The vertical nature of their approach creates a new type of front-line healthcare worker with very specific skills, which may not correspond to the overall needs of the country. In general, people living in remote areas, urban slums or particular geographical areas with high concentrations of ethnic minorities depend heavily on such basic primary care services. As observed elsewhere, “there is a serious risk that weak human resource and systems capacity at central and local levels can be overwhelmed by the growing proliferation of GHP—and other HIV/AIDS initiatives—with separate demands”.42 Even if vertical funds invest resources in strengthening national capacities or improving their harmonization and alignment, difficulties will persist because each initiative has its own governance structures and decision-making process. The United States President s Emergency Plan for AIDS Relief (PEPFAR), for instance, has indicated that it targets children and orphans particularly. The share of children receiving PEPFAR-supported treatment grew from 3 per cent of total beneficiaries in fiscal year (FY) 2004 to 8 per cent in FY2008.