Section II, this Introduction, provides a brief overview of this FY 2008 PEPFAR Operational Plan, as well as three summary tables. Table 1 summarizes the overall $5.980 billion FY 2008 PEPFAR budget in terms of sources of funding. Table 2 summarizes this same $5.980 billion FY 2008 PEPFAR budget in terms of planned and approved uses of funding. As of June 2008, the entire $5.980 billion budget has been approved by the U.S. Global AIDS Coordinator (the Coordinator). Table 2 further breaks down the overall budget into the $5.016 billion in funding from the Department of State (State) and the Department of Health and Human Services (HHS) that is the principal subject of this PEPFAR Operational Plan and $965 million that is described in other agencies� congressional justifications and related documents. Table 3 summarizes how the FY 2008 approved activities are distributed among prevention, care, and treatment program areas.
Section III, Focus Country Activities, provides three summary tables (Tables 4, 5, and 6), and fifteen individual country program descriptions. Each country description is followed by a detailed country budget, which shows funding levels as approved by the Coordinator.
Section IV, Other PEPFAR Country Programs, describes funding needed to support PEPFAR bilateral/regional activities in countries outside of the focus countries, followed by brief program descriptions and two summary tables (Tables 7 and 8).
Section V, Notional Partnership Compacts, provides a summary narrative. Section VI, Central Programs, provides a summary table (Table 9), followed by individual central program descriptions. Section VII, International Partners, provides a summary table (Table 10), and describes PEPFAR�s contributions to UNAIDS and the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM). Section VIII, Technical Oversight and Management, provides a summary table (Table 11) and individual program descriptions. Section IX, Strategic Information/Evaluation, provides a summary table (Table 12) followed by a narrative description.
OVERVIEW
This June 2008 PEPFAR Operational Plan serves as the second iteration and will be updated as additional funding is approved by the Coordinator. It follows �The President�s Emergency Plan for AIDS Relief � U.S. Five-Year Global HIV/AIDS Strategy� and seeks to have an immediate impact on people and strengthen the capacity of host nations to expand programs. In FY 2008, PEPFAR will support care for approximately 8.16 million individuals infected and affected by HIV/AIDS including orphans and vulnerable children (OVCs), and will support antiretroviral treatment (ART) for approximately 1.67 millions individuals.
Section III of this document provides information on each country�s contribution to the total number of individuals to be receiving care and antiretroviral treatment using FY 2008 funding.
The FY 2008 PEPFAR budget is $5.980 billion (see Table 1). This FY 2008 PEPFAR Operational Plan describes the planned uses of $5.016 billion of PEPFAR funding (see Table 2) to expand integrated care, treatment and prevention programs in fifteen focus countries and other bilateral country HIV/AIDS programs; to finance central programs that help focus countries achieve their goals; to provide U.S. Government (USG) contributions to international partnerships, including the Joint United Nations Program on HIV/AIDS (UNAIDS) and the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM); to fund technical oversight and management, and to develop and maintain PEPFAR�s strategic information and evaluation systems.
The planned uses of the remaining $965 million of PEPFAR funding include support for existing bilateral HIV/AIDS programs around the world; international HIV/AIDS research through the HHS National Institutes of Health; HIV vaccine and microbicide research and development through USAID; and TB programs. These programs are described in a variety of congressional budget justification documents and briefing materials of USAID, HHS, Department of Defense (DOD), and State.
The $5.980 billion summarized in this June FY 2008 PEPFAR Operational Plan is composed of the following funding sources:
$ 4,661,930,000 FY 2008 Global Health and Child Survival account (GHCS-State)*
$ 498,925,700 FY 2008 Global Health and Child Survival account (GHCS-USAID)*
$ 34,357,000 FY 2008 Other Foreign Operations accounts (USAID and State)
$ 8,000,000 FY 2008 DOD HIV/AIDS Prevention Program account (DHAPP)
$ 658,387,000 FY 2008 NIH budget (HHS)
$ 118,863,000 FY 2008 Global AIDS Program (CDC/GAP, HHS)
$ 5,980,462,700 TOTAL
The FY 2008 figures reflect funds appropriated in the Department of State, Foreign Operations, and Related Programs Appropriations Act, 2008 (Division J, P.L. 110-161); Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2008 (Division G, P.L. 110-161); and Department of Defense Appropriations Act, 2008 (Division A, P.L. 110-116).
PROGRESS TO DATE
PEPFAR is on its way to achieve its aggressive goals. On many fronts, the process to date has been remarkable, and, as the Institute of Medicine noted, PEPFAR has already achieved what many thought was impossible. In FY 2007, PEPFAR-supported programs reached 57.6 million people with support for prevention of sexual transmission using the ABC approach (Abstain, Be Faithful, correct and consistent use of Condoms). The USG has supplied nearly 1.9 billion condoms worldwide from 2004 through 2007 � as Dr. Peter Piot of UNAIDS has said, more than all other developed countries combined. From FY 2004 through FY 2007, PEPFAR has supported prevention of mother-to-child transmission (PMTCT) for women during more than 10 million pregnancies. For PMTCT clients who have been found to be HIV-positive, antiretroviral prophylaxis has been provided in over 827,000 pregnancies, preventing an estimated 157,000 infant HIV infections. With PEPFAR support, focus countries have scaled up their safe blood programs, and 11 of them can now meet more than half of their annual demand for safe blood � up from just four when PEPFAR started.
PEPFAR has supported HIV counseling and testing for over 33 million people to date, and supported care for more than 6.6 million people infected or affected by HIV/AIDS, including 2.7 million orphans and vulnerable children. Through September 2007, PEPFAR partnerships have supported antiretroviral treatment (ART) for approximately 1.45 million men, women, and children�approximately 1.36 million of whom live in 15 PEPFAR focus countries, and over 1.33 million of whom are in sub-Saharan Africa. Illustrating the broader effect of treatment, PEPFAR treatment support is estimated to save nearly 3.2 million adult years of life through September 2009, and many more beyond that time frame. These additional years of life are ones in which people can play vital roles as parents, teachers, or caregivers.
Please see �The Power of Partnerships: The President�s Emergency Plan for AIDS Relief� for a complete description of progress and achievements during FY 2007.
DISTRIBUTION OF HIV/AIDS FUNDS
The distribution of the FY 2008 PEPFAR funds among prevention, treatment, and care is moving in the direction outlined in the authorization of PEPFAR, while adhering to current evidence-based programming and adjusting to evolving program costs.
See Table 3 for the allocation of funds among program areas for activities that have been approved to date. Twenty-two percent of the budget is allocated to prevention activities; 30% of the budget is allocated to care; and 48% is allocated to treatment. Of note, Abstinence and Be Faithful (AB) activities account for nearly 8 percent of the total prevention, care, and treatment budget, 34 percent of all prevention activities, and 58% of programs that address prevention of sexual transmission of HIV/AIDS. Activities for orphans and vulnerable children (OVCs) account for 10% of the total prevention, care, and treatment budget.
CONGRESSIONAL NOTIFICATION
This PEPFAR Operational Plan links all sources of funding, some of which are notified and detailed to Congress by other parts of the USG. The PEPFAR Operational Plan provides descriptive material to support notifications to Congress for funds from the Global Health and Child Survival (GHCS-State) account.
June 2008 Operational Plan Main Page
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