PEPFAR partners

PEPFAR (the President's Emergency Plan for AIDS Relief) is America's $15 billion initiative to combat the global HIV/AIDS pandemic. AVERT.org has a general introduction to PEPFAR and a discussion of PEPFAR's work in focus countries.

In total, many hundreds of organisations help PEPFAR to plan and implement activities in the Emergency Plan's 15 "focus countries". These partners range from local community groups to large international organisations, commercial companies and government departments. They receive support either directly from US government agencies such as USAID and HHS (which includes the CDC and HRSA), or indirectly through other organisations/projects. The partners that receive funding directly are called "prime partners", whereas the rest are known as "subpartners".

Who receives the most money?

In March 2007, the Office of the Global AIDS Coordinator published lists of PEPFAR's prime partners in Fiscal Year 2006 (from October 1, 2005 through September 30, 2006). These lists reveal how much money PEPFAR agreed to pay each partner for work within each focus country during that year.¹

Analysis of the data reveals that the top prime partners, in terms of obligated funds in Fiscal Year 2006, were as follows:

Partner	Type	Funding in FY 2006	Funding in FY 2005
Partnership for Supply Chain Management	Consortium	$82 million	none
US Centers for Disease Control & Prevention	US government	$59 million	unspecified
Family Health International	Nonprofit	$55 million	$103 million
Focus country government departments	Government	$54 million	$83 million
Catholic Relief Services	Faith-based	$42 million	$53 million
Elizabeth Glaser Pediatric AIDS Foundation	Nonprofit	$38 million	$62 million
Management Sciences for Health	Nonprofit	$31 million	$44 million
Mission for Essential Drugs and Supplies	Faith-based	$31 million	none
University of Maryland	University	$29 million	$12 million
US Agency for International Development	US government	$28 million	unspecified

The top ten list for FY 2006 includes one university, two US government agencies and two faith-based organisations. The top forty includes seven universities (plus one university-owned organisation), six commercial companies, three faith-based organisations and two US government agencies.

For more detailed information, see our documents about PEPFAR partners in 2006 (PDF - 36KB) and PEPFAR partners in 2005 (PDF - 36KB).

Who are the partners?

What follows is a list of some of PEPFAR's most active international partners and their projects, grouped by type. Each of these partners has received at least $1 million from PEPFAR for activities in focus countries, and several will eventually receive more than $100 million.

Note that each partner's name acts as a link to that partner's own website, and words in bold refer to organisations or projects profiled in this page.

Academic institutions

Groups linked to universities offer technical advice and assistance based on research into prevention, care, treatment and communication strategies.

Columbia University established the International Center for AIDS Care and Treatment Programs (ICAP) in July 2004, as part of its Mailman School of Public Health. ICAP includes three major initiatives/programmes in African focus countries: the MTCT-Plus Initiative (supporting comprehensive HIV care and treatment for HIV-infected women and their families, in cooperation with USAID), the Multicountry Columbia Antiretroviral Program (providing treatment, in cooperation with the CDC), and the University Technical Assistance Program (CDC-funded).

Harvard University works with PEPFAR in Botswana, Nigeria, South Africa, Tanzania and Vietnam, in particular through the Harvard Medical School Division of AIDS and the Harvard School of Public Health AIDS Initiative (HAI). The HAI directs its research efforts toward developing HIV/AIDS prevention and treatment strategies for the worst affected parts of the world, and partners with overseas organisations to develop sustained education and training programmes.

The International Training and Education Center on HIV (I-TECH) is a collaboration of the University of Washington and the University of California, San Francisco, funded through a cooperative agreement with the Health Resources and Services Administration (HRSA). I-TECH supports training of health care workers who provide HIV/AIDS clinical care, in at least seven focus countries.

Johns Hopkins University, via the Bloomberg School of Public Health's Center for Communication Programs (CCP), works to prevent HIV infection by designing and implementing strategic communication programmes; by enhancing access to information and the exchange of knowledge; and by conducting research in health communication. CCP is active in most of the focus countries, and is a member of the Health Communication Partnership, the CORE Initiative consortium and the MEASURE DHS programme.

The University of Maryland runs the Institute of Human Virology (IHV), which is dedicated to developing improved methods of prevention and treatment of chronic viral and immune disorders - most notably HIV. The IHV has researchers in several focus countries and is a member of the AIDSRelief consortium.

Commercial companies

A number of US-based firms provide various services including management, training and consultancy.

Abt Associates is one of the world's largest for-profit government and business research and consulting firms. Abt Associates helps to mobilise and coordinate multi-sectoral responses to HIV and AIDS, and provides technical advice and assistance based on its own research. It is the leader of an AIDSTAR consortium. PEPFAR supports the firm's work with governments and organisations in several African focus countries and Vietnam.

Constella Futures is a commercial company formerly known as Futures Group, which became part of the Constella Group in January 2005. Constella Futures specialises in the design and implementation of public health and social programmes for developing countries. It implements the POLICY Project, is a member of the AIDSRelief consortium, and is a partner in Community REACH and MEASURE Evaluation.

John Snow Incorporated (JSI) is a commercial company which provides management assistance, information and training to public health programmes. Activities related to HIV and AIDS include those concerned with injection safety, supply chain management (including the DELIVER project) and monitoring and evaluation (including MEASURE Evaluation). JSI works in many African countries and in Haiti. The JSI Research and Training Institute is part of the Partnership for Supply Chain Management, which now receives much of the funding previously allocated to JSI directly. JSI is also the leader of an AIDSTAR consortium.

ORC Macro (also known as Macro International) is part of the Opinion Research Corporation (ORC). The company's mission is "to deliver high-quality, research-based solutions to complex problems". ORC Macro has been involved in designing, delivering, and evaluating HIV/AIDS programmes since the mid 1980s. Its current projects include MEASURE Evaluation and MEASURE DHS.

University Research Co. (URC) is a professional services firm. With its non-profit affiliate, the Center for Human Services, URC works in the United States and abroad on projects spanning communications and outreach; education and training; health and population; quality management; and research and evaluation. PEPFAR-funded projects include the Quality Assurance Project (QAP).

Faith-based organisations

With the exception of Vietnam, every focus country is predominantly Christian. Faith-based organisations have always been essential to local responses to HIV and AIDS.

Catholic Relief Services (CRS) is the official international relief and development agency of the US Catholic community. Its mission is "to assist the poor and disadvantaged, leveraging the teachings of the Gospel of Jesus Christ to alleviate human suffering, promote development of all people and to foster charity and justice throughout the world". CRS works with counterparts - many of them local faith-based organisations - and is not itself operational in the field. It supports HIV/AIDS prevention and care programmes in many African countries, Guyana and Haiti, but for religious reasons does not promote the use of condoms. CRS is a member of the AIDSRelief consortium.

Fresh Ministries is a multi-faith organisation based in Florida. In October 2004 Fresh Ministries received $10 million from PEPFAR for a project called Siyafundisa, which will be administered in partnership with the Anglican Church of the Province of Sourthern Africa. Siyafundisa will concentrate on children and young adults in South Africa, Mozambique and Namibia, teaching abstinence until marriage and combatting AIDS-related stigma.

Habitat for Humanity and Opportunity International are independent Christain organisations who specialise in providing housing and small business loans, respectively. The two formed a partnership to help orphans and vulnerable children in Zambia, Uganda and Mozambique over five years, for which they received $5.1 million from USAID.

HOPE worldwide is a faith-based charity founded in 1991 by the International Churches of Christ. HOPE worldwide is a PEPFAR partner with prevention, care and treatment projects in Cote d'Ivoire, Kenya and South Africa.

Mission for Essential Drugs and Supplies (MEDS) is an ecumenical partnership of the Kenya Episcopal Conference and the Christian Health Association of Kenya, and is based in Nairobi. MEDS is the purchaser and distributor of the vast majority of PEPFAR-procured antiretroviral drugs in Kenya.

Samaritan's Purse is "a nondenominational evangelical Christian organization providing spiritual and physical aid to hurting people around the world". It is run by Franklin Graham, son of the evangelist Billy Graham. Like HOPE worldwide, CRS, Fresh Ministries and World Vision, Samaritan's Purse is one of nine faith-based organisations to have received funding under the USAID "HIV/AIDS Prevention Through Abstinence and Healthy Choices for Youth" programme.

World Relief is a wholly-owned subsidiary of the US National Association of Evangelicals, which is made up of more than 50 member denominations and hundreds of evangelical churches. World Relief's mission is "to work with, for and from the Church to relieve human suffering, poverty and hunger worldwide in the name of Jesus Christ". The organisation's Mobilizing for Life project promotes a faith-based approach to HIV prevention (abstinence until marriage and fidelity within marriage) in Haiti, Kenya, Mozambique and Rwanda. Condoms are sometimes supplied through pastors to those who request them, but they are not actively promoted. World Relief also helps churches to provide care and support for those affected by HIV and AIDS, including orphans.

World Vision describes itself as "a Christian relief and development organisation working for the well being of all people, especially children". This very large, independent organisation has HIV/AIDS prevention and care projects in several focus countries as part of its HOPE Initiative, and has received PEPFAR funds under the USAID "HIV/AIDS Prevention Through Abstinence and Healthy Choices for Youth" programme. The organisation believes in encouraging condom use among sex workers.

HIV/AIDS nonprofit organisations

Many organisations are soley dedicated to fighting HIV and AIDS around the world.

The Children's AIDS Fund (CAF) - formerly part of Americans for a Sound AIDS/HIV Policy - started work in the US in 1987 and has operated in Africa since 1988. In Uganda, Zambia and South Africa, CAF "works to limit suffering of children and their families caused by HIV disease by providing care, services, resources, referrals, and education". CAF favours "a focus on risk avoidance prevention messaging" (particularly abstinence until marriage) rather than generalised condom promotion.

The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) works to eradicate HIV and AIDS in children and families; to provide care and treatment for those affected; and to support research. EGPAF partners with the CDC to provide ARV treatment (Project HEART) and with USAID to prevent mother-to-child transmission (the Call to Action Project). Between them these projects cover eight African focus countries.

The International HIV/AIDS Alliance is the European Union's largest HIV/AIDS-focused development organisation. The Alliance is an initiative of people, organisations and communities working to support community responses to HIV and AIDS by forging partnerships, sharing knowledge, accessing financial resources, and offering technical assistance. It supports projects in HIV/AIDS prevention, care and treatment, and campaigns for policy changes. Current programmes exist in Côte d'Ivoire, Mozambique, Nigeria, Uganda, Zambia and the Caribbean. The Alliance is a member of the Health Communication Partnership and the CORE Initiative consortium.

Other nonprofit organisations

Other organisations see the fight against HIV and AIDS as critical to their pursuit of wider goals, such as improving public health or eliminating poverty.

The Academy for Educational Development (AED) is "committed to solving critical social problems and building the capacity of individuals, communities, and institutions to become more self-sufficient". AED works in all the major areas of human development, including HIV/AIDS prevention and care. AED has PEPFAR-funded projects in at least nine focus countries.

The American Red Cross has received $7 million from USAID to teach young people in Guyana, Haiti and Tanzania how to prevent HIV infection through "abstinence and other healthy behaviors". The five-year programme is a collaboration with African Red Cross societies. The American Red Cross also works with PEPFAR in Kenya.

CARE is one of the world's largest private international humanitarian organisations. As part of its fight to reduce poverty, CARE works to prevent HIV infection and to mitigate its effects in more than two-dozen poor countries. In the most affected regions, CARE is "maintaining a primary focus on highly vulnerable groups, including migrant laborers, commercial sex workers, truckers, refugees, orphans and adolescents". CARE promotes grassroot efforts and assists local organisations, and is the leader of the CORE Initiative.

Family Health International (FHI) is a nonprofit organisation which aims to improve lives through research, education, and services in family and reproductive health. FHI's expertise is in providing technical and managerial assistance and training to developing country governments, non-governmental organizations and private-sector agencies. It designs, manages and evaluates comprehensive HIV prevention, care, and support programmes in every focus country except Botswana. FHI's largest single project is the IMPACT Project, and other large projects include YouthNet and the Global HIV/AIDS Initiative Nigeria (GHAIN), which alone will receive $193 million over five years. FHI also leads an AIDSTAR consortium, and helps PSI to implement AIDSMark.

JHPIEGO is an affiliate of The Johns Hopkins University. In the years 2002-2007, JHPIEGO is working with the CDC through its University Technical Assistance Project (UTAP) to design, implement and monitor country-specific, comprehensive HIV/AIDS programmes; and to provide training materials and guidelines. JHPIEGO works in at least eight focus countries and is the leader of an AIDSTAR consortium.

Management Sciences for Health (MSH) is a private, nonprofit educational and scientific organisation. MSH works in at least thirteen focus countries to improve public health through integrated technical assistance aimed at improving the management of people, medicines, money, and systems. MSH runs the RPM Plus project, and assists FHI's IMPACT Project and PSI's AIDSMark. MSH is part of the Partnership for Supply Chain Management and is the leader of two AIDSTAR consortia (Sector I and Sector II).

Pact is a nonprofit organisation whose mission is "to help build strong communities globally that provide people with an opportunity to earn a dignified living, raise healthy families, and participate in democratic life". Pact works to prevent HIV incection and to care for those affected by providing technical, organisational and institutional capacity building for communities and organisations. Pact is a partner in Community REACH.

Pathfinder International works to improve the reproductive health of people in the developing world. The organisation has HIV/AIDS projects supported by PEPFAR in at least five focus countries including Vietnam. These projects involve HIV prevention and care, with a particular focus on home-based care and helping especially vulnerable groups, including sex workers and injecting drug users.

Population Services International (PSI) is the world's leading nonprofit social marketing organisation. PSI has been promoting abstinence, fidelity and condoms as HIV prevention strategies since 1988, and also promotes voluntary HIV testing and counselling. On the subject of the ABC (Absitnence, Being faithful, and Condoms), the organisation says that, "PSI's education and communication campaigns are based on the belief that young adults and other vulnerable target groups deserve to have all the facts as their circumstances change and they move from one phase of their lives to another... All three elements must be promoted together to provide maximum protection to those at risk." PSI has projects related to HIV/AIDS - including AIDSMark - in at least thirteen focus countries. PSI also helps with mass media interventions for FHI's IMPACT Project, and is the leader of an AIDSTAR consortium.

Save the Children receives PEPFAR support for HIV/AIDS work in Ethiopia, Mozambique, South Africa and Vietnam. Its programmes include the five-year SCALE-UP Hope Program, which provides care and support for vulnerable children, their families and communities. Save the Children is a member of the Health Communication Partnership.

Major international projects

It is worth noting that some projects, including IMPACT and the CORE Initiative, are due to reach their predetermined end-dates before PEPFAR completes its five-year span in October 2008, and it is likely that new projects will be created. All of the projects listed below are entirely funded through USAID unless stated otherwise.

AIDSMark is a $165 million social marketing project run by PSI. AIDSMark promotes behaviour change to prevent HIV infection by adapting commercial sales and marketing techniques. Both FHI and MSH assist the project, which covers the years 1997-2007.

AIDSRelief is a project that provides ARV treatment in nine focus countries including Haiti and Guyana. It is entirely funded through the Health Resources and Services Administration (HRSA) and is implemented by Cathoilc Relief Services, Catholic Medical Mission Board, Interchurch Medical Assistance, Constella Futures and the University of Maryland's Institute of Human Virology. First year funding for AIDSRelief was $24.7 million, and anticipated total support is $335 million over five years.

AIDSTAR (AIDS Support and Technical Assistance Resources) is a very large, wide-ranging project that will award up to $700 million over five years to 13 contractors. The project was announced in late 2005 and awards were announced in mid-2007. AIDSTAR has two separate parts: Sector I involves HIV prevention, care and treatment, while Sector II addresses institutional capacity building. The seven partnerships implementing Section I are led by FHI, JHPIEGO, MSH, John Snow International, PATH, PSI, and RTI International. The six partnerships implementing Section II are led by Abt Associates, BearingPoint Inc., Booz Allen Hamilton, Training Resources Group, MSH, and Social Sectors Development Strategies.

Community REACH is a five-year HIV/AIDS grant-giving mechanism implemented by Pact in partnership with Constella Futures. Community REACH has provided funds to organisations in 12 focus countries.

The CORE Initiative is a $50-million programme run by a consortium which is led by CARE International. The other partners are the International Center for Research on Women, the International HIV/AIDS Alliance, the Johns Hopkins CCP, and the World Council of Churches. The CORE Initiative partners with community and faith-based groups to advance multi-sectoral responses to the HIV/AIDS epidemic through grants, capacity building and networking. Recipients of large grants (up to $250,000) include Catholic Relief Services and Samaritan's Purse. As of the end of 2004, the Initiative was active in the following focus countries: Kenya, Mozambique, Rwanda, South Africa, Uganda, and Vietnam. The CORE Initiative was created as a five-year programme in early 2003.

DELIVER is a supply chain management project, which is managed by John Snow International. DELIVER helps developing countries to improve logistics systems for various public health and family planning products, most notably condoms.

The Health Communication Partnership (HCP) is run by five partners: the Johns Hopkins CCP (where it is based), the Academy for Educational Development, Save the Children, the International HIV/AIDS Alliance and Tulane University's School of Public Health and Tropical Medicine. HCP works to strengthen public health in the developing world through strategic communication programmes, including mass media campaigns and the branding of health products.

The IMPACT Project is USAID's flagship effort for addressing the global HIV/AIDS pandemic. It is managed by FHI (their largest single project) with assistance from five other organisations including MSH and PSI. The project works in partnership with governments and non-governmental organisations to develop, implement, assess, and refine programming related to all areas of HIV/AIDS prevention, care and treatment. IMPACT manages HIV/AIDS programmes and projects in more than 70 countries. USAID created IMPACT in 1997, and it is due to end in September 2007.

The MEASURE Program (Monitoring and Evaluation to ASess and Use REsults) is "designed to provide and promote the use of accurate and timely information on population, health, and nutrition in developing countries". It includes the MEASURE DHS (Demographic and Health Surveys) programme, which is implemented by ORC Macro, in partnership with the Johns Hopkins CCP, PATH, Casals and Associates, and Jorge Scientific Corporation. MEASURE Evaluation is implemented by the Carolina Population Center at the University of North Carolina at Chapel Hill, in partnership with Constella Futures, ORC Macro, John Snow International and Tulane University.

The Partnership for Supply Chain Management was in September 2005 awarded the contract to run PEPFAR's supply chain. USAID says the supply chain "will provide a one-stop shopping for programs to obtain HIV/AIDS-related products" including drugs, HIV test kits and laboratory materials. The contract funds up to $77 million in system operating expenses and technical assistance over the first three years, and the drugs and supplies handled by the system could total $500 million or more over the same period. The Partnership was established by John Snow International and MSH, and includes 15 other organisations.

The POLICY Project is implemented by Constella Futures, in collaboration with the Centre for Development and Population Activities and Research Triangle Institute. POLICY provides technical and financial support to a range of stakeholders working on family planning/reproductive health and maternal health issues, including HIV and AIDS. The project assists in policy formulation and strategic planning; analysis; awareness raising and advocacy; and capacity-building with local organisations.

The Rational Pharmaceutical Management Plus (RPM Plus) programme aims "to promote the appropriate use of medicines and improve the availability of quality health commodities" - including those for HIV/AIDS - in developing countries. The five-year RPM Plus programme is managed by MSH and operates in eleven focus countries, including Haiti.