety. In 2009,
waste management sites at 25 health facilities will be secured and rehabilitated. As the GoK now procures significant numbers of
re-use prevention injection devices, EP support will shift to meet any arising stock gaps. Continuation of training will be addressed
by institutionalizing safe injection practices in medical training colleges' curricula.
3) Injecting and non-Injecting Drug Use
Injection drug users (IDUs), though relatively small in number in Kenya, are at disproportionately high risk for HIV infection. Many
share needles and syringes and engage in unprotected, often transactional, sex to support their drug dependency. IDUs are
universally recognized as a "bridging" population, hastening the spread of HIV to the general population.
Drug abuse is generally considered to be on the rise in East Africa. The lack of reliable data makes it difficult to engage public and
political leaders in recognizing the scope and scale of the problem. Social norms, legal prohibitions, and an unsupportive policy
environment impede adequate demand reduction measures. Cannabis and khat are the most widely abused drugs; however,
heroin and, to a lesser extent, cocaine, are becoming a serious problem in Kenya. Contrary to popular perceptions, drug abuse is
neither solely associated with poverty or an exclusively male issue. Many young girls and women are also drug abusers, and their
drug abuse is often correlated with child/sexual abuse and transactional sex. Women are more susceptible to drug-related verbal,
physical, and sexual abuse from their drug-taking partners, as well as to poverty and deprivation when limited family income is
spent on drugs.
STATISTICS
Kenya has a generalized HIV epidemic with prevalence at 7.8% nationally. A study of 336 heroin users in Nairobi found that
44.9% were currently, or had previously been, injectors. Of 101 current injectors, 52.5% were HIV-positive. This compares with a
13.5% prevalence rate among heroin users who had never injected. Hepatitis C prevalence also varied dramatically, from 61.4%
among current injectors to 3.8% for those who had never injected.
The 2008 Modes of Transmission Study (MOT) indicates that most-at-risk populations contribute to more than two-thirds of new
HIV infections in Kenya. Targeted interventions for other sub-populations at higher risk of HIV infection, including IDUs, will
include a comprehensive package of services, such as HIV prevention messages, counseling and testing, management of STIs,
risk reduction counseling, abstinence promotion, and provision/promotion of correct and consistent use of male and female
condoms.
REFERRAL AND LINKAGES
EP-supported programs will ensure effective referrals for relevant services, including HIV counseling and testing and HIV care and
treatment services.
4) Male Circumcision
CURRENT CONTEXT
Kenya has a generalized HIV epidemic with a prevalence of 7.8% nationally. Though over 80% of Kenyans are circumcised,
regional variations exist, with Nyanza Province having the lowest rate of male circumcision (MC) at 46% but highest HIV
prevalence of 15.3%. Estimates indicate that about 900,000 males aged 10-50 years are uncircumcised in Nyanza. After
observational and 3 randomized controlled studies demonstrated that MC provides partial protection against acquiring HIV among
sexually active men by 60%, EP funds have supported voluntary medical male circumcision (VMMC) policy development and
service delivery rollout, coupled with critical behavior change communications activities. Such support will continue is 2009, in
sustaining rapid expansion of VMMC services in Kenya, focusing significantly on Nyanza province.
In addition to supporting stakeholder meetings and consultations in 2009, partners will continue supporting the health ministries in
implementing VMMC policy and guidelines in accordance with national recommendations. VMMC activities will include training of
health care providers in district hospitals, health centers and faith-based facilities, community mobilization, and monitoring and
evaluation of pre-op and post-op complications. Service rollout will continue to target areas with existing high demand for VMMC
services. Providers will be trained in provision of VMMC based on the Clinical Manual for MC under Local Anesthesia in Kenya,
including supervision, mentoring, reporting, and follow up services. Other approaches of VMMC service provision will be explored,
including mobile outreaches in locations without fixed facilities. Support will be provided for both consumables and non-
consumable commodities (i.e. autoclaves, instrument packs, surgical lamps, furniture, etc.), as well as personnel and other
infrastructure renovation that will be necessary for service delivery. Mechanisms for ensuring adequate supply and provision of
surgical supplies, STI drugs, and HIV testing will be strengthened. Implementation of the national MC Communication Strategy will
lead to increase in demand for VMMC services. Specific prevention messaging, were applicable, will address male/gender norms
and behaviors that promote safer sexual practices, including addressing any emerging misconceptions that male circumcision
alone protects one from HIV infection. Identified youth and young adults eligible for VMMC will be referred to nearest MC sites,
while linkages with care and treatment sites will be established to benefit those testing positive for HIV in MC sites, including those
identified to be in discordant relationships. VMMC will not be recommended to HIV-positive men at this time. The USG will support
the MOH to routinely collect relevant program indicators to monitor outcomes of VMMC scale up.
Through the Kenya National MC Taskforce, the MOH and USG agencies will collaborate with other development partners
including the Male Circumcision Consortium supported by the Bill and Melinda Gates Foundation and Provincial Health
Management Teams (PHMT) to ensure comprehensive coverage, reduce duplication of services, and ensure standardized
delivery of MC services in the low MC and high HIV prevalence areas in Kenya. Kenya has already developed a VMMC policy
document that emphasizes the promotion of VMMC within a comprehensive HIV prevention package. Meaningful engagement
and consultation with key stakeholders, aimed at providing evidence-based information on the benefits and risks of VMMC have
been successful in gaining their support for its scale up.
Table 3.3.04:
+this narrative also includes $370,000 for RPSO to support construction of a central laboratory.
$58,188: CDC-Kenya, including GAP-Kenya, is co-located with the Kenya Medical Research Institute
(KEMRI) in Nairobi and Kisumu, with most PEPFAR-supported staff based in Nairobi, Kenya. Due to the
dramatic scaling up of PEPFAR activities in Kenya, and the resulting expansion of staff since the inception
of PEPFAR, the capacity of the existing offices has been exceeded. CDC proposes to renovate the existing
ACTIVITY UNCHANGED FROM COP 2008
***
$370,000: This activity relates to the prevention of HIV transmission through blood transfusion in health care
settings. The National Blood Transfusion Service (NBTS) was established in the year 2000 with the goal of
ensuring safe and sufficient blood supplies for the country. Previously blood was obtained solely from family
replacement donors at fragmented hospital-based transfusion units that lacked a standardization of
procedures. A national survey in 1994 estimated that 2% of transfusions transmitted HIV. At least 140,000
transfusions take place each year. This activity will facilitate testing of blood collected in the six Regional
Blood transfusion Centers located in Nairobi, Mombasa, Embu, Nakuru, Kisumu and Eldoret to be
conducted at a centralized laboratory in Nairobi. Centralized testing will help to ensure uniformity and
maintenance of quality testing procedures. Blood samples will be received in the central laboratory through
a courier service. Results will be relayed to the regional centers electronically. In the long term centralized
testing will enhance the testing turn-around-time and cost efficiency of blood processing at the NBTS. The
Centralized laboratory will also house the national offices of the blood transfusion service creating a
physical and functional separation from the Nairobi regional blood transfusion center. This will contribute to
enhanced logistics management, leadership and monitoring of quality testing and services. The national
office has hired managers for quality, technical, ICT and donor care. Cold room storage in the new lab will
facilitate separation of pre-tested blood from that which is tested as well as that of reagents and other lab
supplies from blood and blood products. Additionally, renovations of selected regional and satellite blood
transfusion banks will be conducted.
3. CONTRIBUTIONS TO OVERALL PROGRAM AREA
This activity will contribute to prevention of HIV through blood transfusion. Kenya aims to collect 140,000
units of blood from low risk volunteer blood donors. All the blood will be tested for HIV, hepatitis B, Hepatitis
C and syphilis. This activity will facilitate accurate testing of blood for HIV, hepatitis B, hepatitis C and
syphilis and also reduce the occurrence of adverse transfusion events. Blood donors will be notified of their
test results and given information to promote healthy positive living so that negative donors become regular
repeat blood donors. HIV positive donors will be counseled and referred for evaluation care and treatment
as appropriate. Appropriate blood use will minimize unnecessary transfusions which may expose healthy
individuals to HIV infection. The World Health organization estimates that 10% of HIV may be attributed to
transfusion with infected blood.
4. LINKS TO OTHER ACTIVITIES
This activity relates to the service delivery activities by SCMS which will enhance efficiency by maximizing
on economies of scale achieved through mass procurements and timely delivery of commodities. This
activity also links to Cooperative agreements with NBTS and American Association of Blood Banks (AABB)
for the provision of safe and adequate blood supplies.
5. POPULATIONS BEING TARGETED
This activity will benefit the general population by supporting the acquisition of blood free of HIV infection.
6. EMPHASIS AREAS
The major area of emphasis for this activity is infrastructure development.
New/Continuing Activity: Continuing Activity
Continuing Activity: 15001
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
15001 6446.08 Department of Regional 7000 4061.08 $450,000
State / African Procurement
Affairs Support
Office/Frankfurt
7032 6446.07 Department of Regional 4280 4061.07 $320,000
6446 6446.06 Department of Regional 4061 4061.06 $650,000
Table 3.3.05:
+This activity includes $1,300,000 for health facility infrastructure development
$172,959:
$1,300,000:
1. LIST OF RELATED ACTIVITIES
This activity relates to activities in Basic Care and Support Care and ARV services.
2. ACTIVITY DESCRIPTION
With the increasing number of the people enrolled in HIV care and treatment services since 2004, the clinic
space at health care facilities have been stretched to capacity. Currently there are > 500,000 people on care
compare to < 5,000 in 2004.
Regional Procurement Support Office (RPSO) will perform construction and renovation services for 3-10
care and treatment facilities in Central, Nyanza, Eastern, and Nairobi Provinces. The purpose of this activity
is to improve the physical health care infrastructure in Kenya by renovating the existing infrastructure and
constructing new facilities in the 4 provinces. It is anticipated that RPSO will work with provincial health
management teams, the Ministry of Public Works, and medical superintendents during the assessment and
construction with a view to establishing a strong Ministry of Health/stakeholder collaboration. It is
anticipated that RPSO will ensure that the renovations/constructions undertaken are appropriate for each
level or type of health facility.
This activity will contribute to the continued implementation of the care and treatment activities in Kenya.
The expansion of the existing facilities will enable health care workers to provide quality services to
expanding patient populations.
This activity will link to the ARV services, Basic care and support services in Central, Nyanza and Nairobi.
This activity aims at improving the quality of care and treatment services provided to HIV positive people in
Kenya by improving access to the services.
6. EMPHASIS AREAS / KEY LEGISLATIVE ISSUES ADDRESSED
The main emphasis area for this activity is construction/renovation seeking to rehabilitate and expand the
care and treatment facilities in the country.
Continuing Activity: 19415
19415 19415.08 Department of Regional 7000 4061.08 $2,550,000
Table 3.3.09:
+This activity includes $500,000 to support TB laboratory capacity
$62,768:
$500,000
This activity relates to activities in Adult Care and Support, Pediatric Care and Support, and Adult and
Pediatric ARV Services.
Supported by the Global Fund (GF), Emergency Fund (EF) and other partners, Kenya is presently
upgrading its national TB laboratory capacity as part of the response to an emerging threat of MDR-TB. EP
will continue to assist Kenya's response by improving national MDR-TB laboratory surveillance capacity,
promoting best TB care practices and expanding access to treatment. Presently, EP is strengthening the
national Central Reference TB Laboratory (CRL) culture and drug sensitivity testing (DST) capacity through
improvements in physical infrastructure, culture diagnostics, and development of a laboratory information
system. In FY 09, Kenya plans to optimize DST for TB re-treatment cases according to national guidelines
and expand national coverage of external quality assessments (EQA) for sputum microscopy services from
present 20% to 50% by 2010. EP will continue to support on-going decentralization and strengthening of
DST capacity in regional laboratories such as KEMRI (Nyanza Province), Kericho (North Rift) and AMPATH
(North Rift). These efforts, complemented by those of other partners, will provide better insight into the MDR
-TB burden and contribute to planning for sustained control. EP continues to contribute to the expansion of
fluorescence microscopy (FM) - a more efficient TB diagnostic tool, especially in high volume settings. EP
funds have procured and placed seven microscopes in five geographic regions (Nairobi, Coast Province,
South Rift, North Rift, and Nyanza). In FY09, EP funds will be used to procure an additional five
microscopes for other high volume regional sites. Funds to RPSO will be used to create additional
laboratory space for these expanded activities through renovations of existing buildings and laboratories.
Continuing Activity: 19417
19417 19417.08 Department of Regional 7000 4061.08 $500,000
Table 3.3.12:
Table 3.3.14:
+This activity includes $4,200,000 for lab renovation
$185,777:
$4,200,000
1. ACTIVITY DESCRIPTION
Laboratory services are a critical component in the delivery of high quality health care system.They not only
provide the basis for good clinical diagnosis but also provide an objective means to monitor patient care and
disease trends. The role of the laboratory in HIV prevention and intervention strategies is increasingly being
recognized. The capacities of the laboratories will, therefore, need to be strengthened as Kenya scale up
HIV intervention programmes. A strong lab infrastructure will improve the health system overall and benefit
all disease control programs. Kenya's laboratory infrastructure has long been a source of concern for
providers of care particularly when initiating and continuing ARV treatment. A Kenya Service Provision
Assessment (KSPA) done in 2004 indicated that only 15% of hospitals had the five tests necessary to
manage STIs. The Physical infrastructure is dilapidated and many of the laboratories at district and lower
level were not purpose built. It is also recognized that an investment in equipment and reagents must be
balanced with investment in physical infrastructure to ensure service delivery. The purpose of this activity is
to improve the laboratory infrastructure in Kenya by renovating/building new laboratories. It is anticipated
that the implementer will work with the NPHLS and provincial health management teams in identifying the
laboratories that need improvement with a view to strengthening the provincial laboratory network and
priority district laboratories. It is anticipated that the implementer will ensure that the renovations
undertaken/buildings are in accordance with the standards defined by the NPHLS for each category of
laboratory. Thus this activity will help standardize renovations/buildings across the laboratory networks in
the country.
2. CONTRIBUTIONS TO OVERALL PROGRAM AREA
This activity will contribute to the continued implementation of the Medical Laboratory Services of Kenya
National Policy guidelines and the 2005-2010 strategic plan helping to provide standardized quality
laboratory services and ensure that laboratories have adequate and appropriate infrastructure.
3. LINKS TO OTHER
This activity will link to the support all PEPFAR prevention, care and treatment programs.
4. EMPHASIS AREAS / KEY LEGISLATIVE ISSUES ADDRESSED
The main emphasis area for this activity is infrastructure development.
Continuing Activity: 16545
Table 3.3.16:
Table 3.3.17:
In FY08, CDC programmed funds to RPSO in support of multiple construction and renovation projects,
primarily for MOH facilities and infrastructure. Projects included construction of a dedicated building for the
National AIDS and STI Control Program (NASCOP), renovations to Siaya District Hospital, lab renovations
and renovations to various MOH facilities. However, funds were programmed in the absence of building
plans, and without consultation with an architectural & engineering services contractor. Funds were also
allocated without considering the cost of an A&E contractor. Construction costs in Kenya have also
increased dramatically due to increased costs for materials, labor and fuel. Additional FY 09 funds are
sought to meet the expected funding shortfall resulting from the unplanned-for A& E services contracts, as
well as the under-estimated cost of construction.
Continuing Activity: 19431
19431 19431.08 Department of Regional 7000 4061.08 $350,000
Table 3.3.18:
across the program areas
+Cost Overrun Narrative
A total of $1,200,000 in FY 08 funds was programmed to RPSO for this purpose; however, these funds
Cost Overrun Narrative
primarily for MOH facilities and infrastructure. However, funds were programmed in the absence of building
increased dramatically due to increased costs for materials, labor and fuel. Additional FY09 funds are
Planned projects in FY08 included: renovation of national TB laboratories and microbiology laboratories,
construction of a dedicated building for the National AIDS and STI Control Program, multiple clinical site
renovations and construction, and hospital renovations.
Continuing Activity: 19418
19418 19418.08 Department of Regional 7000 4061.08 $1,200,000
Table 3.3.19:
