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
Elizabeth Glaser Pediatric AIDS Foundation implements a comprehensive HIV care and treatment program
in South Africa that is funded with Track 1 central funding, as well as South Africa COP funding. The
activities do not differ across the funding mechanisms, and this entry is thus a repeat of the South Africa
COP entry. All targets are reflected in the South Africa COP entry.
The long-term goal of the EGPAF care and treatment program in South Africa is to increase life expectancy
amongst HIV-infected persons by increasing access to care and treatment services and service utilization.
Primary emphasis areas are human capacity development and expansion of services through training and
task shifting, local organization capacity building, development of infrastructure, policy and guidelines, and
strategic information. Primary populations to be targeted include infants, men and women, pregnant women,
people living with HIV (PLHIV), and public and private healthcare providers.
Project Help Expand ART (HEART) will expand geographic coverage of services in FY 2008. HEART/South
Africa is part of a larger worldwide initiative by EGPAF to support care and treatment services, and receives
both Track 1 and in-country PEPFAR funding. The program's focus is on integrating PMTCT services to
provide a family-centered model of care that includes access to treatment for HIV-infected pregnant women,
couple counseling, partner testing and screening for TB.
EGPAF utilizes PEPFAR resources to complement those of the KwaZulu-Natal (KZN) Department of Health
(DOH) and private partners, such as faith-based organizations (FBOs) and other non-governmental
organizations (NGOs). These resources fund staff, infrastructure, drugs, laboratory testing and provide
technical support. EGPAF will identify gaps in the program at the site level and implement activities to
address the needs. The intent is to facilitate national and provincial plans and work with the government and
partners to transition programs to South Africa government (SAG) support.
EGPAF has a partnership with a private NGO, the AIDS Health Care Foundation (AHF); this is a cost-
sharing relationship (drugs and staff) to support the AHF care and treatment program. McCord Hospital, a
faith-based organization, is a sub-grantee of EGPAF. The EGPAF partnership with the DOH includes
support for human capacity development, infrastructure rehabilitation and technical support for sites in KZN.
The existing sites are:
(1) McCord Hospital, Durban;
(2) AHF (Ithembalabantu Clinic), Umlazi, Durban;
(3) KZN DOH, Pietermaritzburg Up/Down-referral program (Edendale Hospital and four referral clinics,
Northdale Hospital and five referral clinics); and
(4) KZN DOH, Vryheid Hospital plus three referral clinics, Benedictine Hospital and three referral clinics,
and Edumbe Community Health Centre (CHC) plus one referral clinic, in Zululand District.
This partnership with the DOH will be expanded to the whole Free State province, to Ramotshere Moiloa
(Zeerust) and Tswaing (Delareyville) sub-districts in the North West, to all of the Umgungundlovu and
Zululand districts in KZN, and the Eastern Ekurhuleni and Lesedi sub-districts in Gauteng.
ACTIVITIES AND EXPECTED RESULTS:
ACTIVITY 1: Human Capacity Development
EGPAF will support training of healthcare providers on the following:
1. Screening and treatment of TB/HIV and opportunistic infections, ART in pregnancy, and referral systems
(between PMTCT and ART);
2. Supporting systems to improve access to care and treatment of children (including early infant diagnosis);
3. Capacity building at sites for implementation and management of the comprehensive care, management
and treatment support program;
5. Project management; and
6. Funding health workers to complete a HIV and AIDS Diploma at the University of KwaZulu-Natal.
In addition EGPAF will provide technical assistance for the creation of outreach programs to build capacity
at primary healthcare (PHC) clinics for downward and upward referral in order to maintain patients on ART,
initiate new patients on therapy, and decongest treatment sites that have reached capacity.
ACTIVITY 2: Down Referral Process
The KwaZulu-Natal Health Department (KZNDOH) started providing comprehensive care and treatment
services to HIV-infected patients in May 2004 at hospital level. PHC clinics will be capacitated so that they
are able to manage stable patients on ART referred down from the hospitals or community health centers
(CHCs), and also up refer those that are eligible for initiation of ART to hospital or CHCs that are ARV
The KZNDOH aims to make ART accessible to all by expanding and strengthening existing HIV and AIDS
care and treatment service delivery. A number of CHCs have been accredited by the national and provincial
health departments and will initiate ART. The PHC clinics conduct rapid HIV testing, CD4 testing and
provide the first, second and third adherence counseling sessions, which is also done at CHC and hospital
level, and then refer patients to accredited CHCs or hospitals for initiation. The KZNDOH has identified the
Pietermaritzburg and Zululand Districts as areas needing immediate support as they are poorly resourced
with high HIV seroprevalence rates. The KZNDOH has requested that EGPAF support be extended to these
districts. The districts have identified clinics where stable patients on treatment can be referred to continue
ACTIVITY 3: Pediatric Care and Treatment
Activity Narrative: EGPAF's goal is to ensure that 10 percent of all patients on treatment are children, which has not been
achieved in the Zululand district. To strengthen pediatric HIV care and treatment, EGPAF will provide
training on early infant diagnosis, pediatric HIV clinical staging and diagnosis and ART in children, in
addition to provision of staff, strengthening the linkages between PMTCT and care and treatment.
The Edendale and Northdale pediatric HIV clinic has the largest cohort of pediatrics in the province on ART.
The hospital down refers stable patients to the care of the PHC clinics to free up space for new pediatric
EGPAF aims to:
1. Increase the rate of down referral of stable children on ART;
2. Increase the up referral of new eligible children for initiation of therapy; and
3. Improve linkages between PMTCT programs and care and treatment programs.
EGPAF will provide financial and technical support to eight PHC clinics in the catchment area of the
Edendale and Northdale hospital in Pietermaritzburg, thus capacitating them to: (1) receive and manage
transferred stable pediatric patients on ART from the pediatric HIV clinic; and (2) provide screening and
preparation of eligible HIV-infected patients at three PHC facilities for up referral and initiation of ART at
Edendale Hospital Pediatric HIV clinic. The same approach will be applied as we expand to other provinces,
namely Free State, North West and Gauteng Provinces.
ACTIVITY 4: Counseling and Testing (CT)
The focus will be strengthening comprehensive HIV and AIDS care and treatment services using a family-
centered approach to increase access to CT, by fast-tracking TB, STI, and family planning patients to CT; to
integrate PMTCT with HIV and AIDS care and treatment; to improve referral of eligible pregnant mothers,
partners, family members, and HIV-infected infants and children to treatment sites; to screen for
opportunistic infections. With this focus, EGPAF will increase pediatric care and treatment, couple
counseling, partner testing, and testing for siblings. For patients who test HIV positive and are not yet
eligible for ART, they will be retained through wellness clinics, support groups, patient tracking, etc. The
overall goal is to expand coverage of HIV and AIDS care and treatment services to reach mothers, partners
and children who would not otherwise have access to these services.
The increase in funding in FY 2008 will be used to expand EGPAF program activities viz. human capacity
development, down-referral process, pediatric care and treatment as well as counseling and testing
activities to the Free State, North West and Gauteng Province. In addition, EGPAF will strengthen M&E
systems at all levels of service delivery.
The activities contribute to the PEPFAR 2-7-10 goals.