PEPFAR focuses on country ownership. Although the Office of the U.S. Global AIDS Coordinator (OGAC) has some central funding it uses for regional initiatives in target countries, such as public-private partnerships, the majority of funding is dedicated to the target countries. Efforts in each of the focus countries are coordinated by OGAC, but led by country teams. Each country team, in turn, is led by the U.S. ambassador and includes the host-country government, U.S. government agencies, nongovernmental organizations, multilateral institutions, and other in-country stakeholders. The country teams conduct joint project planning and are charged with development of both a five-year strategic country plan and an annual operational plan (IOM 2007). After the U.S. Global AIDS Coordinator reviews and approves the country operational plans, countries begin to receive funds.