Midpoint Reflections on USAID HIV Local Partner Transition Efforts

Deborah Kaliel; Christy Knight; Latham Avery; Lauren A. White; Lindsay Bonanno; Jason Porter; Kathryn Hoeflich; Courtney Irwin; Christopher Nikola; Amy Paul; Mai Hijazi; Clint Cavanaugh; E. Callie Raulfs-Wang

doi:10.9745/GHSP-D-22-00338

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FIGURE 1
Direct Funding to Local Organizations for a Sustained HIV Response^a
^aThis conceptual framework describes how the local partner transition would improve HIV health outcomes and ultimately contribute to sustained epidemic control for HIV/AIDS. We highlight 5 interrelated potential results of increasing direct funding to local organizations and institutions that may support an effective HIV response: ownership, legitimacy, relationships, capacity, and increased efficiencies.
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FIGURE 2
USAID/PEPFAR International vs. Local Partner Approved Funding Trends, FY2018–FY2022^a,b,c
Abbreviations: FY, fiscal year; PEPFAR, U.S. President’s Emergency Fund for AIDS Relief; USAID, United States Agency for International Development; USD, United States dollar; USG, United States Government.
^aThe dashed line corresponds to the start of the PEPFAR local partner initiative in 2018. Aggregate global percent funding to local and regional partners was calculated by dividing the amount of USAID funding budgeted to local and regional partners by the total amount of funding budgeted to all partners.
^bLocal partners are incorporated in the country served by the PEPFAR program and either owned or staffed by a majority of citizens or legal residents of that country; regional partners are incorporated in another country in the region (as classified by the U.S. Department of State), rather than the specific country in which they are implementing.
^cCalculations exclude USG management and operations costs, budgets for internationally procured commodities including the Global Health Supply Chain Procurement and Supply Management and Rapid Test Kits projects, and regional operating units. Funding data are derived from FACTS Info, an internal USG system (sourced March 31, 2023).
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FIGURE 3
Composition of USAID/PEPFAR Preexisting and Newly Added Local Partners, FY2018–FY2022^a
Abbreviations: FY, fiscal year; PEPFAR, U.S. President’s Emergency Fund for AIDS Relief; USAID, United States Agency for International Development.
^aBars represent a count of the number of local partners with direct USAID/PEPFAR awards each fiscal year. Preexisting partners are those that had a direct USAID/PEPFAR award before the Local Partner Transition (i.e., FY2018 or earlier) or those that have held a direct prime award for at least one year (e.g., a new partner in FY2019 is counted as a preexisting partner in FY2020). New partners each year are those who had not previously had direct awards with USAID/PEPFAR.
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FIGURE 4
Global Aggregate Share of Approved MER Targets for USAID/PEPFAR International vs. Local and Regional Partners, FY2018–FY2022^a
Abbreviations: FY, fiscal year; MER, monitoring, evaluation, and reporting; OVC, orphans and vulnerable children; PEPFAR, U.S. President’s Emergency Fund for AIDS Relief; PrEP, preexposure prophylaxis; USAID, United States Agency for International Development; VMMC, voluntary medical male circumcision.
^aFor each fiscal year, the proportion of USAID/PEPFAR targets for bilateral country programs is shown by partner type. Each row represents a separate MER indicator.