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Appendix 2 - PEPFAR Central Programs Included in Country Operational Plans

The following central programs are presented within each country operational plan.

Program - Antiretroviral Treatment (ART)

Program Description:

HHS will use FY 2009 funding to ensure the integrity of the antiretroviral drug pipeline and thus ensure that all patients have uninterrupted access to antiretroviral treatment. Funding for scientific and technical advice, assistance, and monitoring for this program, as well as management and administrative costs associated with the program, are reflected in the technical oversight and management description.

Program - Abstinence and Be Faithful (AB) for Youth

Program Description:

This program provides central funding for multi-country grants to NGOs to continue 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.

Activities will continue to expand the promotion of primary and secondary abstinence, faithfulness, monogamous relationships, and avoidance of unhealthy sexual behaviors among youth.

Program - Orphans and Vulnerable Children (OVC) Affected by HIV/AIDS

Program Description:

This PEPFAR-supported program continues to fund activities in multiple countries that increase care and support to OVC affected by HIV. The activities supported through this program provide essential services and comprehensive care to improve the quality of life for OVC, and aim to strengthen the quality of OVC programs through the implementation, evaluation, and replication of best practices in the area of OVC programming. The projects funded under this program 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 partner governments' 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.

Several partners have adopted a strategy of reaching communities primarily through their local community/faith-based partners, which has proven effective in engaging sustainable, community-based responses by using a trusted and established mechanism within a community.

Generally, ongoing funding will expand support for NGOs and community/faith-based organizations to collaborate with locally based organizations to scale up activities and programs that:

• Support OVC through microfinance programs for caregivers of OVC;
• Increase capacity of children and youth to meet their own needs;
• Strengthen the capacity of local organizations to provide care for OVC;
• Work toward reducing the stigma and discrimination of OVC 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.

Program - Blood Safety

Program Description:

PEPFAR funds provide central support for 14 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 PEPFAR 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.

In FY 2009, through the coordinated efforts of the National Blood Transfusion Services and the assistance of expert blood transfusion organizations, each of the countries will continue to develop an organized, high-quality blood transfusion system that will produce an adequate supply of safe blood.

Funding will be provided to HHS/CDC for headquarters to support the national blood transfusion services or ministries of health in fourteen countries and the five technical assistance organizations. The funding includes staff travel and salary support for medical officers and public health advisors.

In addition, funding will support donor outreach sessions at regional blood transfusion centers for the recruitment of voluntary non-remunerated blood donors. Interruption of recruitment activities results in severe shortages and relapse to use of family replacement donors who have a higher HIV prevalence than voluntary non-remunerated donors. Funding will also support clinical and administrative staff implementing blood safety activities.

Program - Injection Safety

Program Description:

HHS/CDC will use FY 2009 funding to sustain a safe-injection program that covers the population of each country, using each country's National Injection Safety Plan. The focus of this cooperative agreement is seven countries in Africa and the Caribbean heavily affected by HIV/AIDS: Botswana, Cote d'Ivoire, Haiti, Kenya, Rwanda, South Africa, and Tanzania. The implementation of these National Injection Safety Plans includes management, operations, and monitoring activities. John Snow Inc. coordinates activities with the U.S. Government Mission, the Ministry of Health (MOH), and non-governmental organizations (NGOs), as appropriate, in each country.