The Lancet calls the President’s Emergency Plan for AIDS Relief (PEPFAR) the largest and most successful bilateral HIV/AIDS program
worldwide.79 While it is true that PEPFAR is disease focused and that improving maternal and child nutrition will require a multi-sectoral
approach, PEPFAR represents an important whole of government model for interagency collaboration and public health impact. It also
has very specific goals. Table 2 offers some lessons from PEPFAR’s experience that could be applied to nutrition.
Table 2 Learning from the PEPFAR Model “Whole of Government” Approach: Key Factors of Success
Interagency Coordination at Headquarters: PEPFAR represents the first U.S. government effort that strongly emphasizes a unique
interagency model of coordination of management and operations within the mission of each country.80 In 2010,81 PEPFAR country
teams re-evaluated their U.S. government staffing footprint and organizational structure to focus on “one U.S. government team” to
maximize interagency planning, implementation, and evaluation for HIV/AIDS programming.
• Scaling up support for nutrition in target countries will require a similar model of coordination and management.
Interagency Coordination in Missions: An Interagency PEPFAR Coordinator was placed in missions to coordinate and implement
a whole of government approach to HIV/AIDS. The coordinator is the principal advisor to the ambassador on activities related to
PEPFAR. The coordinator facilitates collaboration in pursuit of objectives and facilitates the Interagency Country Team to ensure
effectiveness in achieving targets. He or she coordinates program management, planning, budgeting, and reporting processes for
the PEPFAR program.
• A Mission Nutrition Advisor can play a key facilitating role in joint program management, planning, budgeting, and reporting to
achieve interagency nutrition targets.
Scaling Up Human Resources for Health: PEPFAR invests in workforce planning and rationalization as an essential component of
responding to health workforce shortages and retention issues.82
• Invest in stronger nutrition workforce planning, nutrition leadership, increase and strengthen the technical and operational
capacity of existing staff, and deploy Nutrition Advisors to missions to achieve ambitious nutrition targets.
Country Ownership:83 PEPFAR invests in country ownership for governments and the engagement of all sectors to set national
guidance and norms for the private sector and NGOs to promote good governance and a r