PEPFAR's focus on optimizing impact is a driving force behind global efforts to reach HIV epidemic control. PEPFAR is partnering with the international community to accelerate towards the UNAIDS 95-95-95 global goals: 95 percent of people living with HIV know their HIV status, 95 percent of people who know their HIV status are accessing treatment, and 95 percent of people on treatment have suppressed viral loads. Progress towards epidemic control will be successfully measured, in part through an effective strategic information framework that not only monitors program outputs, but also key outcomes and programmatic impact.
Given the global HIV progress over the past decade, planning, monitoring and resource allocation needs to occur at the subnational, community, and site levels in order to achieve the greatest impact. Collection and use of disaggregated data that characterizes the populations served in the lowest geographic areas where HIV services are being provided is critical in understanding current program performance and planning for future performance. Consequently, the PEPFAR Monitoring, Evaluation, and Reporting (MER) indicators continue to evolve in order to reflect the progression of U.S. government (USG) support and global HIV response guidelines. Measuring the impact of national and regional above-service delivery area support down to support provided for direct services at the site-level is paramount to PEPFAR’s monitoring and reporting approach.
The objectives of the MER guidance document are to streamline and prioritize indicators for PEPFAR programs. As the PEPFAR MER Indicators were being updated the following was taken into consideration:
Reduction of indicators to focus program monitoring on what matters most for epidemic control;
Standardization of age, sex and key population disaggregations across the prevention and clinical cascades to monitor which populations are being reached with high quality evidence-based services, and to identify which populations are not being reached;
Alignment of indicators with multilaterals and partner governments to avoid duplication of data collection where possible, and to focus on improved data and programmatic quality;
Input from community stakeholders, technical experts, implementing partners, and PEPFAR field staff;
Alignment with other PEPFAR data streams such as site improvement through monitoring systems (SIMS), financial monitoring, and the sustainability index (SID).