The Centers for Disease Control (CGH) is inviting applications for Enhancing the Quality and Reach of Comprehensive and Sustainable HIV/AIDS Prevention Services in the Republic of Zambia under the President’s Emergency Plan for AIDS Relief (PEPFAR).
This NOFO is expected to support the Zambian Ministry of Health (MOH) to achieve and sustain gains made in HIV prevention by supporting direct service delivery (DSD) in four CDC supported provinces for comprehensive, quality, integrated HIV prevention services targeting key populations (KP) and adolescents and young persons (AYP). DSD support includes, but is not limited to, HIV testing services (HTS); linkage of HIV positive KP/AYP to community and facility treatment services, retention and viral load (VL) suppression and other support; linkage of HIV negative KP and AYP to biomedical and non-biomedical HIV prevention services including but not limited to pre-exposure prophylaxis (PrEP), gender-based violence (GBV) prevention and response, STI screening and treatment, and harm reduction programs.
The NOFO is expected to also support HIV prevention programming for AYP including the Determined, Resilient, Empowered, AIDS-free, Mentored and Safe program (DREAMS), HTS, and linkage to prevention services.
Lastly, the NOFO is expected to support Health System Strengthening (HSS) for HIV prevention at all levels of the MOH and National AIDS/STI Council (NAC). Support is expected to encompass leadership and governance, health policy, human resources for health (HRH) including capacity building, health information systems, and HIV surveillance at the national level which requires the conducting of regular mapping and size estimations as well as biobehavioral surveys (BBS).
- Goals and priorities include the following:
- Reducing the prevention and treatment gaps for adolescent girls and young women (AGYW), children, and key populations (KP);
- Strengthening national and local programmatic, financial, and community leadership;
- Designing new partnerships with key private, public, and multi sector entities that can complement existing programs and expand reach;
- Utilizing the PEPFAR platform for broader disease surveillance and public health programming, consistent with the PEPFAR legislative and funding authority;
- Investing in the scale-up of cutting edge behavioral, and implementation science to bend the curve on new infections;
- Improving the care and treatment of HIV/AIDS, sexually transmitted infections (STIs), and related opportunistic infections by improving STI management; enhancing laboratory diagnostic capacity and the care and treatment of opportunistic infections; interventions for intercurrent diseases impacting HIV infected patients including tuberculosis (TB); and initiating programs to provide anti-retroviral therapy (ART);
- Strengthening the capacity of countries to collect, use, and share surveillance data and manage national HIV/AIDS programs by expanding HIV/STI/TB surveillance programs and strengthening laboratory support for surveillance, diagnosis, treatment, disease monitoring, and HIV screening for blood safety; and
- Developing, validating, and/or evaluating public health programs to inform, improve, and target appropriate interventions, as related to the prevention, care and treatment of HIV/AIDS, TB, and opportunistic infections.
- In an effort to ensure maximum cost efficiencies and program effectiveness, HHS/CDC also supports coordination with and among relevant partners. Recipients may be requested to participate in the following programmatic activities:
- Scale-up evidence-based programs to identify and close the major HIV gaps among AGYW, children, and key populations;
- Increase impact through strategic coordination and integration;
- Strengthen and leverage key multilateral organizations, global health partnerships, and private sector engagement;
- Encourage country ownership and invest in country-led plans, putting our national and local partners in the lead and actively enabling their growth through design of the program at all phases;
- Build sustainability through investments in health systems;
- Enhance health equity and reduce disparities in access to and uptake of HIV services;
- Improve performance metrics, monitoring and evaluation and the quality of related data; and
- Promote research, development, and innovation to develop a body of knowledge, enhance awareness and increase the skills and abilities of stakeholders (research is not supported by this NOFO).
- Average One Year Award Amount: $12,000,000
- The expected number of awards is 1-2
- Total Period of Performance Length: 5 year(s)
- Estimated Award Date: September 30, 2023
CDC may require or allow applicants to propose additional related project period outcomes other than those identified in the NOFO.
- Short-Term Outcomes:
- Increased access to HTS including but not limited to SEIT, HIV ST, and SNS
- Increased geographic access and use of HIV bio-behavioral prevention interventions, and TB/HIV treatment services among KP and AYP
- Increased access, availability, and acceptability of AYP- and KP- appropriate services
- Enhanced engagement of AYP in program design, implementation, and evaluation
- Enhanced knowledge and skills among AYP and KP to prevent HIV
- Increased analysis and modeling of health data for disease surveillance
- Improved HIV prevention data quality
- Intermediate Outcomes:
- Increased AYP and KP-self-efficacy in ability to reduce individual sexual risk
- Improved coverage and uptake of HIV and TB prevention and treatment services among KP and AYP
- Long-Term Outcomes:
- Improved TB/HIV patient outcomes among KP and AYP
Strategies and Activities
- Strategy 1: Implement evidence-based interventions to reduce stigma and discrimination for AYP and KP programs
- Generate data/evidence to demonstrate barriers that AYP and KP face when accessing HIV prevention and treatment services
- Use evidence to provide services that respond to the needs of AYP and KP
- Strengthen capacity among health care providers at high volume sites to reduce stigma and discrimination
- Build capacity among community leaders or community gate keepers to support safe delivery of health services to KP/AYP
- Engage the MOH, NAC, and other relevant ministries to review and update relevant policies to reduce stigma and discrimination and enhance safety and security for KP/AYP
- Strategy 2: Implement evidence-based integrated HIV prevention interventions including but not limited to linkage to HTS, TB screening, biomedical prevention services and HIV and TB treatment as prevention
- Provide HTS services to KP using the most safe and effective modalities and strategies
- Strengthen capacity to use data to find and reach ‘hard to reach’ KP groups (e.g., adolescent KP, older MSMs, etc.)
- Link HIV positive KP and AYP to HIV treatment services
- Link HIV negative KP and AYP to appropriate HIV prevention services
- Ensure access to TB screening and treatment services for groups at higher risk for developing TB disease (e.g., household contacts, children, and adolescents, etc.)
- Retain KP and AYP in HIV prevention/treatment services ensuring optimal ‘patient’ level outcomes
- Build capacity of high-volume health facilities to provide KP/AYP appropriate services
- Strategy 3: Develop and implement evidence-based Comprehensive HIV prevention services for AYP including but not limited to DREAMS
- Provide HTS and TB screening services to AYP using the most effective modalities and strategies
- Provide the “full package” of DREAMS – including community-based curriculum delivery, enhanced socio-economic strengthening, social asset building, etc.
- Engage AYP in identifying the most effective and appealing modalities for AYP
- Develop evidence-based strategies for intentional and ethical young engagement
- Strengthen capacity to use data to find and reach AYP including young women not easily reached by conventional services (e.g., sexually and gender-diverse young people)
- Link HIV positive AYP to HIV treatment services
- Link high risk HIV negative AYP to HIV prevention services
- Retain AYP in the HIV and TB prevention/treatment services ensuring optimal ‘patient’ level outcomes
- Strategy 4: Conduct HIV prevention surveys, routine surveillance, evaluations, and data quality improvement processes
- Conduct population size estimation activities for KP and AYP
- Conduct BBS of KP, AYP and other groups as appropriate
- Train MoH on data triangulation and integration approaches to improve KP and AYP program planning
- Support MoH to establish routine data quality review processes
- Review processes include routine programmatic data from the DREAMS database
- Data quality includes accuracy, timeliness, and reliability
- Build capacity for routine data use among health care providers and program managers at all levels
- Support use of routine program data alongside other data sources to continuously inform and improve prevention programming
Target Populations: The target populations for this NOFO are KP, AYP, health care providers, the MOH at all levels, and other relevant Ministries.
- Eligible Applicants
- Government Organizations:
- State governments or their bona fide agents (includes the District of Columbia)
- Local governments or their bona fide agents
- Territorial governments or their bona fide agents in the Commonwealth of Puerto Rico, the Virgin Islands, the Commonwealth of the Northern Marianna Islands, American Samoa, Guam, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau
- State controlled institutions of higher education
- American Indian or Alaska Native tribal governments (federally recognized or state-recognized)
- Non-government Organizations
- American Indian or Alaska native tribally designated organizations
- Ministries of Health
- Additional Information on Eligibility
- This is a fully competitive NOFO and eligibility is unrestricted, meaning any and all types of organizations and entities are eligible to apply.
- In addition, as may be required by host country laws, applicant is expected to comply with and document that it has satisfied all regulatory requirements of their governing entities that could otherwise compromise the integrity and resources provided by this program or make the conduct of expected activities under this award unable to be performed. Applicants must also meet the criteria established in CDC’s pre-award risk assessment to be eligible to receive funds under this NOFO.
For more information, visit Grants.gov.