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
TASO has provided HIV/AIDS services in Uganda since 1987. It is registered with the Government of
Uganda as a non-governmental organization and is categorized as having national focus and nationwide
coverage. The vision of TASO is "A World without AIDS" and the mission is "To contribute to a process of
preventing HIV infection, restoring hope and improving the quality of life of individuals, families and
communities affected by HIV infection and disease". The values underlying the entire TASO programming
are: equal rights, equal opportunities, shared responsibility; obligation to people affected by HIV infection;
human dignity; family spirit; and integrity. TASO promotes the philosophy of "Positive Living with HIV" by
empowering communities to combat stigma; promote HIV prevention; promote access to care and treatment
services; and promoting quality of life of affected people and households. TASO runs 16 direct outlets (11
care centers & 5 training centers) implementing the TASO 2008-2012 Strategic Plan. The outlets reach a
catchment population of about 10 million people, of which 81,000 active adult clients and their 300,000
household members are a part. Over 30% of the outlets deliver services to conflict/post-conflict regions of
Uganda, where TASO has pioneered HIV/AIDS interventions and continues to play the flag-ship role. TASO
proactively addresses challenges faced by refugees/internally displaced persons. The organization also
supports 22 partner sites and 100 community-based initiatives to deliver services. The 22 partner sites are
public and private facilities supported by TASO through sub-granting and technical support using other
funding. TASO is structured in 6 Directorates, namely: Program Management (charged with program
development, QA and technical support), Planning & Strategic Information (charged with M&E), Capacity
Building (charged with training service providers), Human Resources & Administration, Advocacy &
Networking (charged with HIV/AIDS advocacy and networking) and Finance. TASO has over 1,127 program
staff and a force of over 4,000 trained community volunteers. Each TASO service outlet has counseling
rooms, medical rooms, laboratory, drug store, dispensary, training rooms, resource center, client Day
Center, vehicles, ICT systems, as well as adequate staffing organized into; management team, service
delivery teams, operational support team and expert client team (peer educators). Each service outlet has
linkages with supported community-based service providers comprising of community nurses, community
ART support agents, peer support groups and other community HIV/AIDS workers. TASO governance
comprises of the Board of Trustees (highest decision-making body); Regional Advisory Councils (Boards
overseeing TASO work in each of the four regions of Uganda); Center Advisory Committees (local Boards
overseeing each service outlet); Clients' Councils (Clients Boards at each outlet linking clients to all levels of
management and governance). All Boards are elected by members regularly at Annual Assemblies as
TASO is a membership organization. TASO management and governance is guided by national policy and
organizational guidelines. TASO contributes to the national HIV/AIDS strategic plan through:
complementing national efforts; engaging in strategic plan development; support to civil society
coordination; sharing resources with public health facilities in under-resourced areas particularly laboratory
monitoring; and developing human resources for health. Development of appropriate family-friendly and
community-friendly service delivery models for low resource settings is part of TASO's core work. These
service models are regularly disseminated and provide a backbone for adaptation by other partners, one
dissemination forum includes TASO experiential placement training programs focusing on sub-Saharan
Africa. TASO has had a successful track record in implementing PEPFAR activities. By FY 2007, TASO
contributed 16.5% of Uganda's ART enrolment and 20% of PEPFAR supported enrollment. TASO
programming for FY 2009 and the rest of the 2008-2012 period will be influenced by the following broad
principles: evidence-based programming; greater focus on the family; greater focus on community
empowerment; greater involvement of People Living with HIV/AIDS; enhancing partnerships; quality
assurance; consolidating the gains of the national response; enhancing comprehensive accountability
(financial, programmatic, governance and cost-effectiveness); ensuring value addition to national
programming; addressing key drivers of the epidemic; and supporting efforts towards a strong public health
sector. Over 67% of the 100,000 active TASO clients are females and over 60% are in the reproductive age
bracket of 15 to 49 years. One of the effects due to improved health resulting from ART is rebuilding broken
relationships and families; and resuming sexual activity. Feedback has shown that with restoration of hope
due to improved quality of life, clients regard having children as a key part of the plan to rebuild their lives
and families. Mother to Child transmission (MTCT) is the second most common mode of HIV transmission
accounting for up to 20% of new infections and 25,000 pediatric infections each year in Uganda.
In FY 2008, the TASO priorities for PMTCT were: providing health education on PMTCT; identifying HIV
positive, pregnant clients; counseling identified HIV positive, pregnant clients and their sexual partners;
providing ARV prophylaxis for mothers and their new born babies; prioritizing and providing ART to eligible
pregnant women; conducting supportive home visits; linking pregnant clients to antenatal services as part of
a two-way referral mechanism; active follow up of pregnant clients to support delivery in health facilities;
facilitating access to early infant HIV diagnosis at 6 weeks postnatal; engaging in partnership with other
PMTCT stakeholders to promote key activities (including 2 way referral, male involvement, infant feeding
and essential postnatal care for HIV exposed infants); providing family planning information and
commodities to all sexually active clients; providing couple counseling and supported disclosure for both
HIV concordant and HIV discordant couples; supporting concordant positive and discordant couple peer
clubs. Key outputs up to July 31, 2008 were: finalizing and roll-out of the TASO PMTCT Strategy and
Guidelines document; provision of the minimum package of PMTCT services at all 11 TASO service outlets;
100 eligible pregnant women (both TASO clients and referrals in) accessed HAART as priority clients from
the 200 ART slots reserved for the PMTCT program; 50 pregnant women ineligible for HAART received
ART prophylaxis; a functional two-way referral mechanism was established between TASO and other
partners; and 70 service providers were trained to provide PMTCT services.
During FY 2009, TASO will provide PMTCT services using the 4-pronged approach for PMTCT at the 11
Centres (in Gulu, Jinja, Kampala, Masaka, Masindi, Mbale, Mbarara, Rukungiri, Soroti, Tororo and Wakiso).
Each of the Centres directly serves clients from the host district and 6 neighboring districts. PMTCT
mobilization and sensitization activities will target all the 80,000 TASO adult clients; provision of PMTCT
services will target sexually active clients and their partners. TASO will target 400 pregnant women with
PMTCT interventions; 200 to be enrolled on HAART and 200 on ART prophylaxis. Key activities for the
PMTCT Program Area will include: integrating family planning into PMTCT program; provision of the
minimum package of PMTCT services by the 11 TASO Centres; clinical and immunologic staging of all
pregnant women; provision of combination ARV prophylaxis for all pregnant clients not eligible for ART; and
prioritizing eligible pregnant clients for ART; pregnant clients already on ART will receive support to adhere
to treatment in addition to appropriate PMTCT support; health workers will be trained/retrained to provide
PMTCT services in accordance with national guidelines and standards; all pregnant and lactating mothers
Activity Narrative: will be provided with multivitamin supplements. TASO will also invest in laboratory infrastructure
enhancements and establish DNA PCR sample transport systems to reference laboratories. TASO aims at
achieving universal access to HIV prevention, treatment, care and support for infants and children.
The activities under this Program Area are also linked to other USG funding through USAID focusing on
Sexual Prevention, Orphans and Vulnerable Children, Strategic Information and Health Systems
Strengthening. The USG funded activities in TASO are also backed up by activities funded by other
development partners such as DANIDA, DFID and Irish Aid through the Civil Society Fund.
New/Continuing Activity: Continuing Activity
Continuing Activity: 17058
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
17058 17058.08 HHS/Centers for The AIDS Support 6420 5737.08 Provision of $450,000
Disease Control & Organization Comprehensive
Prevention Integrated
HIV/AIDS/TB
Prevention,
Care and
Treatment
Services among
People Living
with HIV/AIDS
Emphasis Areas
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
* Reducing violence and coercion
Refugees/Internally Displaced Persons
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $100,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.01:
sector.
About 81,000 active adult clients were served at various service delivery venues operated by TASO
Centers. In FY 2008, the TASO priorities for Adult Care & Treatment were: providing counseling services to
clients and their family members; screening and treating opportunistic infections; screening and treating
sexually transmitted infections (STI); providing vital information to clients (cotrimoxazole prophylaxis, safe
water, nutrition, STI, FP, PMTCT); enrolling clients on cotrimoxazole prophylaxis; providing safe water
vessels and promoting safe water use; providing LLITN (long lasting insecticide treated nets) and promoting
malaria prevention; providing condoms to sexually active clients; conducting various courses to train service
providers to provide HIV care and support. By March 2008, TASO had 19,000 adult clients accessing ART
at the 11 TASO Centers nationwide (including 1,200 clients of HBAC Tororo). The TASO ART program
registered very high levels of adherence. Over 95% of the clients on ART had adherence levels of over 96%
using a three-day recall. Service providers continued to support the few clients with low adherence through
follow-up. Clients with high adherence were counseled to maintain the good performance. Clients received
ARV drugs both through the facilities (i.e. 11 TASO Centers) and the community (i.e. clients' homes and
Community Drug Distribution Points). Field Officers delivered ARV drugs to Community Drug Distribution
Points and clients' homes. TASO continued supporting models that meaningfully involve PHA; the 1,000
expert clients who had been trained as Community ART Support Agents (CASA) continued playing a
grassroots' support role in to ART clients in the community, these TASO trained resource persons also
support clients in the community accessing treatment from other partners). The 11 Centers continued
running multidisciplinary case conferences to: assess eligibility for ART initiation; assessing client readiness
for ART initiation; switching clients between the facility and community ARV delivery arms. TASO evaluated
the MIS modules for Pharmacy, Laboratory and Stores Management in order to identify and address the
gaps in their capacity to support quality assurance, M&E and logistics management. TASO also evaluated
the ART Data Management modules to enhance generation of information and knowledge from program
data. TASO improved the Clients' Appointment System to ease the pressure of client load on Centre
resources through scheduling clients to visit Centers on appointment. The system was also aimed at
enhancing the quality of services through adequate preparation by service providers. TASO Centers
continued using the Pharmacy Information Management System (PIMS) for facilitating upfront planning of
drug refills through providing critical information such as clients who did not pick up drug refills for follow-up.
TASO units were supported with refurbishment of the existing infrastructure to improve the environment for
service delivery and improve record filing/archives rooms for clients' records. Procurements were made to
fill the identified gaps in various program areas. TASO solicited feedback through periodic meetings for
various teams of service providers. Key issues addressed by meetings and workshops included: program
guidelines; strategic information and knowledge; capacity-building; strategic planning; service delivery
Activity Narrative: models; resolving ART implementation challenges; and other key issues.
During FY 2009, TASO will provide Adult Care & Treatment services at the 11 Centres located in the
districts of Gulu, Jinja, Kampala, Masaka, Masindi, Mbale, Mbarara, Rukungiri, Soroti, Tororo and Wakiso.
Each of the Centers will directly serve clients from the host district and up to 6 neighboring districts. All the
90,000 active adult clients will be facilitated to access a comprehensive package of high quality Adult Care
& Treatment services. The Adult Care & Treatment package will comprise: counseling for clients and family
members; provision of antiretroviral therapy (ART); screening and treating opportunistic infections; pain and
palliative care management, STI screening and management; promoting and providing cotrimoxazole
prophylaxis, safe water, nutrition counseling, PMTCT and family planning; providing LLITN and promoting
providers to provide HIV care and support; and procurement/provision of nutritional supplements for clients.
In order to reach the targeted beneficiaries, TASO will provide Adult Care & Treatment through various
venues and using appropriate and proven service delivery models (TASO is a key partner in developing
innovative client-friendly and community-friendly service delivery models). The TASO Centers will deliver
services to clients through the 11 static outlets, clients' homes and 34 outreach clinics sites (each of the 11
TASO Centers conducts monthly outreach clinics in about 3 public health facilities within 75 Km radius). The
broad service delivery strategies will include mobilization and sensitization, capacity-building, beneficiary
involvement, greater PHA involvement, partnership and collaboration and others. In partnership with
Population Services International (PSI Uganda), TASO will target 20,000 clients to receive a basic care
starter kit consisting of safe water vessels and chlorine solution (Waterguard®), LLITN for prevention of
mosquito bites, cotrimoxazole prophylaxis and condoms to sexually active clients. Additionally Prevention
with Positives (PWP) interventions will be provided; including partner and family-based counseling and
testing, supported disclosure, STI management, PMTCT and FP services or referral, and safe sex
counseling. All adult clients will have the option to access condoms, and the sexually active clients will be
empowered to appreciate, access and use condoms correctly and consistently. The 80,000 clients currently
on cotrimoxazole and 20,000 new clients including children will be provided with cotrimoxazole prophylaxis
and Dapsone will be procured as alternative medicine for a few clients that are allergic to cotrimoxazole.
TASO will target to have at least 95% of ART recipients and 75% of overall active clients accessing
cotrimoxazole prophylaxis. Client sensitization on the importance of the various Care & Treatment services
in improving the quality of clients' lives will be done through counseling, health education talks, music,
dance and drama performances and IEC materials at all service outlets. Staff at the 11 Centres will educate
clients on various Care & Treatment issues through individual and group sessions. The messages delivered
to clients also address male norms/behaviors, gender equity, women's rights and gender violence. The
various TASO field teams will monitor use of Care & Treatment services during regular visits to clients'
homes. TASO will provide STI information to all adolescents and adult clients with emphasis on sexually
active clients. All sexually active clients will be screened for STI routinely and all clients will be screened for
STI at least twice a year. All clients diagnosed with STI will be counseled, treated, helped to mobilize sexual
partners for treatment, given condoms and condom education. Teams at the 11 TASO Centers will follow up
specific STI cases and refer for specialized care where necessary. STI screening is vital as increasing
proportions of clients resume sexual activity arising from improved health due to ART. During FY 2009,
TASO Centers will scale up cervical cancer screening for the female clients above the FY 2008 level.
Clients will continue to receive ARV drugs both through the facility arm (i.e. 11 TASO Centers) and the
community arm (i.e. Clients' Homes and Community Drug Distribution Points). TASO teams will use
experience and program feedback to improve the existing models and exploring more client-friendly service
delivery models. Teams will support clients to uphold the high adherence levels recorded (over 95% of the
clients on ART had adherence levels of over 96% using a three-day recall by FY 2007) and supporting the
few clients with low adherence through follow-up. Gender-related challenges often impede the success of
adult care and treatment services. TASO will continue addressing gender issues affecting care and
treatment through messages focusing on male norms and behaviors, gender equity, women's rights,
domestic violence and coercion. Messages will be delivered through individual and group sessions to clients
that encourage feedback by the recipients and dialogue. Quality assurance (QA) will be done through
ensuring adherence to national and international standards, conducting regular refresher training for service
providers, rigorous support supervision of service providers, technical support visits to service outlets and
teams, conducting regular QA meetings in service delivery departments and conducting regular client
satisfaction feedback exercises. The Adult Care & Treatment program area is related to the program areas
of PMTCT, TB/HIV, Counseling & Testing, ARV Drugs and Services and Laboratory Infrastructure. The
activities under Adult Care & Treatment will not be delivered in isolation but the program area will be
implemented in an integrated service delivery model bringing together activities under all the above program
areas to form a comprehensive service package accessed by TASO clients. The activities under this
Program Area are also linked to other USG funding through USAID focusing on Sexual Prevention,
Orphans and Vulnerable Children, Strategic Information and Health Systems Strengthening. The USG
funded activities in TASO are also backed up by activities funded by other AIDS Development Partners
such as DANIDA, DFID and Irish Aid through the Civil Society Fund.
Continuing Activity: 13226
13226 4054.08 HHS/Centers for The AIDS Support 6420 5737.08 Provision of $730,000
8358 4054.07 HHS/Centers for The AIDS Support 5737 5737.07 Provision of $565,836
4054 4054.06 HHS/Centers for The AIDS Support 3188 693.06 TASO CDC $565,836
Disease Control & Organization
Prevention
Health-related Wraparound Programs
* Child Survival Activities
* Family Planning
* Malaria (PMI)
* Safe Motherhood
* TB
Estimated amount of funding that is planned for Water $20,000
Table 3.3.08:
Continuing Activity: 13230
13230 4057.08 HHS/Centers for The AIDS Support 6420 5737.08 Provision of $4,086,632
8361 4057.07 HHS/Centers for The AIDS Support 5737 5737.07 Provision of $3,786,632
4057 4057.06 HHS/Centers for The AIDS Support 3188 693.06 TASO CDC $2,460,072
Table 3.3.09:
TASO has provided HIV/AIDS services in Uganda since 1987. TASO is registered with the Government of
Uganda as an NGO and is categorized among HIV/AIDS NGOs with national focus and nationwide
services; and promoting quality of life of affected people and households. TASO runs 16 direct outlets
implementing the TASO 2008-2012 Strategic Plan across Uganda. TASO programming for FY 2009 and the
rest of the 2008-2012 period will be influenced by the following broad principles: evidence-based
programming; greater focus on the family; greater focus on community empowerment; greater involvement
of People Living with HIV/AIDS; enhancing partnerships; quality assurance; consolidating the gains of the
national response; enhancing comprehensive accountability (financial, programmatic, governance and cost-
effectiveness); ensuring value addition to national programming; addressing key drivers of the epidemic;
and supporting efforts towards a strong public health sector). TASO also supports 22 partner sites and 100
community-based initiatives to deliver services. About 100,000 people are index clients of the outlets; about
400,000 household members are indirect beneficiaries. The outlets reach a catchment population of about
10 million people. Over 30% of the outlets deliver services to conflict/post-conflict regions/sub-regions of
Uganda (TASO pioneered HIV/AIDS intervention in the conflict/post-conflict regions/sub-regions and
continues to play the flag-ship role). TASO is structured in six Directorates, namely: Program Management
(in charge of program development, quality assurance and technical support), Planning & Strategic
Information (in charge of monitoring and evaluation), Capacity Development (development of human
resources for TASO and partners), Human Resources & Administration, Advocacy & Networking (in charge
of national and global advocacy and networking) and Finance. TASO has over 1,127 program staff and a
force of over 4,000 trained community volunteers. Each TASO service outlet has infrastructure (counseling
rooms, medical rooms, laboratory, drugs store, dispensary, vehicles, ICT systems, training rooms, resource
centre, client Day Centre), management team, service delivery teams, operational support team and a team
of expert clients (peer leaders). Each service outlet has linkages with supported community-based service
providers comprising of community nurses, community ART support agents, peer support groups and other
community HIV/AIDS workers. The TASO governance structure comprises of the Board of Trustees
(highest decision-making body); Regional Advisory Councils (Boards overseeing TASO work in each of the
four regions of Uganda); Centre Advisory Committees (local Boards overseeing each service outlet);
Clients' Councils (Clients Boards at each outlet linking clients to all levels of management and governance).
All Boards are elected by members regularly at Annual Assemblies (TASO is a membership organization).
TASO management and governance is done in accordance with national policies and documented
organizational policies. TASO has had a successful track record in implementing PEPFAR I activities. By
FY 2007, TASO contributed 16.5% of Uganda's ART enrolment and 20% of PEPFAR supported enrollment.
Over 96% of the 20,000 clients accessing ART in TASO have levels of adherence to treatment of over 95%.
Development of appropriate family-friendly and community-friendly service delivery models for low resource
settings is part of core TASO work. These service models are regularly disseminated and provide a
backbone for adaptation by other partners (dissemination fora include TASO experiential placement training
programs focusing on sub-Saharan Africa). TASO contributes to the national HIV/AIDS strategic plan
through: complementing national efforts; engaging in strategic plan development; support civil society
coordination; sharing resources with public health facilities in under-resourced areas (laboratory
monitoring); and developing human resources for health.
This program will support the provision of comprehensive HIV/AIDS prevention, care, treatment, and related
services to HIV positive adults, children and their family members. Services will include antiretroviral
therapy (ART); adherence counseling; TB screening and treatment; diagnosis and treatment of
opportunistic infections (OI); the basic preventive care package (BCP); prevention with positives (PWP)
interventions; family-based and individual confidential HIV counseling and testing; and psycho-social
support. In order not to interrupt critical services and to ensure the continuation of care and treatment, the
previous implementing partner was extended for 6 months through September '07. During this time, the
partner provided ART for 15,000 adults and children. The applicant for the FY'08 program will provide
comprehensive services through an established country-wide network of urban and rural health facilities
with the goal of continuing ART to the existing client base of 15,000, as well as provide comprehensive HIV
support, prevention, care and treatment (as needed) to an additional 70,000 HIV positive individuals. A
family-centered approach will be established, using the index HIV+ client to identify family members, who
will receive confidential HIV counseling and testing and HIV care for those identified as seropositive. All
seropositive clients and HIV+ family members will receive a Basic Preventive Care package that includes:
cotrimoxazole prophylaxis; a safe water vessel and chlorine solution; insecticide treated bed nets; condoms
as appropriate; educational materials; plus PWP counseling. Following national ART treatment guidelines
and services criteria, each health center supported by the applicant will be staffed with trained HIV clinical
and ancillary health care professionals, and will establish systems to monitor patients for ART eligibility and
initiation. Those on ART will receive continuous adherence counseling and support services. PWP
interventions will be an integral part of services to reduce HIV transmission to sexual partners and unborn
children, including specific interventions for discordant couples. Methods to integrate prevention messages
into all care and treatment services will be developed, and will be implemented by all staff. HCT services will
also be offered to sexual partners who are not family members. Depending on the location of each health
center, various service delivery models will be developed to facilitate access and ensure coverage of the
target population; these will include facility, community, and home-based approaches, as well as outreach
activities. The applicant will also develop a more robust program to provide services to conflict and post-
conflict areas of Northern and North-eastern Uganda; these will include HCT at facility-based and mobile
out-reach clinics.
Palliative care (PC) involves the provision of a wide range of services, counseling, and commodities,
including the Basic Care Package, PWP interventions, the Client Kit, and other types of support. FY08 goals
for the applicant will include expanding PC coverage to a greater number of HIV+ clients and their
seropositive family members. All components of palliative care will be available, directly or through referral.
Because many components of PC need not be facility based, increased efforts will be made to provide
services at the community level, and to use PHA networks. Logistics, commodity procurement and human
Activity Narrative: resources will be emphasized. Procurement logistics will be enhanced, as described in the "ARV Drug"
area activity narrative, by working within the National System for commodity procurement and distribution.
Commodities that are relevant to PC include those needed for the prophylaxis, management, and screening
of OIs; and components of the Basic Client Kit. The applicant will work to ensure that these commodities,
drugs and diagnostics are available to meet increased needs. Health care workers will be given refresher
training to improve and update their knowledge of and skills in providing palliative care. This will include
training of health care providers to enhance their capacity to also provide PWP counseling. To ensure
quality assurance, standardized and up-to-date guidelines of palliative care will be provided and service
centers will be supported to ensure quality of service provision. Data collection and monitoring systems will
be maintained and enhanced with the goal of improving patient care, meeting reporting requirements, and
evaluating data to improve program planning.
Table 3.3.10:
By July 31 2008, there were 8,000 children enrolled in care as OVCs regardless of serostatus; 6,126 of
those children were screened for HIV either at the facility or at home under the Home Based HIV counseling
and testing initiative and 4,104 tested HIV positive; 1,200 children have cumulatively been enrolled on ART
(1,023 are active). Pediatric care & treatment is a part of TASO's core activities and an essential component
in the positive living package that is provided to improve the quality of life of pediatric clients. Pediatric care
& treatment is also part of the national HIV/AIDS response to which TASO has made an indelible
contribution towards Pediatric HIV care for exposed and infected children at national, community and
household levels. In FY 2008, the TASO priorities for Pediatric care & treatment included: counseling
services to children and their family members; providing vital information to clients (cotrimoxazole
prophylaxis, safe water, nutrition, STI, family planning for adolescents, PMTCT); management of
opportunistic infections; screening and treating sexually transmitted infections (STI) among adolescents;
providing cotrimoxazole prophylaxis to all children in care; providing safe water vessels and promoting safe
water use; promoting malaria prevention and providing long lasting insecticide treated bed nets for children
especially those under five years of age; providing nutritional supplements for infants and child clients;
promoting HIV prevention among adolescent clients; and formation of adolescent peer support groups.
Achievements include; functional Pediatric ART program at the 11 centers and their associated outreach
clinics; low mortality (5.3%) of children on ART; pediatric HIV training needs assessment was conducted at
the 11 TASO Centers; networking with partners involved in HIV AIDS care and treatment. Challenges
include; unacceptably high median age of ART initiation of 9 years; and case finding of HIV infected children
is problematic. TASO will address these challenges by scaling up PMTCT and early infant diagnosis and
treatment.
In FY 2009, the 11 TASO Centers will provide Pediatric care & treatment services at various locations
including the 34 outreach clinics and the 100 community programs. TASO will continue operating a
collaborative Pediatric care initiative with the Baylor College of Medicine Children's Foundation Uganda at
TASO Kanyanya. Each of the TASO centers will continue directly serving pediatric clients from the host
district and up to 6 neighboring districts. All the 6,000 child clients will be facilitated to access a
comprehensive package of high quality Pediatric care & treatment services as advocated for by the African
Network for the Care of Children affected by AIDS (ANNECA). An additional 1,000 children will be initiated
on ART during FY 2009. Pediatric care and treatment services to be offered include; early confirmation of
HIV infection status; growth and development monitoring; immunizations according to the recommended
national schedule; prophylaxis against opportunistic infections especially Pneumocystis Pneumonia;
treatment of acute infections and other HIV-related conditions; counseling caretakers on optimal infant
feeding, personal and food hygiene, disease staging; ART where indicated, psychosocial support for the
Activity Narrative: infected child, caregiver & family; and referral of the infected child for specialized care if necessary; and
community-based support programs.
The Pediatric Care & Treatment program area is related to the program areas of PMTCT, Adult Care &
Treatment, TB/HIV, Psychosocial support, Counseling & Testing, ARV Drugs and Laboratory Infrastructure.
The activities under pediatric Care & Treatment will not be delivered in isolation but the program area will be
core areas to form a comprehensive service package accessed by TASO child clients and their care givers.
TASO will use a continuous quality improvement approach Plan-Do-Study-Act (PDSA) cycles to enhance
data management, as well as conduct quality assurance support visits and clinical mentoring. Staff from
TASO Headquarters and Regional offices will conduct regular quarterly and adhoc mentoring, support and
supervisory visits to the 11 TASO centers, outreaches and community drug distribution points to support
basic primary care services for HIV exposed and infected children, OI management, ARTTB/HIV integration
and PMTCT. Support supervision will entail assessment of clinic infrastructure, training needs, staffing and
other HR issues, logistics, transportation, children/client satisfaction, liaison with families and communities.
Clinical case reviews, assessment of guideline use and ART regimen decisions, team meetings will also be
conducted during FY 2009.
Table 3.3.11:
community-friendly service delivery models for low resource settings is part of TASO core work. These
During FY 2008, TB control and management continued to be an integral component of overall TASO
programming. TB management comprised of: health education for clients and community members; routine
TB screening for all clients; provision of anti-TB drugs to those diagnosed with TB; training of health service
providers in delivery of TB services; adherence support for clients on TB treatment; supporting the CB-
DOTS strategy of MoH; follow up of all TB clients notified for treatment until treatment completion; record
keeping for TB treatment; engaging in TB partnerships and linkages; referral of TB patients where
appropriate; and advocacy aimed at informing national TB policy. All active clients seen at TASO clinics
were screened for TB using recommended methods including sputum examination and chest X-ray. All
clients diagnosed with TB were provided treatment at TASO centers and/or referred to other partners for
ongoing management as deemed appropriate. Over the period October 2007 to September 2008, the
number of HIV positive clients treated for TB was 2,571 (1,056 male and 1,515 female).
In FY 2009, TASO will provide TB/HIV services at the 11 centers in the districts of Gulu, Jinja, Kampala,
Masaka, Masindi, Mbale, Mbarara, Rukungiri, Soroti, Tororo and Wakiso. TASO will continue to prioritize
the service components and emphasis areas outlined for FY 2008. TASO will aim at serving 3,000 HIV
positive people with TB treatment (1,000 male and 2,000 female) and training 330 service providers in
delivery of HIV/TB services. All the clients served by the 11 Centres will routinely be screened for TB during
provision of Basic Care and ART (100% of the clients will have been screened at least once by the end of
the year). The TB/HIV package will comprise of: client and community education on TB; TB management
training for health service providers; routine TB screening for all clients; provision of anti-TB drugs; supply
chain management for TB drugs and commodities; supporting adherence to TB treatment; supporting
partnerships/linkages for TB treatment; records management for TB services; ensuring proper management
of clinical waste; and referral of TB patients for specialized care. TASO Centres will provide TB/HIV services
using various delivery models such as: facility-based delivery; outreach clinics; and community-based
delivery. Broad outcomes aimed at will include beneficiary empowerment and family/community
empowerment to appreciate and engage in TB control and management efforts. TB infection control will be
given renewed focus through strategies including: continuous TB education for clients and care givers;
reducing congestion in all client waiting areas; use of hoods in the laboratories; proper ventilation in clinic
facilities and mandatory sorting and appropriate disposal of all clinical waste. TB/HIV is related to the
program areas of PMTCT, Adult Care & Treatment, Paediatric Care & Treatment, Counseling & Testing,
ARV Drugs and Laboratory Infrastructure. The activities under TB/HIV will not be delivered in isolation but
the program area will be implemented in an integrated service delivery model bringing together activities
Activity Narrative: under all the above program areas to form a comprehensive service package accessed by TASO clients.
The activities under this Program Area are also linked to other USG funding through USAID focusing on the
Program Areas of Sexual Prevention, Orphans and Vulnerable Children, Strategic Information and Health
Systems Strengthening. The USG funded activities in TASO are also backed up by activities funded by
other AIDS Development Partners such as DANIDA, DFID and Irish Aid through the Civil Society Fund.
Continuing Activity: 13227
13227 4058.08 HHS/Centers for The AIDS Support 6420 5737.08 Provision of $600,000
8362 4058.07 HHS/Centers for The AIDS Support 5737 5737.07 Provision of $525,000
4058 4058.06 HHS/Centers for The AIDS Support 3188 693.06 TASO CDC $465,249
* Increasing women's legal rights
Table 3.3.12:
During FY 2008, HIV Counseling & Testing (HCT) was provided as an integrated component of the TASO
comprehensive HIV prevention package. TASO provided HCT services using the Home Based HIV
Counseling & Testing (HBHCT) model developed in partnership with CDC Uganda. HBHCT is provided to
household members of clients registered at the 11 TASO centers nationwide. TASO realized high
acceptance levels (over 90%) for HCT among household members of clients. Over the period October 2007
to September 2008, the key outputs were as follows: 13,683 clients were counseled (5,748 male and 7,935
female); 12,609 new clients were tested for HIV (5,291 male and 7,318 female); 12,609 clients tested for
HIV were given results (5,291 male and 7,318 female); and 856 clients tested HIV positive (316 male and
540 female). Other HCT priorities included: conducting health education; client mobilization; conducting
HCT beneficiary census; home visits; conducting counseling sessions (pre- and post-test); couple
counseling targeting sexual partners; child counseling targeting child members of client households; HIV
testing or dry-blood spots for children below 18 months; linking HIV positive household members to care;
supporting HIV negative household members to maintain HIV negative serostatus; linking discordant and
HIV positive concordant couples to peer support systems; ensuring a reliable supply chain for HCT
supplies; management of HCT clinical waste; ensuring quality control of HCT services; training service
providers in HCT; reviewing and improving HCT models for service delivery. TASO observed that HIV
prevalence in targeted households was highest among adults and children below 5 years; and over 85% of
the family members reached were testing for HIV for the first time. In preparation for HBHCT services,
clients were also supported to disclose their serostatus to their sexual partners. The clients were counseled
on the benefits of disclosure and guided on the process of disclosure and approaches. Clients chose either
self disclosure or supported disclosure and very few opt for anonymous disclosure. Self-disclosure with
counselors supporting client through coaching; supported disclosure where the client receives coaching and
discloses to partner in presence of the counselor as a mediator; and anonymous third party disclosure
where a client requests the counselor to offer couple counseling and testing to both partners. HCT revealed
discordance rate of 65% amongst TASO clients and their partners. This prompted TASO to focus on
supporting discordant couples through partner counseling and testing, provision of prevention information
including Family Planning and Prevention of Mother-to-Child Transmission (PMTCT) services. Discordant
couple clubs were established at the centers and outreach clinics to address the couple's psychosocial
concerns about discordance and to support club members towards behavior change. Regular meetings and
quarterly workshops were held club members shared experiences and received vital information. Parents
who had not disclosed HIV status to the child clients were supported by the counselors to disclose.
Activity Narrative: In FY 2009, TASO will provide HCT services to household members of clients registered at the 11 centers
located in Gulu, Jinja, Kampala, Masaka, Masindi, Mbale, Mbarara, Rukungiri, Soroti, Tororo and Wakiso
districts. Approximately 40,000 household members of clients require HCT services. All the targeted
household members will have the opportunity to benefit from the whole spectrum of the HCT package,
which comprises: health education; home visits; counseling (pre-test, post-test); couple counseling targeting
sexual partners; child counseling targeting children in the targeted households; HIV testing or dry-blood
spots for children below 18 months; giving of test results; linking HIV+ household members to care;
supporting HIV negative household members to maintain their status; linking HIV discordant and concordant
couples to peer support systems; ensuring reliable HCT supply chain; clinical waste management; quality
control of HCT services; training service providers in HCT; and reviewing HCT delivery models. TASO will
provide HCT to 40,000 people (15,000 male and 25,000 female). The targeted beneficiaries will be reached
through service delivery at various venues including: HBHCT, Outreach Clinics, Community Drug
Distribution Points (CDDP) and facility laboratories. TASO sites will partner with the CDC and JCRC
laboratories to do DNA-PCR testing. The broad service delivery strategies will include mobilization and
sensitization, capacity-building, beneficiary involvement, health education (including gender and legal
issues influencing HCT), partnership and collaboration. HCT is related to the program areas of Adult Care &
Treatment, Paediatric Care & Treatment, TB/HIV, PMTCT, ARV Drugs and Laboratory Infrastructure. The
activities under the counseling and testing program area will be implemented in an integrated service
delivery model bringing together activities under all the above program areas to form a comprehensive
service package accessed by TASO clients. The activities under this Program Area are also linked to other
USG funding through USAID focusing on Sexual Prevention, Orphans and Vulnerable Children, Strategic
Information and Health Systems Strengthening. The USG funded activities in TASO are also backed up by
activities funded by other AIDS Development Partners such as DANIDA, DFID and Irish Aid through the
Civil Society Fund.
Continuing Activity: 13228
13228 8359.08 HHS/Centers for The AIDS Support 6420 5737.08 Provision of $986,475
Table 3.3.14:
By July 31 2008, TASO provided ART to 20,000 clients cared for by the 11 nationally accredited TASO sites
(including HBAC Tororo) according to national ART Treatment Guidelines. TASO has been implementing
the ART program since July 2004. Of the clients on ART, 99.3% are on first-line regimens and less than 1%
are on second line regimens. TASO provides only ARV branded and generic drug supplies approved by the
US Food & Drug Administration (FDA). TASO continues to substitute FDA approved branded ARV drugs
with generic ARV drugs once they have been approved by the US FDA and are available on market. The
cost-savings realized through switching to approved generics were ploughed back into additional treatment
slots for clients. TASO procures ARV drugs from Medical Access Uganda, a company established under the
UNAIDS Drug Access Initiative to procure drugs from the selected pharmaceuticals. TASO procures all
ARV drugs centrally for all 11 sites including HBAC-Tororo in accordance with the TASO Procurement
Policy & Procedures. The sites regularly submit monthly consumption reports that form the basis for re-
order from the Central Stores at TASO HQ. Four percent of the total TASO ARV drug budget is set aside for
an episodic buffer for TASO clients accessing ARV drugs under GFATM in case of temporary stock-outs at
public and GFATM supported facilities. This helps prevent treatment interruption of TASO clients receiving
ARVs from public facilities thus freeing up slots they would otherwise consume for other TASO clients; it
also compliments and strengthens the national ART program. In FY 2008, TASO priorities for ARV Drugs
included: ARV drugs procurement for 20,000 clients on treatment; ARV drug procurement for 200 pregnant
clients and their newborn babies; maintaining a primary buffer stock of ARV drugs for at least 3 months at
each of the 11 TASO sites; maintaining a secondary buffer stock of ARV drugs covering an additional 3
months at the TASO Central Stores; maintaining and regularly updating the 12 month rolling forecast for
ARV drugs; ensuring professional stores and stock control system for ARV drugs; running a computerized
stores management information system for ARV drugs integrated with patient care information systems;
training/re-training pharmacy and stores personnel; and liaising with ARV drug supply partners to keep
abreast with critical market trends.
During FY 2009, TASO will carry out activities under ARV Drugs to support HIV treatment services by the
11 Centers located in the districts of Gulu, Jinja, Kampala, Masaka, Masindi, Mbale, Mbarara, Rukungiri,
Soroti, Tororo and Wakiso. Each of the Centers will directly serve clients from the host district and up to 6
neighboring districts. The ARV Drugs related activities will comprise: ARV drug procurement for 20,000
continuing clients and 2,640 new clients to be initiated on ART (assuming level funding across the year);
ARV drug procurement for prophylaxis for 200 eligible pregnant women and their newborn babies;
maintaining a primary buffer stock of ARV drugs covering at least 3 months at each of the 11 TASO sites;
maintaining a secondary buffer stock of ARV drugs covering an additional 3 months at the TASO Central
Stores; maintaining and regularly updating the 12 month rolling forecast for ARV drugs; ensuring
Activity Narrative: professional stores and stock control practices for ARV drugs; maintaining a computerized stores
management information system for ARV drugs integrated with drug consumption information systems;
abreast with critical market trends. The ARV Drugs program area is related to the program areas of PMTCT,
Palliative Care (Basic), Palliative Care (TB/HIV), Counseling & Testing, ARV Services and Laboratory
Infrastructure. The activities under ARV Drugs will not be delivered in isolation but the program area will be
Program Area are also linked to other USG funding through USAID focusing on the Program Areas of
Strengthening. The USG funded activities in TASO are also backed up by activities funded by other AIDS
Development Partners such as DANIDA, DFID and Irish Aid through the Civil Society Fund.
Continuing Activity: 13229
13229 4056.08 HHS/Centers for The AIDS Support 6420 5737.08 Provision of $7,194,288
8360 4056.07 HHS/Centers for The AIDS Support 5737 5737.07 Provision of $6,766,294
4056 4056.06 HHS/Centers for The AIDS Support 3188 693.06 TASO CDC $6,263,946
Estimated amount of funding that is planned for Food and Nutrition: Policy, Tools $15,000
and Service Delivery
Table 3.3.15:
care centers and 5 training centers) implementing the TASO 2008-2012 Strategic Plan. The outlets reach a
From October 2007 to September 2008, about 100,000 clients were in care by the TASO Centres. All of
these index clients and their eligible household members required laboratory services at some time. TASO
operated 11 laboratories in the districts of Gulu, Jinja, Kampala, Masaka, Masindi, Mbale, Mbarara,
Rukungiri, Soroti, Tororo and Wakiso. By September 2008, the key laboratory outputs were: 12,879 HIV
antibody tests conducted; 3,061 TB Tests (Smears) conducted; 479 Syphilis Tests conducted; 515
Complete Blood Counts done; 419 Lymphocyte Tests conducted; 2,156 CD4 Count Tests conducted (by
TASO Mbarara); 26 Viral Load Tests conducted (by TASO Mbarara); and 78 LFT and/or RFT tests
conducted (by TASO Mbarara). Each of the laboratories had linkage to MoH, CDC Uganda and National TB
& Leprosy Program Central Laboratories for quality assurance. Other key priorities for laboratory
infrastructure were: automating laboratory processes like Hematology and Clinical Chemistry to cope with
the high demand for laboratory services; enhancing quality assurance of laboratory services; capacity
building for laboratory personnel; ensuring steady supply of laboratory reagents and consumables;
reviewing laboratory guidelines and standard operating procedures; enhancing the Laboratory Information
Management Information System (LIMBS).
During FY 2009, TASO will support laboratory infrastructure in the 11 centers located in Gulu, Jinja,
Kampala, Masaka, Masindi, Mbale, Mbarara, Rukungiri, Soroti, Tororo and Wakiso districts. Laboratory
infrastructure will be enhanced through: consolidating automation of laboratory processes like Hematology
and Clinical Chemistry; enhancing QA of laboratory services; capacity building for laboratory personnel;
ensuring reliable supply chain for laboratory reagents and consumables; reviewing laboratory guidelines
and standard operating procedures; enhancing the laboratory information management information system
(LIMBS). Deliverables for FY 2009 will include: 20,000 HIV antibody tests; 5,000 TB Tests (Smears); 500
Syphilis Tests; 600 Complete Blood Counts; 500 Lymphocyte Tests; 5,000 CD4 Count Tests; 100 Viral
Load Tests; and 150 LFT and/or RFT tests. The Laboratory Infrastructure program area is related to the
program areas of PMTCT, Adult Care & Treatment, TB/HIV, Counseling & Testing, ARV Drugs and ARV
Services. The activities under Laboratory Infrastructure will not be delivered in isolation but the program
area will be implemented in an integrated service delivery model bringing together activities under all the
above program areas to form a comprehensive service package accessed by TASO clients. The activities
under this Program Area are also linked to other USG funding through USAID focusing on the Program
Areas of Sexual Prevention, Orphans and Vulnerable Children, Strategic Information and Health Systems
Continuing Activity: 17055
17055 17055.08 HHS/Centers for The AIDS Support 6420 5737.08 Provision of $568,268
Table 3.3.16:
