Zimbabwe – FY 2010 Approved Funding by Program Area, Agency and Funding Source*
*Only appropriations from the GHCS (State) fund account are notified by the Global AIDS Coordinator.
PEPFAR is a key element in the evolving humanitarian program in Zimbabwe, and fully supports Zimbabwe’s own National AIDS Strategic Plan (ZNASP). Zimbabwe’s Ministry of Health and Child Welfare (MOHCW) provides overall country leadership for the national HIV/AIDS response within the framework of the ZNASP. As a consequence of President Obama’s pledge of additional support to Zimbabwe, increased PEPFAR funding is being programmed in close collaboration with MOHCW and other Zimbabwean governmental NGO partners. The working assumption is that given the massive deterioration in public health systems in Zimbabwe, PEPFAR assistance must focus on immediate and short-term “gap filling” within a longer term systems strengthening approach that fosters Zimbabwean leadership and ownership and avoids creation of parallel donor-dependent systems.
PEPFAR works to build the capacity of Zimbabweans to lead initiatives to address HIV. Previous assistance helped to develop Zimbabwean capacity to assume ownership of both measures to better understand the epidemic and to drive mitigation responses. In response to requests by the MOHCW, the FY 2010 program includes several new initiatives that build upon PEPFAR-supported pilot efforts. These include scale-up of combined short-course therapy for pregnant HIV-infected women and complementary EID and prophylaxis; scale-up of VMMC for males over 15 years of age; significant technical, training, and commodity assistance to rebuild the national laboratory systems; and HRH strengthening.
In the short term, PEPFAR is placing particular attention on two key systemic linkages: commodity supply and logistics systems, and laboratory systems. For the first, PEPFAR’s vision is to help the MOHCW expand the staffing and mandate of the small PEPFAR-supported Logistics Support Unit and have it report to the MOHCW Directorate of Pharmacy Services, thereby becoming the overall body for coordinating medicines and medical supply management in the public sector. There are currently several parallel supply systems for different commodities for HIV/AIDS, family planning, malaria, TB, and other programs. PEPFAR is working with the MOHCW, several parastatal organizations, and the donor community to harmonize these systems.
Similarly, Zimbabwe’s national laboratory system has been decimated by a decade of neglect, yet remains critical to work in prevention, care and treatment. PEPFAR will continue to provide short-term support for training, and the necessary equipment and supplies as the system is rebuilt.
In addition to these “horizontal” linkages so critical to all other programs, PEPFAR will continue its focus on selected key “vertical” systems that provide immediate results in prevention, care and treatment while developing longer-term skills and capacity to sustain such results over time.
PEPFAR is working on other key linkages, including real-time information access, supportive staff supervision and mentoring, data dissemination, TB and HIV care referral mechanisms, training critical cadres to provide client-oriented care, and strategic leadership capabilities. PEPFAR programs and targeted TA in FY 2010 and beyond will focus on solidifying national foundational MOHCW documents that all partners refer to – policies, strategic plans, M&E plans, and training curricula.
The FY 2010 proposed activities reflect regular and substantive consultation with the MOHCW, other donors, and a range of implementing partners. In 2010, the PEPFAR interagency team will develop a new five-year Strategic Plan in close consultation with the MOHCW. The new Strategic Plan will use the foundation of many of the FY 2010 activities described above to continue to promote MOHCW sustainability as the public health leader in Zimbabwe.
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