posals as well as through targeted solicitations of research in gap areas not met through open requests.
• Given PEPFAR’s legislative and programmatic objectives to support research that assesses program quality, effectiveness, and population- based impact; optimizes service delivery; and contributes to the global evidence base on HIV/AIDS interventions and program implementation, at the time of this evaluation the committee identified the following gaps in PEPFAR’s research activities:
o Behavioral and structural interventions, especially in areas such as prevention, gender, nonclinical care and support, care and support for orphans and vulnerable children, and treatment retention and adherence. These research activities should employ appropriate methodologies and study designs, without being unduly limited to random assignment designs.
o Costs, benefits, and feasibility of integrating gender-focused programs with clinical and community-based activities.
o Health systems strengthening interventions across the World Health Organization building blocks, with a prioritized goal of determining setting- and system-specific feasibility, effectiveness, quality of services, and costs for innovative models.
• To contribute to country ownership, PEPFAR should facilitate in- country local participation and research capacity building through simplified, streamlined, and transparent application and review processes that encourage submissions from country-based implementing partners and researchers.
Further considerations for implementation of Recommendation 11-1C: Knowledge transfer and dissemination
• The knowledge created within PEPFAR that should be more widely documented and disseminated includes program monitoring data, financial data, research results, evaluation outcomes, best practices, and informal knowledge such as implementation experience, and lessons learned.
• To institutionalize internal and external knowledge transfer and learning, PEPFAR should develop appropriate systems and processes for the most needed types and scale of knowledge transfer. To achieve this, PEPFAR should draw on broad stakeholder input to assess the strengths and weaknesses in current processes and to identify needs and opportunities for improved knowledge transfer.
• PEPFAR should invest in innovative mechanisms and technology to facilitate knowledge transfer across partner countries and implementing partners. Mechanisms currently used successfully on a small scale and an ad hoc basis could be formally scaled up across PEPFAR.