USAID Grant Opportunity for Advancing HIV Epidemic Control in the DR Congo

Deadline: 06-Jun-24

The United States Agency for International Development (USAID) is seeking applications for a Fixed Amount Award (FAA) cooperative agreement from qualified entities to implement the USAID Kitumaini 2030 activity.

USAID/DRC’s vision for Kitumaini is a five-year long activity that will focus on service delivery results in five (5) health zones in Haut-Katanga, with possible expansion to other provinces as guided by Office of the Global AIDS Coordinator (OGAC)/PEPFAR. This activity also intends to strengthen the capacity of local sub-recipients to enhance their capabilities to receive assistance awards from USAID through transition award(s). This service delivery and capacity building activity will include all aspects of HIV epidemic control. Activities will take place in health zones assigned to USAID/DRC. This service delivery activity will prioritize services that focus on priority populations, orphans and vulnerable children (OVC) and key populations (KP). The recipient will coordinate with other implementing partners to facilitate the transition of the existing KP program, Meeting Targets and Maintaining Epidemic Control (EpiC) to Kitumaini.

Objectives

Goal: Improved HIV response to ensure sustained epidemic control in targeted health zones.
This program goal will be accomplished through the achievement of the following four objectives:
- Objective 1: Increase uptake of HIV and other prevention services for priority and key populations.
  - Expected intermediate results:
    - Improved community environment to support prevention services.
    - Increased availability of HIV and other prevention services at both facility and community levels
    - KPs and other high risk populations networks strengthened
- Objective 2: Increase uptake of HIV testing services at both facility and community levels
  - Expected intermediate results:
    - Increased availability of comprehensive HIV testing services
    - Improved HTS approaches to optimize HIV finding and linkage to ART services
    - Improved integration of self-testing and other innovative testing approaches
- Objective 3: Increase uptake and continued engagement in high quality of HIV treatment, OVC and laboratory services
  - Expected intermediate results:
    - Expanded comprehensive HIV care and treatment services for adults and children.
    - Improved health, wellbeing, protection, and economic security among OVC and their families
    - Improved access to lab services
- Objective 4: Strengthen and improve capacity of local health systems for the management of the HIV response.
  - Expected intermediate results:
    - Streamlined data collection processes and procedures to improve functionality of data collection systems.
    - Increased use of reliable data to improve quality and effectiveness of service delivery.
    - Increase technical and operational capacity of local organizations to improve HIV outcomes within the community and ensure long-term sustainability.
    - Institutional capacity of all local NGO partners strengthened and up to two local subawardees became eligible for USAID’s direct award

Funding Information

USAID intends to award one (1) Fixed Amount Award Cooperative Agreement pursuant to this notice of funding opportunity with provisions for Award Renewal and Transition Awards. Subject to funding availability and at the discretion of the Agency, USAID intends to provide an estimated $16.8 million for the initial three-year base period for Phase 1 of the activity.
This award will have an initial 3-year period of performance, with a renewal/continuation period of 2 years (up to 5 years total). The initial award budget will be allocated as Phase 1 of the activity. The actual amount of the Phase 2 renewal award period will be an estimated figure of $11.3 million with the actual amount of the Renewal Award Period higher or lower depending on the specific activities to be performed and adaptations of the activity in the future context andneeds.

Expected Outcomes

Objective 1: Increase uptake of HIV and other prevention services for priority and key populations.
- Expected outcomes:
  - Improved linkages and networks between families, communities, and facilities that enhance easy access to comprehensive and integrated HIV prevention services
  - Reduced levels of stigma and discrimination by health providers
  - Increased capacity of HIV services to mitigate barriers (i.e., social, financial) to accessing HIV services for PLHIV and affected families
  - Increased community engagement to counter sexual and gender-based violence (SGBV) and support survivors
  - Improved violence protection and response systems for KPs and PLHIV;
  - Strengthened referral and coordination mechanisms at subnational levels to address barriers to KP and PLHIV access and service uptake
  - Increased number of facility and community sites that provide comprehensive HIV prevention services
  - Increased number of providers cross-trained in adolescents and youth friendly services, key population friendly services, first line response to violence, PrEP, and PEP
  - Increased uptake of PrEP (PrEP_NEW) by priority and KPs
Objective 2: Increase uptake of HIV testing services at both facility and community levels
- Expected outcomes:
  - Improved HTS services targeting priority populations
  - Improved capacity among health and community providers to deliver high quality
  - HTS services including index testing
  - Improved all HTS community approaches with an emphasis on a) the Scaling-up Index Client trailing; b) Case finding in children; c) HTS focus in priority populations through mobile sites; d) Testing and finding men; e) partner notification; f) Home testing of consenting post-partum breast feeding mothers and their partners; f) High quality self-testing and; g) promotion of recency testing
  - Improved HTS facility approaches by optimization of PITC and other testing entry points, a strict use of HIV risk assessment tools and the improvement of testing yield and linkage to care
  - Improved linkages between HTS, care, and treatment services; by increasing linkage to care to over 95%, increasing early treatment initiation, improved same day initiation as well as community-facility linkage, the tracking and linkage of men to treatment and their retention to care
  - Improved linkage between HTS and effective prevention strategies to assist those testing HIV-negative to maintain their status including scale of PrEP for priority and KPs
  - High quality, comprehensive PMTCT program established with increased continuity of treatment rates of mother/infant pairs by intensifying EID of new-born by midwives and results tracking with emphasis on EID at 2 months. Optimization of final PMTCT outcome and reducing unknown final status among HIV exposed infants
  - Increased use of HTS/Self Testing, especially among high-risk populations, AGYW, pregnant and breastfeeding women (PBFW), Sero discordant couples and KPs
Objective 3: Increase uptake and adherence to high quality of HIV treatment, OVC and laboratory services
- Expected outcomes:
  - Functional adherence support systems established at both facility and community levels to ensure retention for adults and children on ART.
  - Increased number of HIV-positive adults and children receiving care and support services outside of the clinic
  - High-quality, innovative approaches implemented at both facility and community levels.
  - Increased availability of TB/HIV services as part of a comprehensive package of services
  - Strengthened links between health facilities and community-based support services.
  - Improved linkages and systematic referrals between health facilities and OVC programs in the community
  - Increased number of trained community health workers actively supporting HIV care and treatment services, adherence, retention, and linkages between community and health facilities
  - Expansion of ART capacities dispensation by increasing capacity of all facilities to initiate ART and to ensure better retention in care.
  - Strengthen ARV optimization, especially for children through promotion and delivery of Dolutegravir fixed dose combination with tenofovir and lamivudine (TLD) and other ARV regimen optimization.
  - Extension of the management of HIV advanced disease, including diagnosis of AHD through CD4 testing, CrAG, TB Lam and their treatment
  - Increased differentiated models of treatment services both at the facility and community levels.
  - Expanded ARV Multi-Month Dispensation (MMD) across recommended ages bands
  - Improved management of HIV advanced diseases in line with OGAC and WHO evolving recommendations
  - Increased gain on TX_NET_NEW maintained over the fiscal year.
  - Decreased number of patients who interrupted their treatment along the clinical cascade.
  - Improved ART enrollment specifically for children
  - Improved virally suppression for both adults and children (across all age bands)
  - Increased patient satisfaction with care and treatment services
  - Reduced Economic vulnerability of OVC target households.
  - Increased utilization of health/HIV, nutrition, protection, education, psychosocial, and economic strengthening services among target orphans and other vulnerable children and their families
  - Increased number of patients under optimized regimens as per the national and PEPFAR-Global Health Security and Diplomacy (GHSD)’s guidelines.
Objective 4: Strengthen and improve capacity of DRC health systems for the management of the HIV response.
- Expected outcomes:
  - Adequate supply chain management and monitoring for adult and pediatric HIV commodities
  - Expansion of Tier. Net or its equivalent in all high-volume sites
  - Appropriate data validation processes and strategic information exchange fora are in place
  - Quality evidence generated through M&E and operations research are used for decision making
  - Adequate system for scaling up routine VL monitoring is in place
  - Clear leadership exists at provincial and health zone levels to provide a vision and strategy to train and retain skilled health workers
  - Improved GDRC communication and coordination of donors and implementing partners, including PEPFAR and the Global Fund
  - The role of PNLS and local organizations in supporting the HIV response at decentralized levels is well defined and implemented with the aim of addressing long-term sustainability
  - Local sub-recipient organizations have undergone a capacity strengthening process to improve organizational mandates to deliver results as it relates to supporting the HIV response at the health zone and provincial level
  - In collaboration with USAID, identify the key institutional strengthening milestones that must be met by a local entity in order to successfully pass a risk assessment as a prerequisite to directly receive USAID funds
  - Identify one to two high-performing NGO partners that are currently eligible or have the potential to become eligible for transition from subaward to receive direct USAID award within three years.
  - Develop a phased plan to transition the eligible entities and draft scope of work for potential transition award(s) for USAID’s review.
  - Work closely with the health office,, other mechanisms focused on strengthening capacity of local organizations including the Mission’s local award support mechanism, Office of Acquisition and Assistance, and other USAID support offices (e.g.,Office of Financial Management) to support transition of the NGO(s) to direct awards with USAID.
  - Organize a lesson learned sessions with all subrecipients supported for capacity building

Eligibility Criteria

Eligibility to be a Primary Recipient of an award under this NOFO is unrestricted.
USAID welcomes applications from organizations that have not previously received financial assistance from USAID.
Faith-based organizations are eligible to apply for federal financial assistance on the same basis as any other organization and are subject to the protections and requirements of Federal law.

For more information, visit Grants.gov.