Issue Brief
  1. Although PEPFAR supports activities in more than 50 countries, the other countries fall under Regional Operational Plans (ROPs), which were not included in this analysis.

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  2. We simplified PEPFAR’s five category approach for epidemic control status used in this year’s COP guidance into three categories by classifying countries “at epidemic control with at least 73% viral load suppression” and countries “at epidemic control without at least 73% viral load suppression” as “at epidemic control”; maintaining PEPFAR’s “near epidemic control” category; and classifying countries “not at epidemic control but declining infections/mortality” and countries “not at epidemic control with increasing infections/mortality as “not at epidemic control.”

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  3. Test and start is a policy in which at least 95% of those who are identified as HIV positive are linked to antiretroviral treatment immediately upon testing.

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  4. This MPR relates to countries’ adoption and implementation of policies that eliminate fees at the point of care for direct HIV services and related services, such as antenatal care, TB, and cervical cancer in the public sector.

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  5. PEPFAR standards for the OVC program include facilitating testing for all children at risk for HIV, linking children living with HIV to treatment and case management, and reducing risk of sexual violence. The share of COP countries does not include COP countries where this OVC MPR is not applicable, namely, Angola and Vietnam.

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  6. These include Angola, Burundi, Cameroon, Cote d’Ivoire, the Dominican Republic, Kenya, Malawi, Tanzania, Ukraine, and Zimbabwe.

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  7. Additional COP countries may not cite commodity stockout or shortages issues as challenges or priority changes but may mention it elsewhere such as in explanations for not completing certain MPRs (e.g., Eswatini cites stockouts of antiretrovirals as a barrier to completing the MPR related to differentiated service delivery).

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  8. These include Burundi, Democratic Republic of the Congo, Eswatini, Haiti, Angola, Mozambique, Nigeria, and Tanzania.

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  9. These include Burundi, Cote d’Ivoire, Mozambique, Nigeria, Tanzania, Zambia, and Zimbabwe. Additional COP countries may not cite laboratory equipment breakdowns or delays in testing results as major challenges or key issues but rather as explanations for not completing certain MPRs. For example, in Haiti, equipment failures and increased turnaround times for viral load samples, among other issues, are cited as barriers to completing the MPR related to diagnostic network optimization.

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  10. These include Botswana, Burundi, Cote d’Ivoire, Lesotho, Mozambique, Uganda, and Vietnam. Additional countries, such as Eswatini and South Africa, mention interoperability in their MPR explanations.

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  11. These include Botswana, Dominican Republic, Lesotho, Malawi, Uganda, and Zambia. Additional countries, such as Cameroon and Uganda, mention this in their MPR explanations.

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  12. These include the Democratic Republic of the Congo, the Dominican Republic, Lesotho, Mozambique, Nigeria, South Africa, and Uganda.

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  13. These include those of Cote d’Ivoire, Lesotho, Malawi, Namibia, South Africa, Uganda, and Zimbabwe.

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  14. These include those of Botswana, Eswatini, Lesotho, Rwanda, Tanzania, and Uganda.

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  15. These include Angola, Botswana, Burundi, Cameroon, Cote d’Ivoire, the Democratic Republic of the Congo, the Dominican Republic, Eswatini, Ethiopia, Haiti, Kenya, Lesotho, Malawi, Mozambique, Nigeria, Rwanda, South Africa, South Sudan, Tanzania, Uganda, Zambia, and Zimbabwe.

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  16. These include the Cote d’Ivoire, Eswatini, Ethiopia, and Haiti PLLs.

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  17. These include Botswana, Burundi, Cameroon, Cote d’Ivoire, the Democratic Republic of the Congo, Eswatini, Ethiopia, Haiti, Kenya, Lesotho, Malawi, Mozambique, Namibia, Nigeria, Rwanda, South Africa, South Sudan, Tanzania, Uganda, Ukraine, Vietnam, Zambia, and Zimbabwe. In the case of the Dominican Republic, its PLL discusses the lack of robust data on focus clients (“FC”) services, which refers to “migrants of Haitian origin living in the Dominican Republic and their descendants.”

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  18. KFF analysis of data from the HIV Policy Lab, “S10 - Civil society,” accessed April 25, 2022, https://www.hivpolicylab.org/policy/S10.

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  19. Key among these will be six COP countries (Botswana, Eswatini, Kenya, Lesotho, Namibia, and Uganda) identified as “Sustaining Impact Operating Units (OUs)” during the 2022 COP planning process that are expected to release sustainability roadmaps later this year.

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