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The President’s Emergency Plan for AIDS Relief
42 MINUTE READ
January 26, 2023

(Last updated: October 31, 2022)

The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) is commemorating 20 years of providing support to the global effort to end the HIV pandemic. In 2003, PEPFAR was conceived to deliver lifesaving services in countries being devastated by HIV and AIDS. Since then, PEPFAR now assists countries to control the HIV epidemic. PEPFAR, as the U.S. government’s response to the HIV global epidemic, is celebrating 20 years of partnering with countries and communities in support of the global HIV response impacting millions of people around the world with comprehensive HIV prevention, care, and treatment services. As the world’s leader in responding to the global HIV crisis, PEPFAR works in over 50 countries. Worldwide, 18.7 million people are supported by PEPFAR with lifesaving antiretroviral therapy. Nearly 7.3 million orphans and vulnerable children (OVC) and their caregivers are supported by PEPFAR programs. PEPFAR is the largest commitment by any nation to address a single disease in history, investing nearly $100 billion dollars since 2003, making the United States the world’s leader in the HIV response.

PEPFAR in Zambia

January 28, 2023 marks the anniversary of President George W. Bush’s State of the Union address first announcing the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). Twenty years later, the U.S. government, through PEPFAR, has helped not only save and improve millions of lives, but also transform the global HIV/AIDS response.  PEPFAR was and is the largest commitment by any nation devoted to a single disease with nearly 6 billion dollars committed to Zambia since 2003. The end of HIV/AIDS as a public health threat by 2030 is an ambitious, but achievable goal.  Through the work of PEPFAR, Zambia has exceeded UNAIDS HIV targets in treatment and viral suppression through close collaboration with the Zambian government, multilateral partners, civil society and faith-based organizations, and people living with HIV. Congratulations to the PEPFAR Zambia team on twenty years of service to Zambia’s national HIV response in partnership with the Zambian government.

Since 2004, the U.S. government through PEPFAR has provided support to Zambia’s national HIV response in partnership with the Government of the Republic of Zambia through the Ministry of Health (MOH) and National HIV/AIDS/STI/TB Council (NAC). In fiscal year 2022, Zambia received $401.6 million dollars from the US government for HIV prevention, treatment, care and support, and health systems strengthening in support of Zambia’s national HIV response. With this funding, the United States government supported over 1.2 million Zambians with lifesaving HIV medications, at no charge. Keeping people living with HIV on medication is a key component of preventing the spread of HIV.

PEPFAR Zambia has received over $5.9 billion dollars (estimated at over 102 billion ZMW) in support of the national Zambian HIV response. In just the last five years, PEPFAR Zambia has funded 21,126,301 HIV tests, supported more than 2 million voluntary medical male circumcisions, and provided support for more than 500,000 orphans, vulnerable children, and their caregivers in the last fiscal year. Today, PEPFAR Zambia supports over 1.2 million Zambians with lifesaving antiretroviral therapy, who if they continue to take their medicines can live long, healthy lives and prevent the spread of HIV.

As PEPFAR starts its 20th year of global support to end the HIV epidemic, Zambia will receive $402.6 million dollars to continue supporting the national HIV response with special focus on reaching those people living with HIV who have not yet begun treatment, including pediatrics, adolescents and young people and key populations.   PEPFAR Zambia funds five U.S. government agencies in a single unified HIV responds strategy led by the US Ambassador to Zambia. These agencies are the US Centers for Disease Control and Prevention (CDC), Department of Defense HIV/AIDS Prevention Program (DHAPP), Department of State (DoS), and Peace Corps (PC), and United States Agency for International Development (USAID).

Country Operational Plan (COP)

The Country Operational Plan (COP) is the U.S. government’s plan for annual investments in Zambia’s HIV response and are linked to specific results to ensure every U.S. dollar is accounted for and impact maximized. PEPFAR Zambia’s COPs are encapsulated in their annual Strategic Direction Summaries (SDS). Below are links to Zambia’s SDSs since 2015:

DREAMS Zambia

What is the PEPFAR-funded DREAMS program?

DREAMS is a global, public-private partnership between the U.S. President’s Emergency Plan for AIDS Relief  (PEPFAR), Bill & Melinda Gates Foundation, Girl Effect, Johnson & Johnson, ViiV Healthcare, and Gilead. This interagency program seeks to reduce new HIV infections in adolescent girls and young women (AGYW) between 10 and 24 years old across 15 sub-Saharan African countries. DREAMS is designed to meet the complex needs of adolescent girls and young women by helping them become more determined, resilient, empowered, AIDS-free, mentored, and safe.

Why Adolescent Girls and Young Women?

Globally, AGYW are the most vulnerable to new HIV infections, unplanned pregnancy, and sexual violence. In southern Africa, 79% of new HIV infections among 10 and 19-year-olds were among females.1 In Zambia, HIV prevalence among young people between 15 and 24 years old is 3.4% with a disproportionate burden on girls and young women (4.9%) as compared to their male age counterparts (1.8%). Sixty-nine percent of Zambian girls and young women have had sex by age 18 and 26% report their first sexual experience as coerced. 2,3 Additionally, 20.3% of adolescent girls and young having experienced sexual abuse during childhood.4 Such violence has immeasurable negative health and social consequences for girls and young women throughout their lives.
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1 UNAIDS 2019. Women and HIV – A spotlight on adolescent girls and young women.
2 Zambia Demographic and Health Survey (ZDHS) 2018.
3 Zambia Violence Against Children Survey (VACS) 2018.
4 Zambia VACS 2018.

DREAMS in Zambia

Deaf adolescent girls and young women being led through an HIV education activity by DREAMS staff.

Since 2016, PEPFAR has steadily increased investment in DREAMS. As of 2020, PEPFAR invests $30 million per year in the DREAMS initiative in Zambia. Working across 14 districts in seven provinces, DREAMS Zambia targets the most vulnerable adolescent girls and young women in 77 health facility catchment zones with high HIV burdens. DREAMS Zambia has developed a unique model structured around DREAMS centers, where adolescent girls and young women meet in safe, confidential spaces to access a package of HIV prevention services tailored to their individual needs. These services include mentor-led safe spaces, gender-based violence care and support, HIV testing and counseling, family planning, pre-exposure prophylaxis, school scholarships, and economic strengthening. When combined with safe spaces, economic strengthening interventions, such as financial literacy and vocational training, can reduce the economic dependency that can lead to gender-based violence and sexual risk-taking behaviors.

DREAMS also works with adolescent girls’ and young women’s sexual partners, parents, schools, and communities. School-based HIV and violence prevention programs address gender and power relations and build prevention skills among youth. Community mobilization in DREAMS engages men and boys in community conversations about HIV, gender norms and sexuality to build community ownership of HIV risk reduction. These community-based interventions strengthen the supportive network necessary for girls and young women to thrive.

Since DREAMS inception, over 775,000 Zambian adolescent girls and young women have enrolled in the HIV prevention program, with nearly 725,000 completing at least one prevention service with support from DREAMS mentors. Girls and young women who have participated in DREAMS have demonstrated increased knowledge of healthy practices and behaviors that can reduce their risk of contracting HIV. Over time, DREAMS Zambia has observed improved use of modern contraceptive methods and pre-exposure prophylaxis through adolescent-friendly health services offered in DREAMS centers in partnership with government health facilities. Such prevention services are critical to reducing new HIV infections and achieving epidemic control in Zambia.

DREAMS also works with adolescent girls’ and young women’s sexual partners, parents, schools, and communities. School-based HIV and violence prevention programs address gender and power relations and build prevention skills among youth. Community mobilization in DREAMS engages men and boys in community conversations about HIV, gender norms and sexuality to build community ownership of HIV risk reduction. These community-based interventions strengthen the supportive network necessary for girls and young women to thrive.

Since DREAMS inception, over 775,000 Zambian adolescent girls and young women have enrolled in the HIV prevention program, with nearly 725,000 completing at least one prevention service with support from DREAMS mentors. Girls and young women who have participated in DREAMS have demonstrated increased knowledge of healthy practices and behaviors that can reduce their risk of contracting HIV. Over time, DREAMS Zambia has observed improved use of modern contraceptive methods and pre-exposure prophylaxis through adolescent-friendly health services offered in DREAMS centers in partnership with government health facilities. Such prevention services are critical to reducing new HIV infections and achieving epidemic control in Zambia.

PEPFAR in Action

PEPFAR Zambia Welcomes New U.S. Ambassador Michael Gonzales

Michael Gonzales was sworn in as the U.S. Ambassador to the Republic of Zambia in August 2022.  He previously served as the Deputy Assistant Secretary of State for West Africa and African Regional Peace and Security and as the acting U.S. Special Envoy for the Sahel Region.

A career member of the Senior Foreign Service with the rank of Minister-Counselor, Mike’s previous senior positions include service as the Director for Analysis of Africa in the State Department’s Bureau of Intelligence and Research and as Deputy Chief of Mission and Chargé d’Affaires, a.i., at the U.S. Embassies in Kathmandu, Nepal and Lilongwe, Malawi.

One of Ambassador Gonzales’ top priorities is promoting inclusion both within the United States Embassy and in engagements in Zambia. Supporting equity and inclusion is a key component of PEPFAR Zambia’s Country Operational Plan for 2022. This ties into the reimagining of PEPFAR’s strategic direction addressing inequities in HIV service access, ensuring all ages, genders, and population groups at risk for HIV infection receive equitable, HIV prevention and treatment services.

PEPFAR Partners with Miss Zambia 2022 to Support Equity and Inclusion of Deaf and Hard-of-Hearing Adolescent Girls and Young Women

Miss Zambia 2021/2022, Natasha-Joan Mapulanga with DREAMS staff at a PEPFAR outreach event for Deaf adolescent girls and young women.

The United States government through the President’s Emergency Plan for AIDS Relief (PEPFAR) Zambia works to increase access to health services for all Zambians, including the most vulnerable and left behind, through HIV prevention, care and treatment education and linkage to health services.  Commemorating the International Week of Deaf People 2022 themed “Building Inclusive Communities for All”, PEPFAR Zambia conducted outreach activities to engage eligible Deaf adolescent girls and young women (AGYW) through DREAMS and Rise Up! programs that are both designed to prevent the spread of HIV.  Deaf AGYW in the Matero and Kanyama areas of Lusaka were invited to participate in an open house during which more than 60 AGYW from Deaf schools in Lusaka visited a DREAMS center or Rise Up! House. Going further, teams engaged Munali Secondary School where over 50 Deaf AGYW were educated of the services provided by DREAMS and Rise Up! programs, took part in HIV education activities and participated in a discussion on how PEPFAR programs can best accommodate Deaf AGYW.  Building on her celebrity, PEPFAR Zambia partnered with Miss Zambia 2021/2022, advocate and role model, Ms. Natasha-Joan Mapulanga, whose platform and passion is sexual reproductive health rights and empowering AGYW.  Ms. Mapulanga attended the event at Munali Secondary School, talked about her work in sexual reproductive health activism and encouraged the attendees to access the services provided through PEPFAR programming.

 

 

PEPFAR Small Grants Program Empowers Local Zambian Organizations to Combat HIV with 3.49 Million Kwacha Investment

The U.S. government, through the President’s Emergency Plan for AIDS Relief (PEPFAR), has identified twelve organizations as awardees of the 2022 PEPFAR Small Grants Program.  The PEPFAR Small Grants Program was created to support the work of local community and civil society organizations. The annual funding provides grants in amounts between ZMW 155,200 ($10,000) and ZMW 388,000 ($25,000) to support community-led programs with activities that mitigate the spread of HIV for all populations including adolescent girls and young women and key populations, provide support to orphans and vulnerable children (OVC) and their households, and democracy and governance activities.  The twelve organizations, inclusive of three youth-focused organizations and two organizations focused on key populations, are diverse in their missions and in the vulnerable communities they serve. Examples of the work these organizations will do with this funding include increasing access and equity in the delivery of comprehensive HIV services, combating HIV and AIDS stigma and discrimination, and empowerment to families through access to healthcare, parenting skills and household economic strengthening for primary caregivers of OVC. These grants will help strengthen the capacity of community and civil society organizations to deliver and support HIV-related services while improving community engagement.

Chargé d’Affairs, a.i. and Minister of Health Hold Joint Press Conference to Announce COP22 Approval

Chargé d’Affairs, Martin Dale with the Honorable Minister of Health, Madam Sylvia Masebo at the COP22 Approval Meeting – April 7, 2022.

On April 7, 2022, Chargé d’Affairs, a.i., Martin Dale and the Honorable Minister of Health, Madam Sylvia Masebo, held a joint press conference to announce the approval of PEPFAR Zambia’s 2022 Country Operational Plan (COP), which will provide $402.6 million towards Zambia’s national HIV program.   Chargé Dale used the press conference as an opportunity to highlight the 2022 country operational plans focus on adolescent girls and young women, pediatrics and key populations which require additional programmatic focus for Zambia to reach the goal of epidemic control.  He also took the opportunity to recognize the Government of the Republic of Zambia, the Zambian Ministry of Health, civil society organizations representing young people, people living with HIV, key populations and faith-based communities, as well as international and national multilateral partners for their meaningful contributions and partnership throughout the COP22 planning process.

The Honorable Minister of Health, Madam Sylvia Masebo expressed her gratitude for the generosity of the American people and confirmed the Zambian government’s commitment to partnering with the American government.  Chargé Dale told journalists from radio, television, and print media that the U.S. government had already invested more than $5.9 billion towards controlling HIV in Zambia over the past 19 years, demonstrating the commitment of the American people to a strong and healthy Zambia.

PEPFAR Zambia and the GIZ Join Hands for Young Women’s Empowerment in Zambia

PEPFAR Zambia’s USAID supported Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe (DREAMS) initiative produced 20,000 face masks, over 4,400 packs of reusable sanitary pads, and 4,000 cloth bags upon request and for procurement by the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH.  GIZ placed the order through the German-funded “Strengthening Girls’ Rights!” program, which aims to ensure that young people in Zambia are better able to protect themselves against HIV, teenage pregnancy, and gender-based violence. Produced by the young women in the DREAMS initiative, the nearly 30,000 cloth-based products were distributed with COVID-19 support kits for adolescents and young people, which also contained sanitizers, soap, and health information. Prior to the COVID-19 pandemic, the U.S. government had equipped 40 DREAMS centers across five provinces with sewing machines and supplies and trained the young women in the program to make and sell affordable, reusable menstrual pads in their communities. In response to COVID-19, the women adapted their sewing skills to craft and sell the cloth masks both within their communities and to others. In total, 4,450 support kits were handed over to the Ministry of Education and the Ministry of Health for distribution in schools and youth-friendly health facilities in six districts. Sixty schools and 62 health facilities were also supported with PPEs, hygiene products, and health information materials.

PEPFAR Zambia supports the 2022 Regional Adolescent Health Indaba (RAHi) for local and international youth advocates

PEPFAR interagency team participating at the PEPFAR booth during the 2022 Regional Adolescent Health Indaba.

PEPFAR Zambia opened the Inaugural Regional Adolescent Health Indaba (RAHi) under the theme “Closing the tap of new HIV infections through meaningful youth engagement, leadership and innovation on April 8-9, 2022. The RAHi attracted 300+ local and international youth delegates to discuss different health challenges affecting adolescents and young people as well as share best practices to promote access to quality healthcare services for adolescents and young people.  The PEPFAR interagency team led discussions with youth delegates around pre-exposure prophylaxis (PrEP), condoms and STIs, HIV testing, gender-based violence, health service access for persons with disabilities, and adolescent friendly HIV treatment. PEPFAR Zambia sponsored youth delegates to attend the event and provided HIV testing as well as COVID vaccination stations for youth to access health services on-site. The next RAHi is set for February 2023 with Provincial Adolescent Health Indabas organized across the country for adolescents and young people to convene and draw together their experiences in promoting physical, mental and social well-being for youth in Zambia.

PEPFAR SMALL GRANTS PROGRAM

Open period for receipt of applications:  January 3 through March 3, 2023

Applications received after the March 3, 2023 deadline will not be held or reviewed.

The U.S. Embassy is pleased to announce a new round of funding for the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) Zambia Small Grants Program.

Background:  The PEPFAR Small Grants Program is highly competitive funding which supports projects in three thematic areas: HIV prevention, care for children and Adolescents and Young People (AYP), and projects that promote key and priority population education, treatment and adherence in Zambia’s HIV response.

Organizations funded through the PEPFAR Small Grants Program must be providing one or more of the following services:

  1. HIV prevention that includes targeted evidence-based prevention programs. Prevention programs may focus on one or more of the following categories:
  • HIV prevention and sexual violence
  • Norms and behavior change
  • Key and Priority Populations
  • Gender based violence (GBV) and post-GBV care services

Evidence-based means that the program uses a specific curriculum, implementation is monitored and can be measured, and the program has been proven to yield positive results.

  1. Targeted HIV Case Finding Services with the aim of identifying and newly testing, newly linking or re-linking individuals to anti-retroviral treatment (ART). These will include identification, linkage, retention in care, with a focus on reaching key and priority populations, children and Adolescents and Young People (AYP).
  2. Community-based Care and Support – Service delivery specifically for people living with HIV (PLHIV), including children and Adolescents and Young People affected by and living with HIV as well as key and priority populations. This includes activities such as case management adherence clubs, psychological support services, tracking and tracing people who experience treatment interruption or are not virologically suppressed.

The PEPFAR Small Grants Program will fund programmatic costs associated with these activities.  These include supplies/materials, transport, equipment, training related to program implementation, and/or administration in the context of the above activities.  Successful implementation of these activities may also require building the capacity of recipient organizations in areas such as monitoring and evaluation and case management.

Funding Amount:

Up to the Zambian Kwacha equivalent of $25,000.00 maximum may be requested.  Detailed budgets must be submitted with the application.  Funding amounts to successful organizations will be dependent on the results of pre-award risk assessments conducted on all selected organizations.

Applicants must provide recommendations from previous funding agencies indicating successful implementation of projects.

Project Duration:  October 1, 2023, through September 30, 2024

Application forms can be downloaded at https://grants.gov

Who is Eligible to Apply?

In order to apply for funding, organizations must meet the following eligibility requirement:

  • Be a registered civil society, community or faith-based organization in Zambia
  • Been in operation for at least two years
  • Serve HIV-affected, infected and/or high-risk populations
  • Not receiving any other direct funding from the U.S. Government as a prime partner or a sub-recipient

Applications submitted without all required documents will not be considered.

Contact:

Program Manager, Civil Society Engagement
PEPFAR Coordination Office
Embassy of the United States of America
P.O. Box 320065, Lusaka, Zambia
LusakaSmallGrants@state.gov
(+260) 211 357062)

PEPFAR Implementing Agencies in Zambia

Useful Links

PEPFAR has invested more than $5.9 billion dollars in Zambia’s HIV response through the following U.S. government agencies:

PEPFAR Zambia Community-led Monitoring

The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) works to improve the quality of HIV care in Zambia by soliciting and triangulating recipient of care feedback collected by trained community members. PEPFAR Zambia uses this information to strengthen, address gaps and improve the outcomes of HIV services. PEPFAR Zambia seeks not-for-profit organizations with the capacity to collaborate with PEPFAR, key stakeholders, as well as community level recipients of care of PEPFAR supported services. Potential grantees should build on past work, be able to implement a monitoring program to promote cooperation in addressing HIV, encourage all PLHIV constituencies, including but not limited to key populations, adolescent girls and young women and pregnant and breastfeeding women, to share their experience and facilitate discussion and insight that makes a difference in the HIV response.

Who is Eligible to Apply?

  1. Not-for-profit organizations, including civil society, non-governmental organization and public and private educational institutions
  2. Organizations registered with the Government of the Republic of Zambia will be considered eligible.
  3. Must have experience of successfully implementing programs with funding of a minimum of $25,000.
  4. Must have established offices, at least 12 months prior to application submission, in the province for which they are applying to implement the CLM program.
  5. An organization may apply for consideration for more than one province but is only eligible to be one prime CLM Grantee.

Other Eligibility Requirements:

Applicants must register with Grants.gov prior to submitting an application.  Registering with Grants.gov is a one-time process; however, it may take weeks to have the registration validated and confirmed.  It is recommended that the registration process is begun immediately to ensure that the process is completed well in advance of the deadline for applications.  Until that process is complete, you will not be issued a user password for Grants.gov, which is required for application submission. There are four steps that must be completed before being able to register: (1) register organization with System for Award Management (SAM) www.SAM.gov; to get a Unique Entity ID (UEI) (2) register as an Authorized Organization Representative (AOR); and (3) be authorized as an AOR by your organization.  For more information, go to www.grants.gov.  Please note that SAM registration must be annually renewed.  Failure to renew your SAM registration may prohibit submission of a grant application through Grants.gov.

The U.S. Department of State will not make an award to an applicant who does not have a valid and active SAM registration by the time the Department is ready to make an award.

What are the objectives of the Program?

PEPFAR Zambia recognizes the importance of engaging with communities in the development and implementation of its HIV programming. Beginning on January 2023, PEPFAR will continue supporting a CLM program in each province to strengthen previous CLM activities and address client feedback. In partnership with the National HIV/AIDS, STI, and TB Council (NAC), quarterly review meetings of patient and client feedback will be held to identify persistent and common problems, challenges, and barriers to service uptake at the site and facility level. To facilitate and ensure all provinces and PLHIV constituencies are represented, PEPFAR Zambia seeks applicants from community organizations from each province in Zambia. The feedback will be collected and reported using a harmonized reporting tool created by stakeholders. The role of the grantees will focus solely on feedback collection while PEPFAR Zambia will provide oversight of CLM implementation and share the collected feedback with all key stakeholders. Applicants should not plan for dissemination of CLM findings to stakeholders at any point during the lifecycle of the grant unless otherwise directed by PEPFAR Zambia.

The deliverables are:

  1. Include low and high-volume health facilities offering PEPFAR supported HIV related services across the province, as part of data collection.
  2. Collect feedback from all PLHIV constituencies services, including but not limited to key populations, adolescent girls and young women, persons with disability, pregnant and breastfeeding women.  Applications which do not include plans for the inclusion of all constituencies will not be considered.
  3. Submit monthly programmatic and financial reporting.
  4. Participate in quarterly meetings with government, community, USG and implementing partners.
  5. Make actionable recommendations to improve client care based on feedback from recipients of care.

Award Information:
Length of performance period: 11 months

Award amounts: Awards may range up to the maximum of the Kwacha equivalent of $120,000 USD

Funding Instrument Type: Grant

Contact:
PEPFAR Coordination Office – Embassy of the United States of America
P.O. Box 320065, Lusaka, Zambia
LusakaSmallGrants@state.gov

Open period for receipt of applications: To Be Announced.

Contact Information

Country Coordinator:
Tel: +260-211-357-000
Fax: +260-211-357-224

The U.S. President’s Emergency Plan For AIDS Relief,
Embassy of the United States of America
Suddivision 694/Stand 100
Kabulonga District, Ibex Hill Road
Lusaka District
P.O. Box 320065
Lusaka, Zambia

For media related queries, contact the External Engagement Advisor:
Tel: +260-211-357-000
Fax: +260-211-357-224
Email: PEPFARZambia@state.gov