Western Hemisphere

Belize (Total GHCS-State: $20,000)

Peace Corps ($20,000): Given that young people in Belize are disproportionately affected by HIV infection and that Peace Corps focuses on youth development, these FY2009 PEPFAR-funded activities will contribute to the prevention of HIV infection among at-risk youth through the integration of a country specific HIV/AIDS and Life Skills manual. Volunteers and counterparts will facilitate the training of teachers and youth peer educators at a regional level in the effective use of the HIV/AIDS components of the Health and Family Life (HFLE) curriculum in schools. The training will be aimed at changing risky behaviors among youth, such as engaging in casual sexual encounters, engaging in sex in exchange for money or favors, sex with a partner whose status is unknown, using drugs or abusing alcohol in the context of sexual interactions, and using intravenous drugs. The establishment of HFLE resource centers in volunteers' schools and communities will also be encouraged.

Brazil (Total GHCS-State: $1,300,000)

USAID ($800,000): The FY2009 GHCS-State funds will be used in Brazil to strengthen actions to promote health and positive prevention strategies for PLWHA and promote social inclusion of PLWHA through investing in professional qualification, income generation and stronger links between the private sector, civil society and the public sector. Through these funds, USAID will work to contribute toward the sustainability and institutional strengthening of community-based organizations with activities directed toward PLWHA and also toward expansion of access and disclosure of government M&E information systems in HIV/AIDS. USAID will also support the Brazilian national STI and AIDS program's new plan to "combat HIV/AIDS among gay men, MSM and transvestites." Additionally, USAID plans to hire a local employed HIV/AIDS advisor to liaise with the Ministry of Health and Office of HIV/AIDS Coordinator on policy and HIV/AIDS programming functions. In addition, the HIV/AIDS advisor will provide project management duties on existing and planned assistance awards in the USAID portfolio.

HHS/CDC ($300,000): CDC will focus on strengthening M&E through activities such as conducting an M&E training course for twenty students and implementing a monitoring system for PMTCT information. In 2006, CDC assisted the National AIDS Programme (NAP) in developing a method to estimate HIV prevalence using secondary data from antenatal patient cards. FY2009 GHCS-State funds are being used to train M&E teams from 25 of the 27 states and 5 municipalities to utilize this method to determine local estimates of HIV prevalence in pregnant women. Currently 13 states and 4 municipalities are in process of implementing this monitoring method. Although the project to develop and implement a survey designed for high school students and teachers to gauge their knowledge, behavior and attitudes related to HIV and AIDS has been transferred to NAP because the expected timeline to obtain Institutional Review Board clearance in the United States would have exceeded the project period, CDC continues to provide technical assistance to the MoH on this and other projects.

HHS/OGHA ($200,000): This funding will be used to support the staffing of the Health Attaché, which serves as Program Coordinator by facilitating the development and implementation of a unified USG HIV/AIDS program for Brazil. This includes coordinating HIV/AIDS activities and programming in-country with relevant implementing agencies, the partner government, and OGAC, as well as participating in setting program priorities and budget planning with colleagues in the U.S. Embassy, PEPFAR headquarters, and with partner country HIV/AIDS leadership.

Central America Regional Program- $2,671,000

USAID ($1,413,000): USAID will focus on activities to address HIV/TB co-infection, including support to national strategic planning processes, technical assistance to National AIDS Programs and National TB Programs and support to Global Fund HIV and TB projects. These activities will also include the continuation of the comprehensive care component of the regional strategy, particularly as it relates to strengthening human resource capacity and pre-service and in-service education for treatment and care of HIV/TB co-infection and of HIV/AIDS services in general. Additionally, USAID plans to support the development of a Central America Partnership Framework and Partnership Framework Implementation Plan. Resources will support additional management costs such as an increased budget for travel to bring the core working group together for training and other coordination and to convene a stakeholders' meeting. These funds will also enhance the ability of the USG Regional Team to compile existing information and carry out necessary baseline assessments and studies to support the development of a five-year strategy USAID also plans to hire a PEPFAR Coordinator for the Region. Finally, these funds also will be used to support medium and short term technical assistance to facilitate the response for the need for additional reporting requirements and the systematic development of administrative processes to collect data including indicators and other M&E information.

HHS/CDC ($1,133,000): The CDC Central America and Panama regional office works closely with USAID regional and bi-lateral missions. This funding will be used to expand current surveillance activities and implement recommended HIV interventions identified via most recent and viable surveillance data. Funding will be used to support STI sentinel surveillance sites for female and male sex workers in Honduras and Guatemala and expand to more sites. CDC plans to conduct Behavioral Survey Studies with high risk vulnerable populations (MSM, CSWs, and PLWHA) in at least two more countries, Panama and Nicaragua. CDC plans to work to address the need for a national monitoring system for ARV therapy and care to follow-up outcome and impact indicators as coverage, mortality, quality of care, adherence, antiretroviral (ARV) resistance, survival analysis, etc. In Honduras and Panama, CDC will be piloting different monitoring systems to provide inputs, tools and expertise and would expect to implement these systems in at least two other countries. CDC will also focus on strengthening the HIV diagnosis capacity and laboratory infrastructure in the region.

CDC also provides TA other donors in the region, as well as to the national laboratories in Central America to update HIV/AIDS testing with new methodologies, and will continue to disseminate HIV/AIDS laboratory bulletins to maintain the high level of knowledge on actualized information about the new techniques available for HIV diagnosis. CDC also wants to evaluate the HIV diagnostic algorithms in at least one country which will include a cost-benefit analysis. Finally, CDC will also use funding to support the development of a Central America Partnership Framework and Partnership Framework Implementation Plan. Resources will also support additional management costs such as an increased budget for travel as well as for training and other coordination, including funds to support technical assistance needs. These funds will enhance the ability of the USG regional team to compile existing information and carry out necessary baseline assessments and studies to support the development of a five-year strategy.

DoD ($125,000): The DoD plans to support the development of a Central America Partnership Framework and Partnership Framework Implementation Plan. Resources will also support additional management costs including the hiring of a DoD Coordinator for the region and an increased budget for travel, training and administrative coordination. Additionally, funds will support costs associated with an analysis/assessment of ongoing or potential HIV prevention activities with uniformed personnel in Central America.

El Salvador (Total GHCS-State: $20,000)

Peace Corps ($20,000): With FY 2009 PEPFAR GHCS-State funds, Peace Corps will train peer educators and service providers such as health promoters, nurses, teachers, and community leaders in culturally appropriate, low literacy methodologies for HIV/AIDS prevention. These individuals will in turn provide training to at-risk members of rural communities about methods of HIV/AIDS transmission. These activities will be carried out in partnership with the Salvadoran MoH's National HIV/AIDS & STI program, various programs of local NGOs, and the National Hospital Rosales' Infectology Program's Educational Outreach Department.

Honduras (Total GHCS-State: $1,000,000)

USAID ($540,000): Funds will be used to provide TA to the Honduran MoH to: 1) improve the quality of care and treatment services for people living with HIV/AIDS, including counseling and clinical services; and 2) strengthen supply chain management for antiretroviral medications and other HIV-related commodities. This technical assistance will complement and strengthen existing Global Fund efforts to expand the MoH's HIV/AIDS care and treatment program.

HHS/CDC ($175,000): Funds will be used to strengthen TB/HIV co-infection projects in collaboration with the Honduran MoH. This will primarily involve conducting an assessment of current TB/HIV co-infection efforts to identify gaps and provide TA to strengthen the program based on these findings. Funds will also be used to carry out focused qualitative analyses of recent behavioral surveillance survey findings in order to strengthen interventions for priority MARPS.

DoD ($255,000): Funds will be used to provide HIV/AIDS prevention services to the Honduran military. This activity is part of a coordinated effort between DoD, UNFPA and UNAIDS to provide direct behavior change and prevention education to Honduran soldiers, their superiors, and their family members. In addition, the provision of HIV counseling and testing services within the military will be strengthened.

Peace Corps ($30,000): Funds will be used to train volunteers and their Honduran counterparts in methodologies and activities related to HIV/AIDS prevention, gender, and support groups for people living with HIV/AIDS. A portion of these funds will be made available to Peace Corps volunteers as small grants to implement related activities within the communities where they work.

Latin American and Caribbean Regional (Total GHCS-State: $1,088,000)

USAID ($1,088,000): USAID will identify, document and disseminate innovative programmatic HIV/AIDS practices on prevention, treatment, care and support in the Latin American and Caribbean (LAC) region to assist policymakers and program implementers. This will include developing and disseminating technical briefs, case studies and other publications, including development of a web-based annotated bibliography on innovative and promising HIV/AIDS practices. USAID plans to work to address another major issue facing LAC MoHs by attempting to strengthen their overall health systems to respond appropriately to HIV/AIDS in dealing with human resources effectively. The LAC Regional Program will continue to work in partnership with WHO, the Global Health Workshop Alliance and PEPFAR USG partners to expand the reach of the Human Resources for Health Action Framework to develop and implement strategies for an effective and sustainable health workforce. The LAC region will also work with selected countries newly eligible to receive Global Fund grants to assess their capacities for implementing Global Fund financed programs, leading to recommendations on the key steps they need to take to create and/or strengthen existing governance structures for the national HIV/AIDS response so they can prepare for success in submitting proposals to the Global Fund. Finally, in order to address recent shifts in USG funding in the region, a portion of the regional funds will be used to strengthen relations with the Bolivian National HIV/AIDS Program and the MoH, thus helping influence the Bolivian national HIV/AIDS policy and programs to combat HIV/AIDS. Funding will also be used to strengthen and expand targeted VCT services and strengthen laboratories.

Nicaragua (Total GHCS-State: $897,000)

USAID ($577,000): The use of these funds will focus on preventing transmission of HIV/AIDS from high risk groups in Nicaragua. USAID will implement a new project, focused on HIV/AIDS prevention, including funding outreach and behavioral change activities targeting MARPs through a NGO network, improving the quality of and access to health services and NGOs coordination with the MoH, mainly for VCT. As the Global Fund has recently approved a proposal for Nicaragua, USAID will also provide TA to the Global Fund CCM to improve implementation of the Global Fund programs and their complement to USG programs.

HHS/CDC ($300,000): These funds will be used to produce a behavioural surveillance survey in Nicaragua. CDC plans to provide technical and financial assistance to standardize approaches, protocols and guidelines supporting first and second generation HIV/AIDS surveillance, including Behavioral Surveillance Surveys with biological markers (BSS+) in Nicaragua. CDC also plans to provide technical assistance to the Nicaragua MoH and local partners to develop the planning stages for a BSS+ that focuses on high-risk populations, such as CSWs, MSM and PLWHA.

Peace Corps ($20,000): Peace Corps has continued increasing the development of work plans and volunteer assignments to areas where there is an increasing need for the promotion of healthy sexual practices in vulnerable populations of youth. The activities will be focused on prevention activities, including: developing of regional workshops to train youth promoters and male health promoters, implementing volunteer activities support and training program, developing training materials to enhance pre-service training and to celebrate World AIDS Day, and strengthening the role of Peace Corps cross-sector HIV/AIDS Task Force.

Peru (Total GHCS-State: $20,000)

Peace Corps ($20,000): Building on the success of the FY2008 activities, Peace Corps plans to target three additional regional departments, based on discussions with the MoH and departmental authorities, for two rounds of trainings that will cover in detail techniques for carrying out HIV/AIDS prevention activities directed toward various target groups and work toward the final product of preparing municipal district action plans. Additional funds will be reserved for the availability of VAST grants to help districts implement their plans. These funds will also be used to reach approximately 7,000 people through community outreach that promotes HIV/AIDS prevention through other behavior change beyond abstinence and/or being faithful.

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