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:
The program is essentially the same with updated targets. The program will continue to focus on expanding
the counseling and testing (CT) models available in South Africa and on increasing male and couple CT.
The program also will focus on strengthening tuberculosis (TB)/HIV management by screening all clients for
TB, referring clients for TB treatment, providing CT at TB facilities and offering routine offer CT training to
TB facilities. The program was developed in cooperation with the South African Government and the
leveraging of Global Fund support through the South African National AIDS Committee further strengthens
the alignment of the program with government's policies, priorities and strategic plan. Through Global Fund
support the program is developing activities in new provinces in cooperation with provincial departments of
health. New Start is a member of the National VCT Steering Committee and all relelvant provincial VCT
committees. The program has been modified for FY 2009 in the following ways:
The Society for Family Health (SFH) is currently in negotiation with Dischem, South Africa's second largest
retail pharmacy chain, to provide New Start CT services within up to 33 Dischem retail pharmacies. This
partnership will be similar to New Start's franchise partnerships, with the exception that Dischem will not
require a sub-award. The costs of this partnership are clearly identified in our FY 2008 continuation
application budget. Through this partnership, Dischem in-store clinic staff will be trained and supported by
New Start. Dischem will promote and advertise CT services. Dischem has agreed to charge a standard
R25 fee for service. This partnership, which will bring high quality CT services to for-profit retail
pharmacies, will expand the range of models of CT in an innovative, low-cost and sustainable manner.
Because of an inability to get national level buy-in to our national testing week plans, SFH, Right to Care
and Leonie Selvan Communications currently are developing provincial-level testing week campaigns to
take place in late 2008. These campaigns will bring together New Start and other CT service providers in a
week of intensive testing, preceded by a mass media education and promotion campaign. The campaign
will also focus on the provision of quality CT services and provide support to participating CT service
providers. There currently is no day or week reserved for the promotion of CT in South Africa. This
campaign will take place in three provinces and hopefully expand nationally in future years.
SFH proposes adding an additional sub-awardee, Shout-it-Now. Shout-it-Now is a non-profit organization
established in 2007 which aims to eliminate the spread of HIV amongst adolescents. The organization
works in schools, in partnership with provincial government, health experts and corporate sponsors to
deliver MTV-style HIV prevention training and information to teenagers. Cutting-edge interactive video
programmes aim to help young people to protect themselves from HIV infection, unwanted pregnancy and
STI's. Shout-it-Now's message, coupled with innovative technology and HIV testing, aims to change teen
behaviours and reduce the rate of new HIV infections. New Start currently works with Shout-it-Now in
Western Cape, providing CT services to students after they complete the program. The program also will
add an additional four franchise partner NGOs.
Based on a plan approved by the Centers for Disease Control and Prevention (CDC) South Africa and in
cooperation with provincial departments of health, New Start will begin a home-based door to door CT pilot
project.
The program will aim to increase its percentage of couple clients. Although the New Start program probably
sees more couples than any other CT program in the country, our proportion of clients who come for CT as
a couple is currently only 6%. Mass media and/or promotional activities will promote couples CT, as will
door to door CT.
-----------------------
SUMMARY:
This project promotes a mix of community-based and clinical counseling and testing (CT) models. The
Society for Family Health and the Population Services International (SFH/PSI) will manage a franchise
network (under the brand name, New Start) of 12 stand-alone CT sites, each with a mobile CT program.
From these CT sites, SFH will provide training and support to at least six healthcare facilities to increase the
number of tuberculosis (TB) patients who receive HIV CT in clinical settings, and to private healthcare
workers to enable them to make CT a routine part of medical care. Emphasis areas include community
mobilization/participation, development of network/linkages/referral systems, local organization capacity
development, quality assurance/quality improvement/supportive supervision and training. Primary target
populations include men and couples for CT in non-medical settings, and TB patients for CT in medical
settings. Higher risk populations such as prisoners, sex workers, and men who have sex with men are
targeted when possible.
BACKGROUND:
Activities are ongoing. New Start opened in December 2004. At this time, 83% of FY 2006 has elapsed and
New Start has achieved 76% of its FY 2006 client flow goal and exceeded its training target. The program
addresses gender issues primarily by targeting men and couples for CT. To date, 52% of clients are male
and 11% are couples. Although funding for the TB/HIV project only arrived in July 2006, one medical facility
in Durban was able to begin working with New Start in August, 2006. SFH works closely with and has
strong support from the South African government at national and provincial levels. The program started off
with PEPFAR funding and today is co-funded by the South African government.
ACTIVITIES AND EXPECTED RESULTS:
ACTIVITY 1:
SFH will manage a network of 12 stand-alone CT sites, each operating a mobile and workplace CT
Activity Narrative: program. SFH will manage three sites, and partner NGOs will manage the remaining nine sites. SFH will
provide technical, financial, management, marketing, and quality assurance support to the nine sites. The
nine partner-managed "franchise" New Start sites will open in late 2006 and early 2007. Non-profit CT
franchising has proven effective at building the capacity of local NGOs to provide CT services and increase
client flow. New Start franchising is based on standardized systems for management, training, supervision,
quality assurance and referrals and linkages to other services. SFH, the South African government and the
National Institute for Communicable Diseases (NICD) will train New Start counselors and testing staff. SFH
and NICD will carry out quality assurance. Marketing activities will use radio, public relations, print media
and community mobilization to reach men and couples. Beginning in late 2006, Levi's will promote New
Start services through Levi's stores, Levi's sponsored mobile CT and Levi's media activities. Mobile CT and
below-the-line marketing will continue to target prisoners, men who have sex with men, and commercial sex
workers when possible. Mobile CT activities will expand and work with a variety of hosts - including
workplaces, NGOs, communities, churches, and government agencies such as the prison system and the
commuter rail system. New Start has an agreement with the Anglican church to provide CT services
through its parishes. New Start CT protocols include non-medical TB and STI screening. Each New Start
site has a site-specific referral guide to allow counselors to refer clients to an array of post-test care and
support services. Each New Start site also has a Referral Coordinator to maintain linkages with referral
points. From New Start sites, SFH will provide training and support to NGOs not part of the New Start
network in CT service provision and to private doctors in routine offer CT using rapid test kits. These
training and quality assurance activities will be carried out in partnership with NICD and the FPD, the
training arm of the South African Medical Association.
ACTIVITY 2:
SFH will increase the number of TB patients who are tested and referred for HIV treatment. The project will
partner with and mentor NGO, private sector and/or government facilities, strengthen already existing
systems and work to fill important gaps where the testing and referral of TB patients can be improved. The
support provided to these TB healthcare providers will depend on the needs of the facilities. Support will
include some or all elements of the following assistance models: (a) SFH will provide training and support to
partner organizations in routine provider-initiated CT, so that partner organizations can introduce routine
testing for TB patients. (b) SFH will provide training and support to partner organizations in client-initiated
CT, so that partner organizations can introduce and manage their own CT operations in TB facilities. (c)
SFH will create New Start satellite operations at TB facilities. Partner organizations will provide space and
support to New Start to provide CT from TB facilities on a daily basis. (d) SFH will provide training and
support to partner organizations who wish to open New Start franchises within TB facilities.
Franchise partners will be fully integrated into the New Start network. Gender issues will be addressed
through targeting men and couples for CT services, including testing targeting male construction
workers. Testing rates among men are low. Encouraging couple CT allows women a structured
environment to address HIV issues with their male partners. Diminishing HIV stigma is best achieved by
increasing the number of people who learn their HIV status and disclose to family and friends. The
proposed activities encourage sustainability by focusing on human capacity and organizational
development. Franchising develops the capacity of a network of NGOs to provide high quality services,
including the development of workplace programs that bring in revenue to partner NGOs. The proposed
activities also encourage a sustainable response to the need to test large numbers by providing training and
support to private doctors to make CT a routine part of medical care. Mobile CT activities bring
together non-health sectors of society such as churches or workplaces in the fight against HIV.
ACTIVITY 3:
PSI/SFH will develop and carry out a mass media campaign to encourage HIV counseling and testing.
PSI/SFH will work in partnership with at least one private sector partner. The campaign will be national and
will culminate in a one week testing drive. This testing week will bring together PSI/SFH's New Start static
site and mobile testing services, the testing services of other service providers, including other NGO and
Government of South Africa testing services. The campaign's private sector partner will associate its brand
with the campaign and spend its own funds on the campaign. Media used will include television or radio and
public relations. The campaign and one-week testing drive will take place in late 2007 or early 2008. SFH is
developing the campaign, selecting campaign target groups, determining private sector partners and
developing testing targets. SFH will work closely with the government of South Africa
to ensure that the campaign has government support and buy-in at all levels.
ACTIVITY 4:
SFH will partner with Careworks, a private organization which provides healthcare services. Careworks will
provide mobile CT services to men in construction works and in mining throughout the country. This activity
is aimed at reaching men who would otherwise not access testing services at public healthcare facilities.
New/Continuing Activity: Continuing Activity
Continuing Activity: 13784
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
13784 3095.08 HHS/Centers for Population 6607 3509.08 PSI $6,650,783
Disease Control & Services
Prevention International
7855 3095.07 HHS/Centers for Population 4609 3509.07 PSI $6,313,000
3095 3095.06 HHS/Centers for University 3509 3509.06 PSI/SFH $1,225,000
Disease Control & Research Replacement
Prevention Corporation, LLC
Emphasis Areas
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
Workplace Programs
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $430,397
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.14: