PEPFAR New Initiatives

The following sections provide brief descriptions of the new initiatives of PEPFAR.

Partnership Frameworks

The development of Partnership Frameworks began in FY 2008 (Frameworks were called Compacts during early concept development). The goal of a Partnership Framework is to advance the progress and leadership of partner countries in the fight against HIV/AIDS. Partnership Frameworks will help create the policy and financial commitment platform necessary to successfully invest funding and achieve the five-year goals for prevention, care and treatment. This is to be accomplished through long-term, consultative frameworks, which outline mutual, non-binding, political commitments and responsibilities for the USG and partner country governments, and set forth a progression over time of U.S. support and partner country investment and policy change. While this is the overarching goal, negotiations at the country level will define each Partnership Framework and will reflect each country's unique situation, capabilities and priorities. Partnership Frameworks should be fully in line with the national HIV/AIDS plan of the partner country, and should continue to emphasize sustainable programs with increased country ownership (including decision-making authority and leadership).

While the timeline will vary from country to country, four countries, Malawi, Swaziland, Angola, Ghana and Lesotho already have a signed Partnership Framework that is posted on PEPFAR.gov at http://www.pepfar.gov/frameworks/index.htm. The Partnership Frameworks for the Democratic Republic of Congo and Mozambique have been approved, but are not yet signed. The Frameworks for several additional countries are in the final review process and are expected to be ready to sign by early 2010.

In some countries, additional funding for country programs will be made available after the Partnership Framework has been established. These additional funds will be described in subsequent updates to the Country Operational Plans and will be notified at a later date.

Updated Partnership Framework Guidance (Version 2.0) can be found on PEPFAR.gov at http://www.pepfar.gov/guidance/framework/index.htm.

The Headquarters Operational Plan (HOP)

The primary role of agency headquarters (HQ) operations is to support field staff and country-level efforts towards PEPFAR goals. HQ provides this support through:

• Technical support which provides direct technical assistance and central procurements;
• Quality assurance of technical programs;
• Budgetary management and administration;
• Personnel management at headquarters and for country deployment;
• Oversight and management of strategic information and public health evaluation;
• Coordination of multilateral and bilateral partnerships on HIV/AIDS;
• Public affairs;
• Congressional liaison;
• Development of global public-private partnerships;
• Interagency coordination on HIV/AIDS global programs; and
• Support for interagency coordination on other relevant diseases and global priorities, including TB, malaria, education, gender, food and nutrition programs, maternal-child health, reproductive health, and water and sanitation - i.e., "connecting the dots" of development.

The purpose of the HOP is to articulate how these primary functions will be supported across a diverse set of agencies, each of which offers a comparative advantage to global engagement in HIV/AIDS. The specific objectives of the HOP and the planning process to develop it include:

• Strengthening interagency team-building and coordination across the programmatic areas of PEPFAR;
• Aligning the configuration of staffing across agencies to meet the demands of interagency programmatic support as well as management and staffing within agencies;
• Describing the specific activities of each agency and the requested budget across the programmatic areas of PEPFAR;
• Serving as the primary document for review and approval of PEPFAR funding to agencies at the headquarters level; and
• Integrating special HQ initiatives into regular planning and reporting processes.

The HOP includes all PEPFAR funding and activities not currently planned by country or regional teams, including Country Operational Plans (COPs), mini-COPs, and State Department Director of Foreign Assistance Operational Plans (F Ops). The majority of the effort for the HOP will be done by Technical Working Groups (TWGs) and Cognizant Technical Officers (COTRs)/Project Officers/agency equivalent for each of the program areas.

Indirect Cost Models

During FY 2008, the Office of the U.S. Global AIDS Coordinator (OGAC) began an inter-agency process of identifying and categorizing the direct and indirect costs of implementing PEPFAR, in both the field and at headquarters. Participating agencies included: Department of Health and Human Services (HHS), U.S. Agency for International Development (USAID), Peace Corps and Department of Defense (DoD). The goals of the exercise were to identify all of the direct and indirect costs incurred in the implementation of PEPFAR in a manner that was transparent to all stakeholders, supported by data to ensure accountability and followed good governance practices. To date, the DoD and USAID models have been approved by the Office of Management and Budget (See Appendix 3 - Indirect Cost Models for a description of the DoD and USAID models).

Identified direct and indirect costs will continue to be funded through the annual country operational plans (field) and the headquarters operational plan (HQ). Indirect costs will be calculated annually based on the OMB approved indirect cost models for each agency or HHS operating division. These inputs to the models will be updated each year to reflect historical actual cost figures to ensure accuracy. To create transparency and accountability, the models, resulting rates and associated costs will be documented and updated annually in memorandums of understanding between OGAC and each agency.