USAID: Achieving and Sustaining HIV/TB Epidemic Control in the Free State Province (South Africa)

Deadline: 04-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 Free State Province.

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 $54 million in total USAID funding over a 5-year period.

Activity Goal, Objectives and Intended Result

• Goal
  • The goal of the Activity is to promote long, healthy lives for the population of the Free State Province by achieving and sustaining HIV/TB epidemic control
• Objectives & Results
• Objective 1: Close the gaps to achieve HIV/TB epidemic control
  • Complex barriers to access quality health care, client psychosocial barriers, and treatment hesitancy lead to failed treatment initiations and treatment interruptions. This is especially challenging in the Free State Province where the population is severely impacted by poverty, unemployment, migration and other social issues. The Activity will support innovative 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.
  • IR 1.1 Improved pediatric, children, adolescents, and youth HIV treatment outcomes through tailored approaches
    • Expected Outcomes
      • 95% of children and adolescents know their HIV status.
      • 95% of children and adolescents who know their HIV status are receiving ART.
  • IR 1.2 Improved adult clinical outcomes for HIV through sustainable and locally-led social support services and client-centered approaches
    • Expected Outcome
      • 95% of adult PLHIV know their HIV status.
      • 95% of PLHIV who know their HIV status are receiving ART.
  • IR 1.3 Reduced HIV/TB coinfection for pediatric and adults through enhanced and targeted programming for improved treatment outcomes
    • Expected Outcomes:
      • 90% of TB cases are diagnosed.
      • 100% of people with TB infection receive treatment.
  • IR 1.4 Strengthened and targeted integration of HIV prevention interventions, particularly for priority populations such as AGYW, adolescent boys and young men (ABYM), and key and vulnerable populations at risk
    • Expected Outcomes:
      • 100% of supported sites provide friendly services for key and priority populations.
      • 100% of supported sites link at-risk adolescents and youth to prevention services.
  • IR 1.5: Improved awareness and engagement in HIV/TB care, treatment, and prevention programs through strategic marketing and communications
    • Expected Outcomes:
      • Improved and sustainable client literacy, awareness and uptake of HIV care, treatment, and prevention services.
      • Locally-designed and sustainable strategic health communications and marketing campaigns, particularly for key and vulnerable populations developed and implemented.
• 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 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 functional.
  • In alignment with Free State DoH priorities, Objective 2 aims to support the elimination of HIV and TB as public health threats and control of other infectious diseases by strengthening the public health system to maintain and sustain this status over time and be resilient in the face of system-wide shocks, such as pandemics, natural disasters and social unrest.
    • IR 2.1 Adequate, skilled and motivated HRH in all targeted health facilities to maintain and sustain the delivery of healthcare services to PLHIV
      • Expected Outcomes:
        • 100% of supported districts have functional and capacitated staffing within approved organizational structures.
        • Coordinated and sustained provincial health response in support of the HIV/TB interventions, to strengthen the leadership, management structures and policy implementation
    • 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
      • Expected Outcomes:
        • Improved and sustainable systems to ensure medicine and health products availability at health establishments, in line with provincial targets.
        • Improved and sustainable data quality and reporting compliance on the National Surveillance Center (NSC) to improve visibility and medicine availability at Health Establishments.
    • IR 2.3 Sustainable infrastructure, electrification, and telecommunication solutions are identified and developed in collaboration with Free State government counterparts
      • Expected Outcomes:
        • Strengthened and sustainable systems for documenting health services delivery impacts of infrastructure deficits in supported districts
        • Increased advocacy for government counterparts to develop pre-emptive infrastructure deficit mitigation plans
    • IR 2.4 Utilization and management of existing health information systems and data to guide decision making and client management is strengthened
      • Expected Outcomes to be achieved:
        • Increased use and sustained implementation of data health systems, data tools and processes by GoSA data staff
        • 100% of facilities reporting quality data successfully into GoSA – approved health management information systems (HMIS)
    • IR 2.5 Effective governance and management systems at the district and facility levels (management, planning, budgeting and monitoring systems) are in place
      • Expected Outcomes to be achieved:
        • Timely adoption and use of the national health policies and guidelines at the district and site levels.
        • Strengthened and sustainable functional health governance structures at district and site levels
• Objective 3: Leverage community, civil society, and private sector partnerships to improve and sustain service delivery and client outcomes
  • Objective 3 of this activity therefore aims to support Free State-based program innovation, partner leadership and capacity development, and implementation by leveraging community (including traditional health practitioners), civil society, and private sector partnerships to improve service delivery and client outcomes and to address the social determinants of health that support sustained client retention in care.
    • IR 3.1 PLHIV-led and other community organizations are strengthened and actively engaged for improved health outcomes.
      • Expected Outcomes to be achieved:
        • Continuous consultation and coordination with the Free State Provincial Council on AIDS (PCA) through capacity building (e.g., staffing), and joint program development and reviews.
        • 100% of supported districts provide continuous capacity development for selected PLHIV-led structures/community organizations/traditional health practitioners in HIV/TB programs.
    • IR 3.2 Private sector engaged to improve and implement health outcomes
      • Expected Outcomes to be achieved:
        • Availability, access, and provision of health services for clients through private sector partnerships and innovation.
        • Strengthened and sustainable health systems through private sector involvement

Geographic Focus

• The geographic target area of the Activity is the Free State Province with tailored and targeted interventions and technical support at the district level, specifically in the highest HIV and TB burden districts of Thabo Mofutsanyana and Lejweleputswa districts. These districts may change in alignment with USAID, PEPFAR and/or GoSA direction

Eligibility Criteria

• 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.
• USAID welcomes applications from eligible organizations which have not previously received financial assistance from USAID. International or U.S. organizations are not eligible to submit an application for an award as a prime applicant under this request for applications.

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