Malawi - FY 2009 Approved Funding by Program Area, Agency and Funding Source

Malawi - FY 2009 Approved Funding by Program Area, Agency and Funding Source

*Only appropriations from the GHCS (State) fund account are notified by the Global AIDS Coordinator.

The PEPFAR program in Malawi has effectively supported the Government of Malawi's national response to HIV and AIDS through provision of technical leadership at the national level to scale up the ART program in the public and private sectors. This collaboration helped Malawi to initiate greater than 200,000 people on ART, provide PMTCT services to greater than 80% of pregnant women who attend ANC services, and support an aggressive HIV Testing and Counseling campaign which, as a result, provided 1,083,000 HIV tests in 2008. PEPFAR Malawi has demonstrated effective interagency coordination, working closely with other USG bilateral and multilateral programs to leverage resources, such as those of the President's Malaria Initiative (PMI), Title II Food programs, and the Global Fund. Other programmatic strengths include promoting strong country ownership by supporting Malawian health management leaders, being directive in establishing a role for civil society in community interventions, and building a role for men in tackling gender issues that continue to plague progress in combating the AIDS epidemic.

PEPFAR will support implementation of a wide range of prevention programs in Malawi, including support to the new prevention strategy of the Government of Malawi. PEPFAR will complement youth prevention activities supported with the Global Fund resources with activities that promote safer sexual behaviors by Malawian adults, focused on reducing multiple and concurrent partnerships and encouraging mutual faithfulness in the general population, as well as increasing condom use and other preventive behaviors among high-risk groups. PEPFAR will also support successful, country-appropriate models of high quality youth prevention programming that can be scaled-up further with Global Fund resources. Funding will be provided to increase the impact of PMTCT services through mentoring PMTCT sites and district health teams, strengthening infant feeding and community-based support for PMTCT, and integrating support for PMTCT with other maternal and child health efforts. CT activities will also be scaled up, and the program will continue to provide assistance to improve the safety of the national blood supply.

In FY 2009, activities will strengthen prevention and care programs by developing linkages between community interventions and facility-based services, and increasing early referral and retention in care of PLWHA. Funding will also expand the scope, coverage and quality of care and support programs through providing comprehensive interventions for OVC and PLWHA, strengthening integrated community-based platforms for service delivery, and enhancing coordination with other sectors such as education and agriculture. Referral networks among HIV care and treatment, tuberculosis and PMTCT services will be strengthened; and pediatric HIV diagnosis will be scaled up through assistance to both laboratories and health centers. We will also expand the capabilities of the Malawi Defense Force's (MDF's) existing care and support program and continue training programs for MDF health workers in PMTCT, strategic information, clinical practices, and laboratory skills.

Underlying all of these efforts, PEPFAR will seek to foster broad improvements in the health and welfare of Malawians through strengthening the Malawian health system, working to improve national policies, and addressing social and gender norms that increase vulnerability to HIV. Support will be provided to improve surveillance, health management information systems, and monitoring and evaluation of the national health and social welfare response. Laboratory diagnostic and disease monitoring capacity will also be significantly enhanced and technical assistance and logistical support will be provided to improve supply chain management in partnership with PMI. Capacity building will be provided to various stakeholders (national, district, community, and indigenous partners), thereby supporting local ownership and enhancing sustainability of the national HIV/AIDS and health response.

A Partnership Framework between the Governments of Malawi and the United States was signed and document is now available at The Partnership Framework focuses on reducing new HIV infections, improving the quality of treatment and care, mitigating the impacts of HIV/AIDS on individuals and households, and supporting systems needed to achieve these goals. This five-year joint strategic agenda will be supplemented with a Partnership Framework Implementation Plan that provides additional detail.

In order to achieve the goals laid out in the Partnership Framework, additional FY 2009 funds will be used to support health systems strengthening, start up costs for programs that mobilize communities around HIV issues, and train health workers in critical new interventions like male circumcision. Funds will be used to strengthen and extend "wrap-around" services and build linkages with programs that focus on family planning and food and nutrition. These funds have been carefully programmed to lay the foundation for the remainder of Malawi's five-year Partnership Framework plan and to set the stage for increasing ownership of programs by both government and civil society organizations within the country.

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