Summary Program Descriptions

Project Title: Abstinence and Be Faithful (AB)

Budget: FY 2007 GHAI: $19,361,142

Implementing Mechanism: USAID grants with Non-governmental Organizations (NGOs) and Community/Faith-Based Organizations (CBOs/FBOs) include the following organizations: Adventist Development Relief Agency (ADRA), American Red Cross, Catholic Relief Services (CRS), Children’s AIDS Fund, Food for the Hungry, HOPE Worldwide South Africa, International Youth Federation, Pact, Program for Appropriate Technology in Health (PATH), Salesian Missions, Samaritan’s Purse, World Relief, and World Vision.

Contact Person(s): John Crowley (USAID/GH)

Program Description:

This program provides central funding for multi-country grants to NGOs to expand programs that promote avoidance of risky behavior: i.e., delaying sexual activity, increasing “secondary abstinence” among young people; and promoting mutual fidelity and partner reduction, among both youth and the general population. Specific activities include the following:

• Providing skills-based HIV education for young people;
• Stimulating community discourse on healthy norms and behaviors;
• Strengthening the role of parents and other protective influences;
• Promoting initiatives to address sexual coercion and gender-based violence; and,
• Targeting early intervention with at-risk youth.

There are 14 cooperative agreements awarded to carry out AB activities. These 14 Partners work with over 30 local faith-based organizations such as Anglican Church of Kenya Western Diocese, Fellowship of Christian Unions, Kenya Students Christian Fellowship, as well as many secular indigenous community-based organizations. Programs supported include culturally appropriate prevention activities for young people emphasizing “Abstinence” and “Be Faithful” (AB) messages, as well as medically accurate information about condoms for older and at-risk youth and referrals to health providers where at-risk youth can obtain other HIV services. These efforts complement ongoing USAID-funded prevention programs that target risky adult behaviors and contribute to the overall national prevention programs.

By the end of FY 2006, the partners under this program trained more than 160,000 individuals to provide HIV/AIDS prevention education that emphasizes abstinence and/or fidelity. In this time period, partners also reached more than 5.5 million individuals with community outreach programs that promote abstinence and/or being faithful, of which nearly three million aged 14 and under primarily received abstinence messages.

In FY 2006 USAID initiated an evaluation of the AB programs, and the results will be available in FY 2007. Partners have received initial feedback and have begun adjusting their programs to reflect the preliminary findings. A second phase of this evaluation funded in FY 2006 will examine the effectiveness of peer outreach prevention programs.

FY 2007 Program:

With an estimated forty percent of all new infections occurring in youth aged 15-24, FY 2007 funding will continue to scale up youth-oriented AB prevention programs in 14 Emergency Plan focus countries and improve on the quality of their delivery. Activities will continue to expand the promotion of primary and secondary abstinence, faithfulness, monogamous relationships, and avoidance of unhealthy sexual behaviors among youth. Many partners are focusing on expanding their program to reach more parents, men, and other adults who act as barriers to abstinence and fidelity and affect the environment in which youth make decisions. All of these programs are expected to continue to achieve their targets, thereby contributing to the Emergency Plan goal of preventing seven million new infections.

Time Frame: FY 2007 – FY 2008

Project Title: Antiretroviral Treatment (ART)

Budget: FY 2007 GHAI: $105,359,943

Implementing Mechanism: HHS Cooperative Agreements with Non-governmental Organizations (NGO), including Columbia University, Elizabeth Glaser Pediatric AIDS Foundation, Harvard University, and AIDSRelief.

Contact Person(s): Tedd Ellerbrock (HHS/CDC/GAP) and Deborah Parham (HHS/HRSA/HAB)

Program Description:

Emergency Plan funds provide central support to four U.S. organizations working in 13 of the 15 Emergency Plan focus countries. These Department of Health and Human Services (HHS) awarded grants, which were selected based on competitive bidding, to the Mailman School of Public Health of Columbia University, the Elizabeth Glaser Pediatric AIDS Foundation, Harvard University School of Public Health, and AIDSRelief (formerly, the Catholic Relief Services Consortium) have sub-contracted with local in-country organizations, such as: Ministries of Health; faith-based hospitals in nine countries; Muhimbili National Hospital, Tanzania; Moi Teaching and Referral Hospital, Kenya; University of Transkei, South Africa; and Lusaka Health District, Lusaka, Zambia.

The grant recipients are engaged in providing clinical HIV care, including ART; drug and health commodities management; laboratory services for diagnosing HIV infection and opportunistic infections; training of health care workers; community services; and monitoring and evaluation. Areas of focus include the following:

• Providing comprehensive HIV care, including ART, and diagnosing and treating TB and other HIV-related opportunistic infections;
• Selecting and procuring the appropriate ART drugs in accordance with U.S. and host Government policies;
• Ensuring the availability and appropriate use of laboratory services for diagnosing HIV infection and opportunistic infections; and
• Providing training to increase capacity of local staff and encourage local ownership.

As of September 30, 2006, more than 209,000 patients were on ART at 404 medical facilities in 13 countries through this program. As of February 2007, the number of patients receiving ART through this program is projected to increase to approximately 260,000. Further expansion is dependent on the receipt of funding from country budgets.

FY 2007 Program:

HHS will use FY 2007 funding to provide HIV care and treatment for those enrolled in the program through February 2008. Funding for scientific and technical advice, assistance, and monitoring for this program and management and administrative costs associated with the program are reflected in the technical oversight and management.

This program will contribute to achieving critical Emergency Plan goals, including supporting treatment for two million HIV-infected individuals.

Time Frame: FY 2007 – FY 2008

Project Title: Orphans and Vulnerable Children (OVCs) Affected by HIV/AIDS

Budget: FY 2007 GHAI: $21,482,354

Implementing Mechanism: USAID cooperative agreements with Non-Governmental Organizations (NGOs) and Community/Faith-based Organizations (CBOs/FBOs), including the following: Africare, Association of Volunteers in International Service (AVSI), CARE USA, Catholic Relief Services (CRS), Christian Aid, Christian Children’s Fund, Family Health International (FHI), HOPE Worldwide South Africa, Opportunity International, Plan USA, Project Concern International, Project HOPE, Salvation Army, Save the Children, and World Concern.

Contact Person(s): John Crowley (USAID/GH/ISD)

Program Description:

This Emergency Plan-funded program continues to fund activities in multiple countries that increase care and support to OVCs affected by HIV. The activities supported through this program provide essential services and comprehensive care to improve the quality of life for OVCs, and aim to strengthen the quality of OVC programs through the implementation, evaluation, and replication of best practices. These projects support one or more of the following strategic approaches:

• Strengthening the capacity of families and caregivers to cope and address OVC needs;
• Mobilizing and strengthening community-based responses;
• Increasing the capacity of children and young people to meet their own needs;
• Building host government capacity to develop appropriate policies, including legal and programmatic frameworks, as well as essential services for the most vulnerable children;
• Raising awareness within societies to create an environment that enables support for children affected by HIV/AIDS while minimizing stigma;
• Developing, evaluating, disseminating and applying sound practices;
• Creating strong partnerships with local in-country organizations; and,
• Forming public-private alliances.

In FY 2006, almost 500,000 OVC received services from the USG partners with support from this program. One project reached 40,874 children in Ethiopia and 26,005 children in Mozambique with a range of psychosocial, food and nutrition, educational, recreational, and protection services through the mobilization and capacity building of local organizations. Several partners have adopted a strategy of reaching communities primarily through their local community/faith-based partners, this has proven effective in engaging sustainable, community-based responses by using a trusted and established mechanism within a community. In Haiti, in addition to partnering with FBOs, one partner works through a network of children’s safety net organizations that help link OVC caregivers with other local groups such as agricultural and nutrition programs.

FY 2007 Program:

In FY 2007, funding will support OVC partners to carry on collaboration with locally-based organizations to implement and scale up activities that:

• Strengthen the capacity of families and caregivers to address OVC needs in their local context
• Support OVCs through microfinance programs for caregivers of OVCs;
• Increase capacity of children and youth to meet their own needs;
• Strengthen the capacity of local organizations to provide care for OVCs;
• Work toward reducing the stigma and discrimination of OVCs and their caregivers; and,
• Increase OVC access to essential programs and services, specifically in education, psychosocial support, health and livelihood training.

Partners will continue to work with schools, local government and social programs to help identify vulnerable children and to establish links for support including referrals for home based care, food/nutrition, and psychosocial needs. With all 15 partners entering their second full year of implementation, program activities will continue to reach more OVC, while an emphasis on quality will help ensure that interventions are truly making a measurable difference in the lives of children affected by HIV/AIDS.

This program will contribute to achieving the Emergency Plan goal of supporting care for ten million people infected or affected by HIV/AIDS, including orphans and other vulnerable children.

Time Frame: FY 2007 – FY 2008

Project Title: Blood Transfusion Safety

Budget: FY 2007 GHAI: $42,563,000

Implementing Mechanism: HHS/CDC Cooperative Agreements with National Blood Transfusion Services or Ministries of Health in 14 focus countries (Botswana, Côte d’Ivoire, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda and Zambia) and with five technical assistance organizations (American Association of Blood Banks; Sanquin Blood Consulting; Safe Blood for Africa; Social and Scientific Systems, Inc.; and the World Health Organization).

Contact Person(s): Heather Pumphrey (HHS/CDC/GAP)

Program Description:

Emergency Plan funds provide central support for focus countries to develop nationally-directed, regionalized blood systems that address all the processes of a well-functioning system of blood supply, including blood-donor screening and testing; blood collection, preparation and storage; blood-product transportation and distribution; appropriate transfusion practice and blood utilization; physician and blood-banking technologist training; and quality assurance, monitoring and evaluation.

The Emergency Plan blood safety program supports expert blood safety organizations to provide guidance, advice, and training to National Blood Transfusion Services and Ministries of Health in need of technical assistance. The program pairs an expert blood transfusion technical assistance organization with each country’s National Blood Transfusion Service to provide guidance and technical assistance. These technical assistance organizations help advise the Ministries of Health on building renovation, equipment selection and testing strategies.

FY 2007 Program:

Through the coordinated efforts of the National Blood Transfusion Services and the assistance of expert blood transfusion organizations, each of the focus countries will continue to develop an organized, high-quality blood transfusion system that will produce an adequate supply of safe blood. The emphasis for FY 2006 activities will be furthering infrastructure development, completing blood supply testing for HIV and hepatitis, developing blood donor recruitment networks, and providing guidance and training in all of these areas.

This program will contribute to achieving the critical Emergency Plan goal of supporting the prevention of seven million new HIV infections.

Time Frame: FY 2007 – FY 2008

Project Title: Safe Medical Injections

Budget: FY 2007: GHAI $3,281,952

Implementing Mechanism: USAID Task Order Proposal Requests through existing Indefinite Quantity Contracts, including John Snow Inc., University Research Co. LLC , Chemonics International, Initiatives, Inc.

Contact Person(s): Robert Ferris (USAID)

Program Description:

Emergency Plan funds provided central support for injection safety activities in FY 2006 through an integrated approach that included improving the safety of medical practices through technical innovations; developing behavior change communications, education and training campaigns; providing sufficient quantities of injection materials, including needles, and syringes; strengthening logistical systems and management; and strengthening waste management systems for sharps.

In FY 2006, this program improved the availability of safe injection by supporting commodity management and procurement support, including the procurement and distribution of more than 97.2 million syringes in Emergency Plan focus countries. It also expanded capacity building and training in injection practices, supply management, waste handling, and interpersonal communications; reduced the excessive use of injectable pharmaceuticals; developed a standardized system for sharps disposal; and conducted a formal assessment of injection safety and healthcare waste management practices using standardized tools.

FY 2007 Program:

In FY 2007, the USG will continue to implement strategies for wider public understanding and support for the availability of safe medical injections in the Emergency Plan focus countries; decrease the frequency of unnecessary and unsafe injections; improve the supply and distribution systems for commodities needed for safe injections; and improve waste management of sharps. Focus will be on prioritizing sharps procedures at highest risk of HIV transmission (e.g., phlebotomy) and cost-effective strategies (e.g., ensuring availability of sharps containers proximate to point of sharps use).

This program will contribute to achieving the Emergency Plan goal of supporting prevention of seven million new HIV infections.

Time Frame: FY 2007 - FY 2008

Project Title: Drug Quality Assurance

Budget: FY 2007 GHAI: $3,700,000

Implementing Mechanism: HHS/FDA direct expenses and contracts.

Contact Person: Beverly Corey (HHS/FDA) and Michael Johnson (HHS/OGHA).

Program Description:

In direct support of the President’s Emergency Plan for AIDS Relief (the Emergency Plan), the Department of Health and Human Services’ (HHS) Food and Drug Administration (FDA) has implemented an expedited process to help ensure that the United States can provide safe, effective, and quality manufactured antiretroviral drugs to the 15 focus countries. HHS/FDA published guidance for the pharmaceutical industry that encouraged sponsors to submit applications for approval (or tentative approval, if U.S. patents blocked issuance of approval for U.S. marketing) of fixed dose combinations (FDCs – new products that combine already-approved individual HIV/AIDS therapies into a single dosage) or co-packaged versions of previously HHS/FDA-approved FDCs or single-entity antiretroviral therapies for the treatment of human immunodeficiency virus (HIV). Drugs approved or tentatively approved under this expedited process meet all FDA standards for drug safety, efficacy, and manufacturing quality.

HHS/FDA’s involvement includes the following activities:

• Outreach Activities: HHS/FDA is developing and implementing comprehensive outreach programs that target drug manufacturers and national drug regulatory authorities in focus countries. These programs include training in the general marketing application review process; disseminating current good manufacturing practices, review and standards for active pharmaceutical ingredients; and monitoring post-authorization drug safety and manufacturing reporting.
   
• Application Activities: HHS/FDA is expediting the review of new and generic drug marketing applications under the Emergency Plan. Generally, a priority review designation provides for the review of a new drug marketing application within six months or less and the legal standard for review of a generic drug application is 180 days. However, under the expedited review the application (new drug or generic) is reviewed within approximately eight weeks. HHS/FDA reviewers are working closely with potential drug marketing application sponsors to foster the development and submission under the Emergency Plan of well-documented, quality marketing applications that have the highest chance for a successful review. As of January 4, 2007, HHS/FDA had approved or tentatively approved 34 single-entity and co-packaged versions of previously HHS/FDA-approved, brand name antiretroviral drug preparations.
   
• Inspections: HHS/FDA is conducting pre-approval of current Good Clinical Practices inspections of Bioequivalence Studies to ensure the veracity of bioequivalence data and current good manufacturing practices inspections of drug manufacturing sites to ensure drug product quality during manufacturing.
   
• Post-marketing Activities: HHS/FDA is monitoring the drug products distributed under the Emergency Plan to help ensure continued drug safety.

In addition, in FY 2006 HHS/FDA sponsored two technical assistance conferences for regulatory agencies that included Emergency Plan focus countries. The purpose was to educate and support these government agencies in their interpretation and evaluation of the findings and outcomes of the HHS/FDA approval process with the goal of reducing the time to actually procure and distribute antiretrovirals (ARVs) in countries receiving Emergency Plan support following HHS/FDA approval.

FY 2007 Program:

FY 2007 funding will be used to continue to finance the following HIV drug marketing application review and inspection activities necessary for the purchase of drugs for the Emergency Plan:

• The review of approximately 20 new drug and 55 generic drug marketing applications;
• Ten pre-approval inspections of active pharmaceutical ingredients manufacturing facilities;
• Ten pre-approval inspections of finished dosage manufacturing facilities;
• Thirty-five pre-approval inspections of bioequivalence studies; and,
• Two inspections to target manufacturing problems.

Funds may also be required to facilitate activities related to providing consultation and documentation to the World Health Organization (WHO), and to facilitate listing of FDA approved and tentatively approved products on the WHO Prequalification drug website.

Furthermore, in FY 2007 HHS will provide strategic support to ARV producers who would like to participate in the HHS/FDA approval process but need help to do so effectively. Such support will consist of providing guidance in interpreting and complying with the requirements of the HHS/FDA application process. The expected result of this work will be an increase in the number of drug products available in an accelerated manner to be purchased with Emergency Plan funds to treat HIV-infected persons.

In addition, HHS/FDA will plan and attempt to provide regional in-country training to support registration by local drug regulatory authorities of ARVs that have been tentatively approved by HHS/FDA so that they can be procured and distributed to patients in those countries.

This program will contribute to achieving the critical Emergency Plan goal of supporting treatment for two million HIV-infected individuals.

Time Frame: FY 2007 – FY 2008

Project Title: New Partners Initiative (NPI)

Budget: FY 2007 GHAI: $65,000,000

Implementing Mechanisms: USAID Cooperative Agreements and other procurement mechanisms with Non-Governmental Organizations and Community/Faith-based Organizations (C/FBOs) include the following: Ajuda de Desenvolvimento de Povo para Povo, Catholic Medical Mission Board, Christian Reformed World Relief Committee, Church Alliance for Orphans, Foundation for Hospices in Sub-Saharan Africa, Genesis Trust, Geneva Global, Global Outreach for Addiction Leadership & Learning, Kara Counseling and Training Trust, Light and Courage Centre Trust, Luapula Foundation, Mothers 2 Mothers, Natural Family Planning Center of Washington DC, Nazarene Compassionate Ministries, Nordic Assistance to Vietnam, Ong Le Soutien, Réseau Ivoirien des Organisations de PVVIH (RIP+), ServeHAITI, Inc, Universidade Catolica De Mocambique, Visions in Action, World Hope International, and Youth Health Organization.

Contact Person(s): Megan Petersen (USAID/GH), Janet Paz-Castillo (USAID/GH), and Patrick Purtill (OGAC)

Program Description:

NPI is a means to increase the number of Emergency Plan (EP) partners by establishing a competitive grants process for organizations with the desire and the ability to help implement the President's Emergency Plan, but which may have little or no experience in working with the federal government. NPI will increase the total number of EP implementing partner organizations and improve their capacity to respond effectively to help meet the President's goals. Additionally, the initiative will develop indigenous capacity so that affected countries can address AIDS on their own and decrease dependence on foreign organizations and foreign skills.

In coordination with OGAC, USAID will initiate the following actions in order to establish NPI:

• Through an Annual Program Statement or other procurement mechanism, conduct outreach to identify and inform potential partners working in affected countries about NPI;
• Identify potential new partners from among private and voluntary organizations, faith-based organizations, community-based organizations and other non-profit entities with the desire and the ability to help implement the EP but with limited or no experience in working with the Federal Government through current solicitation promotion practices; and
• Improve the capacity and implementation of new partners, including indigenous partners in affected countries, to respond effectively by making available post-award technical (TA) and capacity-building (CB) assistance through an identified partner, competent in providing both TA and CB.

During the first round 22 new partners were selected out of 221 concept papers submitted to USAID.

FY 2007 Program:

The 22 partners identified from Round One will implement prevention and care program in 13 of the PEPFAR focus countries. Post-award activities, including program implementation, will incorporate technical and capacity building assistance such as:

• Conducting needs assessments of the partners to identify priority areas for organizational and technical assistance;
• Reviewing activities, strategies, implementation steps, and outcomes for consistency with the priorities, goals and strategies of the President's Emergency Plan for AIDS Relief;
• Reviewing geographic scale and beneficiaries to ensure that the programs reflect priority needs (e.g., difficult or underserved populations) and are targeted with appropriate strategies;
• Developing clear plans for devolution to indigenous service providers and promotion of sustainability;
• Ensuring that programs are applying evidence-based strategies, reflect best practices and are consistent with national guidelines and policies;
• Developing and implementing monitoring and evaluation plan to ensure quality;
• Ensuring a high level of involvement of local partners in program implementation; and
• Building capacity of indigenous partners.

Additionally, in FY2007, PEPFAR expects to compete and select additional new partners through a competitive process.

This program will contribute to achieving critical Emergency Plan goals, including supporting prevention of seven million new HIV infections and supporting care for ten million people infected or affected by HIV/AIDS, including orphans and vulnerable children.

Time Frame: FY 2007 – FY 2008

Project Title: Supply Chain Management System

Budget: FY 2007 GHAI: $20,000,000

Implementing Mechanism: The Partnership for Supply Chain Management

Contact Person(s): Carl Hawkins (USAID/GH)

Program Description:

In order to respond to the rapid increase in patients being treated and tested and improve the capacity of existing supply chains, the Supply Chain Management System (SCMS) was formed. At the end of FY 2005, the SCMS contract was awarded to the Partnership for Supply Chain Management, a non-profit consortium of 17 organizations, including four African organizations, with extensive experience. The 17 organizations that form SCMS are led by John Snow Inc. and Management Sciences for Health. Each of the 17 partners offer unique capabilities to ensure that high-quality supplies are available to the people who need them. During FY 2006, SCMS began work in all 15 PEPFAR focus countries and supported the USG programs through commodity procurement, technical assistance or coordination of key stakeholders and donors.

The project exceeded its goal of setting up offices in 7 of the 15 countries. To date, SCMS has an established field presence in 14 of the 15 PEPFAR focus countries. Another one of SCMS’s main objectives was to ensure that the lowest priced, highest-quality drugs are available for antiretroviral treatment. To date, over 90% of the ARVs procured by SCMS were generic FDA-approved or FDA tentatively approved.

Additionally, SCMS contributes to the coordination of significant, donor-funded initiatives, such as the World Health Organization/Joint United Nations Programme on HIV/AIDS (UNAIDS) efforts to prepare a global antiretroviral drugs (ARVs) demand forecast through 2008. As the technical secretariat of the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Bank, and PEPFAR’s joint procurement planning initiative, SCMS facilitates national procurement planning and supply chain management of HIV/AIDS commodities in six countries (Ethiopia, Guyana, Haiti, Mozambique, Rwanda, and Vietnam).

FY 2007 Program:

SCMS will continue to build an uninterrupted supply of commodities while building capacity for long-term sustainable procurement and distribution. With FY 2007 funds, SCMS will continue to: improve procurement and distribution; support countries that experience unforeseen stock-outs; coordinate with international organizations to increase efficiency; maintain transparent procurement, quality assurance and control systems; provide freight forwarding and warehousing services; and build on procurement information management systems.

With central FY 2007 funds SCMS will support a headquarters office. Central funds will also be used for the procurement of HIV commodities in emergency situations and on related, follow-up technical assistance to prevent further stock-outs from taking place. SCMS will continue to help lead a coordination effort between major donors and stakeholders such as the Global Fund and the World Bank in the area of commodity procurement and supply chain strengthening.

This program will contribute to achieving two critical Emergency Plan goals, including supporting treatment for two million HIV-infected individuals; and supporting care for ten million people infected or affected by HIV/AIDS.

Time Frame: FY 2007 - FY 2008

Project Title: Technical Leadership and Support

Budget: FY 2007 GHAI: $19,497,436

Implementing Mechanism: USAID, HHS, DOD and State Department contracts and grants

Contact Person(s): Michele Moloney-Kitts (OGAC), Debbi Birx (HHS/CDC), Deborah Parham (HHS/HRSA/HAB), Carolyn Williams (HHS/NIH), Paul Mahanna (USAID/GH/OHA), and Anne Thomas (DOD).

Program Description:

Technical Leadership and Support programs fund technical assistance and other activities to further Emergency Plan policy and programmatic objectives in the field, at headquarters, and internationally. In addition to supporting USG technical assistance, this program utilizes existing contractual and grant mechanisms within USAID, HHS, and the State Department to the maximum extent possible.

FY 2007 Program:

In FY 2007, the technical leadership and support program will fund technical assistance and centrally-funded activities with an emphasis on strengthening several high priority technical areas including; innovative approaches to Prevention of Mother-to-Child Transmission (PMTCT) services, expanding linkages between TB and HIV programming, intensifying counseling and testing interventions, expanding gender initiatives and assisting countries in the development of medical male circumcision interventions as requested by host country governments. In addition, funds will be also utilized to provide assistance to the World Health Organization (WHO) to bolster their HIV/AIDS response to key priority areas.

Funding will be used to accelerate implementation of PMTCT services and improve approaches to infant HIV diagnosis and pediatric treatment. In addition, funds will be used to increase community engagement and address barriers to referrals and linkages within PMTCT programs; and link with other related programs ("wraparounds") to increase PMTCT and to leverage HIV programs to further improve maternal and child health (e.g., antenatal care, food, expanded program on immunization, malaria and safe delivery). Funding for TB/HIV programs will focus on support for capacity-building, laboratory strengthening and improved infection control approaches. Counseling and testing approaches are integral to both PMTCT and TB programs and additional resources requested will assist to intensify prevention counseling for persons testing HIV-negative.

Prevention approaches continue to be a high priority for PEPFAR and these additional funds will help support several key areas to improve efforts to curb the epidemic, such as support the design and scale up of model programs to address critical drivers of the most severe epidemics and support medication assisted therapy for intravenous drug users. In addition, following the WHO’s announcement on medical male circumcision as an HIV prevention intervention, additional funds will help to support the field to strengthen preparatory activities and service delivery approach related to provision of medical male circumcision when consistent with local norms and policies. PEPFAR will work closely with host country governments and within the context of the WHO/UNAIDS normative guidance. Funds will be used to help training centers safely meet existing demand for voluntary medical male circumcision services; and systematically collect, synthesize, and promote the utilization of data to inform future programmatic efforts.

Funds will also support ongoing collaboration with the WHO. The Emergency Plan and the WHO will embark on a new program to scale-up HIV prevention, care and antiretroviral therapy at primary health centers in several key countries. PEPFAR support for WHO will also include efforts to address human capacity deficits through such approaches as task-shifting. Additional resources to WHO will also support international approaches to counseling and testing and strengthen program and policy guidance related to medical male circumcision.

Time Frame: FY 2007 – FY 2008

Project Title: Twinning Center

Budget: FY 2007 GHAI: $4,000,000

Implementing Mechanism: Cooperative Agreement with the American International Health Alliance (AIHA)

Contact Person(s): Sera Morgan (HHS/HRSA/HAB)

Program Description:

American International Health Alliance (AIHA), through a Cooperative Agreement with the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS), has established an “HIV/AIDS Twinning Center” (www.twinningagainstaids.org) to support twinning and volunteer activities in 15 focus countries as part of the implementation of the President’s Emergency Plan for AIDS Relief.

The overall goal of the Twinning Center is to strengthen the human and organizational capacity necessary to scale up and expand HIV/AIDS prevention, care, treatment, and support services within the broader context of human resource development strategies addressing the HIV/AIDS epidemics in these countries. Through the establishment of volunteer-driven institutional/ organizational partnerships of 3-5 years duration and the incorporation of long-term individual volunteers through the Volunteer Healthcare Corps (VHC), the Twinning Center contributes to the President’s Emergency Plan goals by:

• Strengthening educational institutions and training facilities;
• Training and mentoring individual care-givers;
• Developing models of care for improved organization and delivery of services and for rapid scale-up of interventions; and,
• Transferring appropriate technology.

AIHA and its partners work closely with HRSA, host country officials and ministries of health, and U.S. Government teams to create twinning partnerships that advance each country’s Strategic HIV/AIDS Plan and Country Operational Plan (COP). To date, potential twinning partnerships have been identified in Zambia, Ethiopia, Uganda, South Africa, Kenya, Mozambique, and Tanzania. The Twinning Center has conducted site assessment visits to five countries, and has developed partnerships in Zambia, Ethiopia, South Africa, and Tanzania, and is in the process of developing twinning partnerships in Kenya and Mozambique and additional partnerships in Ethiopia and South Africa.

FY 2007 Program:

The initial twinning partnerships were selected in the spring and summer of 2005, with a second round of partnerships established in early 2006. FY 2007 funding will support existing successful twinning partnerships that are capable of rapidly expanding and scaling up for increased impact. In these cases, Twinning Center funding is expected to supplement, not supplant, other funding sources.

This program will contribute to achieving critical Emergency Plan goals, including supporting prevention of seven million new HIV infections; supporting treatment for two million HIV-infected individuals; and supporting care for ten million people infected or affected by HIV/AIDS, including orphans and vulnerable children.

Time Frame: FY 2007 – FY 2008