The procedures support agencies’  internal program management and provide data for external reporting on  PEPFAR results. OGAC, USAID, and CDC Documented Performance Management, but Published Plans and Reports Lack Two Key Elements

		Several Documents Have Been Issued to Meet Planning and Reporting Requirements

OGAC, USAID, and CDC have issued several performance management  planning and reporting documents in response to the requirements  included in the 2008 Leadership Act and practices specified in GPRA. In most cases, these results are also  displayed by country or region. According to the 2008  Leadership Act, these reports are to include an assessment of progress  toward the achievement of annual goals and, if annual goals are not  being met, the reasons for such failures. In addition, GPRA calls for  annual performance reports to compare results with previously  established targets. Limited Information Is Available on Efforts to Validate PEPFAR Data and Address Data Limitations

OGAC has not publicly provided, consistent with GPRA practices,  information on efforts to verify and validate reported performance data. Global AIDS Coordinator to modify the annual report to Congress on  PEPFAR performance in the following two ways:   (1) include comparisons of annual PEPFAR results with previously  established annual targets and   (2) include information on efforts to verify and validate PEPFAR  performance data and address data limitations. Citing the need to consider various related issues and their   consequences in consultation with Congress and other stakeholders,  OGAC partially agreed with our first recommendation to include in  PEPFAR’s annual report to Congress comparisons of annual PEPFAR  results with previously established targets, consistent with a 2008  Leadership Act requirement and a key GPRA practice. OGAC also provided additional background information on  PEPFAR indicators and data validation efforts. Appendix I: Objectives, Scope, and Methodology

In response to directives in the Consolidated Appropriations Act of 2008  and the Tom Lantos and Henry J. Hyde United States Global Leadership  Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008  (2008 Leadership Act) to review global HIV/AIDS program monitoring,  this report (1) describes the Office of the U.S. Global AIDS Coordinator’s  (OGAC), U.S. Agency for International Development’s (USAID), and the  Centers for Disease Control and Prevention’s (CDC) key procedures for  planning and reporting on the President’s Emergency Plan for AIDS  Relief (PEPFAR) program performance and (2) examines published  PEPFAR performance plans and reports. To examine published PEPFAR performance plans and reports and the  extent to which they adhere to established practices, we identified  OGAC’s, USAID’s, and CDC’s most recent publicly available annual  performance plans and reports: for OGAC, the PEPFAR annual  operational plans and annual reports to Congress for fiscal years 2009  and 2010; for USAID, the “Foreign Operations FY 2010 Performance  Report, FY 2012 Performance Plan” that it issued with the Department of  State as part of their joint congressional budget justification for fiscal year  2012; and for CDC, the “Fiscal Year 2012 Justification of Estimates for  Appropriation Committees” and “FY 2012 Online Performance  Appendix.” We systematically reviewed these documents using a matrix  with a series of questions about key performance management practices,  as defined by the 2008 Leadership Act, the Government Performance  and Results Act of 1993, and previous GAO work. Appendix IV: PEPFAR Program Performance Results Reported by OGAC, USAID, and CDC for Fiscal Year 2010

OGAC provides information on PEPFAR program results in its annual  reports to Congress, which are typically published in February.
Why GAO Did This Study

U.S. assistance through the President's Emergency Plan for AIDS Relief (PEPFAR) has helped provide treatment, care, and prevention services overseas to millions affected by HIV/AIDS. In 2008, Congress reauthorized PEPFAR with the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 (2008 Leadership Act). The act requires the Department of State's Office of the U.S. Global AIDS Coordinator (OGAC) to report to Congress annually on PEPFAR performance. The U.S. Agency for International Development (USAID) and the Health and Human Services (HHS) Centers for Disease Control and Prevention (CDC) also report on PEPFAR program performance. Responding to legislative directives, GAO (1) described key procedures for planning and reporting on PEPFAR performance and (2) examined published PEPFAR performance plans and reports. GAO analyzed performance management documents and interviewed officials at OGAC, USAID, and CDC.

What GAO Found

Officials in several offices and divisions in OGAC, USAID, and CDC coordinate and manage PEPFAR program planning and reporting procedures at headquarters and in PEPFAR countries and regions. These procedures, which include PEPFAR-wide annual operational planning and periodic results reporting, support internal agency-specific program management as well as provide information for external reporting on PEPFAR results. OGAC, USAID, and CDC publicly issued plans and reports on PEPFAR performance in recent years consistent with 2008 Leadership Act requirements and GPRA practices; however, two key elements are lacking. First, although OGAC has internally specified annual performance targets, its most recent annual reports to Congress did not identify these targets or compare annual results with them. According to the 2008 Leadership Act, OGAC's annual reports on PEPFAR program results must include an assessment of progress toward annual goals and reasons for any failure to meet these goals. In addition, the Government Performance and Results Act (GPRA) of 1993 calls for federal agency performance reports to compare program results with established targets. Performance documents published by USAID, jointly with State, and by CDC report program targets and results for two and four PEPFAR indicators, respectively. Second, OGAC's most recently published performance plans and reports do not provide information on efforts to validate and verify reported data, while USAID's and CDC's published performance documents cite such efforts by OGAC. In addition, none of the plans or reports refers to noted data reliability weaknesses or efforts to address these weaknesses. GPRA and prior GAO work emphasize the importance of providing information in public performance documents on data verification and other efforts to address identified weaknesses.

What GAO Recommends

GAO recommends that OGAC include in its annual report to Congress (1) comparisons of annual PEPFAR results with established targets and (2) information on efforts to verify and validate PEPFAR performance data and address data limitations. OGAC partially agreed with the first recommendation, pending discussions with stakeholders about implementation issues and consequences, and agreed with the second recommendation.