{"content":[{"text":"UNCLASSIFIED","bbox":{"left":0.117686,"top":0.238529,"width":0.12773599999999996,"height":0.018595000000000028}},{"text":"January 13th, 2021","bbox":{"left":0.267876,"top":0.238529,"width":0.130635,"height":0.018595000000000028}},{"text":"INFORMATION MEMO FOR AMBASSADOR MCCARTER, Kenya","bbox":{"left":0.117686,"top":0.270624,"width":0.542417,"height":0.01930599999999999}},{"text":"FROM: S/GAC Chair, Mike Ruffner and PPM, Christalyn Steers-McCrum","bbox":{"left":0.117686,"top":0.302632,"width":0.584964,"height":0.01930599999999999}},{"text":"THROUGH: Ambassador Deborah L. Birx, MD","bbox":{"left":0.117686,"top":0.334601,"width":0.375669,"height":0.01930599999999999}},{"text":"SUBJECT: Fiscal Year (FY) 2021 PEPFAR Planned Allocation and Strategic Direction","bbox":{"left":0.117686,"top":0.36642,"width":0.668992,"height":0.01930599999999999}},{"text":"Dear Ambassador McCarter,","bbox":{"left":0.117686,"top":0.398264,"width":0.207208,"height":0.018594999999999973}},{"text":"I sincerely hope that this note finds you and your team well, safe, and healthy. We are grateful for your \n leadership protecting staff through this difficult time.","bbox":{"left":0.117686,"top":0.430233,"width":0.7409160000000001,"height":0.03465600000000002}},{"text":"This year has brought unprecedented challenges with the COVID-19 pandemic impacting the entire \n global community. Despite obstacles faced, what has remained unwavering is the tireless commitment \n and incredible resiliency of our PEPFAR program, partners, and team across the over 50 countries in \n which we work. This includes rapid program adaptations, emerging innovations, and client-centered \n solutions to ensure continuity of HIV services. As the threat of COVID-19 has impacted PEPFAR \n countries, PEPFAR country teams and programs have proven to be focused and resilient in the face of \n dual pandemics of HIV and COVID-19.","bbox":{"left":0.117686,"top":0.478112,"width":0.73544,"height":0.11453000000000002}},{"text":"PEPFAR implementation over the past year has shown tremendous effort to maintain clients on treatment, \n initiating and accelerating client centered service delivery adaptations, while doing what was possible in \n HIV prevention programs deeply affected by COVID-19 shutdowns.  The following themes have \n emerged across all of PEPFAR-supported countries; As the economic impact of COVID continues to be \n seen at both national and community levels, it is more important than ever to use granular data and \n expand what is working in specific SNUs for viral load coverage and suppression. We saw differential \n progress in this area independent of the impact of COVID19. Focus groups and deep analytics of client \n returning to care to ensure we are addressing the critical persistent and new structural barriers. Focus on \n areas of recent treatment interruption to understand how COVID may have created or exacerbated barriers \n to access and treatment continuity. Across all countries we see persistent gaps in pediatric diagnosis, \n treatment and viral suppression. Particular attention should be paid to the pediatric cascade and \n identifying challenges by district and country for clear and actionable plans.  In addition, leverage OVC, \n DREAMS and other resources for clear accountability to work with mothers and improve early infant \n diagnosis by two months of age and strengthen resiliency among at-risk women and girls.  Community- \n led monitoring must raise visibility and appropriate response to the needs of populations already \n vulnerable before COVID. The assessment of needs, and strategies to reinforce OVC caregivers and HIV- \n affected families in crisis should contribute to budget and activity planning for care and treatment, \n DREAMS, OVC and wraparound resources.  Furthermore, analyzing expenditures at mechanism and","bbox":{"left":0.117686,"top":0.606016,"width":0.7644850000000001,"height":0.289242}}],"images_bbox":[{"left":0.117647,"top":0.090909,"width":0.797794,"height":0.091856}],"images_bbox_not_text_overlap":[{"left":0.117647,"top":0.090909,"width":0.797794,"height":0.091856}]}