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: 2007 2008 2009
AIDSRelief provides a comprehensive care and treatment program emphasizing strong links between
PLHAs, their family, communities and the health institutions. Its goal is to ensure that people living with
HIV/AIDS have access to Antiretroviral Therapy (ART) and quality medical care.
AIDSRelief is a consortium of five organizations which includes Catholic Relief Services (CRS) working as
the lead agency, the Institute of Human Virology (IHV), Constella Futures Group (CF), Catholic Medical
Mission Board (CMMB) and Interchurch Medical Assistance World Health (IMA); AIDSRelief services are
offered through 15 Local Partner Treatment Facilities (LPTFs), distributed throughout Uganda working in
some of the most underserved and rural areas, including Northern Uganda. These include St. Mary's Lacor,
St Joseph Kitgum, Nsambya Hospital, , Kamwokya Christian Caring Community, Family Hope Center
Kampala, Family Hope Center Jinja,, WTC Kololo, Virika Hospital, Villa Maria Hospital, Kabarole Hospital,
Bushenyi Medical Center 1- Katungu, Bushenyi Medical Center 2- Kabwohe, Kyamuhunga Comboni
Hospital, Kasanga Health Centre and Kalongo Hospital. In order to get services closer to the communities it
serves, AIDSRelief supports 26 satellite sites in selected LPTFs. The Children's AIDS Fund is a sub-
grantee in AIDSRelief and manages a number of the LPTFS. AIDSRelief is planning to activate 4 additional
LPTFs and phase out 1 LPTF in this grant year. As of June 30, 2007, AIDSRelief in Uganda was providing
care and support to 46,500 patients and antiretroviral treatment to 12,700 HIV-infected people of which 877
are children.
AIDSRelief has developed and improved the supply chain management capacity of the 15 sites it supports.
AIDSRelief procures Antiretroviral drugs (ARV) through a global procurement mechanism which provides
very competitive pricing, with delivery, warehousing and distribution through Joint Medical Stores (JMS).
This collaboration builds and strengthens the existing distribution network that specifically works for faith-
based healthcare facilities in Uganda. In year 4, AIDSRelief received drugs from Clinton Foundation which
enabled the program to scale up treatment despite the flat-lined budget.
Standard Operating Procedures (SOPs) have been developed in accordance with national guidelines that
guide supply chain activities from product selection, forecasting, procurement and consumption monitoring.
AIDSRelief has ensured excellent supply chain management and uninterrupted ARVs provision through
local capacity building at critical points within the supply management chain. In addition, the program has
implemented an ARV dispensing software developed by MSH RPM Plus enabling LPTFs to track the use of
ARVs; this dispensing tool has enabled LPTFs to enter accurate pharmacy data, forecast drug needs,
monitor patient numbers on ARVs and generate accurate pharmacy reports and initiate appropriate stock
replenishment. These reports, used to track inventory movement through the chain, permit continuous
modulation of patient enrollment to reflect ARV drugs availability and ensure a guaranteed and continuous
supply of drugs for each patient initiated on therapy.
In FY08, AIDSRelief will expand its services to 5 new LPTFs and 11 satellite sites with the goal to reach
23,618 patients on ART, of which 2,834 will be children, and 54,813 patients in care and support. This
request will provide ARVs for 6,608 patients. The program will leverage additional resources for ARVs from
other donors such as the Clinton Foundation, but will cover other ART related support such as purchase of
OI drugs, laboratory supplies and technical assistance to the LPTFs. At the end of Year 5, AIDSRelief will
be supporting a total of 23 LPTFs and 37 satellites.
The program will continue to procure adult 1st line, alternative 1st line, and 2nd line therapies for adults and
children. The AIDSRelief Supply Chain Management Team will assist with capacity building, technical
backstopping and on-going training in supply chain logistic management which includes forecasting, stock
management, standard operating procedures and use of ART Dispensing Tool at the LPTF level. This will
turn the supply situation into a pull system; AIDSRelief has and will continue to support its sites with
frequent on-site mentoring, quarterly partner forums and access to a web based site on which difficult cases
can be discussed. This process is designed to provide LPTFs with ongoing clinical technical assistance
and to keep them abreast with the latest developments in HIV patient care. Therapeutic Drug Committees
will continue to be rolled out from the country program level to all LPTFs and this will further improve
management and forecasting of drugs for better patient outcomes. Technical assistance will also be
provided to laboratory, finance and monitoring and evaluation staff.
The Institute for Human Virology will participate in the periodic review of National Treatment Guidelines in
order to assist in the selection of regimens most appropriate to the Ugandan context. Choice of regimen is
guided by most recent evidence to ensure that the most effective and durable regimen available within the
national guidelines with the possible toxicity and resistance profile is used. The current choice of primary
regimen for AIDSRelief sites consists of Truvada (TVD) combined with Nevirapine (NVP) or Efavirenz (EFV)
for patients on Rifampicin containing tuberculosis protocols or intolerant to NVP. Aluvia (lopinavir/ritonovir)
is used for those who are intolerant to both NVP and EFV. For those who have renal insufficiency,
AZT/3TC will be substituted for TVD. Limited quantities of Stavudine (D4T) to be combined with
Lamivudine (3TC) are also procured to be used for patients with both renal insufficiency and anemia. The
choice of regimen is based on the more favorable pharmacokinetic and safety profile and is supported by
extensive clinical evidence. The choice of regimen is also designed to preserve optimal therapeutic choices
for second line regimens, which in the AR program consists of AZT (or D4T in cases of anemia, or TDF in
patients failing AZT or D4T as their primary regimen) coupled with 3TC and Aluvia. All drugs with exception
of TVD and Aluvia (which are currently not available as generics) are procured in generic form. AIDSRelief
provides AZT, 3TC and NVP for children less than 5 years of age, and D4T, 3TC and EFV/NVP for those
above 5 years and ABC as an alternative for those affected by severe anemia.
AIDSRelief will continue to work closely with the Ugandan Ministry of Health (MOH), the USG team in-
country, and other partners and programs to harmonize and strengthen pharmaceutical supply chain
systems. It will coordinate with other procurement and treatment agencies to ensure that LPTFs have
access to a stable chain of supply and no occurrence of any stock outs.
Coordinated by Constella Futures, strategic information (SI) activities incorporate program level reporting,
enhancing the effectiveness and efficiency of both paper-based and computerized patient monitoring and
management (PMM) systems, assuring data quality and continuous quality improvement, and using SI for
program decision making across all LPTFs. AIDSRelief has built a strong PMM system using in-country
networks and available technology at 15 LPTFs in COP07. In COP08, Constella Futures will work with the
new sites and also carry out site visits to all LPTFs to provide technical assistance that will ensure
continued quality data collection, data entry, data validation and analysis, and dissemination of findings
across a range of stakeholders. It will ensure compilation of complete and valid HIV patient treatment/ARV
data; enhance analysis of required indicators for quality HIV patient treatment and ARV program monitoring
and reporting; and provide relevant, LPTF-specific technical assistance to develop specific data quality
improvement plans. In year 5, AIDSRelief will support LPTFs roll out of IQCare, an electronic data
management software deployed in COP'07, to enhance sustainability of PMM systems. The program will
promote these systems through a Training of Trainers (TOT) and peer to peer training model in SI, where
"expert" LPTF staff will train others in various skills. AIDSRelief will promote the data use culture, to enable
Activity Narrative: LPTFs use data for informed clinical decisions and adaptive management. It will ensure that different data
systems at health facilities are harmonized for effective and efficient reporting.
AIDSRelief developed a sustainability plan in Year 4 focusing on technical, organizational, funding, policy
and advocacy dimensions. To date, the program has been able to increase access to quality care and
treatment, while simultaneously strengthening health facility systems through human resource support,
equipment, financial training and improvements in health management information. In COP08, the program
will further build on this foundation to closely work and collaborate with Makarere University Department of
Nursing and other nursing schools attached to the LPTFs to incorporate comprehensive HIV/AIDS training
modules into existing curricula. The program will also support linkages between LPTFs and the MOH to tap
into locally available training institutions. These approaches will ensure continuity of skills training.
AIDSRelief will particularly focus on its relationship with indigenous organizations such as the Uganda
Catholic Medical Bureau and Uganda Protestant Medical Bureau to build their institutional capacity to
support LPTFs integrate ART and other care and support programs into their health care services. These
strategies will enable AIDSRelief to fully transfer its knowledge, skills and responsibilities to in country
service providers as part of the program's sustainability plan.
PLHAs, their family, communities and health institutions. Its goal is to ensure that people living with
St Joseph Kitgum, Nsambya Hospital, Kamwokya Christian Caring Community, Family Hope Center
Kampala, Family Hope Center Jinja, Virika Hospital, Villa Maria Hospital, Kabarole Hospital, Bushenyi
Medical Center 1- Katungu, Bushenyi Medical Center 2- Kabwohe, Kyamuhunga Comboni Hospital,
Kasanga Health Centre and Kalongo Hospital. In order to get services closer to the communities it serves,
AIDSRelief supports 26 satellite sites in selected LPTFs. The Children's AIDS Fund is a sub-grantee in
AIDSRelief and manages a number of the LPTFS. AIDSRelief is planning to activate 4 additional LPTFs
and phase out 1 LPTF in this grant year. As of June 30, 2007, AIDSRelief in Uganda was providing care
and support to 46,500 patients and antiretroviral treatment to 12,700 HIV-infected people of which 877 are
children.
other donors such as the Clinton Foundation, but will cover associated ART related support such as
purchase of OI drugs, laboratory supplies and technical assistance to the LPTFs. At the end of Year 5,
AIDSRelief will be supporting a total of 23 LPTFs and 37 satellites.
The program will continue to provide comprehensive assistance to LPTFs. This includes training and on-site
mentorship of medical staff, strengthening of HIV/AIDS community outreach activities, quality
assurance/quality improvement of HIV services, strategic information, capacity building of management and
financial staff, provision of opportunistic infection drugs, medical supplies and laboratory reagents, and staff
and minor infrastructure support. The decentralization of HIV services through 37 satellite sites will increase
accessibility of such services to those who live in remote areas. This approach reinforces AIDSRelief's care
model with communities, satellite sites and LPTFs strongly interlinked by health providers and community
volunteers in order to meet the need of HIV/AIDS patients. AIDSRelief technical staff with significant
experience in this area will assist local partners in improving community nursing support, building
community health teams, and establishing clinic feedback mechanisms. Hands-on training of trainers will
replicate the model throughout the AIDSRelief network, an effort which will have positive benefits for
surrounding communities and treatment programs.
AIDSRelief, because of its work through partners who are firmly embedded within communities, has the
ability to support involvement of communities. AIDSRelief supported facilities are currently providing varying
levels of home based care and community preventative services. Further development of these community
health programs to provide integrated HIV care and preventative services is critical to ensuring sustainable
treatment programs and maximizing funding investments. Community health programs will be structured to
promote family based care through disclosure counseling, secondary prevention, and family based testing
and education. In addition, motivated patients who make up most of the LPTFs' community volunteers will
be used as resource to support patients on therapy, disseminate HIV care and prevention literacy.
AIDSRelief will adapt existing, locally appropriate Information Education and Communication (IEC) and
Behavior Change Communication (BCC) materials, as well as to identify gaps in these media and develop
materials as needed to be used by health workers and community volunteers.
AIDSRelief will assist LPTF networks with PLHA groups serving as volunteers in the community to
strengthen adherence programs, which have been demonstrated to be a key component of good clinical
outcomes. Emphasizing the importance of adherence and community linkages at all AIDSRelief supported
sites has enabled the program to achieve high and durable viral suppression. The program will also
strengthen linkages within the LPTFs, particularly those between PMTCT, TB and CT services with ART
services. Emphasis will also be given to build capacity and develop strong linkages with the satellite sites
and other community interventions. LPTFs external and internal integration will be reinforced so that core
AIDSRelief care and treatment activities will be integrated with ancillary services and program activities of
other providers in the same region. A total of 290 facility level staff and 720 community volunteers will be
given comprehensive HIV/AIDS training enabling them to fulfill their responsibilities. AIDSRelief will follow-
up classroom-based training with on site clinical mentorship for clinicians and site level support for other
cadres of workers. Regional CME and quarterly partners' forums will complement LPTF's staff training,
allow experience sharing and reinforce knowledge and skill transfer from AIDSRelief technical staff.
Task shifting to maximize human resources will be emphasized at facility and community levels. At the
LPTFs, the strategy will be based on using nurses and clinical officers for the routine follow-up of stable
patients, using protocol driven nurse and clinical officer management of non-critical acute symptoms and
using nurses and pharmacists for routine medication dispensing to stable patients. At the community level,
AIDSRelief will encourage the development of community based satellite clinics staffed by clinical
officers/nurses/community health workers for the routine care of stable patients and the use of community
health teams for the delivery of home based care and for medication delivery.
AIDSRelief will continue to strengthen the health system management of LPTFs. The program will conduct
biannual finance and compliance trainings and program finance staff will carry out regular site visits to
provide technical assistance. LPTF trained finance staff in key internal control operations will be able to set
up appropriate cost accounting systems and adopt a program budgeting approach. LPTFs will also be
assisted to develop a more efficient organizational management structure.
networks and available technology at 15 LPTFs in COP07. In COP08, Constella Futures will carry out site
visits to provide technical assistance that will ensure continued and improved quality data collection, data
entry, data validation and analysis, and dissemination of findings across a range of stakeholders. It will
ensure compilation of complete and valid HIV patient treatment/ARV data; enhance analysis of required
indicators for quality HIV patient treatment and ARV program monitoring and reporting; and provide
relevant, LPTF-specific technical assistance to develop site specific data quality improvement plans. In year
5, AIDSRelief will support the roll out of IQCare, an electronic data management software deployed in
COP'07, which will enhance sustainability of PMM systems. The program will promote these systems
through a Training of Trainers (TOT) and a peer to peer training model, where "expert" LPTF staff will train
Activity Narrative: others in various skills. AIDSRelief will promote the data use culture to enable LPTFs to use data for
informed clinical decisions and adaptive management.
Catholic Medical Bureau and Uganda Protestant Medical Bureau to build their institutional capacity and to
support LPTFs integration of ART and other care and support programs into their health care services.
These strategies will enable AIDSRelief to fully transfer its knowledge, skills and responsibilities to in
country service providers as part of the program's sustainability plan.
