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
The Foundation for Professional Development (FPD) supports the expansion of access to comprehensive
HIV and AIDS palliative care by focusing on human capacity development with a view to increasing the
detection and treatment of patients with TB and HIV co-infection. The emphasis areas for these activities
are local organization capacity building and HCD. Target populations for these activities include people
living with HIV and AIDS (PLHIV) and most at risk populations.
FPD is a South African Private Institution of Higher Education working exclusively in the health sector in
Southern Africa. With PEPFAR funding, FPD supports the public sector expansion of access to
comprehensive HIV and AIDS care by focusing on provision of antiretroviral therapy (ART) and increasingly
basic health care (wellness programs) for people living with HIV (PLHIV) who do not yet require ART. Due
to the acknowledged drop-off of patients who test positive for HIV between testing and actually entering
ART the basic care program attempts to provide a continuum of basic care at places of testing to ensure
retention of patients.
This approach allows patients to be enrolled in a care support program that allows regular contact with
health care providers, monitoring of CD4 counts and early referral of patients into ART programs. Activities
include supporting the establishment of such programs in public sector, NGO and FBO CT sites, through
the provision of staff, training, equipment purchase, technical assistance, mentoring, and refurbishment of
facilities. Care programs offer psychosocial support through support groups and individual counseling and
treatment of opportunistic infections. The program also includes dedicated staff (tracers) who follow-up on
any patients who drop out of the program to determine the reason and where possible attempt to convince
such patients to return to the program. The emphasis areas for this activity are human capacity
development, gender, local organization capacity development and construction and renovation.
Coordination with provincial Departments of Health (DOH) takes place through Memorandums of
Understanding (MOUs). FPD provides substantial assistance initially to public sector facilities and works
towards a diminished role over time, working towards sustainability at the sites. Sub-agreements are used
to partner with NGOs and FBOs to provide care support services where public sector facilities are either
overcrowded or not accessible. Gender issues are embedded in all aspects of the project and include
collecting gender-specific data in treatment programs, linkages with NGOs working in the gender field, CT
services that specifically focus on couple counseling, domestic violence and abuse detection. Other issues
addressed by this project are: 1) Male norms and behaviors that are addressed in the counseling provided
at basic care sites. All staff actively work towards reducing violence and coercion by identifying victims of
ACTIVITIES AND EXPECTED RESULTS:
ACTIVITY 1: Support to Government ART, CT and PHC clinics
PEPFAR funds are used to respond to requests from provincial DOH to support South African Government
(SAG) ART, CT and Primary Health Care Clinics (PHC) through temporarily seconding clinical and
administrative staff, providing equipment, refurbishment and technical assistance. The FPD-supported staff
will play a critical role in introducing the provision of basic care programs at these sites as they will
supplement to government staff. Patients enrolled in such programs will be linked into the electronic patient
record system currently supporting patients on ARVs to allow patient tracking, mentoring by FPD specialists
and early referral to treatment facilities.
ACTIVITY 2: Support to NGOs and FBOs
Numerous NGOs and FBOs in the areas where FPD supports ART services are involved with CT activities
but seldom provide basic care, FPD will partner with these organizations to expand their services to include
a basic care component, including regular monitoring of CD4 counts at six month intervals, diagnosis and
treatment of opportunistic infections and psychosocial support. Patients enrolled in such programs will be
linked into the electronic patient record system currently supporting patients on ARVs to allow patient
tracking, mentoring by FPD specialists and early referral to government treatment facilities. It is anticipated
that this activity will also leverage existing resources in these organizations in support of basic care
programs and to expand the services provided to patients enrolled in the basic care program especially for
psychosocial support and income generation. FPD will also provide additional support through its Compass
Project, an organizational development project funded by the Dutch Government. This project provides
technical assistance to help develop and strengthen these local organizations in the areas of governance,
management, and M&E.
ACTIVITY 3: Referral and linkages
FPD will continue to strengthen and expand the referral networks and linkages of its partner NGOs and
CBOs with care and treatment services for clients identified to be HIV-infected. Linkages with community
mobilization and outreach activities will be initiated to promote the uptake of both HIV CT and basic care
services, including the regular monitoring of CD4 counts, treatment of opportunistic infections including the
provision of cotrimoxazole, and psychosocial support.
FY 2008 COP Activities: Although FPD has not in past years been funded for basic care activities such
activities were conducted at the ART sites that FPD supports. New activities will include expanding care
support activities to where CT takes place in both public and civil society facilities. This will help to ensure
that those who are HIV-infected but not yet eligible for treatment are enrolled in a care program. Where
feasible such programs will also be introduced at Primary Care facilities. A critical component will be
integrating patient data from basic care programs into the electronic record system that currently supports
patients on ART; this will allow better patient tracking and referral and allow the FPD clinical mentoring team
to also support patients on basic care.
FPD will contribute to the PEPFAR goals of 2-7-10 by developing the capacity of organizations to expand
access to ART services for adults and children, building capacity for monitoring ART service delivery and
Activity Narrative: reaching thousands of individuals with care and ART.
The program supports the expansion of access to comprehensive HIV and AIDS care by focusing on
service delivery and Human Capacity Development with a view to increasing the detection and treatment of
patients with TB and HIV coinfection. The emphasis areas for these activities are construction/renovation
and HCD. The target populations for these activities include people living with HIV and AIDS (PLHIV), and
most at risk populations.
The Foundation for Professional Development (FPD) is a South African Private Institution of Higher
Education working exclusively in the health sector in Southern Africa. PEPFAR funding has allowed large
scale training and antiretroviral treatment to take place over the past year. FPD supports ART sites that are
in high TB prevalence areas with case rates ranging from 300-1500:100,000 and as such there is a need to
integrate TB and HIV services, improve the diagnosis and treatment of TB and provide training to health
care professionals on TB/HIV in FY 2008. FPD provided training to over 800 clinicians and nurses on the
management of TB/HIV during FY 06 and introduced programs in all the ARV clinics it supports to increase
the identification of TB/HIV co-infected individuals while in FY 2007 the emphasis is on strengthening TB
treatment sites with regard to identification of HIV co-infected individuals an initiation of ART at such sites.
Treatment related activities are closely coordinated with provincial Departments of Health (DOH) through
memorandums of understanding (MOUs) with provincial DOH and through close coordination with district
TB programs. National Department of Health (NDOH) guidelines are also incorporated in all activities and
training programs. A gender focus is built into all aspects of the project ranging from ensuring gender parity
in uptake of testing and treatment, including gender in data collection, all counselors will be trained on
aspects relating to male norms and behavior and equal access to training activities will be ensured. It is
envisaged that FPD will be the main project implementer; however, sub-agreements with CBOs and FBOs
may be used to increase community participation and to increase CT for TB and HIV. This project will place
specific emphasis on gender issues in the context of the CT activities. All CT staff will be trained and
provided with counseling tools in order to equip them to undertake couple counseling, identify, counsel and
refer victims of sexual abuse and violence, and reduction of stigma and discrimination. Most of these
activities will be aimed at strengthening the public healthcare system, promoting closer cooperation
between the public sector and civil society institutions, and developing human capacity. Activities will offer
sustainable and long-term benefits for the South African healthcare system.
FPD will continue to work with the national and provincial departments of health and specifically with the
HAST (HIV, AIDS STI, and TB) managers to prioritize interventions designed to address weaknesses
(identified by the departments of health) in the DOTS and TB/HIV programs. FPD will focus on improving
policy adherence and patient follow-up. Individuals will be hired for each site as tracers to track patients and
ensure that referrals are completed. FPD is setting aside funding to develop (with other relevant partners or
agreement counterparts) standardized tools to ensure that policies and guidelines recommended by NDOH
are followed, including guidelines for infection control. FPD will continue to integrate TB/HIV interventions
with existing agreement programs as they work seamlessly and side by side with government employees at
ACTIVITY 1: Support to South African Government
PEPFAR funds will be used for human resources at public sector ART sites and surrounding TB clinics.
Funds will be utilized predominantly and in the form of salary support for FPD staff seconded to these sites.
Sustainability will be ensured through strengthening systems and developing and supplementing capacity of
existing government staff to increase identification of TB/HIV co-infected individuals, through promoting
routine HIV CT for TB patients and routine TB screening of HIV patients at ART treatment sites. This will
allow in time withdrawal of FPD seconded staff. Emphasis will also be placed on strengthening systems and
developing and supplementing capacity to increase identification of TB/HIV co-infected individuals, through
promoting routine HIV counseling and testing (CT) for TB patients and routine TB screening of HIV patients
at TB treatment sites. Dedicated and cross-trained TB/HIV counselors will be placed at all TB sites who will
actively promote CT among TB patients. TB Nurses will be deployed to all ARV sites and tasked with
increasing the diagnosis of TB, especially sputum-infected TB in patients receiving ART. TB screening will
be done by nurses following a protocol of history taking, routine sputum specimens, and x-rays as needed,
and suspected smear-negative TB will be referred to an infectious disease clinician. These dedicated
nurses will also ensure a fast track for patients requiring TB therapy and will maintain contact with patients
to ensure they are not lost to ART. Co-infected patients who are on ARV treatment and TB treatment
simultaneously will receive additional clinical monitoring due to the increased risk of Immune Reconstitution
Syndrome, and challenges in the profiling of side effects. Emphasis is placed on adherence support to
address the heightened risk of non-compliance due to high pill burden, and to cope with higher incidence of
side effects due to drug interaction and overlapping hepatotoxicity. This activity plays an institutional
strengthening role at TB sites with a view to such sites becoming ART down referral sites. PEPFAR funds
will also be used to address minor infrastructure needs e.g. sputum rooms, nebulization apparatus and
mobile x-ray facilities to improve the diagnosis and infection control of TB transmission. Funds will be
utilized for culture and sensitivity tests where MDR-TB is suspected if government protocols or facility
budgets do not make provision for such testing.
ACTIVITY 2: Outreach
Active TB case finding will be utilized at selected sites to increase uptake of TB and HIV testing among
contacts of patients with TB and HIV coinfection. Dedicated staff (mentioned in Activity 1) will actively trace
all contacts of TB patients on treatment to encourage the participation of these contacts in CT for both TB
and HIV. ACTIVITY 3: Human Capacity Development. This activity ensures a cadre of skilled healthcare
practitioners, in predominantly government service, who are able to provide care to PLHIV who are co-
infected with TB. Healthcare workers will be trained on various subjects such as: clinical management of
AIDS and TB, Management of CT, Palliative care, and Adherence and Workplace, using a proven short
course training methodology that provides training close to participants work. PLHIV form part of the faculty
to help with stigma reduction among participants and to articulate the needs of PLHIV. To maintain
Activity Narrative: knowledge, an alumni program of newsletters and regular refresher sessions has been developed. Given
the high risk that MDR-TB poses for immune compromised individuals, particular emphasis will be placed
on training facility managers, facility designers and clinical managers on infection control. Training takes
place in all provinces for both public and civil society organizations, for public sector training such training is
coordinated with relevant HR Departments. ACTIVITY 4: Referral and linkages. The strengthening and
expansion of referral networks and linkages with care and treatment services for clients identified TB/HIV co
-infected will be a central focus of the project. Linkages with community mobilization and outreach activities
will be initiated to promote the uptake of both TB and HIV CT services PEPFAR funds may be utilized in the
form of sub-awards for NGOs working in the field of DOT support and community outreach.
FY 2008 COP activities will expand on the activities successfully started in previous years. FPD will
contribute to the PEPFAR goals of 2-7-10 by developing the capacity of organizations to expand access to
ART services for adults and children, building capacity for monitoring ART service delivery and reaching
thousands of individuals with care and ART.
This Foundation for Professional Development (FPD) project focuses on promoting early diagnosis of HIV
as an entry point to wellness programs and access to prophylactic treatment. FPD will expand counseling
and testing (CT) activities through various models ranging from institutional based CT at antiretroviral
treatment (ART) sites to introduce new easily accessible CT at sites based in civil society e.g. pharmacies,
faith-based organizations (FBOs), tertiary academic institutions and private medical practices. FPD will
focus on offering routine CT (RCT) to all patients admitted to public sector hospitals where FPD supports
ART services. All patients who test positive will be referred to wellness programs to reduce loss to treatment
initiation. The emphasis areas are gender, human capacity development and local organization capacity
development. The activities will directly and indirectly target people living with HIV (PLHIV) and most-at-risk
FPD is a South African private institution of higher education working exclusively in the health sector in
southern Africa. PEPFAR funding has enabled large-scale training and substantially increased access to
ART. FPD has not received PEPFAR funding for CT activities in the past, even though CT services are an
integral part of the comprehensive care package offered at a number of FPD-supported clinics since FY
2004. To date, FPD has provided training for approximately 800 clinicians and nurses on CT. Coordination
with provincial Departments of Health (DOH) takes place through Memorandums of Understanding (MOUs).
The project will focus on various gender-related activities. It is envisaged that FPD will be the main project
implementer, but given that this is a new project activity, sub-agreements with local non-governmental
organizations (NGOs) and FBOs may be used to increase community participation and to increase CT
FPD's activities will be aimed at strengthening the existing healthcare system, promoting closer cooperation
between the public sector and civil society institutions, and developing human capacity. It is expected that
all activities will offer sustainable and long-term benefits for the South African healthcare system.
ACTIVITY 1: Support to the South African Government at the sites where FPD is supporting treatment
FPD will increase dedicated staff who will focus on expanding CT services for couples, infants and children
and adults, as well as cross-testing (testing STI and TB patients for HIV and vice versa). Dedicated CT
nurses and counselors will offer RCT for all patients moving through these healthcare facilities. Standard
registers and negotiated performance targets will be used to drive this activity and monitor its
implementation. PEPFAR funds will largely be used for human resources (e.g. nurses and lay counselors).
PEPFAR funds will also be utilized for training and to address minor infrastructure needs where necessary
for the delivery of CT services at government, NGO, and FBO sites. PEPFAR funds will be utilized for the
procurement and distribution of HIV test kits if necessary and may be utilized for CD4 count testing where
such tests are required to increase access to care.
ACTIVITY 2: Establishment of New CT Sites
FPD will introduce new civil society based CT services at easily accessible sites such as private medical
practices, private pharmacies, tertiary educational facilities, mobile testing sites and NGOs and FBOs. In
addition, FPD will expand of CT services in the existing treatment services sites. Outreach activities will be
introduced to create awareness of these services in the larger community with specific emphasis on at risk
groups and vulnerable populations. The introduction of new testing sites at NGOs, FBOs, student
healthcare services, private practices, and private pharmacies will ensure the widespread and sustainable
availability of CT services. Emphasis will be placed on promoting client-friendly rapid testing facilities. The
introduction of CT services in venues that are not perceived as having an HIV or AIDS connotation (private
pharmacies or private medical practices) will contribute to overcoming stigma induced barriers to accessing
CT due to fears of being seen at an "AIDS facility". Staff will be trained on proper recording and data
ACTIVITY 3: Human Capacity Development
FPD will provide training in CT services for medical practitioners, lay counselors, and nurses to ensure strict
adherence to CT protocols and high quality counseling. This activity emphasize gender issues as all
participants and CT staff will be trained on couple counseling, identifying and referring of victims of sexual
abuse and violence, and stigma reduction. The program will address gender by creating an ARV-related set
of services that will increase gender equity through mitigating the burden of care on women. At the time of
CT and other ARV related services women will be identified and -- if they fit the profile -- will be referred to a
number of faith-based programs that also support the clinics and CT sites. These faith-based programs
provide women with resources ranging from accommodation, to nutritional support and job creation
programs. Male norms and behaviors are addressed in the counseling provided at these facilities and all
staff actively work towards reducing violence and coercion by identifying victims of violence. The FBO
partners provide a shelter for female victims of violence. Training takes place in all provinces for both public
and civil society organizations. For public sector training such training is coordinated with relevant human
ACTIVITY 4: Linkages and Referrals
The strengthening and expansion of referral networks and linkages with care and treatment services for
clients identified as HIV-infected will be a central focus of the project. FPD will link with local CBOs, NGOs,
and FBOs to increase demand for CT services and to help with referral and follow up. All CT staff will be
trained on referrals and linkages. Each CT site will have a list of local service providers that patients can be
referred to. All referrals will be bi-directional and followed up to make sure that clients are accessing the
services and providers are providing the services. PEPFAR funds will largely be used for human resources
(e.g. nurses and lay counselors) in support of CT services.
PEPFAR funds will largely be used for human resources (e.g. nurses and lay counselors) in support of CT
services. PEPFAR funds will also be utilized for training and to address minor infrastructure needs where
necessary for the delivery of CT services at government sites. The government will provide test kits at
government sites and kits will be purchased for use at non government sites. Funds may be utilized for CD4
count testing where such tests are required to increase access to care. FPD will also expand new civil
society based CT services at easily accessible sites such as tertiary educational facilities, NGOs and FBOs.
Outreach activities will be introduced to create awareness of these services in the larger community with
specific emphasis on at risk groups and vulnerable populations. The introduction of new testing sites at
NGOs, FBOs, student healthcare services will ensure the widespread and sustainable availability of CT
services. Emphasis will be placed on promoting client-friendly, provider-initiated, rapid testing.
The above activities will be continued in FY 2008. Activities will be expanded to at least 20 new sites in FY
The Foundation for Professional Development's (FPD) treatment activities focus on building public and
private sector capacity to deliver safe, effective and affordable antiretroviral therapy (ART). PEPFAR funds
will be used to procure ARVs and other drugs to support the expansion of faith-based organization (FBO)
treatment services in Pretoria (Gauteng province), one facility in the inner city and one in a nearby township.
Services will be expanded at the Pretoria Inner-City Clinic (PICC) in collaboration with a faith-based
coalition, the Tshwane Leadership Foundation and at Leratong Hospice. Both sites have been developed by
the not-for-profit private sector, and antiretroviral drugs will only be provided to residents who cannot access
public sector treatment for specific reasons. The Leratong Hospice will begin providing ART through
PEPFAR funding in 2007. For all of the Gauteng Department of Health (GDOH) facilities assisted by FPD
other than the PICC and Leratong Hospice, drugs are provided through the South African Government's
(SAG) ART roll-out program. The emphasis areas are construction/renovation, gender, human capacity
development (HCD) and local organization capacity building. Target populations for the activities include
the general population and people living with HIV (PLHIV). FPD will consider using the Partnership for
Supply Chain Management to assist with the procurement of drugs.
Southern Africa. Previous PEPFAR funding has allowed the training of thousands of healthcare
professionals and supported the provision of ART to thousands of PLHIV in South Africa. It provides
assistance to over 25 large public sector ART roll-out facilities. Although the SAG has a robust ARV roll-out
program, it is not universally accessible. This project provides ART and related services to vulnerable
groups living in the inner-city of Pretoria and in one of the surrounding townships who cannot afford private
care and do not have access to public sector care due to factors such as long waiting lists, inability to pay
minimum public sector user fees, fear of discrimination, and stigma.
Started with FY 2006 funding, this project partners FPD in a strategic alliance with the Tshwane Leadership
Foundation and the Leratong Hospice who operate clinics that do not provide ARVs. Both partners are
FBOs that currently provide social welfare services to PLHIV in the city, including hospice care. FY 2006
funds were used at one of these facilities to serve as a rapid initiation and stabilization site for patients
whose lives are at risk due to long waiting lists. Negotiations are currently underway with the GDOH to have
these clinics accredited as down referral sites for the major ART clinics at Tshwane District Hospital and
Kalafong Hospital (both already supported by FPD). Every effort is made at all facilities to reduce stigma
through staff training, one-to-one counseling, and counseling for families and support groups. Sustainability
is partially addressed through the public-private partnership (PPP) with the Tshwane Leadership
Foundation. This organization brings together a large number of churches in the city and has access to
additional funding sources to support the project. In addition, the government supports all drugs and labs. It
is only at one clinic where FPD provides drugs. FPD is working on getting this clinic accredited so that the
provincial government will supply the drugs. FPD is also working with government to transfer responsibility
for salaries when positions are filled.
ACTIVITY 1: Procurement and Distribution of Drugs
These sites provide an integrated ART service including treatment, palliative care, wellness programs and
psychosocial support for adults and children, and income generation schemes for women. The sites have a
minimum target of 10% of patients who will be children. PEPFAR funds will be used for the procurement
and distribution of ARV drugs for the PICC and the Leratong Hospice, supporting the salaries of necessary
doctors, nurses, pharmacists, social workers, counselors, and administrative staff. This project has a close
working relationship with an FBO consortium that supports the community of the inner-city and it is
envisaged that they will provide palliative care services and psychosocial support. Subject to needs
assessments, PEPFAR funds may be used to address minor infrastructure needs. Technical assistance and
systems strengthening will be provided for forecasting drug needs, procurement, storage, and related data
ACTIVITY 2: Human Capacity Development
Human capacity development is promoted by requiring all clinical staff at the three sites to attend mandatory
training. Training for staff at these sites will include training on supply chain management to ensure proper
procurement and related systems. The pharmacist that will supervise dispensing at all sites will also receive
refresher training. As part of the overall FPD program, FPD training ensures a cadre of skilled healthcare
practitioners able to provide care to PLHIV. Healthcare workers are trained in various courses, including
clinical management of AIDS and TB, counseling and testing, palliative care, adherence and workplace
AIDS programs using a proven short-course training methodology. PLHIV form part of the faculty to help
with stigma reduction among participants and to articulate the needs of PLHIV. To maintain knowledge, an
alumni program including regular continuing medical education (CME) opportunities, meetings, journals,
newsletters and mentorship has been developed. This program provides alumni with membership in a
relevant professional association (Southern African HIV Clinicians Society). FPD's public-private partnership
(PPP) with Eskom (large power and utility company) and Discovery Health (private health insurance
company) also financially support this training. All staff at the three PEPFAR-funded facilities will access all
of the training opportunities.
ACTIVITY 3: Quality Assurance/Supportive Supervision
Quality assurance mechanisms developed through a strategic alliance with JHPIEGO will be expanded to
these sites. These quality assurance mechanisms allow clinic staff to rate all aspects of service delivery
from drug procurement to patient care. This process will lead to continuous improvement of quality and will
be rated once a year by an external consultant. In addition, monitoring of CD4 counts, viral loads, and
resistance testing are part of the monitoring system.
This project will contribute to PEPFAR's 2-7-10 goals by expanding access to ART services for adults and
Activity Narrative: children, by building capacity for ART service delivery including the provision of ARVs, and increasing the
demand for and acceptance of ARV treatment.
The Foundation for Professional Development (FPD) program supports the public sector expansion of
access to comprehensive HIV and AIDS care by focusing on provision of care, and through human capacity
development (HCD). Activities supporting improved and expanded service delivery in public sector ART
clinics include the provision of staff, clinical and management training, equipment, technical assistance,
mentoring, and refurbishment of facilities. Additional HCD activities include an international volunteer and
an intern program. The emphasis areas for these activities are Human Capacity Development, Local
Organization Capacity Building and Workplace Programs. Target populations for the activities include
people living with HIV (PLHIV) and the Business Community. The activities also target most at risk
Southern Africa. Since FY 2005, FPD has supported treatment for thousands of PLHIV and training for
thousands of healthcare providers and managers delivering ART and related services. Coordination with
provincial Departments of Health (DOH) takes place through Memorandums of Understanding (MOUs).
FPD provides substantial assistance initially to public sector facilities and works towards a diminished role
over time, working towards sustainability at the sites. Sub-agreements are used for supporting a national
HIV consumer line (HIV 911). Gender issues are embedded in all aspects of the project and include
collecting gender specific data in treatment programs, linkages with NGOs working in the gender field,
counseling and testing (CT) services that specifically focus on couple counseling, domestic violence and
Other issues addressed by this project are: 1) Male norms and behaviors that are addressed in the
counseling provided at ART sites. All staff actively work towards reducing violence and coercion by
identifying victims of violence; 2) stigma and discrimination is addressed in counseling and training
programs; and 3) volunteers, including Peace Corps volunteers, will be involved at treatment sites.
ACTIVITY 1: Support to Government ARV Clinics
(SAG) ART sites through temporarily seconding clinical and administrative staff, providing equipment,
refurbishment and technical assistance. The FPD-supported staff play a critical role in service delivery and
have been able to reduce waiting times to less than a week at most facilities. FPD works with each public
sector site to determine the number of staff needed, and the timeframe for transferring them into SAG
employment. Most sites provide an integrated system of treatment and prevention, including CT and
wellness services. These services emphasize adherence and promote ART services among referral clinics
(TB, STI & Family Planning). All sites are also linked to a system of dedicated tracers who follow-up on any
patients who drop out of treatment to determine reasons and where possible try to encourage patients to
return to treatment. All sites are pediatric treatment sites and a minimum target is set at 10% of patients.
FPD's support to SAG ARV clinics will expand substantially to include increased numbers of patients.
ACTIVITY 2: Human Capacity Development (HCD)/Clinical Training
This activity ensures a cadre of skilled healthcare practitioners able to provide care to PLHIV. Healthcare
workers will be trained in various courses (clinical management of AIDS and TB, CT, palliative care,
adherence and workplace AIDS programs) using a proven short-course training methodology that provides
training close to where participants work. PLHIV form part of the faculty to help with stigma reduction among
participants and to articulate the needs of PLHIV. To update knowledge, an alumni program including
regular continuing medical education (CME) opportunities, meetings, journals, newsletters and mentorship
has been developed. This program provides alumni with membership in a relevant professional association,
the Southern African HIV Clinicians Society. Eskom (large power and utility company) and Discovery Health
(large health insurance company) are in a PPP with FPD to financially support this training.
Training takes place in all provinces for both public and civil society organizations. For public sector training
such training is coordinated with relevant human resources departments.
ACTIVITY 3: HCD/Management Training
This activity addresses the severe shortage of skilled managers within the public, NGO and FBO sector to
manage rapid scale-up of AIDS care through a one year management training program, offered in
association with Yale University, designed to develop local organizational capacity. Students are recruited
through a competitive scholarship program and graduates are enrolled with the SA Institute of Healthcare
Managers to provide them access to alumni services. Quality assurance mechanisms for Activities 2 and 3
are those currently prescribed by the Council for Higher Education for SA Universities. Impact studies and
participant surveys and external impact assessments are also conducted on a regular basis to assess
relevance quality and impact. Results of these surveys are used to make revisions to the management
training program. The management training program will be expanded in FY 2008 to introduce a lower level
operational management course geared at clinic rather than program managers. A need for such training
has been identified during the past two years of management training that has shown that the skills needed
at the clinic manager level is much more operational rather than strategic, the current management training
program does not meet the specific need of this more junior level managers.
ACTIVITY 4: HCD/Internship Program
There is a growing need for rapid expansion of the development of human capacity to support ARV
treatment programs. Based on the success of the current internship program that improves the skills of
graduate students by partnering them with implementing PEPFAR partners or public sector institutions, FPD
will continue to support a formalized HCD Program. FPD is well placed for this activity as training and HCD
activities are FPD's core business. The USG PEPFAR Task Force is developing a more robust HCD
Activity Narrative: strategy, and this activity will contribute to that strategy. FPD will coordinate with universities and other
institutions to recruit interns and will mentor both the intern and the recipient organization to ensure that
interns are optimally utilized to promote treatment initiatives.
ACTIVITY 5: HCD/Placement Project
This activity further expands FPD's role in HCD in the public sector by providing a user-friendly recruitment
mechanism that attempts to meet severe shortages of healthcare workers in the public sector by recruiting
local and internationally qualified professionals against public sector funded vacancies, on both a
remunerated and voluntary basis. Support provided includes matching applicants with vacancies, fast-
tracking the registration of international participants and mentoring international recruits. Atlantic
Philanthropies, a charitable organization, funded the startup of this activity in 2006 through a public-private
partnership (PPP) with FPD.
ACTIVITY 6: HCD/Call Center/Clinical mentoring support
The call center will provide access for healthcare workers to infectious disease specialists, pediatricians and
clinical pharmacologists through a toll-free line for queries related to treatment and post-exposure
prophylaxis. This call centre closely cooperates with the HIV 911 Call Centre that handles consumer queries
for referral to AIDS service organizations in both the public and the civil society sectors.
FPD will contribute to the PEPFAR 2-7-10 goals by expanding access to ART services for adults and
children, building capacity for ART service delivery, and increasing the demand for and acceptance of ARV
The Foundation for Professional Development (FPD) program supports the expansion of access to
comprehensive HIV and AIDS care by focusing on human capacity development (HCD). The project aims to
develop human capacity in strategic information (SI) at AIDS service organizations by having master's
degree fellows work for a six-month period on the monitoring and evaluation (M&E) systems of South
African PEPFAR partners. The emphasis areas for this activity are strategic information and local
organization capacity building. In FY 2008, this fellowship program has been offered to other PEPFAR
countries whereby they can provide funds to support fellows who are recent graduates of South African
universities but must return to their country of origin after they complete their coursework. This practicum
experience with a South African PEPFAR partner will provide them with skills for future work in M&E when
they return to their countries. FPD has also offered to teach other PEPFAR countries how to start a similar
program in their country. This new activity aims to improve south-to-south capacity development.
FPD is a South African private institution of higher education working exclusively in the health sector in
Southern Africa. With PEPFAR funding, FPD supported treatment to thousands of people living with HIV
(PLHIV) and training for thousands of healthcare providers and managers. This activity, started in FY 2006,
supports the more formalized approach to human capacity development (HCD) needs in South Africa. It will
be scaled up through the FPD given their ability to expand to all universities. FPD, as a nation-wide training
institution, is well placed for implementation of this activity as training and other HCD activities are their core
business and FPD has well-developed relationships with other academic institutions in the country. These
relationships will create a conduit to recruit master's degree fellows from a variety of these institutions. FPD
also provides training to various PEPFAR partners and other health service institutions. FPD will facilitate
the placement of fellows with PEPFAR partners who need to strengthen their M&E capacity. With FY 2008
funding, FPD will support the expansion of access to comprehensive HIV and AIDS care by focusing on
HCD. In addition to training and mentoring, this activity will close the gaps in capacity in a number of South
African institutions implementing PEPFAR-funded activities. M&E expertise is lacking for many partners,
who must develop systems and overall capacity to document progress toward implementation of the South
African PEPFAR program. Emphasis will be placed on ensuring gender representation in the recruitment of
ACTIVITIES AND EXPECTED RESULTS:
ACTIVITY 1: Human Capacity Development
The project is aimed at improving the skills of graduate students at masters degree level who have a
specialization or interest in SI by partnering them with implementing PEPFAR partners or other related
AIDS service organizations. The fellows who will provide M&E and SI assistance and support to these
organizations will be recruited from South African universities that specialize in SI-related qualifications.
Both the fellows and the organizations will be technically supported by FPD, university and USG M&E staff.
In addition, an effort will be made to design projects that are of interest to the fellow, so both the
organization and the fellow will benefit.
ACTIVITY 2: Local Organization Capacity Development
The project further supports the ability of such organizations to engage in SI activities by providing them
with a fellow with specialized knowledge in SI related disciplines. The aim of the fellowship is not just to do
reports for the organization, but also to provide technical assistance in the development and maintenance of
M&E systems. It is required that the organization accepting the fellow has a full-time M&E Officer, so the
systems built during the fellowship are sustainable. Funding will be utilized to appoint a dedicated project
manager, pay stipends and transport costs for fellows and to allow FPD to coordinate with various
universities and recipient organizations with regard to recruitment, placement and evaluation of the
program. The sustainability component of this project revolves around the premise that some of the
recipient organizations will recruit the fellows at the end of their placement period. It is also expected that
fellows will have effected a substantial improvement in the strategic information capacity of the recipient
organization during their placement and that this improvement will be maintained after their departure.
FPD will contribute to the PEPFAR 2-7-10 goals by developing the capacity of organizations to expand
access to antiretroviral therapy services for adults and children, building capacity for monitoring ART service