USAID Grants for Achieving and Sustaining HIV/TB Epidemic Control in South Africa

Deadline: 15-Apr-2024

The United States Agency for International Development in Southern Africa (USAID/SA), through the Regional Office of Acquisition and Assistance (ROAA) is seeking applications for a Cooperative Agreement for funding of an activity entitled “Achieving and Sustaining HIV/TB Epidemic Control in the Mpumalanga Province.”

The goal of the Activity is to promote long, healthy lives for the population of the Mpumalanga Province by achieving and sustaining HIV/TB epidemic control.

This Activity will collaborate with the Mpumalanga DoH and its three districts to support the successful execution of the Mpumalanga Province APP 2023/24 and future provincial health strategies. The Mpumalanga DoH actively encourages the primary health care approach, which is based on accessibility, equity, community participation (through but not limited to civil society and community-based organizations) and intersectoral collaboration. Investing in and building the capacity of South Africa local organizations (private and non-profit) will foster locally-led and locally-developed innovative approaches towards achieving Mpumalanga DoH’s objectives of universal health coverage, improved clients’ experience of care, and reduced morbidity and mortality.

The Activity will promote a continuum of care for PLHIV and leverage community platforms, including PLHIV networks, faith-based institutions, and social support services. In collaboration and support of Provincial and District departments (Health, Social Development and Basic Education), the Activity will tailor systems strengthening interventions to the needs and context of the Mpumalanga Province, addressing the major impediments to eliminating HIV as a public health threat for all populations.

Objectives

• Objective 1: Close the gaps towards eliminating HIV/TB as a public health threat through tailored and sustainable approaches
  • Complex barriers to accessing quality health care, client psychosocial barriers, and treatment hesitancy lead to failed treatment initiations and treatment interruptions. This is especially challenging in the Mpumalanga Province where the population is severely impacted by poverty, unemployment, migration and other social issues. The Activity will support PLHIV to know their status, initiate HIV treatment and maintain adherence and retention on ART. This will be achieved through sustainable comprehensive community-based and -led activities which are linked to health facilities for integrated, simplified, client-centered HIV/TB prevention and treatment models that facilitate lifelong healthy outcomes for all PLHIV and prevent onward HIV and TB infections.
  • Mpumalanga province has achieved the first 95 of the UNAIDS targets but is lagging at 80% for the second 95 on ART coverage. Further, health facility utilization rates have declined since the SARS-CoV[1]2 pandemic, as less people seek health services. It is therefore imperative that community-centered interventions are implemented to ensure equitable access to health and close the HIV/TB gap. In addition, empowered and resilient communities will be key in closing the gaps and sustaining the response. Annually, specific interventions in support of achieving Objective 1 will be determined in collaboration with the Mpumalanga Provincial and District Departments of Health and USAID.
• Objective 2:  Sustain health gains through strengthened, improved and resilient health systems
  • As South Africa progresses toward the elimination of HIV and TB as public health threats, the management of HIV as a chronic condition, and TB as a curable infectious disease, will require a sustainable health system that is resilient, well-financed and managed, and efficiently resourced (e.g. human resources, equipment, commodities). Access to care must be equitable and affordable, and the necessary systems for planning for such access must be functioning.
  • Objective 2 aims to support the sustainable elimination of HIV and TB as public health threats and control of other infectious diseases by strengthening the Mpumalanga public health system to maintain this status over time and be resilient in the face of system-wide shocks, such as pandemics, natural disasters, and social unrest. The COVID-19 pandemic demonstrated the importance of health system resilience and the need to support districts to mitigate the impact of such shocks on the health system and patient care.
  • Objective 2 will focus on some of the most significant development challenges in Mpumalanga Province related to health systems strengthening, including human resources for health (HRH), essential medicines and commodities, data use for decision making and implementation of policies and guidelines related to eliminating HIV as a public health threat. If there are seconded staff, Mpumalanga DoH encourages that they remain aligned to DoH staffing policies, supervision, and management practices. Collaboration with the private sector, including institutions of higher learning, can augment GoSA workforce skills and competencies. This Activity aims to leverage partnerships with a range of private sector actors with the capacity to contribute to addressing factors affecting the health system.

Funding Information

• USAID intends to award one (1) Cooperative Agreement pursuant to this NOFO. Subject to funding availability and at the discretion of the Agency, USAID intends to provide up to $190 million in total USAID funding over a 5-year period.
• The estimated start date will be upon the signature of the award, on or about August 1, 2024, with full implementation of interventions to begin on or about October 1, 2024.

Intermediate Results (IRs)

• Objective 1 has three intermediate results (IRs) as detailed below:
  • IR 1.1 Improved pediatric HIV/TB treatment outcomes through tailored approaches in Mpumalanga Province
  • IR 1.2 Improved adult clinical outcomes for HIV and TB patients/clients in Mpumalanga province
  • IR 1.3 Strengthened HIV prevention services, with a specific focus on children, adolescents, youth, men, and key populations at-risk
• Objective 2, there are four (4) IRs as detailed below:
  • IR 2.1 Adequate, skilled, and motivated HRH in all targeted health facilities to maintain and sustain the delivery of healthcare services to PLHIV
  • IR 2.2 Essential medicine and commodities, equipment, instruments, and devices needed to deliver quality HIV/TB health and other infectious disease services are available at targeted health care facilities
  • IR 2.3 Utilization and management of existing health information systems and data to guide decision making and client management is strengthened
  • IR 2.4 Effective governance and management systems at the province, district, and facility levels (management, planning, and monitoring systems) are in place

Geographic Focus

• The geographic target area of the Activity is the Mpumalanga Province with tailored and targeted interventions and technical support at the district level, specifically in the high HIV and TB burden districts of Ehlanzeni, Nkangala, and Gert Sibande.

Eligibility Criteria

• Eligible Applicants
  • Eligibility is restricted to local entities. For purposes of consistency and reporting, the definition of “local entity” means an individual, a corporation, a nonprofit organization, or another body of persons that:
    • Is legally organized under the laws of South Africa;
    • Has as its principal place of business or operations in South Africa;
    • Is majority owned by individuals who are citizens or lawful permanent residents of South Africa; and
    • Is managed by a governing body the majority of who are citizens or lawful permanent residents of the country receiving assistance.
• New Partners
  • USAID encourages applications from new partners that have not previously received USG funding. However, resultant awards to these organizations may be delayed because USAID generally must conduct pre-award surveys of these organizations in order to make a risk assessment decision, in accordance with ADS 303.3.9 for NGOs.
• Number of Concept Notes or Applications
  • An entity may only submit one concept paper/application for funding in response to this NOFO. Potential sub-awardees may be proposed across multiple concept papers/applications. USAID discourages exclusive teaming arrangements.
• Cost Sharing or Matching
  • Cost sharing is an important element of the USAID-recipient relationship. Cost Share defines cost share as “the resources a recipient contributes to the total cost of an agreement”. It is critical that the activity continues after USAID assistance ends. In addition to USAID funds, Applicants Achieving and Sustaining HIV/TB Epidemic Control in the Mpumalanga Province. USAID has established a required cost share contribution of at least ten percent (10%) of the USAID funding amount. Such funds may be mobilized from the recipient; other multilateral, bilateral, and foundation donors; host governments; and local organizations, communities, and private businesses. For guidance on cost sharing in cooperative agreements, please consult 2 CFR 200 (US Organizations) or Cost Share Standard Provision (Non-US Organizations).
• Exclusive Commitments
  • USAID discourages any applicant from requiring exclusive commitments by local entities or other proposed sub-partners, including international organizations, to participate as part of a consortium or sub-award. Proposed sub-partners participating in a consortium may elect to participate in another consortium under a different application.

For more information, visit Grants.gov.