Summary Program Descriptions

Project Title: Abstinence and Be Faithful (AB) for Youth

Budget: FY 2006 GHAI: $24,809,743

Implementing Mechanism: USAID grants with Non-governmental Organizations (NGOs) and Community/Faith-Based Organizations (CBOs/FBOs) include the following organizations: Adventist Development Relief Agency (ADRA), American Red Cross, Catholic Relief Services (CRS), Children�s AIDS Fund, Food for the Hungry, Fresh Ministries, HOPE Worldwide South Africa, International Youth Federation, Pact, Program for Appropriate Technology in Health (PATH), Salesian Missions, Samaritan�s Purse, World Relief, and World Vision.

Contact Person(s): Chris McDermott (USAID/GH)

Program Description:

This program provides central funding for multi-country grants to NGOs to expand 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,
  • Targeting early intervention with at-risk youth.

By the end of FY 2005, 14 cooperative agreements were awarded and launched. USAID partners under this program include eight Community/Faith-Based Organizations. Partners in turn work with over 30 local Community/Faith-Based Organizations such as Anglican Church of Kenya Western Diocese, Fellowship of Christian Unions, Kenya Students Christian Fellowship, and Scripture Union.

Programs supported include culturally appropriate prevention activities for young people emphasizing �Abstinence� and �Be Faithful� (AB) messages. These efforts complement ongoing USAID-funded prevention programs that target risky adult behaviors and contribute to more balanced national prevention programs. AB messages developed by the partners reached over 800,000 youth as of September 2005. Some partners exceeded their targets through intensive outreach to youth through schools, churches, and community clubs that engaged in interactive learning to promote AB messages. Youth club activities included drama and music, and often seek to obtain a personal commitment to help people living with AIDS in the community. Partners have mobilized schools and community and faith-based networks in multiple countries. In Ethiopia and Zambia, for instance, one cooperating agency trained over 640 peer educators (both in-school and out-of-school), adult mentors and partner program staff to provide HIV/AIDS prevention education promoting AB messages.

FY 2006 Program:

With an estimated half of all new infections occurring in youth 15-24, FY 2006 funding will scale up youth-oriented AB prevention programs in 14 Emergency Plan focus countries. Activities will continue to expand the promotion of primary and secondary abstinence before marriage, faithfulness in marriage and monogamous relationships, and avoidance of unhealthy sexual behaviors among youth. With all 14 partners now poised for their first full year of implementation, program activities and numbers of youth reached are expected to increase significantly as these programs go to scale. By September 2006, these grants are projected to reach over three million youth aged 10-24 years old with AB messages in the 15 countries, contributing to the Emergency Plan goal of preventing seven million new infections.

Time Frame: FY 2006 � FY 2007

Project Title: Antiretroviral Treatment (ART)

Budget: FY 2006 GHAI: $105,465,389

Implementing Mechanism: HHS Cooperative Agreements with Non-governmental Organizations (NGO) including Catholic Relief Services (CRS), Columbia University, Elizabeth Glaser Pediatric AIDS Foundation, and Harvard University.

Contact Person(s): Tedd Ellerbrock (HHS/CDC/GAP) and Thurma Goldman (HHS/HRSA/HAB)

Program Description:

Emergency Plan funds provide central support to four U.S. organizations working in 12 of the 15 Emergency Plan Focus Countries. The Department of Health and Human Services (HHS) awarded grants, which were selected based on a competitive bid, to the Mailman School of Public Health of Columbia University, the Elizabeth Glaser Pediatric AIDS Foundation, Harvard University School of Public Health, and AIDS Relief (formerly, the Catholic Relief Services Consortium). These grantees have sub-contracted with local in-country organizations, such as: Ministries of Health; faith-based hospitals in nine countries; as well as Muhimbili National Hospital, Tanzania; Moi Teaching and Referral Hospital, Kenya; University of Transkei, South Africa; and Lusaka Health District, Lusaka, Zambia.

The grant recipients are engaged in providing clinical HIV care, including ART; drug and health commodities management; lab services for diagnosing HIV infection and opportunistic infections; training of health care workers; community mobilization; and monitoring and evaluation. Areas of focus include the following:

  • Providing comprehensive HIV care, including ART and diagnosing and treating TB and other HIV-related opportunistic infections;
  • Selecting and procuring the appropriate ART drugs in accordance with U.S. and local Government policies;
  • Ensuring the availability and appropriate use of laboratory capabilities for diagnosing HIV infection and OI; and,
  • Providing training to increase capacity of local staff and encourage local ownership.

As of September 30, 2005, more than 92,000 patients had started on ART at 205 medical facilities in 12 countries through this program. As of February 2006, the number of patients receiving ART through this program is expected to rise to approximately 140,000. Further expansion is dependent on the receipt of funding from country budgets.

FY 2006 Program:

HHS will use FY 2006 funding to provide HIV care and treatment for those enrolled in the program through February 2007. 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 headquarters and technical assistance description.

This program will contribute to achieving critical Emergency Plan goals, including supporting treatment for two million HIV-infected individuals.

Time Frame: FY 2006 � FY 2007

Project Title: Blood Transfusion Safety

Budget: FY 2006 GHAI: $25,600,000

Implementing Mechanism: HHS/CDC Cooperative Agreements with National Blood Transfusion Services or Ministries of Health in 14 Focus Countries (Botswana, C�te d�Ivoire, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda and Zambia) and with five technical assistance organizations (American Association of Blood Banks; Sanquin Blood Consulting; Safe Blood for Africa; Social and Scientific Systems, Inc.; and the World Health Organization).

Contact Person(s): Heather Pumphrey (HHS/CDC/GAP)

Program Description:

Emergency Plan funds provide central support for Focus 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 Emergency Plan 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.

FY 2006 Program:

Through the coordinated efforts of the National Blood Transfusion Services and the assistance of expert blood transfusion organizations, each of the Focus Countries will continue to develop an organized, high-quality blood transfusion system that will produce an adequate supply of safe blood. The emphasis for FY 2006 activities will be furthering infrastructure development, completing blood supply testing for HIV and hepatitis, developing blood donor recruitment networks, and providing guidance and training in all of these areas.

This program will contribute to achieving the critical Emergency Plan goal of supporting the prevention of seven million new HIV infections.

Time Frame: FY 2006 � FY 2007

Project Title: Orphans and Vulnerable Children (OVC) Affected by HIV/AIDS

Budget: FY 2006 GHAI: $21,695,354

Implementing Mechanism: USAID cooperative agreements with Non-governmental Organizations (NGO) and Community/Faith-based Organizations (FBO) include to following: Africare, Association of Volunteers in International Service (AVSI), CARE USA, Catholic Relief Services (CRS), Christian Aid, Christian Children�s Fund, Family Health International (FHI), HOPE Worldwide South Africa, Opportunity International, Plan USA, Project Concern International, Project HOPE, Salvation Army, Save the Children, and World Concern.

Contact Person(s): Chris McDermott (USAID/GH)

Program Description:

This Emergency Plan-funded program continues to fund activities in multiple countries that increase care and support to OVC affected by HIV. The activities supported through this program are to provide comprehensive and compassionate care to improve the quality of life for OVC, and 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 APS support one or more of the following strategic approaches:

  • Strengthening the capacity of families to cope with their problems;
  • Mobilizing and strengthening community-based responses;
  • Increasing the capacity of children and young people to meet their own needs;
  • Ensuring governments 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;
  • Developing, evaluating, disseminating and applying best practices;
  • Creating strong partnerships with local in-country organizations; and,
  • Forming public-private alliances.

By the end of FY 2005, a total of 15 OVC agreements were awarded and launched. Most of these (10 of the 15) awards were made late in the year, and as a result the partners have focused on planning in FY 2005. The OVC partners in the program included six FBOs. These six FBOs work with over 20 grass-roots community/faith-based organizations. Programs are underway in the following thirteen focus countries, Botswana, Cote D�Ivoire, Ethiopia, Haiti, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, and Zambia.

In FY 2005, almost 200,000 OVC received services from the USG partners. One project reached 6,134 children in South Africa and 3,127 children in Kenya with a range of psychosocial, health, food and nutrition, educational, recreational, and protection serves through the mobilization and capacity building of local organizations. 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 given the trusted and established mechanism within a community. In Haiti, in addition to partnering with FBO, one partner works through a network of children�s safety net organizations that helps link OVC caregivers with other local groups such as agricultural and nutrition programs.

Another social support model being used is training local teachers with an integrated set of psycho-social support skills to counsel children on coping with parental illness or death. A creative program in South Africa provided 392 volunteer savings and loans groups (VSL), made up of caregivers of OVC to help support care for 1,372 children.

FY 2006 Program:

In FY 2006, funding will support NGO and community/faith-based organizations to collaborate with locally based organizations to scale up activities and programs that:

  • Support OVC in the areas of 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 psychosocial support including referrals for home based care, food and nutritional needs. With all 15 partners now poised for their first full year of implementation, program activities and numbers of OVC reached are expected to increase significantly as these programs go to scale.

This program will contribute to achieve a critical Emergency Plan goal of supporting care for ten million people infected or affected by HIV/AIDS, including orphans and vulnerable children.

Time Frame: FY 2006 � FY 2007

Project Title: Drug Quality Assurance

Budget: FY 2006 GHAI: $3,700,000

Implementing Mechanism: HHS/FDA direct expenses and contracts.

Contact Person: Beverly Corey (HHS/FDA) and Michael Johnson (HHS/OGHA).

Program Description:

In direct support of the President�s Emergency Plan for AIDS Relief (the Emergency Plan), the Department of Health and Human Services� (HHS) Food and Drug Administration (FDA) has implemented a new, expedited process to help ensure that the United States can provide safe, effective, and quality manufactured antiretroviral drugs to the15 developing countries designated under the Emergency Plan. HHS/FDA published guidance for the pharmaceutical industry that encouraged sponsors to submit applications for approval (or tentative approval, if U.S. patents blocked issuance of approval for U.S. marketing) of fixed dose combinations (FDC) or co-packaged versions of previously HHS/FDA-approved FDC or single-entity antiretroviral therapies for the treatment of human immunodeficiency virus (HIV). [Note: FDCs are new products that combine already-approved individual HIV/AIDS therapies into a single dosage.] Drugs approved or tentatively approved under this new expedited process will meet all FDA standards for drug safety, efficacy, and manufacturing quality.

HHS/FDA�s involvement includes the following activities:

  • Outreach Activities: HHS/FDA is developing and implementing comprehensive outreach programs that target drug manufacturers and national drug regulatory authorities in Focus Countries. These programs include training in the general marketing application review process; disseminating current good manufacturing practices, review and standards for active pharmaceutical ingredients; and monitoring post-authorization drug safety and manufacturing reporting.
  • Application Activities: HHS/FDA is expediting the review of new and generic drug marketing applications under the Emergency Plan. Generally, a priority review designation provides for the review of a new drug marketing application within six months or less and the legal standard for review of a generic drug application is 180 days. However, under the new Emergency Plan policy, the application (new drug or generic) would be reviewed within approximately eight weeks. HHS/FDA reviewers are working closely with potential drug marketing application sponsors to foster the development and submission under the Emergency Plan of well-documented, quality marketing applications that have the highest chance for a successful review. As of February 1, 2006, HHS/FDA had approved or tentatively approved 15 single-entity and co-packaged versions of previously HHS/FDA-approved, brand name antiretroviral drug preparations.
  • Inspections: HHS/FDA is conducting pre-approval of current Good Clinical Practices inspections of Bioequivalence Studies to ensure the veracity of bioequivalence data and current good manufacturing practices inspections of drug manufacturing sites to ensure drug product quality during manufacturing.
  • Post-marketing Activities: HHS/FDA is monitoring the drug products distributed under the Emergency Plan to help ensure continued drug safety.

In addition, in FY 2005 HHS/FDA sponsored a technical assistance conference for regulatory agencies from the Emergency Plan Focus Countries. The purpose was to educate and support these government agencies in their interpretation and evaluation of the findings and outcomes of the HHS/FDA approval process with the goal of reducing the time to actually procure and distribute antiretrovirals (ARV) (in countries receiving Emergency Plan support) following HHS/FDA approval. International drug regulatory authorities from 14 of the 15 Emergency Plan focus countries participated in the forum.

FY 2006 Program:

FY 2006 funding will be used to finance the following HIV drug marketing application review and inspection activities necessary for the purchase of drugs for the Emergency Plan:

  • The review of approximately 11 new drug and 47 generic drug marketing applications;
  • Ten pre-approval inspections of active pharmaceutical ingredients manufacturing facilities;
  • Ten pre-approval inspections of finished dosage manufacturing facilities;
  • Thirty-seven pre-approval inspections of bioequivalence studies; and,
  • Two inspections to target manufacturing problems.

Funds may also be required to facilitate activities related to providing consultation and documentation to the World Health Organization (WHO), and to facilitate listing of FDA approved and tentatively approved products on the WHO Prequalification drug website.

Furthermore, in FY 2006 HHS will provide strategic support to ARV producers who would like to participate in the HHS/FDA approval process but need help to do so effectively. Such support will consist of providing guidance in interpreting and complying with the requirements of the HHS/FDA application process. The expected result of this work will be an increase in the number of drug products available in an accelerated manner to be purchased with Emergency Plan funds to treat HIV-infected persons.

In addition, HHS/FDA will plan and provide regional in-country training to support registration by local drug regulatory authorities of ARVs that have been tentatively approved by HHS/FDA so that they can be procured and distributed to patients in those countries.

This program will contribute to achieving the critical Emergency Plan goal of supporting treatment for two million HIV-infected individuals.

Time Frame: FY 2006 � FY 2007

Project Title: Safe Medical Injections

Budget: FY 2006:

GHAI $15,685,996 USAID
$14,805,000 HHS/CDC
$30,490,996 Total

Implementing Mechanism: USAID Task Order Proposal Requests through existing Indefinite Quantity Contracts, including John Snow Inc., University Research Corporation, Chemonics International, Initiatives, Inc., and HHS/CDC Cooperative Agreement with John Snow, Inc.

Contact Person(s): Glenn Post (USAID/GH/OHA), Robert Chen (HHS/CDC), Robert Ferris (USAID/GH)

Program Description: Emergency Plan funds provided central support for injection safety activities in FY2005 through an integrated approach that included improving the safety of medical practices through technical innovations; developing behavior change communications, education and training campaigns; providing sufficient quantities of injection materials, including needles, and syringes; strengthening logistical systems and management; and strengthening waste management systems for sharps.

In FY 2005, the Emergency Plan:

  • Continued its support for commodity management and procurement support -- procuring and distributing more than 89.4 million syringes and 1 million safety boxes in Emergency Plan focus countries.
  • Expanded capacity building and training in injection practices, supply management, waste handling, and interpersonal communications -- training 13,037 people in injection safety related activities.
  • Developed the Injection Safety Facilitators� Guide to train healthcare workers in injection safety.
  • Assisted the injection safety program in Namibia to make significant gains in reducing the excessive use of injectable pharmaceuticals in scale-up healthcare facilities. The average number of types of injections prescribed per patient per treatment was reduced from 1.42 in the fourth quarter of 2004 to 0.73 in the second quarter of 2005.
  • Developed and launched a 20-minute documentary film on injection safety in Ethiopia in February 2005. A total of 300 copies of the film were duplicated and distributed.
  • Developed a standardized system for sharps disposal. In Guyana, facility waste management plans led to major improvements in the physical state of disposal sites and to consistent use of safety boxes for curative care. A major innovation has been the introduction of needle removers and locally constructed needle barrels in sites with high water tables, which reduced the amount of waste and increased safety.
  • Worked closely with the Ministry of Health in Zambia to facilitate the completion of the National Infection Prevention strategic plan for scale-up of activities at the district levels. National Infection Prevention/Injection Safety guidelines were disseminated to targeted districts.
  • Conducted a baseline assessment of new scale-up areas in Nigeria using a standardized assessment tool. Trained consultants collected data from the identified hospitals and health facilities, both public and private.

FY 2006 Program:

In FY 2006, the USG will continue to implement strategies for wider public understanding and support for the availability of safe medical injections in the Emergency Plan focus countries through injection safety activities that aim to cover the population of each country; decrease the frequency of unnecessary and unsafe injections; improve the supply and distribution systems for commodities needed for safe injections; and improve waste management of sharps.

This program will contribute to achieving the Emergency Plan goal of supporting prevention of seven million new HIV infections.

Time Frame: FY 2006 - FY 2007

Project Title: Supply Chain Management System

Budget: FY 2006 GHAI: $15,000,000

Implementing Mechanism: The Partnership for Supply Chain Management

Contact Person(s): Carl Hawkins (USAID/GH)

Program Description:

An effective supply chain management system has multiple functions essential for procurement of medicines integral to the success of the President�s Emergency Plan for AIDS Relief (PEPFAR). These functions include procurement, warehousing and freight forwarding, distribution and logistics and rational use of the products. Lack of antiretrovirals (ARV) and other drugs to treat patients with AIDS or HIV infection is an emergency and stock outs of key medicines are not acceptable. It is essential that this system be resilient in crises and responsive to USG country programs to prevent stock outs of key medicines and track shipments and use of medicines through a comprehensive management information system. In order to respond to the rapid increase in patients being treated and tested a new Supply Chain Management System (SCMS) was formed. At the end of FY 2005, the SCMS contract was awarded to the Partnership for Supply Chain Management, a non-profit consortium of 17 organizations with extensive experience and skill led by John Snow Inc. and Management Sciences for Health. The purpose of SCMS is to implement a safe, secure, reliable, and sustainable procurement and supply chain management system for pharmaceuticals and other medical products needed to provide care and treatment of persons with HIV/AIDS and related infections. The Partnership for Supply Chain Management will work under the guidance of a technical management team with all national and international partners in a collaborative and transparent way to ensure that life saving tests and medicines will reach patients served by this program.

FY 2006 Program:

In FY 2006, SCMS will help to create, enhance and promote a secure and sustainable supply chain management system that is reliable and coordinated with complementary programs, which will include drug procurement in multiple countries. Central funds will be utilized to conduct in-depth assessments in the 15 Focus Countries in the President�s Emergency Plan for AIDS Relief and to establish country offices when appropriate. FY 2006 funds will also support the development of a state of the art logistics management information system, which will contribute to global forecasts in coordination with key USG partners to better estimate worldwide demand for HIV/AIDS related pharmaceuticals and manage the large volume of procurement under this contract.

This program will contribute to achieving two critical Emergency Plan goals, including supporting treatment for two million HIV-infected individuals; and supporting care for ten million people infected or affected by HIV/AIDS, including orphans and vulnerable children.

Time Frame: FY 2006 - FY 2007

Project Title: Technical Leadership and Support

Budget: FY 2006 GHAI: $29,270,439

Implementing Mechanism: USAID, HHS and State Department contracts and grants

Contact Person(s): Michele Moloney-Kitts (OGAC), Debbi Birx (HHS/CDC), Thurma Goldman (HHS/HRSA) and Constance Carrino (USAID/GH/OHA)

Program Description:

Technical Leadership and Support programs funds technical assistance and other activities to further Emergency Plan policy and programmatic objectives, in the field, at headquarters, and internationally. In addition to supporting USG technical assistance from the agencies, this program utilizes existing contractual mechanisms within USAID, HHS, and the State Department to the maximum extent possible.

  • HHS supports the University Technical Assistance Projects (UTAP) cooperative agreement program that funds ten Universities in order to provide technical assistance to ministries of health and other organizations working on HIV/AIDS prevention, care and treatment programs. These programs operate in 25 countries in Africa, the Caribbean, South America and Asia that participate in the U.S. Department of Health and Human Services/ Centers for Disease Control and Prevention's (HHS/CDC) Global AIDS Program (GAP). UTAP was established to augment and expand HHS/CDC's efforts to provide technical assistance to GAP countries in the development, implementation and evaluation of HIV prevention, care, and treatment programs and the necessary infrastructure (e.g., laboratory services) to support prevention and care programs and services. The participating universities include: University of North Carolina at Chapel Hill, University of California, San Francisco, University of Maryland, University of Medical and Dentistry of New Jersey, Tulane University, Johns Hopkins University, Columbia University, Baylor College of Medicine, Harvard University, and Howard University.
  • HHS supports The International Training and Education Center on HIV (I-TECH) to train health care workers in countries and regions hardest hit by the AIDS epidemic, particularly in Botswana, the Caribbean, Ethiopia, Haiti, India, Kenya, Malawi, Namibia, South Africa, Thailand, Uganda, Vietnam, and Zimbabwe. I-TECH was established in 2002 by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) in collaboration with the HHS Centers for Disease Control and Prevention (HHS/CDC). ITECH is part of the University of Washington, in partnership with University of California, San Francisco.
  • USAID uses several of its standing contracts and grants to facilitate access to technical expertise for program design, strategy development, and general support of field programs and policy development. For example, OGAC has called upon USAID to use these standing contracts and grants to provide teams to help countries develop, draft, and prepare their Country Operational Plans and USG Five Year Strategies.
  • OGAC will further facilitate joint nutrition- and food-related technical assistance with USDA in support of people living with HIV/AIDS in several PEPFAR countries. Funds will be used primarily by USDA participants in OGAC�s Food and Nutrition Technical Working Group, responsible for technical excellence in targeted food and nutrition program interventions for people infected and affected by HIV/AIDS.
  • OGAC uses a variety of mechanisms to support policy development, international conferences and workshops to further Emergency Plan goals.

During FY 2005, technical leadership and support funds supported the development of the New Partners Initiative and the Supply Chain Management Request for Applications (RFA) and the development and drafting of strategies for FY 2006 Country Operational Plans on site. Funds were also used to develop and implement evaluations; facilitate meetings; and support periodic scientific reports and analyses.

FY 2006 Program:

In FY 2006, HHS will provide short and long-term technical assistance support to Focus Countries and other Emergency Plan countries in the advancement of key emergency plan activities such as monitoring and evaluation, capacity building and technical leadership for the prevention, care, and treatment of HIV/AIDS.

Technical leadership and support funds will be also used by USAID to support both short- and long-term consultants for the provision of technical assistance to Focus Countries. Specific activities will assist countries with preparing and/or updating strategies; drafting and developing the annual Country Operational Plans; developing, drafting and implementing Emergency Plan evaluations; assisting with the provision of technical leadership support in prevention, care and treatment; providing meeting facilitation needs; and supporting periodic scientific reports and analyses. USAID will also provide assistance to OGAC in periodic trainings, workforce or operational management reviews that support the continued improvement of the implementation of the Emergency Plan at headquarters and in the field.

OGAC will use technical leadership and support funds to develop comprehensive country training plans and technical assistance work plans for prevention, treatment, and care that are coordinated across all implementing partners and with host country counterparts; workforce management strategies to deal with HIV/AIDS issues, including support for workforce planning, and expanded roles and retention of qualified staff. Instituting quality assurance in both the public and private sectors as well as in-depth analysis and application of evidence-based lessons learned in the area of gender, prevention of alcohol and injection drug use risk behaviors and HIV transmission and the strengthening of the interface between HIV prevention and care and treatment services is a priority. Funds will also be used to develop better indicators, monitoring and evaluation approaches to track the progress and impact of investments in human capacity to reach Emergency Plan goals.

This program will contribute to achieving critical Emergency Plan goals, including supporting prevention of seven million new HIV infections; supporting treatment for two million HIV-infected individuals; and supporting care for ten million people infected or affected by HIV/AIDS, including orphans and vulnerable children.

Time Frame: FY 2006 � FY 2007

Project Title: Twinning Center

Budget: FY 2006 GHAI: $4,200,000

Implementing Mechanism: Cooperative Agreement with the American International Health Alliance (AIHA)

Contact Person(s): Matthew Newland (HHS/HRSA/HAB)

Program Description:

American International Health Alliance (AIHA), through a Cooperative Agreement with the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS), has established an �HIV/AIDS Twinning Center� ( to support twinning and volunteer activities in 15 focus countries as part of the implementation of the President�s Emergency Plan for AIDS Relief.

The overall goal of the Twinning Center is to strengthen the human and organizational capacity necessary to scale up and expand HIV/AIDS prevention, care, treatment, and support services within the broader context of human resource development strategies addressing the HIV/AIDS epidemics in these countries. Through the establishment of volunteer-driven institutional/ organizational partnerships of 3-5 years duration and the incorporation of long-term individual volunteers through the Volunteer Healthcare Corps (VHC), the Twinning Center will contribute to the President�s Emergency Plan goals by:

  • Strengthening educational institutions and training facilities;
  • Training and mentoring individual care-givers;
  • Developing models of care for improved organization and delivery of services and for rapid scale-up of interventions; and,
  • Transferring appropriate technology.

AIHA and its partners work closely with HRSA, host country officials and ministries of health, and U.S. government teams to create twinning partnerships that advance each country�s Strategic HIV/AIDS Plan and Country Operational Plan (COP). To date, potential twinning partnerships have been identified in Zambia, Ethiopia, Uganda, South Africa, Kenya, Mozambique, and Tanzania. The Twinning Center has conducted site assessment visits to five countries, and has developed partnerships in Zambia, Ethiopia, South Africa, and Tanzania, and is in the process of developing twinning partnerships in Kenya and Mozambique and additional partnerships in Ethiopia and South Africa.

FY 2006 Program:

The initial twinning partnerships were selected in the spring and summer of 2005, with a second round of partnerships to be established in early 2006. FY 2006 funding will support existing successful twinning partnerships that are capable of rapidly expanding and scaling up for increased impact. In these cases, Twinning Center funding is expected to supplement, not supplant, other funding sources. Some examples of twinning partnerships are described below:

  • In Zambia, the Twinning Center is forging relationships with the Zambian Military medical providers and the Department of Defense. Professional exchanges are occurring to provide training and education to the Zambian physicians while DOD physicians are providing bedside mentoring in the Zambian military hospitals. As a result of this partnership, Zambia will increase the number of military and civilian persons receiving quality ART drugs and services.
  • Another twinning partnership is building capacity at the University level in pre-service education for nursing in Tanzania. The partnership between the University of Michigan and Muhimbili University Center for Health Sciences in Dar Es Salaam will strengthen nursing HIV/AIDS education for Tanzanians while building a sustainable infrastructure for the expanding role of nurses.
  • Other twinning arrangements fostered through AIHA include US and African palliative care organizations to build infrastructure in Zambia and a �south to south� partnership between Brazil and Mozambique to strengthen care and treatment. By 2007, these and other twinning agreements will take place in addition to creating new opportunities for volunteer healthcare workers.

This program will contribute to achieving critical Emergency Plan goals, including supporting prevention of seven million new HIV infections; supporting treatment for two million HIV-infected individuals; and supporting care for ten million people infected or affected by HIV/AIDS, including orphans and vulnerable children.

Time Frame: FY 2006 � FY 2007

Project Title: New Partners Initiative (NPI)

Budget: FY 2006 GHAI: $25,000,000

Implementing Mechanisms: USAID Cooperative Agreements and other procurement mechanisms with Non-governmental Organizations

Contact Person(s): Patrick Purtell (OGAC) and Chris McDermott (USAID/GH)

Program Description:

NPI is a means to increase the number of Emergency Plan (EP) partners by establishing a competitive grants process for organizations with the desire and the ability to help implement the President's Emergency Plan, but which may have little or no experience in working with the Federal Government. NPI will increase the total number of EP implementing partner organizations and improve their capacity to respond effectively to help meet the President's goals. Additionally, the initiative will develop indigenous capacity so affected countries can address AIDS on their own and decrease dependence on foreign organizations and foreign skills.

In coordination with OGAC, USAID will use FY 2006 funding to initiate the following actions in order to establish NPI:

  • Through an Annual Program Statement or other procurement mechanism, conduct outreach to identify and inform potential partners working in affected countries about NPI;
  • Identify potential new partners from among private and voluntary organizations, faith-based organizations, community-based organizations and other non-profit entities with the desire and the ability to help implement the Emergency Plan but with limited or no experience in working with the Federal Government through current solicitation promotion practices;
  • Improve the capacity of potential new partners to respond effectively by making available technical and capacity-building assistance through an Annual Program Statement and other procurement mechanisms; and,
  • Develop indigenous capacity in affected countries to address AIDS by providing technical and capacity-building assistance.

This program will contribute to achieving critical Emergency Plan goals, including supporting prevention of seven million new HIV infections; supporting treatment for two million HIV-infected individuals; and supporting care for ten million people infected or affected by HIV/AIDS, including orphans and vulnerable children.

Time Frame: FY 2006 � FY 2007

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